The purpose of this study was to examine the effects of the presence of peers upon the oral reading performance of high achieving and low achieving students in a regular classroom setting.Related literature and research in the area of social facilitation has indicated that the presence of an audience serves to increase drive level. The interaction of drive level and habit strength results in the emission of dominant responses. During early stages of learning, incorrect responses are dominant since a response hierarchy has not been established. As learning occurs and mastery level is approached, correct responses become dominant.In order to relate these research findings to the classroom, subjects whose reading skills were below grade level were selected to represent those in the learning stage. Students whose reading skills placed them above grade level were selected to represent those in the mastery stage.The research hypotheses were as follows:1. The presence of peers will adversely affect a student's performance on an oral reading task when the instructional reading level of that student is below grade level.2. The presence of peers will enhance a student's performance on an oral reading task when the instructional reading level of that student is above grade level.Subjects were drawn from five fourth grade classes in two elementary schools in east central Indiana. A total of 76 subjects (34 low achievers and 42 high achievers) participated in the study. Participation in the study required that each student read orally at his instructional level a one hundred word passage in the presence of peers and again in isolation. Instructional levels were determined for each student through the administration of an initial placement test. This is a group test which is provided for each reading level to ensure that the student is placed at his/her instructional level. The passages read were d--aim from supplementary materials provided with the basal. reading series and designed for use at appropriate instructional levels. The passages were unfamiliar to the subjects. Data were collected in the classroom during the regularly schedule reading period in an effort to maintain normal classroom atmosphere. The subject's performance was tape recorded under each treatment condition. These tape recordings were later scored by a panel of judges. Responses which were scored as errors were miscues, repetitions, insertions, and omissions. The dependent variable was the subject's oral reading performance under each of the two treatment conditions. Oral reading performance was selected as the dependent variable because it represents not only an observable, measureable variable, but also an established classroom activity.A repeated measures design was utilized to investigate differences in performance of high achievers and of low achievers under audience present and audience absent conditions. Since the research hypotheses were directional in nature, a one tailed t test for correlated groups was selected to determine the statistical significance of the differences between means using the .05 level of confidence.Results of statistical analysis revealed that there was no significant difference between the oral reading performance of either the low achieving or high achieving groups under audience present and audience absent conditions. Thus support was not found for the research hypotheses that the presence of an audience would adversely affect the oral reading performance of low achieving subjects and enhance the performance of high achieving subjects.

Background The use of school scoliosis screening for early detection of adolescent idiopathic scoliosis (AIS) in order to avoid the need of invasive surgery remains controversial. In an internationally large population-based cohort of students, the Hong Kong scoliosis screening programme has been shown to have low referral rate of students for radiographic diagnosis and high accuracy in identifying AIS patients requiring clinical follow-up. However, before school scoliosis screening is considered worth implementing, its direct effect on the need of surgery should also be assessed as stipulated in the literature. Therefore, we aimed to examine the temporal change of the rate of AIS patients in need of surgery since the inception of the Hong Kong screening programme in 1995, and assess the change of the rate across age and birth year of adolescents. Methods A large scale data collection was made from the Duchess of Kent Children Hospital (DKCH), the Prince of Wales Hospital (PWH) and the Department of Health. We obtained the screening history, spinal curvature, surgical status and demographics of AIS patients aged between 10 and 19 years who visited either of the DKCH or PWH, the only two public specialist hospitals in Hong Kong that managed AIS patients, during 1996 to 2009. The data have been carefully collated and cleaned before data analysis. Age-period-cohort model estimated by the modern intrinsic estimator was used to delineate the effects due to age, period taken as calendar year, and cohort taken as birth year on the rate of reaching an indication for surgery, taken as a Cobb angle ? 45° or operated for AIS. Results During 1996 and 2009, a total of 1,117,182 students participated in the Hong Kong scoliosis screening programme. Of which, 16,780 visited either DKCH or PWH, and had AIS detected. The incidence rate of AIS in Hong Kong adolescents generally increased over years. The proportion of AIS patients who previously participated in screening for scoliosis was 43% in 1996 and increased to over 90% after 2001. A total of 636 AIS patients received spinal fusion surgery. The mean curvature at operation in patients who were previously screened for scoliosis was 2.48 (95% CI = 11.35 to 12.65; p-value = 0.031) smaller than that in those who were not screened. The relative risk of indication for surgery was the maximal at the age of 14-15 years. Since the start of the programme, the risk of reaching indication for surgery generally increased but the rate was reduced by 2004-2005 onwards. However, the risk was fairly stable across birth cohorts. Conclusions This was the largest study that examined the temporal trend of the rate of requiring surgery for AIS in adolescents. The risk of requiring surgery for AIS increased due to changes in the incidence of AIS and exercise pattern. The Hong Kong scoliosis screening programme has provided important information on the annual trends about AIS, a disorder with unfortunately poor knowledge of its aetiology. / published_or_final_version / Nursing Studies / Master / Master of Philosophy

A series of epidemiological studies are presented of cancer risk after kidney transplantation and in human immunodeficiency virus (HIV) infection, based on data linkage between Australian, nationwide, population-based cohorts of kidney transplant recipients, people with HIV, and cancer. Risk factors were studied for the two most commonly registered cancers after kidney transplantation, lip cancer and non-Hodgkin lymphoma (NHL). The importance of established risk factors for lip cancer was confirmed, including exposure to solar ultraviolet radiation (UVR) and tobacco smoking. New evidence was observed of an association with immunosuppressive agents which potentiate UVR-related cellular damage, which may have broader implications for non-melanoma skin cancer risk in this setting. Clinic-based data suggest that NHL arising early and late after transplantation may be aetiologically distinct. Results observed herein support the possibility of two mechanisms of lymphomagenesis: one predominantly of primary Epstein Barr virus infection during intense immunosuppression and another, of dysregulated lymphoid proliferation in the context of prolonged immunosuppression. Importantly, risk of NHL was observed to persist even ten years after transplantation. For both lip cancer and NHL, risk was significantly reduced on transplant failure and reinstitution of dialysis when immunosuppression is usually ceased. The effect on cancer risk of reduction of immunosuppression was investigated for infection-related and other cancers. Risk was significantly reduced for some other infection- and immunodeficiency-related cancers including Kaposi sarcoma (KS) and melanoma, and non-significantly for anogenital cancers. No effect on risk was observed for cancers of the stomach, leukaemia, or the common epithelial cancers. Risk was significantly higher on reinstitution of dialysis for thyroid cancer. Cancer incidence was examined in HIV infection since the introduction of effective antiretroviral therapy and the reduction in the extent of HIV-related immunosuppression. The patterns observed were entirely consistent with those seen in kidney transplant recipients. Rates of KS, NHL and melanoma declined significantly, whereas rates of anal cancer remained stable. Rates of lung cancer and leukaemia were unchanged. Rates of prostate and colorectal cancers were consistently lower than general population rates. These observations highlight the differential role of current immune function and argue against a generalised effect of immunosurveillance in cancer prevention.

Performance and throughput rates at South African tertiary institutions are low, especially within the science, engineering and technology fields of study. The causes of this poor performance and throughput are difficult to predict, and incorrect assumptions are often made on which students are most likely to fail. The need to investigate this issue is vital in South Africa, where the contributing factors to poor performance and throughput are exacerbated by recent political and economic disparities in the diverse population. In order to better understand the issue within the built environment sector, this study evaluated the performance and throughput rates of fifteen first-year cohorts within the Department of Quantity Surveying at the Nelson Mandela Metropolitan University. The main aim of this study was to investigate the changes in the student population within the department, and to develop a framework for the future prediction of a student’s likelihood of success or failure. In order to achieve this objective, a retrospective longitudinal approach, i.e. a cohort study, was adopted. The study plotted the trends in performance and throughput rates over a period of time; it measured the strength of the relationships between several variables and performance and throughput; and it culminated in the establishment of predictors of performance and throughput rates. Ultimately, the prediction variables could be utilised in the development of influence diagrams as prediction frameworks. The research revealed that the performance and throughput rates of students in the department are improving. This highlights the importance of undertaking a narrow, departmental level analysis; as the findings in this smaller sphere do not match the general theory and assumptions covered in the literature.

No description available.

Yes / Born in Bradford is a prospective pregnancy and birth cohort in the UKs 6th largest city. Between 2007 and 2011 12,453 women (13,776 pregnancies), 3,448 of their partners and 13,818 babies were recruited. Half of families are in the poorest fifth of deprivation for England and Wales, and 45% are of Pakistani origin. Recruitment was in one Metropolitan District. This allows consideration of the impact of local circumstances, including service provision and policy choices, and engagement with the local community to implement evidence based responses to study findings. The introduction of a large study into a local health economy contributed to organizational changes including the development of a paperless maternity data system and better links between primary, secondary, and child health services. Embedding research in practice can lead to improved quality of routine data collected, for example on infant growth, and make routine data available for research, enhancing its cost effectiveness. Early adoption of research findings locally includes the introduction of routine vitamin D supplementation and an oral glucose tolerance test for all pregnant women. Findings that consanguinity was associated with a doubling of risk for congenital anomaly and that 30% of all anomalies in children of Pakistani origin could be attributed to consanguinity reinforced local commitment to community education about genetics and targeted genetic counselling. These findings also led to the establishment of a regional congenital anomalies register. In partnership with the European ESCAPE consortium (14 cohorts in 12 countries) a significant association was found between fetal growth and air pollution. The European Environmental Agency Director stated that this evidence is sufficient to trigger changes in EU regulations. Some findings can be quickly embedded in local provision, some have a resonance that prompts regional changes, some are generated with collaborators and can lead to policy change at international level.

BACKGROUND Few high-quality observational studies have been conducted to examine clinically relevant features of emotional distress and Major Depressive Disorder (MDD) in adults with primary cerebral glioma. Our knowledge of these important complications of glioma is currently poor. AIMS This thesis aims to answer a series of relevant clinical questions. I have studied: [1] the frequency, independent clinical associations and course of general emotional distress measured using the NCCN Distress Thermometer (DT); [2] the utility of three depression screening tools for identifying MDD; [3] the frequency, independent clinical associations and course of MDD in glioma; [4] current patterns of practice, and the apparent tolerability of antidepressant treatment of depression in glioma; and [5] barriers to the effective management of MDD in glioma. METHODS I conducted a prospective, twin-centre, observational cohort study. Adults with a new histological diagnosis of primary supratentorial glioma were enrolled and interviewed three times: shortly after starting radiotherapy (T1), three months later (T2) and six months later (T3). At each time point participants completed the DT, the Hospital Anxiety and Depression Scale (Depression subscale, HAD-D), the Patient Health Questionnaire-9 (PHQ-9) and the Structured Clinical Interview for DSMIV MDD (SCID). Barriers to depression management were studied using questionnaires completed by the patient and their named GP. RESULTS During a two-year recruitment period, 223 patients were eligible and 155 provided useable data (57.4% male, mean age = 54.2 years, 85.8% high-grade glioma, 78.1% radical radiotherapy, 55.5% chemotherapy). [1] High distress (DT score ≥ 4/10) was consistently a frequent complication, occurring in between 36.4% ± 7.6% of patients at T1 to 33.7% ± 10.2% at T3. In a logistic regression analysis, high distress at T1 was independently associated with MDD, functional impairment and younger age (χ2 for model = 39.882, p < 0.001, R Square = 0.312). Patients who reported high distress at T1 (median DT score = 8; IQR 7 - 9) remained highly distressed on follow-up (T2 median score = 8, IQR 6 - 8; T3 median score = 7, IQR 5 - 8). [2] As screening tools, the HAD-D and PHQ-9 showed good internal consistency (α = 0.769 - 0.862 at any time point). The HAD-D displayed the best operating characteristics on ROC curve analysis. At a threshold of 7+, sensitivity = 0.933, specificity = 0.907 and Positive Predictive Value (PPV) = 0.56. A threshold of 8+ displayed similar PPV, however. [3] The cross-sectional prevalence of MDD was 13.5% ± 5.4% at T1, 14.8% ± 6.7% at T2 and 6.8% ± 5.8% at T3. Inter-rater diagnostic agreement was good (κ = 0.81, 95% CI 0.60 – 1.00). MDD was independently associated with a past history of depression (OR = 3.8, 95%CI 1.5 - 9.8), and with current functional impairment (OR = 3.6, 95%CI 1.4 - 9.4). MDD persisted for at least three months in 9/17 patients who could be followed up. [4] The frequency of antidepressant prescription was 8.4% ± 4.4% at T1, 7.4% ± 4.9% at T2 and 12.6% ± 6.9% at T3. Citalopram was the most frequent antidepressant choice. Antidepressant tolerability appeared to be good among patients who could be followed up. [5] Barriers to the management of depression included 78.4% of GPs regarding major depression as a normal reaction to having glioma, and 39.2% expressing a belief that major depression did not always require treatment. In addition, most patients expressed a degree of resistance to any kind of future depression treatment. DISCUSSION This is the largest cohort study of depression in consecutively presenting adults with glioma, and the first to utilise criterion standard structured interview diagnoses in a longitudinal design. There is a degree of theoretical uncertainty about the nosological validity of MDD in glioma, although the clinical relevance of this uncertainty can be debated. Methodological limitations to the presented study include an absence of alternative potential psychiatric diagnoses to MDD, the likelihood of selection bias in recruitment, and considerable attrition. Due to these and other limitations, findings from this study are tentative and should ideally be replicated. Clinicians should have a high index of suspicion for identifying low mood in glioma patients, particularly those with functional impairment or previous depressive episodes. The HAD-D (suggested threshold 8+) can reasonably be used to screen for depression, if desired. Caution is required when prescribing antidepressants. Clinicians should be educated about the frequency and consequences of MDD in glioma. Researchers interested in psychological neuro-oncology could convene a meeting to guide future projects, particularly since multi-centre studies may be necessary to recruit sufficient sample sizes in future.

Asthma, a huge burden on millions of individuals worldwide, is one of the most important public health issues in many countries. As genetic and   environmental factors interact, asthma may be programmed very early in life, perhaps even in utero. The aim of this thesis was to assess the impact of gestational age, cord blood immunoglobulin E (IgE), a family history of asthma, migration, and pertussis immunization in early life on the development of asthma in child and adult populations. As a proxy for asthma disease, dispensed asthma medication was used as the main outcome variable based on data from the Swedish Prescribed Drug  Register. Data from other national registers were used to control for  confounders. Three of our studies were based on national cohorts, and one on a local birth cohort that was initiated in 1974–75. Gestational age had an inverse dose-response relationship with dispensed asthma medication in 6– to 19-year-olds. Odds ratios for dispensed asthma medication increased with degree of prematurity compared with children born in term. Furthermore, asthma medication was more likely to be dispensed among children and adolescents born early term after 37–38 weeks’ gestation than among those at the same age who were born in term. Elevated cord blood IgE and a family history of asthma in infancy were associated with a two- to threefold increased likelihood of dispensed asthma medication and self-reported allergen-induced respiratory symptoms at the age of 32–34 years, but the predictive power was poor. Age at migration had an inverse dose-response relationship with dispensed asthma medication at the age of 6–25 years in adoptees and foreign-born children with foreign-born parents. International adoptees and children born in Sweden to foreign-born parents had three- to fourfold higher rates of asthma medication compared with foreign-born children who were raised by their foreign-born birth parents. No association was found between pertussis immunization in early infancy and dispensed asthma medication in 15-year-olds. The type of vaccine or vaccine schedule did not affect the outcome. Fetal life is a vulnerable period. This thesis strengthens the evidence that every week of gestation is important for lung maturation. Cord blood IgE, however, did not predict the risk of asthma in adults. Furthermore, the study of migrating populations demonstrated that environmental changes at any age during childhood may affect the risk of asthma. Another, important public health message from this thesis is that vaccination against pertussis in early childhood can be considered safe with respect to the long-term development of asthma.

published_or_final_version / Dentistry / Master / Master of Philosophy

Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.