The purposes of this study were to determine which perinatal risk variables arecorrelated with phonological disorders and to determine how preschoolers' developmental functioning is related to phonological impairment. Subjects were 101 low SES boys (n=46) and girls (n=55) randomly selected from a county Head Start program in north-central Indiana. The mean age of the preschoolers was 65 months. Information about perinatal risks and developmental abilities was obtained from mothers or primary caregivers. Using the Maternal Perinatal Scale (Dean, 1985) and the Bankson Bernthal Test of Phonology (Bankson & Bernthal, 1990), it was found that three moderate inverse correlations existed between perinatal risk items and phonological scores (mothers' weight before pregnancy, the number of pregnancies prior to the birth of the child that resulted in death, and the number of medical conditions experienced by mothers before or during pregnancy). Hierarchical multiple regressions indicated that developmental scales of the Minnesota Preschool Inventory (Ireton & Thwing, 1979) significantly accounted for phonological ability in these children, with the scales of Letter Recognition, Self-Help, Expressive Language, and Fine Motor contributing the most unique variance. Implications of these findings are discussed relative to the developmental apraxia of speech debate. / Department of Educational Psychology

The present study was undertaken to determine the relationship between perinatal complications and subsequent development of Attention Deficit Hyperactivity Disorder (ADHD) and other behavioral characteristics. The biological mothers of 74 children diagnosed with ADHD and 77 children displaying no characteristics of the disorder completed the Maternal Perinatal Scale (MPS), the Behavior Assessment System for Children-Parent Rating Scales (BASC-PRS), and a demographic survey. In addition, the biological mothers of 120 children with no characteristics of ADHD or any other behavior disorders completed only the MPS so that exploratory factor analysis of the MPS could be completed.Following factor analysis, stepwise discriminant analysis of the resulting five factors was utilized to explore the nature of the relationship between such perinatal factors and ADHD. Results of this analysis indicated that emotional factors, or the amount of stress encountered during pregnancy and the degree to was planned, were the items that maximized the separation between the ADHD and Non-ADHD groups. Additional discrimination between the groups was attributed to the extent of insult or trauma to the developing fetus and the outcome of prior pregnancies. ADHD children were also found to have experienced twice as many behavioral, social, or medical problems, and were more likely to reach developmental milestones with delays.Stepwise discriminant analysis also revealed the Attention Problems and Hyperactivity scales of the BASC-PRS were most significant in differentiating between the ADHD and Non-ADHD subjects. Using the BASC-PRS resulted in approximately 90% of the total sample being correctly classified as ADHD or NonADHD. Canonical correlation analysis indicated that emotional factors and the general health of both the mother and the developing fetus were the best predictors of later behavioral patterns reported on the BASC-PRS. / Department of Educational Psychology

No description available.

The discovery of new immunosuppressive drugs has resulted in an improvement of short-term graft survival. Despite this achievement, long-term cardiac allograft survival has not been correspondingly improved. Cyclosporine A (CsA), an effective immunosuppressive drug, has been shown to increase the risk of hyperlipidemia, hypertension, kidney injuries and chronic rejection despite its extensive use in the clinical setting. Therefore, these side-effects of CsA, may further contribute to graft failure over long-term. Early studies have shown that fish oil may reduce side-effects of CsA. These beneficial effects of fish oil may be related to n-3 fatty acids (n-3 FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Flaxseed oil is another major source of an n-3 FA, namely α-linolenic acid (ALA). However, its impact on heart transplantation has not been fully explored. The current study aimed to investigate whether dietary flaxseed oil and fish oil reduce post-transplant complications and prolong graft function in a rat cardiac allograft model. Male Fischer and Lewis rats were used as donors and recipients, respectively, to generate a heterotopic cardiac allograft model. After transplant, animals were randomly assigned into 3 groups and fed a diet supplemented with: a) 5% w/w safflower oil (control n=7), b) 5% w/w flaxseed oil (n=8) or c) 2% w/w fish oil (n=7) and an intraperitoneal injection of cyclosporine A (CsA) (1.5 mg/kg/d) over 12 weeks. Body weight, blood pressure (BP), plasma levels of lipids, CsA, and select cytokines, fatty acid profile of hearts (native and graft) and liver tissues as well as graft function and chronic rejection features were assessed. Body weight and blood CsA levels were similar among the groups. As compared to controls, both diet treated groups demonstrated a significantly lower systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (pressure (DBP) (p<0.001), mean arterial pressure (MAP) (p<0.001), heart rate (p<0.05), abdominal fat (p<0.05) and plasma levels of macrophage chemoattractant protein-1 (MCP-1) (p<0.05). Moreover, the fish oil group had significantly (p<0.05) lower plasma levels of triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), as compared to the control group. High-density lipoprotein cholesterol (HDL) concentrations were significantly higher (P<0.05) in the flaxseed oil-treated group as compared to the other two groups. Data of this study suggest that both flaxseed oil and fish oil may provide similar biochemical, hemodynamic and inflammatory improvements after heart transplantation; however, these apparent beneficial changes were not accompanied with significant reductions in chronic rejection states or apparent histological evidence of cyclosporine-induced nephrotoxicity in this model.

This project set out to derive a prediction rule based on preoperative clinical variables to identify patients with high risk of developing atrial fibrillation following cardiac surgery. Methods: Prospectively collected data from a perioperative database was corroborated with chart review to identify eligible patients who had non-emergent surgery in 2010. Details on 28 preoperative variables were collected and significant predictors (p<0.2) were inserted into multivariable logistic regression and recursive partitioning. Results: 305 (30.5%) of 999 patients developed new onset postoperative atrial fibrillation. Eleven variables were significantly associated with atrial fibrillation, however, both final models included only three: left atrial dilatation, mitral valve disease and age. Bootstrapping with 5000 samples confirmed that both final models provide consistent predictions. Coefficients from the logistic regression model were converted into a simple seven point predictive score. Conclusions: This simple risk score can identify patients at higher risk of developing atrial fibrillation after cardiac surgery.

In recent decades, there has been a seemingly inexhaustible rise in the use of caesarean section (CS) worldwide. The overall aim with this thesis is to explore the effects of and reasons for an increase in the CS rate at a university hospital in Dar es Salaam, Tanzania. In Study I, we analysed time trends in CS rates and maternal and perinatal outcomes between 2000 and 2011 among different obstetric groups. In Study II, we documented the occurrence and panorama of maternal ‘near-miss’ morbidity and death, and analysed their association with CS complications. We also strived to determine if women with previous CS scars had an increased risk of maternal near-miss, death, or adverse perinatal outcomes in subsequent pregnancies. Studies III and IV explored women’s and caregivers’ in-depth perspectives on CS and caregivers’ rationales for their hospital’s high CS rate. During the study period, the CS rate increased from 19% to 49%. The rise was accompanied by an increased maternal mortality ratio (odds ratio [OR] 1.5, 95% Confidence Interval [CI] 1.2–1.8) and improved perinatal outcomes. CS complications accounted for 7.9% (95% CI 5.6–11) of the maternal near-miss events and 13% (95% CI 6.4–23) of the maternal deaths. Multipara with previous CS scars had no increased risk of maternal near-miss or death compared with multipara with previous vaginal deliveries, and a lower risk of adverse perinatal outcomes (adjusted OR 0.51, 95% CI 0.33–0.80). Both women and caregivers stated they preferred vaginal birth, but caregivers also had a favourable attitude towards CS. Both groups justified maternal risks with CS by the need to ‘secure’ a healthy baby. Caregivers stated that they sometimes performed CSs on doubtful indications, partly due to dysfunctional team-work and a fear of being blamed by colleagues.  This thesis raises a concern that maternal health, interests, and voices are overlooked through the CS decision for the benefit of perinatal outcomes and caregivers’ liability. An overuse of CS should be seen as a sign of substandard care and preventing such overuse needs to be among the key actions when formulating new targets for the post-2015 era.

To investigate the relationship between birth asphyxia and neurological impairment a cohort of 184 infants with a low (≤3) one-minute Apgar score was studied. All were singletons, apparently normally formed, and born at term (≥37 weeks' gestation) in the John Radcliffe Hospital, between January 1984 and September 1985. The 181 cohort survivors were traced at the age of five years; 159 were assessed by a paediatrician on a battery of neurodevelopmental tests, and information about a further eight was obtained from other sources. Three infants in the cohort died neonatally with a diagnosis of birth asphyxia, and three had spastic quadriplegia, profound developmental delay and visual impairment. Examination of the perinatal histories of these six children, including their fetal heart rate patterns in labour and acid-base status at delivery, found convincing evidence of birth asphyxia. Only one other child in the cohort exhibited similar signs of birth asphyxia; he was unimpaired at the age of five. To assess the impact of birth asphyxia on the overall rate of cerebral palsy, all cases of cerebral palsy born to Oxford residents in the study period were identified. Of 30 cases of cerebral palsy, the three identified in the follow-up study were the only ones whose impairment could be attributed to birth asphyxia in a full-term birth. Birth asphyxia therefore accounted for 10% of all cases of cerebral palsy, a fraction that agrees with previous estimates. The frequency of cerebral palsy due to birth asphyxia was estimated as 1 in 3800 full-term livebirths. A detailed analysis of the test scores of the 159 children assessed by the paediatrician failed to show any association between their acid-base values at delivery and test scores, or between their fetal heart rate patterns in labour and test scores. These results conform with the view that birth asphyxia has an "all or nothing" effect, and that it presents as a cluster of abnormal neonatal signs, including persistent cerebral depression, severe acidaemia, neonatal encephalopathy, and multiorgan dysfunction.

Rehabilitation of edentulous patients with Implant-supported Complete Fixed Dental Prosthesis (ICFDP) is a well-documented treatment option. This dissertation assessed the relation between the rate of biological/mechanical complications and the type of metal framework alloy, length of cantilever extension. The results showed that long-term clinical outcomes of ICFDP were favorable. While 30% of patients experienced biological complications, 66.6% of the prostheses needed to be repaired during follow-up period. The risk of prosthesis failure and mechanical complications was significantly higher in silver-palladium frameworks as compared with palladium-silver or type IV gold alloys. The length of cantilever was not correlated with the amount of marginal bone loss. The rate of marginal bone loss around anterior implants was higher than that of posterior implants associated with cantilever segments. The treatment improved the patients’ quality of life and 96% of patients would undergo the same treatment again if required.

Rehabilitation of edentulous patients with Implant-supported Complete Fixed Dental Prosthesis (ICFDP) is a well-documented treatment option. This dissertation assessed the relation between the rate of biological/mechanical complications and the type of metal framework alloy, length of cantilever extension. The results showed that long-term clinical outcomes of ICFDP were favorable. While 30% of patients experienced biological complications, 66.6% of the prostheses needed to be repaired during follow-up period. The risk of prosthesis failure and mechanical complications was significantly higher in silver-palladium frameworks as compared with palladium-silver or type IV gold alloys. The length of cantilever was not correlated with the amount of marginal bone loss. The rate of marginal bone loss around anterior implants was higher than that of posterior implants associated with cantilever segments. The treatment improved the patients’ quality of life and 96% of patients would undergo the same treatment again if required.

Thesis (M.S.)--University of Hawaii at Manoa, 2007. / Includes bibliographical references. / viii, 12 leaves, bound ill. 29 cm