The acoustic reflex refers to the contraction of a middle ear muscle in response to sound. The contraction causes a stiffening of the middle ear system and, consequently, the flow of acoustic energy to the cochlea is impeded. By measuring the change in admittance in the auditory system during sound stimulation it is possible to indirectly monitor the middle ear muscle contractions. Such measurements provide useful information regarding the integrity of the auditory system and the location of the auditory pathology.

Speech reception threshold testing by bone conduction is very useful in diagnostic audiometry. However, there are little data regarding the CID W-1 spondee word lists used with the Radioear B-71 and B-72 and Pracitronic KH 70 bone conduction vibrators at higher presentation levels for testing hearing impaired clients. Data are needed in order that results of speech reception thresholds using the CID W-1 word lists via these three bone conduction vibrators at higher intensity levels can be used confidently in the clinic. More data are available for speech reception thresholds using the CID W-1 word lists via earphones. This study compared speech intelligibility presented via bone conduction at higher intensity levels to that presented via earphone at higher intensity levels. Twelve normal hearing adults, with thresholds artificially elevated by binaural speech noise masking to simulate a hearing impairment, were used as subjects. Recorded CID W-1 spondee word lists were presented via four transducers: Radioear B-71, Radioear B-72, and Pracitronic KR 70 bone vibrators, and a TDH-39 earphone. Investigation of each bone conduction vibrator was accomplished by using forehead placement and using binaural speech noise masking via earphones. Investigation of the earphone was accomplished by simultaneously presenting binaural speech stimuli and speech noise masking. Spondees from the CID W-1 word lists were presented to the subject via a transducer. A bracketing technique was used to estimate the speech reception threshold. Using the intensity level of the predetermined SRT as 0 dB, each list was presented at one of the following levels: +4, +2, O, -2, -4, and -6. Performance-intensity functions, the percentage of correctly identified spondees as a function of presentation level, were obtained for each transducer. The percentage of spondees correctly identified increased with the stimulus level for all transducers. Using linear regression, the line of best fit was calculated for each subject's data under each transducer condition. A one way analysis of variance indicated that there was a significant difference in the slopes of the performance-intensity functions of the transducers. A follow-up test for the one way analysis of variance indicated that there was a signficant difference between the TDH-39 earphone and each of the bone conduction vibrators. There were no significant differences among the bone conduction vibrators. Results of the study suggested that CID W-1 word lists and the 50 percent criterion may be inappropriate for use with these bone conduction vibrators at higher intensity levels. Given that there was a preponderance of data points below 50 percent for the bone vibrators, a criterion of less than 50 percent might be more appropriate. Because presentation levels might be elevated for sensorineural hearing impaired listeners, their SRT performances could be affected. Consequently, the results of speech reception threshold testing via bone conduction at higher intensity levels should be interpreted with caution in clinics.

Implementing differentiated instruction in classrooms with students who have mixed skill levels often results in teachers facing many challenges. The purpose of this qualitative case study was to explore social studies teachers' perceptions of the challenges they faced when implementing differentiated instruction in classrooms with mixed skill levels and what teachers perceived they needed to help overcome these challenges. This project study was guided by the conceptual frameworks of constructivism from Piaget and Bruner along with the theoretical framework of Vygotsky's zone of proximal development. The research questions focused on the viewpoints of teachers on implementing differentiated instruction in their classrooms, what challenges they faced when implementing differentiated instruction in a social studies classroom with mixed skill levels, and what support teachers need to overcome these challenges. Data were gathered using structured interviews of the 10 individual teachers chosen through purposeful sampling from a school in metro-Atlanta, Georgia. Data were transcribed and analyzed using coding by highlighting common words to identify themes to answer the research questions. Data analyses revealed that teachers needed professional development that defined what differentiated instruction is, how to implement it, and how to get to know their students better, as well as time to observe other teachers implementing differentiated instruction. A professional development plan was developed to help meet these needs for teachers. Implications for social change include an improved understanding of differentiated instruction and how to support teachers to overcome the challenges of implementing differentiated instruction. This may lead to better instruction and more academic success for all students which may lead to better assessment scores.

In 2014, Louisiana experienced substantive issues with quality of care in nursing homes. The state had the lowest nurse staffing level among all states, and 7,666 deficiencies for immediate jeopardy violations were recorded from 2011 to 2013. Despite ample research on nurse staffing and quality of care, there is no consensus on how higher nurse staffing relates to quality. The purpose of this quantitative, correlational research was to determine the relationship between nurse staffing levels and quality measures in Louisiana. Donabedian's category structure, process, and outcome was the conceptual framework used to develop the research questions. The data included the quality of care deficiency score and the quality measures found in the Centers for Medicare and Medicaid datasets. The quality measures were the deficiencies and the prevalence of nursing home residents with pressure ulcers, urinary tract infections, and physical restraints. Generalized linear models were used to analyze the relationship between nurse staffing levels and the quality measures. The findings suggested that RNs, nonprofits, chain-affiliated nursing homes, and smaller facilities are important to improve the quality of care in Louisiana nursing homes. These variables were associated with fewer quality of care deficiencies and fewer pressure ulcers. These findings have implications for social change. This information may help inform and direct policy makers in the development and implementation of Medicaid-managed long-term services and supports programs in order to improve the quality of care of a vulnerable population: the elderly and disabled.

Theses (Msc.(Med.)(Pharmacy))--University of Limpopo, 2010. / With the availability of Highly Active Antiretroviral Therapy (HAART), one of the limitations of treatment safety is the occurrence of adverse events associated with antiretroviral agents. The aim of this study was to establish whether stavudine dosage reduction prevents toxicity from developing and minimizes the incidence of symptomatic hyperlactataemia/lactic acidosis (LA) in adults female HIV/AIDS infected patients. This retrospective study covered adult patients treated at the adult ARV clinic, Dr George Mukhari Hospital. The records of 88 patients aged between 27 and 59 years, initiated and treated from August 2004 to January 2006, were analyzed ( 67 females and 21 males). Twenty nine females started their treatment on a regimen containing 40 mg stavudine while 38 females were started on 30 mg stavudine. A group of male patients (n=21) were included for comparison. Seven males started on 40 mg stavudine and 14 were on 30 mg stavudine. Ten out of twenty nine females who started treatment on 40 mg stavudine developed elevated lactate levels while nineteen received 30 mg stavudine as reduced dose. Eight out of nineteen further developed elevated lactate levels when on 30 mg stavudine but eleven out of nineteen remained stable on treatment with 30 mg stavudine as reduced dose. In the group started on 30 mg stavudine, thirteen females out of thirty seven developed elevated lactate levels while twenty four were stable on their treatment. Key words: stavudine, dosage reduction, lactate levels, hyperlactataemia, lactic acidosis.

Parmi les outils de réduction de dose d’exposition en scanner, le plus récent est l’emploi des Reconstructions Itératives (RI). Ces nouveaux algorithmes permettent de corriger de façon répétée les données d’acquisition par modélisation, rendant envisageable la compensation sur les images reconstruites, du bruit engendré par une acquisition scanographique à basse dose. Ce travail a eu pour but d’évaluer, à travers 5 études originales, la performance des RI en scanner thoracique, en particulier leur potentiel de réduction de dose et leurs applications cliniques. La 1ère étude a permis de valider la réduction de bruit sans perte d’information diagnostique sur 32 scanners thoraciques grâce à un algorithme de RI de 1ère génération (IRIS). L’évaluation initiale de cette technique a permis de l’intégrer en pratique clinique donnant lieu à la 2e étude évaluant IRIS chez 80 patients ayant bénéficié de 2 scanners thoraciques successifs dans le cadre d’un suivi. Malgré une réduction de dose de 35% par réduction du milliampérage, IRIS a permis de maintenir une qualité image similaire à celle du scanner initial. L’évaluation d’un algorithme de RI de 2e génération (SAFIRE) a ensuite été réalisée sur des examens acquis à dose encore plus réduite : (a) chez 80 patients étudiés par angioscanner à bas kilovoltage avec 50% de réduction de dose ; et (b) chez 50 patients étudiés en scanner double source avec acquisition simultanée d’images pleine dose et d’images à dose réduite de 60%. Enfin, SAFIRE a été évalué dans une situation clinique particulière, l’embolie pulmonaire, permettant une réduction de dose de 60% sans perte de performance diagnostique. / Among the different tools available to save dose in CT, the most recent option is the use of Iterative Reconstructions (IR) instead of Filtered Back Projection. These new algorithms can correct repeatedly the acquisition by modeling data, making possible the compensation of the noise generated in reconstructed images by a low-dose CT acquisition. The purpose of the present work was to evaluate, through 5 original studies, the performance of IR in chest CT, especially their potential for dose reduction and clinical applications.Based on 32 chest CT examinations, the first study validated the level of noise reduction achievable with a first-generation IR algorithm (IRIS). This initial evaluation allowed us to investigate the performance of IRIS in clinical practice, giving rise to the second IRIS study; the latter evaluated 80 patients who underwent two successive chest CT examinations for monitoring. Despite a 35% dose reduction achieved by reduction of the tube current, IRIS provided a similar image quality in comparison with that of the initial examination. A second-generation IR algorithm (SAFIRE) was then evaluated on examinations obtained at lower dose levels in (a) 80 patients who had undergone low-kilovoltage chest CT angiography with a 50% dose reduction; and (b) 50 patients studied with a dual source CT system providing simultaneously full-dose and low- dose (reduction of 60%) images. Lastly, SAFIRE has been evaluated in the specific context of acute pulmonary embolism where the diagnostic performance of low-dose SAFIRE images was found to be similar to that of full-dose FBP images.

This study investigated eight possible predictors of satisfaction levels in smallcollege football players. The sample (N = 442) included eight nonscholarship football programs from the NCAA Division III or NAIA classifications. Measures included Zhang's Revised Version of Chelladurai's Leadership Scale for Sport, and a seven-item subscale of the Scale of Athlete Satisfaction. The six subscales of the Revised Leadership Scale for Sport each yielded a significant linear relationship with the satisfaction outcome measure: social support (I= .696), situational consideration (I= .665), positive feedback (r = .654), teaching and instruction (I= .627), democratic behaviors (I = .501), and autocratic behaviors (I= -.372). Minimal correlations were found between satisfaction and the two other predictors evaluated: each team's win/loss percentage (I= .164) and each player's estimated amount of playing time (r = .121). With the large sample size, these two modest correlations were also statistically significant. However, as neither accounted for more than 2% of the total variance in satisfaction levels, they are not likely to have practical significance. The predictors were also evaluated via stepwise multiple regression analysis to assess which combination(s) would account for more of the overall variance. Unfortunately, a mild case of multicollinearity made it difficult to attribute relative importance to the predictors. For example, the situational consideration subscale recorded especially high correlations with several of the other Revised Leadership Scale for Sport subscales. Overall, results indicate that specific coaching behaviors are more associated with player satisfaction in small-college players than are reported in previous samples of other types of athletes. As such, coaches are encouraged to provide support for players in off-the-field endeavors, offer positive feedback on performance goals, and combine knowledge of the sport with the ability to make adjustments in strategies and coaching behaviors. A comparison of the current sample of nonscholarship, small-college football players and a sample of full-scholarship (NCAA Division I-AA) football players revealed several interesting differences. In the current sample, the correlations between social support and satisfaction, and democratic behavior and satisfaction, were substantially higher. Additionally, a much stronger negative relationship existed between autocratic coaching behaviors and satisfaction among small-college players.

Production functions were generated for dry matter and grain yields of corn, A continuous variable plot design replicated four times was established in the spring of 1974 in Vernal, Utah. Each replication included ten salt treatments and twenty irrigation levels. The salt treatments resulted in an average root zone salinity ranging from 2 . 7 to 14.9 mmho s/cm. Irrigation levels ranged from 4.2 to 45.0cm of water applied. Dry matter (Kg/ha) yield showed an 83 percent reduction over the range of salt applied and a 52 percent reduction over the range of water applied. Grain yield declined 96 and 64 percent over the range of salt and water applied, respectively . Salinity sensors produced results corresponding closely to measurements taken from the saturation extract of soil samples . Thermocouple psychrometers and a four probe resistivity meter produced results inconsistant with those of the soil samples.

Wheat (Triticum aestivum L.) zygotic embryogenesis occurs in a dynamically regulated ovular environment, and in ovulohormones regulate embryogenic processes. Levels of ABA, IAA, and the cytokinins Z, ZR, DHZ, DHZR, iP, and iPA were studied in developing wheat kernels from anthesis to maturity . High cytokinin and low IAA and ABA levels were associated with the early stage of embryo formation and active tissue histodifferentiation. Following histodifferentiation, cytokinin levels declined while IAA accumulated throughout the stage of active grain growth and then declined with grain maturity. ABA levels increased at the soft-dough developmental stage and through to grain maturity. Endogenous +ABA levels in developing wheat grains treated with fluridone, which indirectly blocks ABA synthesis, declined at the soft-dough stage. As a result, mature desiccated fluridone-treated kernels exhibited little dormancy. However, fluridone-treated kernels were not viviparous, suggesting a strong caryopsis-embryo interaction in maintaining embryogenically competent tissues. Induction of embryogenically competent wheat callus cultures was highly variable between genotypes and pre-initiation environments. Genotypic and environmental influences altered endogenous hormone levels and affected embryogenic competence. Establishment of competent embryo explants for somatic embryo induction was favored by a high cytokinin-to-auxin ratio and very low ABA levels throughout histodifferentiation (around 4 to 8 DPA). Similar to embryos forming within the caryopses, competent callus cultures had a high cytokinin (Z)-to-auxin ratio at 7 DPI. Increased frequency of embryogenic cultures was achieved when embryo explants were excised during a narrow window of low hormone levels. Wheat line and pre-initiation environment affected this window. Simulation in vitro of the in ovulo wheat kernel environment improved zygotic embryogenesis in vitro . Embryos exposed to physiologically normal ABA levels and low 0 2 tensions of 2.5 mM (7%) most closely approached morphological and physiological normalcy. The culmination of these studies clearly defines windows of embryo development for explant excision, associated roles of plant hormones in embryogenesis, and in ovulo hormone levels that vastly improve the frequency of successful embryogenesis when simulated in in vitro culture systems.

Denna rapport var en kvalitativ empirisk intervjustudie där fyra lärare deltog som alla hade någon form av hörselproblematik. Syftet var att undersöka hur lärare med hörselskador upplever buller i den egna arbetsmiljön. Vidare var syftet att undersöka lärarnas sätt att hantera den problematik som hörselskadan medför i deras arbetsmiljö. Informanterna utsattes för, i deras mening, höga ljudnivåer mellan 1-4 timmar per arbetsdag. När det gällde hur hörselproblemen påverkade dem i deras yrkesutövande upplevde lärarna att det medförde det vissa positiva effekter, då genom en ökad disciplin bland eleverna samt minskade ljudnivåer i klassrummet. Det påverkade dem även negativt då genom exempelvis svårigheter att alltid uppfatta vad elever sa, trötthet samt deltidssjukskrivning. Sättet informanterna hanterade hörselproblemen var bl.a. genom att läsa på läppar och genomtänkta pedagogiska val för att underlätta för dem utifrån deras specifika hörselproblem. Lärarna i studien betonade även vikten av att ha en god ordning på lektionerna för att minska ljudnivån, de var även noga med att berätta för eleverna om sin hörselproblematik vilket gjorde att eleverna försökte hålla ner judnivån tack vare visad hänsyn. / The report was an empirical qualitative interview study in which all four teachers who participated had some form of hearing problem. The aim of the study was to determine how teachers with hearing impairment perceive noise in their working environment. Furthermore, the aim was to examine teachers' ways of dealing with the problems that occur in their working environment due to their hearing impairment. The subjects were exposed to, in their view, high noise levels during 1-4 hours per working day. When questioned about how their disabilities affected them in the workplace, some positive effects where observed. In particular it led to increased discipline among the students as well as an improved working environment. Some negative effects were also observed. Such as having difficulties understanding conversations due to hearing impairment, fatigue and part-time sick leave. The informants handled auditory problems by lip-reading and adapting their educational techniques based on their specific hearing problems. The teachers in this study stressed the importance of maintaining good order during in the classroom in order to reduce noise, furthermore they informed their students about his or her hearing problem which encouraged students to minimize noise out of respect for the teacher's disability.