Thesis (M.S.)--Boston University

A exposição pré-natal ao álcool é uma das principais causas evitáveis de prejuízos ocasionados no nascimento, bem como alterações no desenvolvimento e comportamento do bebê. Ainda não se sabe qual a dose suficiente para causar danos psiconeurobiológicos. Esse fato é preocupante, visto que o consumo de álcool durante a gestação envolve risco de embriotoxicidade e teratogenicidade fetal. Com modelos animais de exposição pré-natal ao álcool é possível evidenciar diferentes tipos de prejuízos. A utilização de uma dieta líquida para administração via oral torna a exposição ao álcool nenos estressante e indolor para o animal. O presente trabalho pretende verificar os efeitos de diferentes doses de etanol, no desenvolvimento, maturação e comportamento de filhotes cujas mães foram expostas ao álcool no período prénatal. Para o experimento principal foram necessários ratos Lister Hooded (93 fêmeas e 31 machos) em idade reprodutiva (45-60 dias) para os acasalamentos. Durante a gestação as ratas do grupo tratado receberam uma dieta líquida nutricionalmente balanceada com duas diferentes doses de álcool (10 e 26%), enquanto os grupos controles receberam a mesma dieta líquida sem álcool ou apenas ração e água. O período de exposição à dieta líquida seguiu-se até o dia do parto. Os testes de desenvolvimento (peso, reflexo postural, geotaxia negativa e força de agarrar), maturação (abertura dos olhos e erupção dos dentes incisivos) e comportamento (campo aberto e labirinto em cruz elevado) foram realizados entre o primeiro dia pós-natal (DPN) e o DPN 60. Após 22 dias de exposição ao álcool cinco ratas foram sacrificadas para a verificação dos níveis de álcool no sangue. Durante os experimentos foi constatada uma alta taxa de mortalidade por canibalismo nas ninhadas. Nos testes, foi observado um atraso no desenvolvimento reflexo nos primeiros dias de vida, em que os ratos expostos à dieta líquida com etanol mostraram-se atrasados em relação aos grupos controles, no entanto, não foi observado diferença de peso ao nascer entre os grupos. Os grupos tratados com álcool demonstraram atraso na erupção dos dentes incisivos quando comparados aos grupos controle. No teste de comportamento labirinto em cruz elevado, o grupo tratado com 26% de álcool apresentou maior número de entradas no braço aberto e no braço fechado, permaneceu mais tempo no braço aberto e fez o maior número de respostas de risco. Os prejuízos causados pelo álcool podem variar de acordo com os fatores envolvidos, como os níveis de alcoolemia, quantidade de álcool ingerida, suscetibilidade da espécie e do ambiente, entre outros. No entanto, mesmo sob doses moderadas foi possível verificar que o etanol administrado no período prénatal pode ocasionar prejuízos motores, maturacionais e comportamentais, não sendo “segura” a ingestão alcoólica durante o período gestacional. / Prenatal alcohol exposure is one of the main avoidable causes of birth defects, including developmental and behavioral dysfunctions. The minimum quantity of alcohol required to develop psyconeurobiological damage is still unknown. However, it is well known that alcohol intake during the gestational period can lead to fetal embryotoxicity and teratogenicity. The present work intends to show the effects of different alcohol doses on development, maturation and behavior of pups whose mothers were exposed to alcohol during gestation. For this we used an animal model of prenatal alcohol exposure. A liquid diet administrated orally was chosen as a painless and stress free exposure to alcohol for the animal. For the main experiment we used Lister Hooded rats (93 females and 31 males) in reproductive age (45-60 days). During the gestational period, two groups of rats were given a nutritionally balanced liquid diet with two different alcohol doses, 10% and 26% respectively. Control groups were delivered the same liquid diet but without alcohol or alternatively dry food and water ad libtum. The exposure period to the liquid diet was suspended on the day of parturition. The developmental tests (weight, righting reflex, negative geotaxis and grip strength), maturational tests (eyes opening and incisors eruption) and behavioral tests (open field and elevated plus maze) were preformed between the first postnatal day (PND) and PND 60. After 22 days of alcohol exposure, five female rats were sacrificed for blood alcohol levels analysis. During the experiment we observed high litter mortality due to cannibalism. Pups from the alcohol group showed delayed righting reflex development in the first days of life compared with control groups. However, no weight difference at birth was found between the groups. Alcohol exposed groups also showed a delay in incisors eruption when compared with controls. In the elevated plus maze test, the alcohol group exposed to 26% of alcohol showed a higher number of entry in open arms and closed arms, spent more time in open arms and had the highest number of risk response. The damages caused by alcohol intake during the gestational period can be different depending on several factors such as, alcohol intake, blood alcohol levels or species susceptibility. Nevertheless, we could show that even a moderate alcohol intake during gestational period is not “safe” and as a result, motor, maturational and behavioral defects can arise.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology MMed(O&G) Johannesburg, April 2015 / Background Pre-eclampsia and its complications remain a significant cause of maternal and perinatal morbidity and mortality on a global level. There are few data regarding the maternal and fetal outcome of pre-eclampsia at term. Studies suggest that poor maternal outcome is more prevalent as one approaches term, while there are conflicting findings regarding the outcomes of the babies born to term pre-eclamptic patients. Objective To determine the prevalence of pre-eclampsia in term pregnancies at Rahima Moosa Mother and Child Hospital (RMMCH), a hospital that provides district and higher level referral services, and to assess the severity of maternal disease in pre-eclampsia at term, as well as fetal outcomes. Methods This was a prospective cross-sectional, descriptive study on women giving birth at term with pre-eclampsia. All women were followed up until delivery. The indication for and mode of delivery, maternal progress and complications, as well as fetal outcome, were recorded. Results Seventy-eight patients were entered into the study, giving a hospital prevalence rate of pre-eclampsia at term of 1.2%. The major maternal complications were those of severe hypertension (75.6%), eclampsia (9%), HELLP syndrome (3.8%), and pulmonary oedema (7.7%). There was one maternal death. Fifty-one patients (65%) delivered by caesarean section. Major fetal complications encountered were respiratory distress (7.5%) and birth asphyxia (3.7%). There was one neonatal death from meconium aspiration.

This thesis examines the extent to which spiritualism and science inform the paintings of Evelyn De Morgan (1855-1919). I propose that her works in the period 1870-1919 incorporate Darwinist themes of evolutionary development integrated with a spiritualist paradigm of the progression of the soul after death. Chapter one examines the context and influences on De Morgan's mature works, including her family and friends. It considers the impact of her role as a professional woman artist in Pre-Raphaelite circies, and also her engagement with spiritualist practices as a medium. Chapter two argues that De Morgan's works are underpinned by a Darwinian model of evolution, expressed in her works as the progression of the soul, through the vehicle of the female physical body to the metaphysical realm. Chapter three considers how De Morgan reconfigures traditional Christian iconography and narratives through Platonist philosophy in order to create an alternative, feminist vision of divinity. Chapter four continues the exploration of science and spiritualism in relation to female empowerment through De Morgan's representation of witches and occult figures. It proposes that De Morgan's involvement in female suffrage and experience as a medium generate specific spiritualist meanings in her portrayal of occult figures. Chapter five asserts that De Morgan's recurrent concern with water and related imagery correlates with her spiritualist beliefs. It seeks to demonstrate that paintings with water imagery, including sea-scapes, sheils and mermaids, conflate contemporary scientific and spiritualist concerns, which integrate the idea of evolutionary and spiritual development. The conclusion draws together the principal findings of the thesis, and argues that the empirical evidence and close analysis of De Morgan's works in the period 1870-1919 show that they are primarily motivated by De Morgan's engagement with spiritualism.

Introduction: Increasing incidence of vision impairment in the United States reinforces the urgent need for research and public health awareness. Eye diseases are of common concern in Asian and other ethnic groups globally. Glaucoma, cataracts, macular degeneration, myopia, and retinitis are types of eye diseases and common causes of vision impairment in Asians. This study addressed the current gap in knowledge regarding vision impairment prevalence among Asian-Americans by geographical location and level of education. Socio-ecological theory was used as the theoretical foundation. Method: A cross-sectional secondary dataset from U.S. Census Bureau included 3,916,947 participants' survey responses from 2011 through 2015 which was analyzed using a logistic regression model. The model addressed the relationships between variables such as education level, geographic location, and vision impairment. Results: The results in this study exhibited that educational level and geographic location were statistically significant, p < 0.001 and p = 0.004 respectively and they were determined as predictors of vision impairment among Asian-Americans. The statistical significance p < 0.001 for age and gender as confounders in the results exhibited that the variations in these confounders were responsible for vision impairment prevalence. Conclusion: The findings from this study have positive implications for social change among Asian-American communities. This can serve as a basis for exploring the relationships between vision impairment and other social or environmental factors which have not yet been assessed.

No description available.

BACKGROUND. There are various methods of health care follow-up of children born very preterm (VP, ≤31 week gestation) from a neonatal intensive care unit (NICU). Whilst the gold standard is the systematic NICU based follow-up program, which provides highly specialised neurodevelopmental and medical assessment, it is not feasible at all the appropriate times for all infants because of cost and geographical constraints. In Queensland, and elsewhere, 50% of children born VP rely on primary care-general practice for their screening and health needs once discharged from hospital. Recently, randomised and interrater agreement studies have shown the feasibility of the use of a questionnaire-based collection of late health status in children born VP. A preterm-targeted childhood primary health screening and surveillance program which draws from these methods may be effective in collecting long-term disability data and meeting the screening needs of children born VP. AIM. To (1) develop and (2) assess a Preterm-Targeted Screening and Surveillance Program against the routine National Health Medical Research Council (NHMRC) program for the early detection of sensorineural based disability in children born VP by general practitioners in the primary health setting for (1) prevalence estimation and (2) as a screening tool. METHODS. A two-part approach was chosen. Part 1 was a reconstructed cross-sectional cohort of 388 of 523 (74.2%) located and consented 2, 4 and 7 year ca (corrected age) children with a birthweight ≤ 1250 grams (g) born in Queensland. Epidemiological information was collected on child health outcomes and factors relating to the feasibility of providing a standardised targeted screening and surveillance program to be used by general practitioners to detect sensorineural based disability in children born VP. The Preterm- Targeted Screening and Surveillance Program was developed using World Health Organisation (WHO) screening program criteria and NHMRC evidence based health practice criteria. Part 2 was a multicentred randomised controlled trial to test the efficacy of the newly developed program in 202 VP infants who were randomised to receive the NHMRC or Preterm-Targeted Screening and Surveillance Program. The primary outcome was correct identification of sensorineural disability (developmental quotient >-1 standard deviation (SD), cerebral palsy, bilateral blindness or deafness requiring aids) at 12-months ca by general practitioners assessed against gold standard paediatric assessments. The odds ratios (OR) calculated the disability status (agreed vs. disagreed/unsure). Kappa statistics (k) and screening test characteristics calculated interrater agreement and screening accuracy (agreed vs. disagreed). Logistic regression investigated factors that might affect agreement between general practitioners and paediatric assessment for disability. Secondary outcomes were designed to be descriptive and included post-natal depression, parental stress, health service utilisation and satisfaction. RESULTS. Part 1 demonstrated that in Queensland there is no state-based information on 25.8% of children born VP. Children assessed suffer from sensorineural impairment and a range of other health and developmental problems. In addition, there is limited specialist child health resources located outside the major metropolitan areas and families rely heavily on general practitioners for child health care. Parents and general practitioners clearly demonstrated that they would use an evidence-based targeted childhood screening and surveillance program for children born VP. The Preterm-Targeted Screening and Surveillance Program provide parents and health practitioners with an evidence based-high accuracy standardised screening for sensorineural and non-sensorineural domains. In Part 2, 195 of 202 infants randomised were assessed for the primary outcome. There was no difference in the correct identification of sensorineural disability between general practitioners in either group shown by an OR of 0.91 (95%CI 0.50, 1.65) (preterm-targeted 65.6% vs. NHMRC 67.6%). No prognostic factors independently affected this outcome. Interrater agreement was fair (preterm-targeted k =0.30, p for Ho=0.001 vs. NHMRC k =0.29, p for Ho=0.002). The preterm-targeted group had more disability identified (73% vs. 33%) with less under-referrals (27% vs. 67%) but poorer specificity (70% vs. 92%) with more over-referrals (30% vs. 8%) compared to the NHMRC group. Secondary outcomes showed that children born VP experience high rates of health services use but their families experience similar rates of depression and parental stress compared to the general paediatric population. Satisfaction results suggest that the program was well received. CONCLUSION. A comprehensive epidemiological approach to collecting a broad range of VP child health outcomes and health service data was successfully used to develop an evidence-based Preterm-Targeted Screening and Surveillance Program which proved to have excellent uptake by parents and general practitioners. Assessing the program using a randomised methodology has allowed demonstration of its efficacy as a screening tool when used by general practitioners in the primary health setting. The Preterm-Targeted Screening and Surveillance Program is superior in identifying disability at 12-month ca compared to the standard NHMRC program. Whilst the results are promising, the program will not provide totally accurate prevalence of disability data because of the overestimation of disability.

In this study, the balance between conceptual and procedural teaching and its effect on the development of algebraic reasoning was examined. Participants included two seventh grade mathematics teachers and their students in targeted classes (N = 33). One video taped lesson from each teacher was selected for in-depth analysis of the balance between conceptual teaching, procedural teaching, and classroom time that included neither. Student participants took pretest and posttest algebra tests. Distribution of student responses and scores were analyzed for the degree of conceptual understanding demonstrated by students and then related to observed instructional practices. It was concluded that the students of the teacher with a more explicit conceptual emphasis in her lessons performed better on the test and were better able to exhibit flexible reasoning in unfamiliar contexts. Students whose teacher focused more heavily on procedural instruction without conceptual connections were less flexible in their reasoning and unable to apply some of the procedures taught in class.

As part of a strategic research initiative at UBC to design and evaluate integrated underground mining and mineral processing systems, work has been done to determine how to utilize the coarse rejects of pre-concentration in the underground environment. An amenability study for nine orebodies from four of Xstrata Nickel’s Ontario operations evaluated both processing and waste disposal methods. Metallurgically the orebodies showed amenability to dense media separation and conductivity sorting. The dense media results showed high mass rejections and high metal recoveries for all nine orebodies. Conductivity sorter results were not as consistent, but still showed good results. Dense media rejects were examined to determine the applicability of their use in rockfills and composite minefills. The geotechnical properties indicated that the rejects would provide a competent material for minefills. The mix designs were examined for both strength and rheological properties and showed that fills utilizing rejects were comparable to fills currently used by industry. Composite fills containing rejects had significantly lower void ratios, decreasing cement requirements for a given strength requirement. Conceptual designs for pre-concentration systems based on the metallurgical, reject characterization, and mix design were developed for each of the four mines in the study. The designs took into consideration the current mining plans.

The purpose of this study was to examine the impact on the academic performance of Hispanic pre-kindergarten students after participating in a three year structured literacy program compared to the academic performance of Hispanic prekindergarten students not in a structured literacy program in selected elementary schools in the Laredo Independent School District in Texas. This study’s objective was to determine if participation in a structured literacy program is beneficial. This study will provide information and direction for district educators and school leaders contemplating the benefits of a three year old pre-kindergarten program at all district campuses. The researcher’s hypothesis that young Hispanic children, given the opportunity to attend a three year old structured literacy program, will acquire literacy skills and perform academically above what is normally is expected for this age group, is supported by literature and studies reviewed. Key to the purpose of this study is the understanding that as children grow and develop in today’s competitive society, literacy is important because it provides a foundation for life-long learning. For that reason it becomes necessary to educate all children at an early age. Given that in today’s volatile educational system, a comprehensive early childhood program has not been adopted much less one that focuses on pre-literacy and literacy skills; it is vital to examine the possible benefits. Currently, school districts and private institutions allow children to enter a kindergarten at different levels of literacy development and reading readiness; this is even truer for today’s divergent and burgeoning Hispanic population. Based on research, students tend to fare better, both short-term and long-term when allowed to enter an early educational setting. While no specific program is identified as key to this success, it only stands to reason that one that is structured and that has a well defined curriculum would fare better. Conclusions from this study provide data reflecting a need to provide an early pre-literacy program, improvement of teacher training, and greater parental involvement. It is this researcher’s contention that schools benefit from further research regarding the implementation of like programs in other geographic regions and with other participants.