Class of 2015 Abstract / Objectives: To characterize the types of renal dosing recommendations provided in the prescribing information (aka package insert) before and after the FDA guidance for industry document regarding renal dosing, released in 1998. Methods: The prescribing information (PI) for all new molecular entities (NMEs) for three time periods was collected from the FDA website. Time period 1 was January 1995 to December 1997 and represents dosing recommendations prior to the FDA guidance statement. Time period 2 was January 2000 to December 2002 and time period 3 was January 2011 to December 2013. These represent recommendations after the FDA guidance statement. The renal dosing recommendations for each NME were reviewed and classified as either specific (includes CrCl, serum creatinine), nonspecific (mild, moderate, or severe impairment), caution, unnecessary, no information or other by two investigators independently. A further analysis was conducted for NMEs in time periods 1 and 2 with LexiComp and the most recent PIs located on FDA or company website. Presence of dialysis (hemodialysis or peritoneal) dosing recommendations was also recorded. Results: Time period 1 had significantly less NMEs characterized as No information in Lexicomp in comparison to original PIs (p= 0.02). A statistically significant decrease in original PIs characterized as Caution was observed between time periods 2 and 3 (p= .0004) and time periods 1 and 3 (p= 0.001). Conclusions: Terminology used in renal dosing recommendations in PIs does not seem to be clearer over the past years. There remains a need for improved quality of dosing information within PIs.

Dissertation (MCommunication Pathology)--University of Pretoria, 2013. / Speech-Language Pathology and Audiology / Unrestricted

Language and communication difficulties of young children with visual impairment (VI) may be ascribed to intellectual disability, multiple disabilities and autism spectrum disorder (ASD) rather than sensory impairment. As a result, the impact of VI on communication development has been underestimated and undertreated. Speech-language therapists should be included on the early intervention team for children with VI. There is a need to review and critically appraise recent peer reviewed research to examine the strength of the evidence and to describe the language and communication developmental characteristics in young children with VI. A literature review regarding the developmental characteristics of children with VI was compiled as a foundation of information. A systematic search of recent literature (2003-2013) was then completed using the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Primary and secondary search phrases were used in three databases and 1661 articles pertaining to language and communication developmental characteristics were identified. Once the inclusion criteria were applied, the level of evidence of the nine remaining publications was determined. Thematic analysis was used to describe the early language and communication characteristics of children with VI. All the studies were from developed countries and participants from seven of the nine articles had congenital VI. Five studies received an evidence level rating of III while four articles were rated as IIb. Two main themes emerged from the studies, 1) early intervention and 2) multiple disabilities and ASD. Language and communication development is affected by VI especially in the early stages of development and speech-language therapists should therefore be included in early intervention for children with VI. Recent evidence on the early language and communication difficulties of children with VI is stronger than in the past where studies were mostly on evidence level IV, i.e. descriptive research and expert opinion. Language and communication difficulties are missed or not prioritized in children with VI due to the co-occurrence of multiple difficulties such as intellectual disability, ASD and multiple disabilities. Six articles attempt to address this problem. The impact of VI itself on communication remains unclear because the effect of VI on language and communication development cannot yet be separated from the primary conditions. Children with VI are a hidden population for speech-language therapists. This systematic review motivated the need for speech-language therapists to become involved in early intervention for children with VI from the perspective of prevention of further delay, intervention for existing delays and advocating for the awareness of the possible communication problems. Children with VI, specifically those in developing countries within Sub-Saharan Africa with acquired VI, need to receive greater focus not only within research but also in clinical practice. The identified language and communication developmental characteristics and early intervention guidelines by ASHA (2008) provide the framework for improved service provision by speech-language therapists to young children with VI. / Dissertation (MComm Path)--University of Pretoria, 2015. / Speech-Language Pathology and Audiology / Unrestricted

Thesis (Ed.D.)--Boston University / Research suggests that web-based education increases opportunities for underserved populations to be integrated into educational activities (Schmetzke, 2001; Burgstahler, 2002; Opitz, Savenye, & Rowland, 2003). This may be true for students with disabilities because they have more flexibility to participate in formal education. However, Moisey (2004) found that people with disabilities had lower rates of enrollment and educational achievement than people without disabilities. These findings raise the question of whether or not web-based = education helps increase students with disabilities' access to learning opportunities and improve their learning outcome. This study investigated the degree of difficulty blind persons had in accessing and using web-based educational resources provided by Thailand Cyber University (TCU). Based on a mixed methods design, the data were collected in two phases. Quantitative data were collected first, in order to identify accessibility problems and conformance levels reported by automated web accessibility evaluation tools. Qualitative data was collected from interviews with blind participants in the second phase to expand the understanding of the accessibility problems and usability issues that were not discovered in the quantitative phase by the automated web accessibility evaluation tools. The findings indicate that all of the 13 selected web pages failed to meet a minimum requirement of WCAG 2.0. This means those selected web pages would be inaccessible for the blind. However, the findings indicate blind participants rated only one of the 13 pages as inaccessible. Moreover, their ratings of difficulty on "usability" were higher than their ratings of difficulty on "accessibility" on the same web page. On six out of 22 tasks, blind and sighted user groups agreed on the ratings. Nevertheless, the time that it took to complete each task varied greatly between the two user groups. / 2031-01-01

The purpose of this study was to measure the speech perception of children with speech sound disorders and compare it to that of adults and typically developing children. A secondary purpose was to determine if an adaptive-tracking tool, the Wide Range Acoustic Accuracy Scale (WRAAS) equalized task demands across participants independent of perceptual ability. The participants included 31 adults, 15 typically developing children, and 15 children with speech sound disorders. Children with speech sound disorders all had difficulty producing /r/ correctly. Each participant completed perceptual testing discriminating differences in three syllable contrast pairs: /bɑ/-/wɑ/, /dɑ/-/gɑ/, and /rɑ/-/wɑ/. Results indicated that children with speech sound disorders had significantly poorer perception than the adults for /bɑ/-/wɑ/ and /dɑ/-/gɑ/ and significantly poorer perception than their typically developing peers for the /rɑ/-/wɑ/ contrast. Adults and typically developing children did not differ in their perception of any contrast. Results also indicated that WRAAS equalized the number of trials across all participants irrespective of perceptual ability. We discuss clinical implications of these results and how WRAAS may be used in future research and in clinical work to efficiently and effectively determine perceptual abilities of children with speech sound disorders.

Barn med funktionsnedsättningar upplever mer problem med hälsan och lägre livskvalitet än barn utan funktionsnedsättning. En integrativ litteraturstudie användes för att beskriva och belysa barns upplevelser av att leva med synnedsättning. En analys av 13 artiklar utfördes. Barn med synnedsättning beskrev bland annat hur de undvek sociala situationer där problem relaterat till synnedsättningen kunde uppstå.Många barn deltog tillsammans med sina familjer i fritidsaktiviteter anordnade för barn med synnedsättning arrangerade av olika organisationer. Barnen beskrev både positiva och negativa upplevelser av sina möten med vården. Några av barnen beskrev en frustration över att behöva förklara sitt tillstånd för vårdpersonal som inte var insatta i deras hälsohistorik. Fysisk aktivitet och skola var ett återkommande ämne i flera studier och barnens självkänsla och självförtroende påverkades av möjligheterna till att delta inom dessa områden. Barnen upplevde besvikelse och frustration över den stigmatisering som en synnedsättning innebar. Studien belyser ett relativt outforskat ämne där forskning inriktad på att mäta välbefinnande hos barn och ungdom som lever med synnedsättning är sparsam både utomlands och i Sverige. Genom att samla den befintliga forskningen kan kunskapen öka och leda till en mer individanpassad vård och omvårdnad. / Children with disabilities experience more problems and difficulties with their health and decreased quality-of-life conditions than other children. An integrative litteraturestudy was used to describe the experiences of children with visual impairment and their everyday-life. This study includes an anlysis of 13 articles. The children described scenarios in which social settings were avoided due to problems or concerns that may arise involving the visual impairment. Many of the children with visual impairment and their families attended leisure services that were arranged by different childrens organisations. The children described both positive and negative experiences when meeting with their caregivers. Some of the children described a frustration of having to explain their medcial and health condition to caregivers who were not familiarwith their medical and personal history. A recurring theme in several studies was physical activity and school and how self-esteem and confidence of the children often depended on opportunities to participate in these subjects. Children experienced disappointments and frustrations over the stigmatisation that visual impairment involved. The study encompasses a topic that is relatively unexplored and in need of further research to provide greater understanding. Research that focuses on evaluating the well being of children and youth living with vision loss is sparingly both in Sweden and abroad. By summarizing the existing research, increased knowledge could lead to a more individualized nursing care for these children.

Indiana University-Purdue University Indianapolis (IUPUI) / Chronic consumption of a high-fat diet is a lifestyle factor that increases the risk for cognitive impairment (Granholm et al., 2008; Greenwood & Winocur, 2005; Mattson, 2004; Winocur & Greenwood, 2005). A high-fat diet appears to facilitate cognitive impairment through the promotion of insulin resistance (Greenwood & Winocur, 2005; Stranahan et al., 2008; Winocur & Greenwood, 2005). A gap in the literature is an established timeframe of the progression and underlying mechanism, which study in animals would better afford. Furthermore, A limited number of studies have investigated the relationship between a high-fat diet and behavioral dysregulation such as anxiety and depression. The 1st aim of the study was to determine if consumption of a high-fat diet leads to cognitive impairment and behavioral dysfunction at 3, 8, or 13 weeks of consumption. The 2nd aim was to determine if cholesterol levels and HBP activity are aberrantly increased in specific regions in mice that display feeding induced cognitive/behavioral dysfunction. Consumption of the experimental specialty diets produced a number of significant behavioral effects. These significant effects began to emerge after only 3 weeks of low-and high-fat feeding with increased anxiety-like behavior displayed higher in the high-fat diet group for the Elevated Plus Maze and Open Field Test. There was increased thigmotactic behavior and floating in the low-fat diet group in the Morris Water Maze (MWM) task, therefore making cognitive assessment uninterpretable. This pattern in the behavioral tasks were more robust in the 8 week group and alleviated in the 13 week group. There was only a significant difference in depression-like symptoms in the Forced Swim (FS) Task in the 3 week group. Cholesterol analysis is still under review in Dr. Elmendorf’s lab to correlate cholesterol levels and cognitive/behavioral impairment.

While Attention-deficit/hyperactivity disorder (ADHD) is one of the most common psychological disorders diagnosed during development, adult ADHD remains vastly under recognized and undertreated. In an effort to better understand current issues with adult ADHD assessment, this study examined the relationship between symptoms, impairment, and executive functioning. Results indicate that among individuals who screened negative for ADHD, those higher in executive function reported experiencing significantly less impairment than those lower in executive function. Executive function was shown to have a negative relationship with impairment and ADHD symptomology was shown to have a positive relationship with impairment. Additionally, impairment was significantly predicted by ADHD symptoms and executive function, and there was a significant interaction between executive function and ADHD symptoms in predicting impairment. Understanding the relationship between executive function, ADHD symptoms, and impairment is critically important in better understanding adult ADHD.

This study examined the relationship between language skills and reticence in 37 children with language impairment (LI) and 37 typically developing peers matched for age (ranging from 6;11 to 10;1 years) and gender. Subtests of the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999) were used to evaluate language ability. The Teacher Behavior Rating Scale (C. H. Hart & C. C. Robinson, 1996) was used to evaluate reticence. The current study replicated previous research by documenting significantly higher levels of reticence in children with LI when compared to typical peers. Significant group differences were also found in paragraph comprehension, syntax construction, and pragmatic judgment skills, with children with LI performing poorer on each language subtest compared to typical peers. No significant gender differences were observed on any of the comparisons. Multiple regression analyses were applied to evaluate the relationship between the language subtests and reticence in the group with LI and the typical group. Results for both groups indicated that paragraph comprehension, syntax construction, and pragmatic judgment skills were not significant predictors of reticent withdrawal behavior, either in combination or independently. Results suggest that language alone cannot predict reticence in either children with LI or their typical peers.

No description available.