Background: Theoretical disadvantages are associated with the use of heat-crimped piston prostheses in stapedotomy. Loose crimping could result in prosthesis displacement or slippage. Alternatively, overly tight crimping may cause trauma to the incus with resultant necrosis. Objectives: 1) Analyze outcomes of patients undergoing stapedotomy with heat-activated piston-style prostheses, and 2) compare outcomes between prostheses made by different manufacturers. Study Design: Retrospective. Setting: Vanderbilt Medical Center. Patients and Methods: Cases undergoing stapedotomy between 2005 and 2016 were reviewed. Audiometric assessments were recorded in accordance with American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) guidelines. Patients who lacked audiometric follow-up before 6 months or after 1 year were excluded. Intervention(s): Diagnostic, therapeutic, and rehabilitative. Main Outcome Measure(s): Postoperative air-bone gap (ABG) and achievement of an ABG is less than or equal to 10dB. Results: Three hundred fifty-eight patients met inclusion criteria. At short-term follow-up (<6 mo), the mean ABG was 11 8 dB in the entire cohort; this did not differ based on manufacturer (p ¼ 0.13). The majority of patients (63%) achieved an ABG less than or equal to 10 dB. At longer-term follow-up, the mean ABG was 9 7 dB; again no differences were noted when comparing prosthesis manufacturer (p ¼ 0.20). 70% of patients achieved an ABG less than or equal to 10 dB at longer-term follow-up. When comparing short- to long-term follow-up, ABG did not significantly change over time (p ¼ 0.76). The overall revision rate was 1.9% (n ¼ 7). Conclusion: Favorable hearing outcomes are obtained both short- and long-term following stapedotomy and placement of heat-crimped piston prostheses. Both prosthesis groups appear stable in the middle ear environment long-term, as evidenced by a 1.9% revision rate among them.

By revealing deeper meanings and connecting the visitor to the resource, interpretation strives to accomplish a number of goals. Interpretation can increase knowledge of a program\'s topic, change the visitor's attitude toward something, change future behaviors, and increase appreciation for a place and its resources. While literature exists professing best practices for interpretation, little empirical support is present in the research literature to validate these practices' individual links to desired outcomes. This study empirically identifies attributes of the interpreter that statistically linked to visitor outcomes. We tracked 31 interpreter attributes and 10 intended outcomes of interpreters in 376 live interpretive programs in 24 units of the U.S. National Park Service (NPS) and conducted visitor surveys immediately following the programs. This research addresses the following question: Which interpreter attributes most consistently lead to desired outcomes? Our research shows that the interpreter attributes most consistently associated with positive visitor outcomes were the interpreter's apparent degree of confidence and expression authentic emotion. The results can be used to inform interpretive training throughout the National Park Service. / Master of Science

Background and aims: Hypertension is a public health problem and a major reason for hospitalisation and death. In Mozambique, low levels of detection, treatment and control have been described. However, data on target-organ damage and associated clinical conditions is lacking. We therefore aimed at characterising the clinical profile of patients with severe hypertension, describing the pattern of target organ damage and determining the outcomes at 6-month follow-up. Methods: We designed a prospective descriptive cohort study to assess adult patients with severe hypertension defined according to the Joint National Committee VII guidelines. The study was conducted from July 2015 to May 2017 at Mavalane General Hospital in Maputo-Mozambique. Patients were characterized through physical examination, laboratory profile, electrocardiography, and echocardiography, and followed for six months to assess occurrence of complications such as hypertensive heart failure, stroke, renal failure, hospital admission and death. Data were analysed using SPSS software version 20.0. The study was approved by the National Bioethics Committee for Health of Mozambique. Results: We studied 116 subjects (111 [95.7%] black; women 81 [70%]). Women were slightly younger than men (mean 57 years vs 59 years); 18 (15.5%) patients were younger than 44 years. The risk profile of the studied population included obesity (46; 42.5%); dyslipidaemia (59; 54.1%); diabetes (10; 8.6%) and smoking (8; 6.9%). At baseline, mean values for systolic and diastolic blood pressure were 192.3 ± 23.6 and 104.2 ± 15.2, respectively. The most frequent target-organ damage were left atrial enlargement in 91 (88.3%) with atrial fibrillation in 9 (7.9%); left ventricular hypertrophy in 57 (50.4%); hypertensive retinopathy in 30 (26. 3%) and renal damage in 29 (25.7%) subjects. Major events during 6-month follow-up were hospitalisations (12; 10.3%) and death (10; 8.6%). Renal damage (4; 4.2%), stroke (4; 3.4%) and heart failure (2; 1.7%) were the most common complications occurring over the follow up period. Conclusion: Severe and complicated hypertension affects young people with higher incidence of obesity, diabetes and smoking than that found in general population. High occurrence of target organ damage is found at baseline, particularly heart damage, renal lesion and stroke. On follow up, severe hypertension is associated with high number of hospitalisations and high case-fatality rate. Moreover, renal damage, stroke and hypertensive heart disease were common complications on follow up. Further research is needed to understand the determinants of these poor outcomes.

This dissertation describes the observations of the interaction of adult learners at remote distance education sites. The researcher audited 11 complete courses at four receive sites during two academic terms. The observations were done in the Com-Net, audio-graphic system provided by Utah State University. The courses were provided for university credit to adults around the state. The research was designed to answer three research questions: 1.What interactions do learners at a distance exhibit in their educational setting? 2.What observable events appear to prompt the beginning and ending of the learners' interactions? 3.What observable outcomes result from the learners' interactions? A field study was conducted, using qualitative methodologies. In addition to answering the three research questions, the researcher observed four types of interaction already described in the literature of the field of distance education and identified a fifth type of interaction based on the field observations. The researcher also expanded on Burnham's definition of parallel learning in distance education. Finally, in this document, the researcher offers a definition of adult learner interaction at remote sites. The definition is provided to spark further discussion and research

Intervention programs providing support for father parenting skills need a practical but psychometrically strong observational measure of fathers’ early positive parenting interactions with children. The primary purpose of this project was to develop a valid, reliable observational measure of father-child interaction, based on research and theory, that predicts child outcomes, identifies fathers’ strengths, and will be useful for home visiting practitioners. This study sought to fulfill this need by developing a new measure called Dads’ Parenting Interactions with Children—Checklist of Observations Linked to Outcomes (PICCOLO-D) for home visitors to use to identify fathering strengths. Developed with extant video observations of over 400 ethnically diverse, lowincome fathers, 73 positive observable behavioral items of early positive father-child interaction were tested for variability, reliability, and validity. The final measure of 21 items representing four domains of positive parenting, affection, responsiveness, encouragement, and teaching, demonstrated good reliability and validity, including associations with children’s language, cognitive, and social emotional outcomes into prekindergarten. Contextual influences were examined within father ethnicity and child gender groups and in a second observational setting. European and Latino American fathers had higher scores than African American fathers. Fathers had higher scores with daughters than sons. Fathers had higher scores in a semistructured play setting than in a father-choice setting. The new measure is intended for use as part of an individualized strengths-based approach for home visiting practitioners.

No description available.

No description available.

The current study examined preservice teachers’ expectations for student academic, behavior, and social, outcomes using the Prognostic Outlook Scale (Thelen, Burns, & Christiansen, 2003). A 2 x 2 x 2 MANOVA analysis was used to determine differences between label specificity (i.e., Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic label versus the Individuals with Disabilities Education Improvement Act [IDEA] Emotional Disturbance [ED]) label, behavioral presentation (i.e., internalizing versus externalizing) and symptom severity (i.e., mild versus severe). The goal was to identify labels that elicit higher expectations for students with ED in order to inform the labeling practices within the school setting. Results suggested statistically significant differences for the behavioral presentation (p < .001) condition. Statistically significant interactions for behavioral presentation and label specificity (p = .043) and behavioral presentation and severity (p = .045) were also found. Implications and limitations of findings will be discussed.

The Building Construction Science program at Mississippi State University is undergoing a major curriculum review and revision process in preparation for accreditation by the American Council for Construction Education (ACCE). This will be the program’s first attempt at accreditation in its 10-year history. None of the faculty in the program have ever been through an accreditation – making the process more challenging. What’s more, the accrediting body recently adopted an outcomes-based approach to curriculum review that hinges on programs demonstrating student achievement of 20 different student learning outcomes. These outcomes have been recognized by many as ambiguous and difficult to define – reducing motivation of programs and their faculty to move forward with accreditation. This has been the impetus for this study. The purpose of this research was to define what the 20 student learning outcomes mean for the BCS program and identify the program’s effectiveness toward including the outcomes required for accreditation into their curriculum and assessing student achievement. The study was conducted in three parts: Defining the 20 outcomes, mapping outcomes to the curriculum, and identifying assessments used to measure student achievement of the outcomes. A modified Delphi was used that incorporated the Nominal Group Technique for initial data gathering and 2 stages of surveys to identify the most essential learning criteria that define each learning outcome. The Delphi included a sample of BCS faculty, Alumni, and construction industry members. A syllabus review of the program’s core construction courses was used to map the outcomes through the curriculum and identify assessments connected to the intended outcomes. The results of the inclusion mapping were organized into three categories of Missing, Adequate, or Overlapping. The results of the study generated an initial list of 355 learning criteria across the 20 student learning outcomes that were reduced to a final list of 173 criteria identified as essential to demonstration of student achievement for the learning outcomes. The curriculum evaluation showed that nearly two-thirds of the learning outcomes are likely being redundantly included in the curriculum, and about five are missing. Assessments were shown to be included in all courses but many were difficult to connect to specific learning outcomes.

No description available.