Tympanometry and acoustic stapedial reflex (ASR) are routinely used in audiology clinics to assess the functional integrity of the eardrum and middle ear system in humans. Conventional tympanometry (which delivers a probe tone of 226 Hz into the ear canal and measures the mobility of the eardrum as the air pressure in the ear canal is varied) and acoustic reflex testing are effective in detecting middle ear pathologies in children and adults. However, the clinical application of these two tests to infants younger than 7 months has major limitations. In recent years, high frequency tympanometry (HFT) with a probe tone of 1000 Hz has been trialled successfully in young infants (< 7 months) and research on ASRs as they apply to this age group is continuing. Although preliminary HFT data for this population are emerging, there has been no detailed study that describes the effect of age on HFT and ASR results, no clear guideline on ways to interpret the HFT results, and no investigation to measure the feasibility and reliability of the ASR findings. For these reasons, systematic investigation into the use of HFT and ASR measures for evaluating the middle ear function of young infants is warranted. This thesis aimed to: (i) investigate the feasibility of obtaining HFT and ASR findings from newborn and 6-week-old infants, and study the characteristics of the immittance findings in these two age groups; (ii) investigate methods within HFT to measure the middle ear admittance of newborn babies; (iii) establish normative HFT data from healthy newborn babies using the new component compensation method; (iv) examine the test-retest reliability of the ASR test in healthy neonates; and (v) investigate the test-retest reliability of the ASR test in 6-week-old infants. The aims of the thesis were met through five studies. In study one (Chapter 2), a pilot study was conducted to examine the feasibility of performing HFT and ASR in 42 healthy infants and study the characteristics of the immittance findings obtained from these infants using a longitudinal study design. In this pilot study, all infants were tested at birth and then re-tested approximately 6 weeks after the first test. This study confirmed the feasibility of obtaining valid immittance findings from healthy young infants. Most importantly, the findings of this pilot study revealed that the mean values of the majority of HFT parameters and acoustic stapedial reflex threshold (ASRT) obtained at 6 weeks were significantly greater than those obtained at birth, indicating the need to have separate sets of normative data for both tests for newborn and 6-week-old infants. In study 2 (Chapter 3), three different methods to measure middle ear admittance (often described as peak compensated static admittance) in 36 healthy neonates were compared. The three methods were the traditional baseline compensation method (compensated for the susceptance component at 200 daPa pressure) and two new component compensated methods (compensated for both the susceptance and conductance components at 200 daPa and -400 daPa). The results showed that the mean middle ear admittances obtained by compensating for the two components of admittance at a pressure of 200 daPa (YCC200) and -400 daPa (YCC-400) were significantly greater than that using the traditional baseline compensation method (YBC). The higher mean admittance results obtained using the new component compensated methods suggests that the two new methods have the potential to better separate normal from abnormal admittance results. The test-retest reliability of YBC, YCC200 and YCC-400 was investigated, with the result that a lower test-retest reliability was obtained for YCC-400 than for the other two measures. It was, therefore, concluded that the component compensation method compensated at 200 daPa may serve as an alternative method for estimating middle ear admittance, especially in the context of assessing neonates using HFT. In study 3 (Chapter 4), normative data were gathered using the new component compensation method (compensated at 200 daPa) on a group of 157 healthy newborn babies. In addition to the component compensated static admittance (YCC), normative data showing the 90 % ranges for tympanometric peak pressure, admittance at 200 daPa, uncompensated peak admittance, and traditional baseline compensated static admittance (YBC) were established in this study. No gender effect was found on any of the tympanometric measures. In study 4 (Chapter 5), the use of ASR to evaluate middle ear function in neonates was studied. The feasibility of obtaining ipsilateral ASR from neonates by stimulating their ears with a 2 kHz tone and broadband noise (BBN) was demonstrated. ASRs were elicited from 91.3% of 219 full-term normal neonates, while the remaining 8.7% of neonates who had flat tympanograms and no transient evoked otoacoustic emissions did not exhibit ASRs. Good test-retest reliability was demonstrated in the ASRT obtained using both the 2 kHz and BBN stimulus; there was no significant difference between test and retest conditions and intra-correlation coefficients of 0.83 for the 2 kHz tone and 0.76 for the BBN stimulus. In the last study (Chapter 6), the test-retest reliability of ASRT obtained from 70 6-week-old infants was investigated. The methodology described in Chapter 5 was followed. No significant difference in ASRT between test and retest conditions was found for the 2 kHz tone (mean ASRT = 67.3 dB HL versus 67.1 dB HL) and BBN stimulus (mean ASRT = 80.9 dB HL versus 81.6 dB HL). Good test-retest reliability of ASRT with intra-correlation coefficients of 0.78 was found for both the 2 kHz tone and the BBN stimulus. In essence, through achieving the aforementioned aims, the current research program was able to enhance the minimal literature available concerning the use of HFT and ASR testing in young infants. Ultimately, the findings presented in this thesis will inform clinicians of the recent developments in HFT and ASR testing, and assist them in evaluating the middle ear function of young infants with accuracy and confidence.

Background: Impaired proprioception has been reported in patients with neck pain. The most common way to assess proprioception is the testing of joint position sense. Researchers usually uses advanced technical equipment. Laser pointer tests have been described for testing global joint position sense against two-dimensional targets, which can also be used clinically. One-dimensional targets can provide accurate information about deviations in the current motion plane and allow easy calculation of a number of additional output variables. Objectives: Evaluate test-retest reliability of a new clinical test using laser pointer and a one-dimensional target for assessment of cervical joint position sense. Design: Cross-sectional test-retest reliability study. Method:The study included 56 individuals, 30 healthy controls and 26 with neck pain were tested at two occasions 6-8 days apart. Calculation of the reliability was done by analysing relative, ICC, and absolute, SEM, reliability. Results: The results were relatively scattered but showed an overall moderatereliability with an ICC between 0,51-0,73, but in some cases a poor reliability under 0,5 except for two measures that showed good reliability over 0,77.The SEM for total group were between 0,72°-2,87°, indicating a relatively high level.  Conclusions: Current research demonstrates an overall moderate reliability testing JPS with a laser pointer and a one-dimensional target.

Submitted by Maike Costa (maiksebas@gmail.com) on 2017-03-16T12:50:00Z No. of bitstreams: 1 arquivototal.pdf: 1944500 bytes, checksum: 05e8286b4b498ec1583d5bd8886221ef (MD5) / Made available in DSpace on 2017-03-16T12:50:00Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1944500 bytes, checksum: 05e8286b4b498ec1583d5bd8886221ef (MD5) Previous issue date: 2015-10-29 / The use of questionnaires in epidemiological studies has allowed a broader knowledge of the adverse oral conditions that affect the quality of life. This way, may be important ally to development of public health politics and strategies of prevention and treatment. Thus, the objective of this paper was to evaluate the reproducibility of oral health-related quality of life, SOHO-5 (Scale Oral Health Outcomes for Five-Year-Old Children – children version) for 5-years-old children and OHIP- 14 (Oral Health Impact Profile) for 12 years school applied to public school students of a small city of Paraiba outback. To this end, an only examiner (intra-examiner kappa = 0.82) had a census of all children available, totaling 59 students with 05 years and 39 to 12 years who underwent a clinical examination based on World Health Organization criteria to dental cavity (DMFT) and application of a quality of life questionnaire related to oral health. After the thirty-day period, this process was repeated reproduction of the same application conditions. As the results, it was found that the variables of the SOHO-5: “difficulty playing” (kappa=-0,042); “difficulty eating” (kappa=0,112); “difficulty drinking” (kappa=0,028) and “difficulty sleeping” (kappa=0,184) showed more vulnerable in the two moments assessment questionnaire. The OHIP-14 showed regular agreement for the item: "he was worried because of problems with their teeth/her mouth" (kappa=0,256), and moderate agreement for "problem to speak a word" (kappa = 0.505), "pain in your mouth and teeth" (kappa = 0.408), "for your meals" (kappa = 0.437) and "felt ashamed" (kappa = 0.402). There was no correlation between the response pattern of children under 5 years in both the questionnaire application moments for all items and agreement to regulate moderate between the responses of children under 12. However, although of changing the standard of responses, the OHIP-14 showed better reproducibility than the SOHO-5. / O uso de questionários em estudos epidemiológicos tem permitido um conhecimento mais amplo sobre as condições bucais adversas que afetam a qualidade de vida. Dessa forma, podem ser importantes aliados para o desenvolvimento de políticas de saúde pública e estratégias de prevenção e tratamento. Assim, o objetivo deste trabalho foi avaliar a reprodutibilidade de questionários de qualidade de vida relacionada à saúde bucal, o SOHO-5 (Scale Oral Health Outcomes for Five-Year-Old Children– versão da criança) para as crianças de 05 anos e OHIP-14 (Oral Health Impact Profile) para os escolares de 12 anos aplicados a escolares da rede pública de um município de pequeno porte do sertão paraibano. Para tanto, um único examinador (kappa intraexaminador=0,82) contou com o censo de todas as crianças disponíveis, totalizando 59 escolares com 05 anos e 39 com 12 anos que foram submetidos a um exame clínico com base nos critérios da Organização Mundial de Saúde para cárie dentária (CPO-D e ceo-d) e aplicação de um questionário de qualidade de vida relacionada à saúde bucal. Após o período de trinta dias, esse processo foi repetido com reprodução das mesmas condições de aplicação. Como resultados, verificou-se que as variáveis do SOHO-5: “dificuldade de brincar” (Kappa=-0,042); “dificuldade de comer” (Kappa=0,112), “dificuldade de beber” (Kappa=0,028) e “dificuldade para dormir” (Kappa=0,184) mostraram-se mais vulneráveis nos dois momentos avaliação do questionário. O OHIP-14 mostrou concordância regular para o item: “ficou preocupado por causa de problemas nos seus dentes/sua boca” (Kappa=0,256) e concordância moderada para “problema para falar alguma palavra” (kappa= 0,505), “dores em sua boca ou dentes” (kappa = 0,408), “parar suas refeições” (Kappa= 0,437) e “sentiu-se envergonhado” (kappa= 0,402). Dessa forma, não houve concordância entre o padrão de resposta das crianças de 5 anos nos dois momentos de aplicação do questionário para todos os itens e concordância de regular a moderada entre as respostas das crianças de 12 anos. Contudo, apesar de alterar o padrão de respostas, o OHIP-14 apresentou melhor reprodutibilidade que o SOHO-5.

No description available.

The purpose of this study was to evaluate an updated list of digitally recorded Speech Recognition Threshold (SRT) materials for test-retest reliability. Chipman (2003) identified 33 psychometrically equated spondaic words that are frequently occurring in English today. These digitally recorded words were used to determine the SRT of 40 participants using the American Speech-Language Hearing Association guidelines. The participants were between the ages of 19 and 83 years and presented with hearing impairment ranging from normal to severe. The individual's pure-tone averages classified 16 participants with normal hearing to slight loss, 12 participants with mild loss, and 12 participants with moderate to severe hearing loss. The speech materials were presented to participants in one randomly selected ear. The SRT was measured for the same ear in both the test and retest conditions. The average SRT for the test condition was 22.7 dB HL and 22.8 dB HL in the retest condition with an improvement of 0.1 dB for retest but no significant difference was identified. Using a modified variance equation to determine test-retest reliability resulted in a 0.98, indicating almost perfect reliability. Therefore the test-retest reliability was determined to be exceptional for the new SRT words.

The approach-avoidance task (AAT) is an implicit task that measures people’s behavioral tendencies to approach or avoid stimuli in the environment. In recent years, it has been used successfully to help explain a variety of health problems (e.g., addictions and phobias). Unfortunately, more recent AAT studies have failed to replicate earlier promising findings. One explanation for these replication failures could be that the AAT does not reliably measure approach-avoidance tendencies. Here, we first review existing literature on the reliability of various versions of the AAT. Next, we examine the AAT’s reliability in a large and diverse sample (N = 1077; 248 of whom completed all sessions). Using a smartphone-based, mobile AAT, we measured participants’ approach-avoidance tendencies eight times over a period of seven months (one measurement per month) in two distinct stimulus sets (happy/sad expressions and disgusting/neutral stimuli). The mobile AAT’s split-half reliability was adequate for face stimuli (r = .85), but low for disgust stimuli (r = .72). Its test–retest reliability based on a single measurement was poor for either stimulus set (all ICC1s < .3). Its test–retest reliability based on the average of all eight measurements was moderately good for face stimuli (ICCk = .73), but low for disgust stimuli (ICCk = .5). Results suggest that single-measurement AATs could be influenced by unexplained temporal fluctuations of approach-avoidance tendencies. These fluctuations could be examined in future studies. Until then, this work suggests that future research using the AAT should rely on multiple rather than single measurements.

O protocolo de teste/reteste no labirinto em cruz elevado (LCE) mostra que a experiência prévia no labirinto produz alterações duradouras nas respostas comportamentais de roedores. Nesse contexto, ratos submetidos ao LCE pela primeira vez apresentam um aumento característico na exploração dos braços abertos e uma redução dos comportamentos de avaliação de risco após a administração de drogas ansiolíticas. Na reexposição ao labirinto, porém, essas drogas tornam-se ineficazes em alterar as medidas tradicionais do LCE. Esse fenômeno foi inicialmente observado com o benzodiazepínico clordiazepóxido e referido como one-trial tolerance (tolerância de um ensaio OTT). A proposta do presente estudo é compreender a OTT por meio do exame dos fatores hormonais, cognitivos e neuroanatômicos envolvidos nesse fenômeno. A administração sistêmica do benzodiazepínico midazolam ou de metirapona, um bloqueador da síntese de glicocorticóides, reduziu a frequência dos comportamentos de avaliação de risco e dos níveis plasmáticos de corticosterona quando injetados antes das sessões teste ou reteste. Além disso, a reexposição de ratos ao LCE foi caracterizada por uma avaliação de risco mais proeminente, de acordo com a análise fatorial, e pela ativação de estruturas límbicas envolvidas com aspectos cognitivos do medo, como a região ventral do córtex pré-frontal medial (CPFm) e a amígdala, mostrada por meio da distribuição da proteína Fos. Midazolam administrado antes da primeira exposição ao LCE produziu uma redução significativa do número de neurônios Fos-positivos no córtex cingulado anterior, área 1 (Cg1) e nos núcleos anterior e pré-mamilar dorsal do hipotálamo. Por outro lado, midazolam causou uma redução no número de neurônios Fos-positivos no CPFm, amígdala, núcleo dorsomedial do hipotálamo e núcleos da rafe em ratos reexpostos ao LCE. Cg1 foi a única estrutura-alvo do benzodiazepínico em ambas as sessões. Resultados comportamentais similares aos produzidos pelo tratamento sistêmico foram obtidos com infusões de midazolam intra-Cg1. Esses resultados apontam para um papel crucial dos comportamentos de avaliação de risco no desenvolvimento da OTT e indicam o Cg1 como um importante sítio de ação ansiolítica dos benzodiazepínicos em roedores. / The elevated plus maze (EPM) test/retest protocol has shown that prior experience to the maze produces enduring changes in behavioral responses of rodents. In this context, rats submitted for the first time to the EPM display a characteristic increase in open arm exploration and reduced risk assessment behaviors after the administration of anxiolytic drugs. Upon re-exposure to the maze, however, these drugs become unable to change the traditional measures of the EPM. This phenomenon was initially observed with the benzodiazepine chlordiazepoxide and referred to as one-trial tolerance (OTT). The purpose of the present study is to understand the OTT through the exam of the hormonal, cognitive and neuroanatomical factors involved in this phenomenon. The systemic administration of the benzodiazepine midazolam or metyrapone, a glucocorticoids synthesis blocker, reduced the frequency of risk assessment behaviors and the corticosterone levels when injected before the test or retest sessions. Moreover, the re-exposure of rats to the EPM was characterized by more prominent risk assessment behaviors, according to the factor analysis, and by activation of limbic structures involved with cognitive aspects of fear, such as the ventral regions of the medial prefrontal cortex (mPFC) and amygdala, as shown through the distribution of the Fos protein. Midazolam injected before the first exposure to the EPM produced a significant decrease in the number of Fos-positive neurons in the anterior cingulate cortex, area 1 (Cg1), anterior and dorsal premammillary nuclei of hypothalamus. On the other hand, midazolam caused a decrease in the number of Fos-positive neurons in the mPFC, amygdala, dorsomedial nucleus of hypothalamus and raphe nuclei in rats re-exposed to the EPM. Cg1 was the only structure targeted by the benzodiazepine in both sessions. Behavioral results similar to those produced by systemic treatment were obtained with intra-Cg1 infusions of midazolam. These results point to a crucial role of the risk assessment behaviors in the development of the OTT and indicate the Cg1 as an important locus for the anxiolytic-like action of benzodiazepines in rodents.

No description available.

No description available.

No description available.