Medicine and Health Sciences Commons^™

Effects Of Delayed Auditory Feedback On The Bereitschaftspotential, Jennifer L. Johnson

Theses and Dissertations

This study examined the brain electrical activity of normal speakers in a non-delayed auditory feedback (DAF) condition and when experiencing DAF to determine the effect DAF would have on the Bereitschaftspotential (BP). The BP reflects the preparatory state of a person prior to motor execution of an act and can be observed 1500 to 500 ms prior to voluntary movement. The participants in the study included 10 adults with normal speech. Each read a series of 30 sentences, both without DAF and with DAF, while the BP was measured. Results indicate that the BP is present across the scalp in …

Psychometrically Equivalent Cantonese Bisyllabic Word Recognition Materials Spoken By Male And Female Talkers, Brooke Kristin Conklin

Theses and Dissertations

The purpose of this study was to create psychometrically equivalent word lists in the language of Cantonese for word recognition testing. Frequently used bisyllabic Cantonese words were recorded by a native female and male talker. The word lists were evaluated by administering the word recognition lists to 20 native speakers of Cantonese with normal hearing. Each list was presented at 10 different intensity levels ranging from -5 to 40 dB HL in 5 dB increments. Logistic regression was used to determine the words with the steepest logistic regression slopes. The 200 words with the steepest slopes were then formulated into …

Split-Half Reliability Of Mlu And Mlu2 In Two Methods Of Utterance Segmentation, Alyse Diana Kemeny

Theses and Dissertations

Concerns regarding Mean Length of Utterance (MLU) has led to adaptations of this method of analysis. A recent study by Johnston (2001) introduced an alternative to MLU called MLU2. The current study investigates the split-half reliability of MLU and MLU2 as well as another alternative, Median Length of Utterance (Med-LU). Split-half reliability was found for these methods when segmented into Phonological and Communication Units. Split-half reliability of MLU2 was generally higher than that of MLU, and both were higher than Med-LU. The study suggests that MLU2 may also be a valuable tool for clinicians in analyzing child language.

Inter- And Intra-Subject Variability: A Palatometric Study, Marybeth Corey Sanders

Theses and Dissertations

Electropalatometry (EPM) has proven to be a useful clinical and research tool for measuring tongue-to-palate contact. The goal of this study was to determine whether the development of a database of standardized palatometric articulation files is feasible by examining the variability which exists within and between speakers. Twenty standard American English dialect speakers were fitted with palatometer pseudopalates. Test stimuli were VCV nonsense words using a schwa in the initial position, the 15 palatal consonants, and three corner vowels, /a/, /i/, /u/. From these palatometric recordings a variability index was created to examine intra- and interspeaker variability. Different aspects of …

The Relationship Between Pragmatic Language And Behavior Subtypes In Typically Developing Children, Lisa Jeppson Christensen

Theses and Dissertations

This study examines the relationship between syntactic and pragmatic language and reticence, solitary-active passive withdrawal, solitary-passive withdrawal, prosocial skills, and likeability. The Children's Communication Checklist (CCC-2), a language checklist, and Teacher Behavior Rating Scale (TBRS), a behavior checklist, were completed by three 2nd-grade teachers and three 4th-grade teachers about each of their students. Factor analysis was used to determine two composite language measures from the CCC-2 scales. The results of two hierarchal regression analyses indicated that social behaviors were significant predictors of pragmatic language, but not structural language. In particular, solitary-passive withdrawal and reticence were significant predictors of pragmatic language …

Social Outcomes Of Students With Language Impairment: An Eight-Year Follow-Up Study, Meghan A. Baldridge

Theses and Dissertations

This study re-examined the language and social skills of four females with language impairment who were initially studied eight years ago (Brinton, Fujiki, Montague, & Hanton, 2000; Fujiki, Brinton, Isaacson, & Summers, 2001). Language measures included the Clinical Evaluation of Language Fundamentals-Fourth Edition (Semel, Wiig, & Secord, 2003) and a thirty minute language sample. Social measures included the UCLA Loneliness Scale-Version 3 (Russell, 1996), parent, teacher and student forms of the Social Skills Rating System (Gresham & Elliott, 1990), and an interview with each participant's teacher or speech-language pathologist. Results of the current assessment were compared to results from the …

Phlebitis Rates In Trauma Patients: Peripheral Intravenous Catheters Started In Or Outside The Emergency Department, Ligia J. Zarate

Theses and Dissertations

Ligia J. Zarate College of Nursing Master of Science Peripheral catheter-related phlebitis is the inflammation of a superficial vein that can lead to infection or thrombus formation if untreated. About 150 million peripheral intravenous catheters (PIVC) are inserted in the United States each year with phlebitis rates reported between 5% and 70%. Many PIVCs are started on trauma patients, but the rate of phlebitis in trauma patients whether the PIVC is started outside the emergency department (ED) or inside the ED is unknown. Therefore, the purpose of this pilot study was to determine phlebitis rates in trauma patients when PIVC's …

Vocal Efficiency In Trained Singers Vs. Non-Singers, Kristi Sue Fulton

Theses and Dissertations

Vocal efficiency is a measure of the efficiency of the energy conversion process from aerodynamic power to acoustic power. Few studies have been conducted to measure vocal efficiency in trained singers to determine whether "vocal athletes" are more efficient than non-singers. Data were collected from 20 trained singers (10 male and 10 female) and 20 non-singers (10 male and 10 female) to determine if there were any significant differences between the two groups. During the recording, each participant produced a series of syllables at combinations of three different levels of pitch and loudness. The acoustic and aerodynamic data were analyzed …

The Effect Of Language Ability Of Internalizing Students On Improvement In Strong Kids: A Social And Emotional Learning Curriculum For Students In Grades 4-8, Shelby Carrera Hansen

Theses and Dissertations

This study assessed the influence of language on the ability of children identified as being at risk for internalizing behavior disorders to successfully participate in a social skills intervention program. Fourth and fifth grade students participated in Strong Kids: A Social and Emotional Learning Curriculum in Grades 4-8, a program which promotes emotional resiliency. The Clinical Evaluation of Language Fundamentals-Fourth Edition (CELF-4) and Children's Communication Checklist-Second Edition (CCC-2) were both completed to obtain a global language score and pragmatic language score. The Teacher's Report Form (TRF), a shortened 10-item version of the Internalizing Student Symptom Scale (ISSC), and a 20-item …

The Impact Of Vocal Function Exercises On Normal Voice Production, Karen Hart Thomas

Theses and Dissertations

This study attempted to replicate and expand previously published research in order to increase our understanding of how Vocal Function Exercises (VFE) might improve vocal function in normal voices. Measures were made to reflect potential post-treatment changes in acoustic and aerodynamic variables, including a measure of vocal efficiency. The participants of the study included 35 adults with normal voices. Each completed a series of speech tasks (sustained vowels, maximum phonation time, reading of a standardized passage, and repetition of syllable strings) before and after a four-week treatment period. Testing of pre- and post-treatment data revealed no clear improvement in acoustic …

Narrative Skills In Children With Spina Bifida And Hydrocephalus, Melissa Ann Halliday

Theses and Dissertations

This study examined how 22 children with spina bifida and hydrocephalus (SBH) and 22 matched control children with the same vocabulary age (VA) performed on story retelling and story generation tasks. The children were asked to retell two stories of different lengths (Stein and Glenn's Melvin, the Skinny Mouse and The Tiger's Whisker) and generate two stories from different stimuli (wordless picture book and verbal story starter). Analyses were conducted in terms of global narrative organization (story structure), local connection of ideas (cohesion), and productivity (number of words and utterances). Two-way ANOVAs were conducted to analyze how the stories and …

Patterns Of Anticipatory Coarticulation In Adults And Typically Developing Children, Kurtt R. Boucher

Theses and Dissertations

Coarticulation is the kinematic and spectral overlap between adjacent sounds during speech production. Coarticulation patterns in typical adults have been well established; however, the manner in which coarticulation is developed in children is still unclear. Research has provided conflicting views, showing that children exhibit more, less, or an equal degree of coarticulation when compared to adult speakers. Considering the divergent findings present in the literature regarding coarticulation in children, the purpose of the present study is to further investigate anticipatory coarticulation in typically developing young children between the ages of three and six years. This study focuses on the acoustic …

Psychometrically Equivalent Trisyllabic Words For Speech Reception Threshold Testing In Cantonese, Misty Noelani Kim

Theses and Dissertations

The purpose of this study was to develop, digitally record, evaluate, and equate Cantonese trisyllabic words which could then be used in the measurement of the speech reception threshold. A selection of 90 frequently utilized trisyllabic words were selected and then digitally recorded by male and female talkers of Standard Cantonese and presented to 20 subjects with normal hearing beginning at 6 dB below their pure-tone average (PTA) and ascending in 2 dB increments until one of the following criteria had been met: (a) the participant responded correctly to 100% of the test items, or (b) the presentation level reached …

Neurophysiologic And Behavioral Measures Of Phonetic Perception In Adult Second Language Speakers Of Spanish, Jaden D. Hellewell

Theses and Dissertations

Infants 6-8 months old are able to identify nearly every speech sound contrast on which they have been tested, regardless of whether that contrast represents an across-category (two different phonemes) phonetic change in their native language or not. A child's ability to identify non-native consonant contrasts greatly diminishes by 11-12 months of age. The present study examined speech sound discrimination in three groups of listeners. Adult second language (L2) listeners of Spanish were compared with native English listeners with no knowledge of Spanish and native Mexican listeners to determine if they would show the ability to discriminate phonetic distinctions that …

Identification And Characterization Of Helper Phage Gene Products Involved In Mobilization Of Staphylococcal Pathogenicity Island Sapi1, Sandra Mckenzie Tallent

Theses and Dissertations

Staphylococcal pathogenicity island SaPI1 is excised from genomic DNA and extrachromosomal copies are amplified during the vegetative growth of staphylococcal phage 80α. The amplified genetic element is subsequently encapsidated and transduced at very high frequency. Previous studies have demonstrated that the transducing particles have virions with tails that appear identical to those of helper phage 80α but have smaller capsids, commensurate with the smaller genome of the SaPI (Lindsay et.al., 1998). The morphology of the transducing particles, coupled with the observation that the genomic sequence of SaPIl (GenBank U93688) does not reveal any obvious phage structural proteins, has led to …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

The Substituted Pyrrole Jb-03-14 Induces Autophagic Cell Death And Growth Arrest In Breast Tumor Cells, Christopher Ryan Arthur

Theses and Dissertations

The use of chemotherapy in the treatment of cancer has stimulated the demand for better chemotherapeutic agents that are more potent at destroying tumor cell populations and more selective for the specific tumor versus normal host tissues. This project is directed at discovering new anti-tumor agents that are effective against breast cancer based on structures derived from marine organisms, specifically brominated pyrroles. We utilized an in vitro breast cancer model to study the effects of pyrroles on tumor proliferation and survival, as well as growth arrest and cell death. Our findings indicate that the substituted pyrrole JG-03-14 induces time dependent …

The Effect Of Pediatric Hospital Specialization On Patient Safety And Effectiveness Of Care, James Mitchell Harris Ii

Theses and Dissertations

Provider specialization is an area of interest in health care as patients, payers and policy makers are now demanding better performance and demonstrated proof of the benefits of specialization. While previously ignored in the specialization debate, now even the hospitals focusing on pediatric care (i.e. children's hospitals) are experiencing pressure to demonstrate their value. The current study attempts to answer the questions: do hospitals specializing in pediatric care provide better quality pediatric inpatient care; and do they do so for differing types of patient outcomes and across different levels of care complexity? Contingency Theory is used to develop and assess …

Analgesic Use In U.S. Emergency Departments For Patients Reporting Moderate To Severe Pain: Diagnosis And Select Patient Characteristics Influencing Narcotic Analgesic Prescribing Practices, Hassan Zakaria

Theses and Dissertations

Objective: This study aims to examine the relationship between emergency department patient encounter characteristics and narcotic analgesic prescribing practices in order to determine what patient characteristics, if any, influence the decision to prescribe narcotics.Methods: Cross sectional data on patients presenting to U.S. emergency departments from the 2003 and 2004 National Hospital Ambulatory Medical Care Survey were analyzed. Patients reporting moderate to severe pain were included in the sample and analysis. Chi square tests of significance were used to assess the association between individual demographic and encounter characteristics to narcotic prescription or administration. Separate multiple logistic regressions were then performed on …

The Effect Of A Nominal Fee On Treatment Choices For Children Needing Dental Rehabilitation, D'Audra M. Cole

Theses and Dissertations

Objective: The purpose of the study was to determine if a co-payment resulted in a differential preference for general anesthesia (GA) or oral sedation (OS) and, if so, to examine whether age, the number of appointments, perceived risks of treatment, child's awareness during treatment, or insurance type appeared to play a role in this preference.Methods: Using a cross-sectional survey design, questionnaires were distributed to caregivers of patients in the waiting room of the Virginia Commonwealth University Pediatric Dental Clinic. Two different questionnaires were distributed randomly. Both surveys described a scenario with the need for dental treatment under general anesthesia (GA) …

Oral Health Services In A Medical Setting, Robert William Mansman Ii

Theses and Dissertations

Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's …

Overbite Correction And Smile Esthetics, Kevin Erick Kelleher

Theses and Dissertations

The purpose of this prospective clinical study was to investigate differences in outcomes from two common treatment modalities used to reduce deep overbite: maxillary incisor intrusion using an intrusion arch and posterior tooth eruption using an anterior bite plate. Pre-treatment, post-overbite correction and post-treatment records were gathered from 32 patients who presented with deep overbite malocclusions to the Virginia Commonwealth University orthodontic clinic. Both groups of patients experienced reductions in overbite and maxillary incisor display as well as maxillary and mandibular incisor proclination and mandibular incisor occlusal movement during treatment. In the intrusion arch group, the center of resistance of …

Obesity As A Risk Factor For Preeclampsia: Role Of Inflammation And The Innate Immune System, Tanvi Jayendra Shah

Theses and Dissertations

Obesity is a known risk factor for preeclampsia, but the reason for this risk is unknown. We sought to demonstrate how obese individuals are predisposed to preeclampsia by mechanisms involving inflammation and the innate immune system. First, we used immunohistochemical studies to identify neutrophil infiltration, NF-κB activation and COX-2 expression in vascular tissue of obese women. We then demonstrated similar neutrophil infiltration and vascular inflammation in preeclamptic women.We used in vitro experiments to test if neutrophils and their products, reactive oxygen species (ROS) and tumor necrosis factor-alpha (TNFα) can activate NF-κB and cause expression of its inflammatory products, COX-2, thromboxane …

Prediction Of In-Vivo Antimuscarinic Activity (Ama) By In-Vitro Receptor Binding Assessment And Pk/Pd Modeling For Prototypical Drugs, Taghrid Y. Obied

Theses and Dissertations

Purpose: To establish a tool, termed as antimuscarinic activity (AMA), to predict the incidence of antimuscarinic adverse events (AMAEs).Methods: A literature review, focused on drugs having off-target interaction with muscarinic receptors, was performed. Prototypical drugs olanzapine, diphenhydramine, paroxetine were selected for the analysis. Scopolamine and darifenacin were included as positive and negative controls, respectively. Physiochemical properties, pharmacokinetic data, and clinical incidence of AMAEs for the selected drugs were collected from reported literature. Extrapolation of literature data was carried-out to obtain exposure data. To determine the drugs muscarinic affinity (Ki values), experiments were performed using 3H-QNB and membrane suspensions of M1, …

Disparities In The Use Of Emergency Contraceptives, Rebecca Dallman

Theses and Dissertations

Purpose: Unintended pregnancies are often a burden to pregnant women and to the health care system. The rates of unintended pregnancies have decreased since the wide use of contraceptives has increased; however, young women, women with low income, and racial/ethnic minorities are more likely to use contraceptives inconsistently, which increases the risk of an unintended pregnancy. This risk could be reduced with the proper use of emergency contraceptives (ECs).Methods and Analysis: A cross-sectional study was conducted using the data from the female respondents of the 2002 Cycle 6 NSFG. Logistic regression was used to determine rates of use of ECs …

Novel Sulfated 4-Hydroxycinnamic Acid Oligomers As Potent Anticoagulants, Brian Lawrence Henry

Theses and Dissertations

The occurrence of thrombosis in several pathophysiological conditions creates a huge need for anticoagulation therapy. Thrombin and factor Xa have been prime targets for regulation of clotting through the direct and indirect mechanism of inhibition. This work investigates chemo-enzymatically prepared oligomers of 4-hydroxycinnamic acids (DHPs) as potential anticoagulants. Oligomers were prepared through peroxidase-catalyzed oxidative coupling of 4-hydroxycinnamic acids. The products resulting from this reaction are called CDs, FDs and SDs. Structurally, these sulfated DHPs are unique and do not resemble any of the anticoagulants known in the literature.DHP oligomers were found to increase clotting times at concentrations comparable to heparin. …

The Utility Of Depression Screening Measures After Traumatic Brain Injury, Amy H. Riddick

Theses and Dissertations

Objectives: Identifying reliable, practical and easy to use tools to assess depression in patients with traumatic brain injury (TBI), is a necessary first step to addressing a high incidence problem. The intention of this study is to validate depression screening measures with a criterion-based structured interview among people with TBI. The final outcome will identify which measure is the best indicator of depression diagnosis in this population. Methods: 112 participants with TBI were administered the Beck Depression Inventory (BDI), Neurobehavioral Functioning Inventory (NFI), The Hamilton Rating Scale for Depression (Ham-D), and the Structured Clinical Interview for DSM-IV TR Axis I …

Children With Special Needs Oral Health Quality Of Life Survey, Kristin Elizabeth Nelson

Theses and Dissertations

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life …

Anesthesia Clinical Performance Outcomes: Does Teaching Methodology Make A Difference?, Nina E. Mclain

Theses and Dissertations

Researchers have studied memory recall of crisis-oriented or emotional events in non-educational settings. However, within the health care field, there has been a limited study of the the concept of recall of crisis oriented or emotional events in& health care education. Crisis-oriented events such as natural disasters, acts of bioterroism, and industrial accidents, have been reported to impact memory. Patient safety is a primary focus in anesthesia education, appropriate crisis management is imperative to quality anesthesia care. Due to the critical nature of anesthesia delivery, there is a strong, constant need to develop methods that will enhance, support, and improve …

Transition From Health Maintenance Organizations To Consumer Driven Health Plans: Measurement Of Initial Impacts For Members With Chronic Conditions, Carl F. Goff

Theses and Dissertations

New consumer driven health insurance products are designed to contain health care costs by making consumers more accountable for the care they receive through being responsible for more cost sharing, making decisions regarding health care providers they will use, and increasing exposure to and use of health information for services and providers. Potential benefits of consumer driven products include increased information regarding personal health and a more knowledgeable patient base. Potential drawbacks of consumer driven products include negative impacts on consumers with chronic and complex health conditions.

The purpose of this study was to ascertain differences in health services utilization …