Effects of class III malocclusion on young adults' vocal tract development

"A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, June 30, 2009."Thesis (B.Sc)--University of Hong Kong, 2009.Includes bibliographical references (p. 27-30).published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Effect of games towards children’s mathematics performance

This study aims to investigate if there a significant different in pre and post of Early Mathematics performance. A single group pre-test and post-test with intervening Early Mathematics based games was used in this research. This involved assessment on the early Mathematics abilities (Ginsburg & Baroody, 2003). This program was conducted among preschoolers (aged 5-6 years old) in one selected rural preschool in Menggatal district, Sabah. The school has 4 classes of 25 students each, with a total of 100 preschoolers. One sample t-test was conducted to compare mathematics ability of children before and after intervention. Mean score for pre-test is 15, while mean score for post-test is 22.32. There was a significant difference in the scores for mathematics ability in pre-test (M=15.78, SD=.99) and post-test (M=22.32, SD=.78), t (86) (=-28.52, p = 0.000). The results show,that the use of games developed by authors are effective in improving preschoolers early Mathematics performance

Early Mathematics learning in reading and writing numerals: Learning through "What are the numbers?" A picture book made up flora and fauna in Borneo.

Learning through picture books is a method which is widely used in preschools to teach mathematics. However, the research findings on the benefits of using picture books in learning mathematics remain inconclusive. This study aimed to i) investigate the effects of a picture book entitled “What are the numbers?” (a picture book made up flora and fauna in Borneo) on early mathematics achievement (reading and writing numerals up to 20) and ii) to get feedback on how appropriate the use of “what are the numbers” from teachers and parents. The book consists elements of critical thinking, communication, collaboration and creative thinking. The effects were measured by comparing the change in early mathematical ability of children in reading and writing numerals up to 20 by using the Rasch measurement model. The mean of the pre-test achievement was -1.99 logits and the mean of the post-test achievement was 1.75 logits which shows a difference of 3.74 logits. The effect size of the difference between the post-test and pre-test achievement was 1.4, which is considered large. Teachers and parents gave positive feedback on the use of the picture book. They commented that the picture book is able to attract children’s attention, enhance their thinking skills and nurture creativity among children. In conclusion, the picture book based on the 4C approach enhanced early mathematics achievement of children

Mentor-Mentee Programme for STEM education at Preschool

The objectives of this research were to; (i) determine mentors’ perspectives  on their communication skills, teamwork skills, problem solving skills and social responsibility after joining the Mentor-Mentee Programme for STEM Education; (ii) identify the differences between the assessment of STEM mentors’ perspective on their personal qualities before and after joining the program; and (iii) identify the problems or challenges that the mentors experienced in mentoring activities compared to classroom teaching, opinions before and after participating in the program, and the challenges faced in the program. Based on the objectives, a survey research was conducted to collect data from 53 students (mentors) in the targeted population through questionnaire. Paired sample t-test was conducted to compare various skills of mentors before and after joining the program. For Communication Skills, the mean score for pre-test is 5.50, while mean score for post-test is 5.00. There was a significant difference in the scores for communication skills in pretest (M=5.00, SD=.86) and posttest (M=5.50, SD=.68); t (58) (=-3.785, p = 0.000). Teamwork skills also show significant difference in the scores in pretest (M=5.59, SD=.89) and posttest (M=6.06, SD=.67); t (58) (=-3.325, p = 0.002). Besides, Problem Solving Skills shows significant difference in the scores in pretest (M=5.00, SD=.99) and posttest (M=5.74, SD=.68); t (58) (=-4.897, p = 0.000). However, in the social responsibility skills, there is no significant difference between pretest (M=5.48, SD=1.11) and posttest (M=5.67, SD=0.85), t (58) (=1.086, p = 0.282). These results suggest that the program increases the communication skills, teamwork skills and problem-solving skills of mentors. However, the social responsibility skills do not show a significant difference although the mean score of posttest is higher than the pretest. This can be caused by the high social responsibility skills of mentors prior to the programs they have already been dealing with small kids. The sense of responsibility is higher than handling adults or students in primary or secondary school. In addition to this, some mentors mentioned they are not confident and worried about the STEM program. Nonetheless, positive findings were elicited from the interview. Mentors felt that they gained positive improvement and the program helped them increase their creativity. The mentors also suggested that the quality of module to be improved, competency of mentors to be upgraded, and duration of the intervention be extended. Quality in service instruction over STEM pedagogy best practices is a recommendation for practice

A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease.

Novel coronavirus disease 2019 (COVID-19) is a highly infectious, rapidly spreading viral disease with an alarming case fatality rate up to 5%. The risk factors for severe presentations are concentrated in patients with chronic kidney disease, particularly patients with end-stage renal disease (ESRD) who are dialysis dependent. We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infection until he developed respiratory symptoms and was admitted to the hospital. Imaging studies upon admission were consistent with bilateral interstitial pneumonia. He was placed in droplet-eye precautions while awaiting COVID-19 test results. Within the first 24 h, he deteriorated quickly and developed acute respiratory distress syndrome (ARDS), requiring intubation and increasing respiratory support. Losartan was withheld due to hypotension and septic shock. COVID-19 was reported positive on hospital day 3. He remained in critical condition being treated with hydroxychloroquine and tocilizumab in addition to the standard medical management for septic shock and ARDS. Our case is unique in its atypical initial presentation and highlights the importance of early testing

Association of Parameters of Mineral Bone Disorder with Mortality in Patients on Hemodialysis according to Level of Residual Kidney Function.

Background and objectivesThe relationship between mineral and bone disorders and survival according to residual kidney function status has not been previously studied in patients on hemodialysis. We hypothesized that residual kidney function, defined by renal urea clearance, modifies the association between mineral and bone disorder parameters and mortality.Design, setting, participants, & measurementsThe associations of serum phosphorus, albumin-corrected calcium, intact parathyroid hormone, and alkaline phosphatase with all-cause mortality were examined across three strata (<1.5, 1.5 to <3.0, and ≥3.0 ml/min per 1.73 m2) of baseline residual renal urea clearance using Cox models adjusted for clinical characteristics and laboratory measurements in 35,114 incident hemodialysis patients from a large United States dialysis organization over the period of 2007-2011.ResultsA total of 8102 (23%) patients died during the median follow-up of 1.3 years (interquartile range, 0.6-2.3 years). There was an incremental mortality risk across higher serum phosphorus concentrations, which was pronounced among patients with higher residual renal urea clearance (Pinteraction=0.001). Lower concentrations of serum intact parathyroid hormone were associated with higher mortality among patients with low residual renal urea clearance (i.e., <1.5 ml/min per 1.73 m2), whereas higher concentrations showed a higher mortality risk among patients with greater residual renal urea clearance (i.e., ≥1.5 ml/min per 1.73 m2; Pinteraction<0.001). Higher serum corrected total calcium and higher alkaline phosphatase concentrations consistently showed higher mortality risk (Ptrend<0.001 for both) irrespective of residual renal urea clearance strata (Pinteraction=0.34 and Pinteraction=0.53, respectively).ConclusionsResidual kidney function modified the mortality risk associated with serum phosphorus and intact parathyroid hormone among incident hemodialysis patients. Future studies are needed to examine whether taking account for residual kidney function into the assessment of mortality risk associated with serum phosphorus and intact parathyroid hormone improves patient management and clinical outcomes in the hemodialysis population

There's no place like home: 35-year patient survival on home hemodialysis.

The vast majority of maintenance dialysis patients suffer from poor long-term survival rates and lower levels of health-related quality of life. However, home hemodialysis is a historically significant dialysis modality that has been associated with favorable outcomes as well as greater patient autonomy and control, yet only represents a small minority of the total dialysis performed in the United States. Some potential disadvantages of home hemodialysis include vascular access complications, infection-related hospitalizations, patient fatigue, and attrition. In addition, current barriers and challenges in expanding the utilization of this modality include limited patient and provider education and technical expertise. Here we report a 65-year old male with end-stage renal disease due to Alport's syndrome who has undergone 35 years of uninterrupted thrice-weekly home hemodialysis (ie, every Sunday, Tuesday, and Thursday evening, each session lasting 3 to 3¼ hours in length) using a conventional hemodialysis machine who has maintained a high functional status allowing him to work 6-8 hours per day. The patient has been able to liberalize his dietary and fluid intake while only requiring 3-4 liters of ultrafiltration per treatment, despite having absence of residual kidney function. Through this case of extraordinary longevity and outcomes after 35 years of dialysis and a review of the literature, we illustrate the history of home hemodialysis, its significant clinical and psychosocial advantages, as well as the barriers that hinder its widespread adaptation

Incremental Hemodialysis: The University of California Irvine Experience.

Incremental hemodialysis has been examined as a viable hemodialysis regimen for selected end-stage renal disease (ESRD) patients. Preservation of residual kidney function (RKF) has been the driving impetus for this approach given its benefits upon the survival and quality of life of dialysis patients. While clinical practice guidelines recommend an incremental start of dialysis in peritoneal dialysis patients with substantial RKF, there remains little guidance with respect to incremental hemodialysis as an initial renal replacement therapy regimen. Indeed, several large population-based studies suggest that incremental twice-weekly vs. conventional thrice-weekly hemodialysis has favorable impact upon RKF trajectory and survival among patients with adequate renal urea clearance and/or urine output. In this report, we describe a case series of 13 ambulatory incident ESRD patients enrolled in a university-based center's Incremental Hemodialysis Program over the period of January 2015 to August 2016 and followed through December 2016. Among five patients who maintained a twice-weekly hemodialysis schedule vs. eight patients who transitioned to thrice-weekly hemodialysis, we describe and compare patients' longitudinal case-mix, laboratory, and dialysis treatment characteristics over time. The University of California Irvine Experience is the first systemically examined twice-weekly hemodialysis practice in North America. While future studies are needed to refine the optimal approaches and the ideal patient population for implementation of incremental hemodialysis, our case-series serves as a first report of this innovative management strategy among incident ESRD patients with substantial RKF, and a template for implementation of this regimen