Videofluoroscopic Analysis to Determine the Effects of Thickened Liquid on Oropharyngeal Swallowing Function in Infants with Respiratory Compromise

In clinical practice, infants who present with dysphagia during instrumental assessment are frequently placed on a diet that includes thickened liquids. There is scant empirical evidence available to support this common treatment practice. Studies that have previously attempted to evaluate the effectiveness of thickened liquids as a treatment option for infants with dysphagia have been limited by poorly defined physiologic parameters and small, heterogenous populations of study. The purpose of this dissertation was to systematically evaluate the effects of thickened liquids in a homogeneous sample of infants through retrospective analysis of archived videofluoroscopic swallow studies. Fifteen different temporal and physiologic measures were recorded from frame by frame analysis of 242 swallows selected from the videofluoroscopic swallowing studies of 25 infants with respiratory compromise. Each subject provided a sample of both thin and nectar thickened liquid swallows for comparison. In total, 121 swallows of thin liquid barium and 121 swallows of nectar thickened liquid barium were analyzed. Significant differences were found among the following variables between swallows of thin liquid barium and swallows of nectar thickened liquid barium: number of sucks per swallow, suck time, oral transit time, time to initiate velar movement, scores on the penetration-aspiration scale, location of the bolus before the swallow, and presence of residue after the swallow. There were greater numbers of sucks per swallow, longer suck and oral transit times, lower mean scores on the penetration-aspiration scale, and longer time to initiate velar movement for swallows of nectar thickened liquid barium as compared to swallows fo thin liquid barium. Bolus material collected at a more inferior location along the upper aerodigestive tract during swallows of the nectar thickened liquid barium. There was greater frequency of residue in the pharynx following swallows fo the nectar thickened liquid barium. The contribution of these variables to overall swallowing safety is discussed. Results point to improved swallowing safety with the use of nectar thickened liquids as a result of prolonging the oral phase of swallowing, thereby reducing the frequency of pharyngeal swallow and opportunities for airway compromise during bottle feeding

G-133: A soft x ray solar telescope

The GOLDHELOX Project, NASA payload number G-133, is a robotic soft x ray solar telescope designed and built by an organization of undergraduate students. The telescope is designed to observe the sun at a wavelength of 171 to 181 A. Since we require observations free from atmospheric interference, the telescope will be launched in a NASA Get-Away-Special (GAS) canister with a Motorized Door Assembly (MDA). In this paper we primarily discuss the most important elements of the telescope itself. We also elaborate on some of the technical difficulties associated with doing good science in space on a small budget (about $100,000) and mention ways in which controlling the instrument environment has reduced the complexity of the system and thus saved us money

Humoral Dysregulation Associated with Increased Systemic Inflammation among Injection Heroin Users

Injection drug use is a growing major public health concern. Injection drug users (IDUs) have a higher incidence of co-morbidities including HIV, Hepatitis, and other infections. An effective humoral response is critical for optimal homeostasis and protection from infection; however, the impact of injection heroin use on humoral immunity is poorly understood. We hypothesized that IDUs have altered B cell and antibody profiles.A comprehensive systems biology-based cross-sectional assessment of 130 peripheral blood B cell flow cytometry- and plasma- based features was performed on HIV-/Hepatitis C-, active heroin IDUs who participated in a syringe exchange program (n = 19) and healthy control subjects (n = 19). The IDU group had substantial polydrug use, with 89% reporting cocaine injection within the preceding month. IDUs exhibited a significant, 2-fold increase in total B cells compared to healthy subjects, which was associated with increased activated B cell subsets. Although plasma total IgG titers were similar between groups, IDUs had significantly higher IgG3 and IgG4, suggestive of chronic B cell activation. Total IgM was also increased in IDUs, as well as HIV Envelope-specific IgM, suggestive of increased HIV exposure. IDUs exhibited numerous features suggestive of systemic inflammation, including significantly increased plasma sCD40L, TNF-α, TGF-α, IL-8, and ceramide metabolites. Machine learning multivariate analysis distilled a set of 10 features that classified samples based on group with absolute accuracy.These results demonstrate broad alterations in the steady-state humoral profile of IDUs that are associated with increased systemic inflammation. Such dysregulation may impact the ability of IDUs to generate optimal responses to vaccination and infection, or lead to increased risk for inflammation-related co-morbidities, and should be considered when developing immune-based interventions for this growing population

An evaluation of a performance management system within a division of a large organisation in the public sector

Thesis (MA)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: Today’s competitive and dynamic business world, solicits ever higher levels of performance and productivity. At the core of this drive to higher performance is the enhancement and managing of employees’ performance through a Performance Management system. Performance Management however, is a very complex, multi-dimensional and integrated system with a number of interacting critical prerequisites. Even in ideal circumstances, these fundamental elements would, in all likelihood, not all be satisfied during the initial phases of implementing a Performance Management system. The concern existed, on the basis of the abovementioned probabilities, that the Performance Management system of the Children and Families Division (CAF) of the Department of Health and Human Services (DHHS) of Tasmania, Australia, was not enjoying optimal operational effectiveness. The aim of this study was to identify those factors in the system that are underdeveloped, possibly unsuccessfully implemented or in need of attention as they impact negatively on the effective running of the CAF’s Performance Management system. A suitable tool for this diagnostic purpose already exists in the form of the Performance Management Audit Questionnaire (PMAQ), developed by Spangenberg and Theron (1997). Through administering and analysing the PMAQ results, the CAF could obtain a clear indication of the system’s current effectiveness and would be able to identify where the problem areas are in order to refine the system for greater operational effectiveness. The results successfully identified the underdeveloped or absent areas of the organisation’s current Performance Management system. The results further found a clear difference between managerial and non-managerial perceptions of the effectiveness of the Performance Management system. The implications of these findings are discussed in terms of proposed remedial actions that could be implemented to address the problem areas.AFRIKAANSE OPSOMMING: ‘n Konstante strewe na steeds hoër vlakke van prestasie en produktiwiteit is aan die orde van die dag in die huidige hoogs kompeterende en dinamiese besigheidswêreld. Die verbetering en bestuur van werknemers se prestasie deur middel van ‘n Prestasiebestuurstelsel, blyk ‘n sleutel te bied tot hierdie strewe na hoër prestasie. Prestasiebestuur is egter ‘n hoogs komplekse, multidimensionele en geintegreerde stelsel met ‘n aantal interverwante kritieke vereistes. Selfs onder ideale omstandighede, sou dit onwaarskynlik wees dat al hierdie fundamentele elemente aangespreek sou kon word gedurende die anvanklike fases van die implementering van ‘n Prestasiebestuurstelsel. In die lig van die bogenoemde waarskynlikhede, het daar spesifiek twyfel geheers oor die mate waartoe die Prestasiebestuurselsel van die ‘Children and Families’ (CAF) afdeling van die ‘Department of Health and Human Services (DHHS) in Tasmanië, Australie, optimale operasionele effektiwiteit weerspieël. Die doel van hierdie studie was om die faktore binne die stelsel te identifiseer wat onderskeidelik onderontwikkeld, onsuksesvol geimplementeer, of aandag benodig het ten einde hulle negatiewe impak op die effektiewe bedryf van die CAF se Prestasiebestuurstelsel aan te spreek. ‘n Geskikte hulpmiddel vir so ‘n diagnostiese doelwit het reeds bestaan in die vorm van die Performance Management Audit Questionnaire (PMAQ) wat deur Spangenberg en Theron (1997) ontwikkel is. Deur middel van die administrasie van die PMAQ en die analise van die resultate, sou die CAF ‘n duidelike aanduiding kon verkry van die stelsel se effektiwiteit en sou hulle die probleemareas kon identifiseer ten einde die stelsel tot groter operasionele effektiwiteit te verfyn. Die resultate het die leemtes en onder-ontwikkelde areas binne die organisasie se huidige Presasiebestuurselsel suksesvol geidentifiseer. Die resultate het verder gedui op ‘n duidelike verskil tussen die persepsies van bestuurders en nie-bestuurders oor die effektiwiteit van die Prestasiebestuurstelsel. Die implikasies van hierdie bevindings word ten slotte bespreek in terme van die voorgestelde remediëringsaksies wat geimplementeer sou kon word om die probleemareas aan te spreek