Assessing Dietary Advancement for Dysphagia Patients at Risk for Aspiration

Fiberoptic endoscopic evaluation of swallowing (FEES) evaluates oral intake safety by allowing direct observation of laryngeal function before and after swallowing. The purpose of this study was to delineate the impact of abnormal vocal fold mobility and altered laryngeal sensation on dietary management in hospitalized patients previously diagnosed with aspiration

Training In a Good Way : Evaluating the Effect of a Culturally Responsive Pre-training Intervention on Learning and Motivation

Employee Training and Development (T&D) is a crucial component to an organization’s success and its ability to remain competitive. Although researchers in the field have discovered ways to enhance the effectiveness of training programs through the design, delivery, and evaluation process, research has not provided empirically-based recommendations for how to best train individuals whose cultural backgrounds may influence receptiveness of training curriculum. This is particularly relevant for employees whose cultural groups have been historically discriminated against, where cultural norms implicit in the training design may be met with resistance on behalf of the trainees. In the field of multicultural education, an instructional approach has been suggested to overcome cultural differences between instructor, curriculum writers, and students known as culturally responsive education. I evaluated a pre-training video prime based on this approach in the context of multi-site data-use training program for Native American educational professionals. Data-use training was delivered after exposure to one of two videos that framed the objectives of data use either in a culturally responsive way or in a generic mainstream fashion. Participants filled out surveys after the video but before the training, and then again after the training. Prime type was randomly assigned by training location. I hypothesized that participants who received a culturally responsive training prime would learn more during the data-usage training than participants who did not, and that this effect would be mediated by heightened affective motivators immediately following the culturally responsive prime. None of the hypothesized pathways were supported. There was no direct effect of my prime manipulation on knowledge (Hypothesis 1) or skill acquisition (H2), or on pre-training motivation to learn (H3), research-related self-efficacy (H4), goal-commitment (H5), or identification with research (H6). Furthermore, there were no indirect effects of my manipulation on knowledge (H7) or skill (H8) acquisition through pre-training motivation to learn, self-efficacy, goal-commitment, or identification with research. The motivation to learn subscale for valence had a significant positive direct effect on knowledge and skill acquisition and self-efficacy significantly positively predicted skill acquisition. Goal-commitment and motivation to learn subscales for instrumentality and expectancy had a significant negative relationship with skill acquisition. Lack of support for my hypothesized pathways is explained partially by the failure of my independent variable to influence perceptions of cultural responsiveness. A manipulation check revealed that participants did not appraise my culturally responsive priming video as significantly more relevant or culturally appropriate compared to the alternative mainstream video. Findings on the positive effects of valence and self-efficacy are discussed in support of current literature. Negative effects of expectancy are discussed in terms of stereotype threat. The implications and applications for trainers and researchers in training and minority education are followed by a consideration of this study’s limitations and suggestions for future research

Laryngeal and respiratory patterns in patients with paradoxical vocal fold motion

SummaryThe purposes of this study were to determine the differences in spirometric measures obtained from patients with endoscopically-documented paradoxical vocal fold motion (PVFM) and to compare them to a group of normal subjects without endoscopically-documented paradoxical vocal fold motion during non-provocative breathing and following speech. Thirty eight subjects with documented paradoxical vocal fold motion using transnasal flexible laryngoscopy (TFL) and no history of asthma and 21 normal subjects with documented normal breathing patterns and normal findings on endoscopy underwent flow-volume loop studies. Endoscopic judgments of vocal fold motion from three breathing conditions were made by two observers. The results of the endoscopic judgments indicate that paradoxical motion occurs whether breathing through the nose or mouth in the PVFM subjects, mainly after speaking and inhalation. In addition, the spirometry results indicated that the inspiratory measure of FIVC%, FVC% and FIV0.5/FIVC were significantly lower in the PVFM group compared to the normal subjects. The data supports the hypothesis that in patients with PVFM, inspiratory spirometric values play a role in identifying patients with PVFM. The finding of vocal fold closure following a speech utterance in the majority of the PVFM subjects but not in the normal control group warrants further investigation

Aerodynamic Changes in Patients with Chronic Cough Treated with Cough Suppression Therapy

Voice therapy has been suggested as the choice of treatment for patients with chronic cough. However, the voice aerodynamic parameters that may account for improvement in cough symptoms have not been well studied. The purpose of this study was to determine the changes in the aerodynamic parameters of phonation and self-ratings of cough severity following cough suppression therapy

Multiscale Modeling of UHTC: Thermal Conductivity

We are developing a multiscale framework in computational modeling for the ultra high temperature ceramics (UHTC) ZrB2 and HfB2. These materials are characterized by high melting point, good strength, and reasonable oxidation resistance. They are candidate materials for a number of applications in extreme environments including sharp leading edges of hypersonic aircraft. In particular, we used a combination of ab initio methods, atomistic simulations and continuum computations to obtain insights into fundamental properties of these materials. Ab initio methods were used to compute basic structural, mechanical and thermal properties. From these results, a database was constructed to fit a Tersoff style interatomic potential suitable for atomistic simulations. These potentials were used to evaluate the lattice thermal conductivity of single crystals and the thermal resistance of simple grain boundaries. Finite element method (FEM) computations using atomistic results as inputs were performed with meshes constructed on SEM images thereby modeling the realistic microstructure. These continuum computations showed the reduction in thermal conductivity due to the grain boundary network

Exercise-induced laryngeal obstruction: natural history and effect of surgical treatment

The current follow-up study concerning the supraglottic type of exercise-induced laryngeal obstruction (EILO) was performed to reveal the natural history of supraglottic EILO and compare the symptoms, as well as the laryngeal function in conservatively versus surgically treated patients. A questionnaire-based survey was conducted 2–5 years after EILO was diagnosed by a continuous laryngoscopy exercise (CLE) test in 94 patients with a predominantly supraglottic obstruction. Seventy-one patients had been treated conservatively and 23 with laser supraglottoplasty. The questionnaire response rate was 70 and 100% in conservatively treated (CT) and surgically treated (ST) patients, respectively. A second CLE test was performed in 14 CT and 19 ST patients. A visual analogue scale on symptom severity indicated improvements in both the groups, i.e. mean values (± standard deviations) declined from 73 (20) to 53 (26) (P < 0.001) in the CT group and from 87 (26) to 25 (27) (P < 0.001) in the ST group. At follow-up, ST patients reported lower scores regarding current level of complaints, and higher ability to perform exercise, as well as to push themselves physically, all compared to CT patients (P < 0.001). CLE scores were normalized in 3 of 14 (21%) CT and 16 of 19 (84%) ST patients (Z = −3.6; P < 0.001). In conclusion, symptoms of EILO diagnosed in adolescents generally decreased during 2–5 years follow-up period but even more after the surgical treatment. Patients with supraglottic EILO may benefit from supraglottoplasty both as to laryngeal function and symptom relief

Attenuation of ischemic liver injury by augmentation of endogenous adenosine

Hepatic grafts from non-heartbeating donors may alleviate the organ shortage, but they inherently suffer from warm ischemia. In the present study, we tested our hypothesis that augmentation of endogenous adenosine by inhibition of nucleoside transport with R75231 attenuates ischemic liver injury. Adult female beagle dogs underwent 2-hr hepatic vascular exclusion with venovenous bypass. R75231 was given to the animals by continuous intravenous infusion for 30 min before ischemia at a dose of 0.1 mg/kg (Group 2, n=6), 0.05 mg/kg (Group 3, n=6), or 0.025 mg/kg (Group 4, n=6). Nontreated animals were used as the control (Group 1, n= 10). Animal survival, hepatic tissue blood flow, liver function, and histopathology were analyzed. Two- week animal survival was 30% in Group 1, 83% in Group 2, 100% in Group 3, and 100% in Group 4. Postreperfusion hepatic tissue blood flow was markedly improved by the treatment. Treatment significantly attenuated liver enzyme release, lipid peroxidation, and changes in adenine nucleotides and purine catabolites. Structural abnormality of the liver after reperfusion was markedly improved by R75231 treatment, showing better architecture and less neutrophil infiltration. Preischemic administration of a nucleoside transport inhibitor ameliorated ischemic liver injury due to the positive effects of augmented endogenous adenosine, and is applicable clinically when the liver is procured from a controlled non-heartbeating donor

Regeneration of Cryoinjury Induced Necrotic Heart Lesions in Zebrafish Is Associated with Epicardial Activation and Cardiomyocyte Proliferation

In mammals, myocardial cell death due to infarction results in scar formation and little regenerative response. In contrast, zebrafish have a high capacity to regenerate the heart after surgical resection of myocardial tissue. However, whether zebrafish can also regenerate lesions caused by cell death has not been tested. Here, we present a simple method for induction of necrotic lesions in the adult zebrafish heart based on cryoinjury. Despite widespread tissue death and loss of cardiomyocytes caused by these lesions, zebrafish display a robust regenerative response, which results in substantial clearing of the necrotic tissue and little scar formation. The cellular mechanisms underlying regeneration appear to be similar to those activated in response to ventricular resection. In particular, the epicardium activates a developmental gene program, proliferates and covers the lesion. Concomitantly, mature uninjured cardiomyocytes become proliferative and invade the lesion. Our injury model will be a useful tool to study the molecular mechanisms of natural heart regeneration in response to necrotic cell death

Pathways to Prevention: Improving Nonresident African American Fathers' Parenting Skills and Behaviors to Reduce Sons' Aggression

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102680/1/cdev12127.pd