An in-depth analysis of real and perceived barriers to speech and language program participation for children with speech and language delays : a question of barriers to service?

The current study investigated the effects that barriers (both real and perceived) had on participation and completion of speech and language programs for preschool children with communication delays. I compared 36 families of preschool children with an identified communication delay that have completed services (completers) to 13 families that have not completed services (non-completers) prescribed by Speech and Language professionals. Data findings reported were drawn from an interview with the mother, a speech and language assessment of the child, and an extensive package of measures completed by the mother. Children ranged in age from 32 to 71 mos. These data were collected as part of a project funded by the Canadian Language and Literacy Research Networks of Centres of Excellence. Findings suggest that completers and non-completers shared commonalities in a number of parenting characteristics but differed significantly in two areas. Mothers in the noncompleting group were more permissive and had lower maternal education than mothers in the completing families. From a systemic standpoint, families also differed in the number of perceived barriers to treatment experienced during their time with Speech Services Niagara. Mothers in the non-completing group experienced more perceived barriers to treatment than completing mothers. Specifically, these mothers perceived more stressors and obstacles that competed with treatment, perceived more treatment demands and they perceived the relevance of treatment as less important than the completing group. Despite this, the findings suggest that non-completing families were 100% satisfied with services. Contrary to predictions, there were no significant differences in child characterisfics and economic characteristics between completers and non-completers. The findings in this study are considered exploratory and tentative due to the small sample size.

Social physique anxiety across physical activity settings : a meta-analytical review

The purpose of this meta-analytic investigation was to review the empirical evidence specific to the effect of physical activity context on social physique anxiety (SP A). English language studies were located from computer and manual literature searches. A total of 146 initial studies were coded. Studies included in the meta-analysis presented at least one empirical effect for SPA between physical activity participants (i.e., athletes or exercisers) and non-physical activity participants. The final sample included thirteen studies, yielding 14 effect sizes, with a total sample size of 2846. Studies were coded for mean SPA between physical activity participants and non-physical activity participants. Moderator variables related to demographic and study characteristics were also coded. Using Hunter and Schmidt's (2004) protocol, statistical artifacts were corrected. Results indicate that, practically speaking, those who were physically active reported lower levels of SPA than the comparison group (dcorr = -.12; SDeorr.-=-;22). Consideration of the magnitude of the ES, the SDeorr, and confidence interval suggests that this effect is not statistically significant. While most moderator analyses reiterated this trend, some differences were worth noting. Previous research has identified SPA to be especially salient for females compared to males, however, in the current investigation, the magnitude of the ES' s comparing physical activity participants to the comparison group was similar (deorr = -.24 for females and deorr = -.23 for males). Also, the type of physical activity was investigated, and results showed that athletes reported lower levels of SP A than the comparison group (deorr = -.19, SDeorr = .08), whereas exercisers reported higher levels of SPA than the comparison group (deorr = .13, SDeorr = .22). Results demonstrate support for the dispositional nature of SP A. Consideration of practical significance suggests that those who are involved in physical activity may experience slightly lower levels of SPA than those not reporting physical activity participation. Results potentially offer support for the bi-directionality of the relationship between physical activity and SP A; however, a causality may not be inferred. More information about the type of physical activity (i.e., frequency/nature of exercise behaviour, sport classificationllevel of athletes) may help clarify the role of physical activity contexts on SPA.

The cardiovascular hemodynamic responses to various levels of orthostatic stress in children

The ability of the cardiovascular system to quickly and efficiently adapt to an orthostatic stress is vital for the human body to function on earth. The way in which the various aspects of the cardiovascular system work together to counteract an orthostatic stress has been previously quantified in the adult population. However, there are still many unknowns surrounding the topic of how the cardiovascular system functions to cope with this same stress in children. The purpose of this study was to describe the cardiovascular hemodynamic adaptations to various levels of orthostatic stress induced using a lower body negative pressure (LBNP) chamber in pre-pubertal boys. A secondary purpose was to determine indices of baroreceptor sensitivity (BRS) at both rest and during low levels of LBNP in this same pediatric sample. Finally, this study aimed to compare the relative responses to LBNP between the children and adults. To complete the study 20 healthy pre-pubertal boys and adult males (9.3 ± 1.1 and 23 ± 1.8 years of age respectively) were recruited and randomly exposed to three levels of LBNP (15, 20 and 25 mmHg). At rest and during the application of the LBNP heart rate (HR), manual and bcat-by-beat systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MAP) were monitored continuously. Aortic diameter was measured at rest and peak aortic blood velocity (PV) was recorded continuously for at least I minute during each baseline and LBNP condition. From the raw data HR, stroke volume (SV), cardiac output (Q), total peripheral resistance (TPR), low frequency baroreceptor sensitivity (LF BRS), high frequency baroreceptor sensitivity (HF BRS) and LFIIIF ratio were calculated. At rest, llR wa'i higher and SBP, SV, Q and LF/HF ratio were lower in the children compared to the adult males (pgJ.05). In response to the increasing LEN!> IIR and TPR increased, and LF BRS. SV and Q decreased in the adult group (pSf).05). while the same levels of LBNP caused an increase in TPR and a decrease in SBP, SV and Q in the children (pSf).05). Although not significant, the LF/HF ratio in the adult group showed an increasing trend in response to increased negative pressure (p=O.088). As for resting BRS, there were no significant differences in LF or HF BRS between the children and the adults despite a tendency for both measures to be 18% lower in the children. Also the LF/HF ratio was almost significantly greater in the adults compared to the children (p=O.057). In addition, a comparison between the relative adult and child responses to LBNP yielded no significant group by level interactions. This result should be taken with caution though, as the low sample size and high measurement variability generated very low statistical power for this analysis. In conclusion, the results of this study suggest that the hemodynamic adaptations to an orthostatic stress were less pronounced in the prepubertal males, most likely due to an underdeveloped autonomic system. These results need to be strengthened by further research before any implications can be derived for health care purposes.

Textual characteristics of coarse sediments in selected streams of the Niagara Peninsula, Ontario

The streams flowing through the Niagara Escarpment are paved by coarse carbonate and sandstone sediments which have originated from the escarpment units and can be traced downstream from their source. Fifty-nine sediment samples were taken from five streams, over distances of 3,000 to 10,000 feet (915 to 3050 m), to determine downstream changes in sediment composition, textural characteristics and sorting. In addition, fluorometric velocity measurements were used in conjunction with measured -discharge and flow records to estimate the frequency of sediment movement. The frequency of sediments of a given lithology changes downstream in direct response to the outcrop position of the formations in the channels. Clasts derived from a single stratigraphic unit usually reach a maximum frequency within the first 1,000 feet (305 m) of transport. Sediments derived from formations at the top of waterfalls reach a modal frequency farther downstream than material originating at the base of waterfalls. Downstream variations in sediment size over the lengths of the study reaches reflect the changes in channel morphology and lithologic composition of the sediment samples. Linear regression analyses indicate that there is a decrease in the axial lengths between the intial and final samples and that the long axis decreases in length more rapidly than the intermediate, while the short axis remains almost constant. Carbonate sediments from coarse-grained, fossiliferous units - iii - are more variable in size than fine-grained dolostones and sandstones. The average sphericity for carbonates and sandstones increases from 0.65 to 0.67, while maximum projection sphericity remains nearly constant with an average value of 0.52. Pebble roundness increases more rapidly than either of the sphericity parameters and the sediments change from subrounded to rounded. The Hjulstrom diagram indicates that the velocities required to initiate transport of sediments with an average intermediate diameter of 10 cm range from 200 cm/s to 300 cm/s (6.6 ft./sec. to 9.8 ft./sec.). From the modal velocitydischarge relations, the flows corresponding to these velocities are greater than 3,500 cfs (99 m3s). These discharges occur less than 0.01 p~r cent (0.4 days) of the time and correspond to a discharge occurring during the spring flood.

The convergence of psychopathy, self-rated vulnerability, and other-rated vulnerability

Previous research has found that victims of crime tend to exhibit asynchronous movement (e.g. Grayson & Stein, 1981), and the fact that victims display different body language suggests that they may be sending inadvertent signals to their own vulnerability (e.g. Murzynski & Degelman, 1996). Body language has also be en linked with s e l f identification as a victim (Wheeler et aI., 2009), and self-identification has be en found to act as a proxy for more severe victimization (Baumer, 2002) and greater fear of crime (Greenberg & Beach, 2004). The first prediction in the present study, then, was that self-perceived vulnerability would be correlated with body language, while number of previous victimizations mayor may not show the same relationship. Findings from the present study indicate that self-perceived vulnerability exhibits a positive correlation with the body language cues that approaches significance r (10) = .45,p =.07, one-tailed. Different types of victimization, however, were not significantly correlated with these cues. A second goal of the study was to examine the relationship between psychopathic traits and accuracy in judgments of vulnerability. Seventy male participants rated the vulnerability of 12 female targets filmed walking down a hallway who had provided selfratings of vulnerability. Individuals scoring higher on Factor 2 and total psychopathy were significantly less discrepant from target self-rat~ngs of vulnerability, r (64) = - .39,p < .001; r (64) = - .29,p >.01, respectively. The final purpose of this study was to determine which body language cues were mos t salient to raters when making judgments of vulnerability. Participants rated the apparent vulnerability of a target in 7 video clips portraying each body language cue in isolation and a natural walk. Results of repeated measures analyses indicate that the videos rated as most vulnerable to victimization were those displaying low energy and l a ck of synchrony, followed by wide stride, short stride, and stiffknees, while the video displaying ne ck stiffness did not receive significantly different ratings from the mode l ' s natural walk. Replication with a larger sample size is necessary to increase confidence in findings and implications.

Comparison of classification ability of hyperball algorithms to neural network and k-nearest neighbour algorithms

The main focus of this thesis is to evaluate and compare Hyperbalilearning algorithm (HBL) to other learning algorithms. In this work HBL is compared to feed forward artificial neural networks using back propagation learning, K-nearest neighbor and 103 algorithms. In order to evaluate the similarity of these algorithms, we carried out three experiments using nine benchmark data sets from UCI machine learning repository. The first experiment compares HBL to other algorithms when sample size of dataset is changing. The second experiment compares HBL to other algorithms when dimensionality of data changes. The last experiment compares HBL to other algorithms according to the level of agreement to data target values. Our observations in general showed, considering classification accuracy as a measure, HBL is performing as good as most ANn variants. Additionally, we also deduced that HBL.:s classification accuracy outperforms 103's and K-nearest neighbour's for the selected data sets.

Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.

Peer-Led Team Learning as an Instructional Strategy for Secondary School Science

This study investigated the impact of an instructional learning strategy, peer-led team learning (PLTL), on secondary school students' conceptual understanding of biology concepts related to the topic of evolution. Using a mixed methods approach, data were gathered quantitatively through pre/posttesting using a repeated measures design and qualitatively through observations, questionnaires, and interviews. A repeated measures design was implemented to explore the impact of PLTL on students' understanding of concepts related to evolution and students' attitudes towards PLTL implementation. Results from quantitative data comparing pre/posttesting were not able to be compared through inferential statistics as a result of inconsistencies in the data due to a small sample size and design limitations; however, qualitative data identified positive attitudes towards the implementation of PLTL, with students reporting gains in conceptual understanding, academic achievement, and interdependent work ethic. Implications of these findings for learning, teaching, and the educational literature include understanding of student attitudes towards PLTL and insight into the role PLTL plays in improving conceptual understanding of biology concepts. Strategies are suggested to continue further research in the area of PLTL.

The Compliance Costs of Taxes on Businesses and Individuals a Review of the Evidence

This Paper Reviews the Literature on the Compliance Costs Incurred by Businesses and Individuals Because of One Or More Taxes. It Presents Both the Main Characteristics, Such As Sample Size, Interview Techniques and So On, and the Key Findings of the Nineteen Studies Reviewed. in General, One Can Conclude That Simpler Taxes Lead to Lower Compliance Costs.

Suivi à long terme de l’efficacité d’un traitement de physiothérapie sur l'incontinence urinaire d'effort persistante en période postnatale

L’incontinence urinaire d’effort (IUE) est une condition fréquente en période postnatale pouvant affecter jusqu’à 77% des femmes. Neuf femmes sur dix souffrant d’IUE trois mois après l’accouchement, vont présenter une IUE cinq ans plus tard. Le traitement en physiothérapie de l’IUE par le biais d’un programme d’exercices de renforcement des muscles du plancher pelvien est reconnu comme étant un traitement de première ligne efficace. Les études ont prouvé l’efficacité de cette approche sur l’IUE persistante à court terme, mais les résultats de deux ECR à long terme n’ont pas démontré un maintien de l’effet de traitement. L’effet d’un programme en physiothérapie de renforcement du plancher pelvien intensif et étroitement supervisé sur l’IUE postnatale persistante avait été évalué lors d’un essai clinique randomisé il y a sept ans. Le but principal de la présente étude était d’évaluer l’effet de ce programme sept ans après la fin des interventions de l’ECR initial. Un objectif secondaire était de comparer l’effet de traitement à long terme entre un groupe ayant fait seulement des exercices de renforcement du plancher pelvien et un groupe ayant fait des exercices de renforcement du plancher pelvien et des abdominaux profonds. Un troisième objectif était d’explorer l’influence de quatre facteurs de risques sur les symptômes d’IUE et la qualité de vie à long terme. Les cinquante-sept femmes ayant complétées l’ECR initial ont été invitées à participer à l’évaluation du suivi sept ans. Vingt et une femmes ont participé à l’évaluation clinique et ont répondu à quatre questionnaires, tandis que dix femmes ont répondu aux questionnaires seulement. L’évaluation clinique incluait un pad test et la dynamométrie du plancher pelvien. La mesure d’effet primaire était un pad test modifié de 20 minutes. Les mesures d’effets secondaires étaient la dynamométrie du plancher pelvien, les symptômes d’IUE mesuré par le questionnaire Urogenital Distress Inventory, la qualité de vie mesurée par le questionnaire Incontinence Impact Questionnaire et la perception de la sévérité de l’IUE mesuré par l’Échelle Visuelle Analogue. De plus, un questionnaire portant sur quatre facteurs de risques soit, la présence de grossesses subséquentes, la v présence de constipation chronique, l’indice de masse corporel et la fréquence des exercices de renforcement du plancher pelvien de l’IUE, venait compléter l’évaluation. Quarante-huit pour-cent (10/21) des participantes étaient continentes selon de pad test. La moyenne d’amélioration entre le résultat pré-traitement et le suivi sept ans était de 26,9 g. (écart-type = 68,0 g.). Il n’y avait pas de différence significative des paramètres musculaires du plancher pelvien entre le pré-traitement, le post-traitement et le suivi sept ans. Les scores du IIQ et du VAS étaient significativement plus bas à sept ans qu’en prétraitement (IIQ : 23,4 vs 15,6, p = 0,007) et (VAS : 6,7 vs 5,1, p = 0,001). Les scores du UDI étaient plus élevés au suivi sept ans (15,6) qu’en pré-traitement (11,3, p = 0,041) et en post-traitement (5,7, p = 0,00). La poursuite des exercices de renforcement du plancher pelvien à domicile était associée à une diminution de 5,7 g. (p = 0,051) des fuites d’urine observées au pad test selon une analyse de régression linéaire. Les limites de cette étude sont ; la taille réduite de l’échantillon et un biais relié au désir de traitement pour les femmes toujours incontinentes. Cependant, les résultats semblent démontrer que l’effet du traitement à long terme d’un programme de renforcement des muscles du plancher pelvien qui est intensif et étroitement supervisé, est maintenu chez environ une femme sur deux. Bien que les symptômes d’IUE tel que mesuré par les pad test et le questionnaire UDI, semblent réapparaître avec le temps, la qualité de vie, telle que mesurée par des questionnaires, est toujours meilleure après sept qu’à l’évaluation initiale. Puisque la poursuite des exercices de renforcement du plancher pelvien est associée à une diminution de la quantité de fuite d’urine au pad test, les participantes devraient être encouragées à poursuivre leurs exercices après la fin d’un programme supervisé. Pour des raisons de logistique la collecte de donnée de ce projet de recherche s’est continuée après la rédaction de ce mémoire. Les résultats finaux sont disponibles auprès de Chantale Dumoulin pht, PhD., professeure agrée à l’Université de Montréal.

Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in Hospital

[Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China

Pour une utilisation optimale des données personnelles à des fins de recherche : vers un réseau de ressources collectives

Thèse par articles. Articles (4) annexés à la thèse en fichiers complémentaires.

Efficient estimation using the characteristic function : theory and applications with high frequency data

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Évaluation de l’effet du neurofeedback sur les capacités d’inhibition d’enfants ayant un Trouble déficitaire de l’attention avec hyperactivité

Le neurofeedback (NF) suscite actuellement un vif intérêt dans la prise en charge du trouble déficitaire de l’attention avec hyperactivité (TDAH) chez l’enfant. Proposée comme méthode alternative à la médication par de nombreux cliniciens, notamment aux États-Unis, le NF est une intervention non-invasive de type électrophysiologique qui repose sur l’apprentissage par conditionnement opérant de l’autorégulation d’ondes cérébrales déviantes. Les études empiriques qui étayent cette pratique font toutefois l’objet de virulentes critiques de la part de spécialistes dans le domaine du TDAH en raison de résultats systématiquement positifs mais non spécifiques, auxquels s’ajoutent de nombreuses lacunes méthodologiques. Les travaux de cette thèse visent à appliquer une méthodologie stricte de type essai clinique contrôlé avec assignation aléatoire afin d’isoler les effets particuliers du NF, en appliquant un protocole d’entraînement propre au déficit primaire sous-tendant le TDAH, soit l’inhibition motrice, dans le but d’évaluer la spécificité de cette intervention. Dans un premier temps, les connaissances relatives à la nosologie du TDAH, à ses principaux traitements, au NF et aux capacités d’inhibition chez l’enfant ayant un TDAH sont présentées (Chapitre 1). Ensuite, les études réalisées dans le cadre de cette thèse sont exposées. Dans l’étude initiale, la spécificité du NF est évaluée sur les capacités d’inhibition grâce à des mesures subjectives, soit des questionnaires de comportements complétés par les parents, ainsi que des mesures objectives, à savoir des tâches neuropsychologiques (Chapitre 2). Afin de préciser davantage les conséquences d’un entraînement à l’autorégulation d’ondes cérébrales, l’étude subséquente s’est intéressée à l’impact neurophysiologiques de l’amélioration des capacités d’inhibition, par le biais d’une étude en potentiels évoqués employant une tâche de performance continue de type Stop-signal (Chapitre 3). Les principaux résultats reflètent un recrutement sous optimal, avec une puissance statistique insuffisante pour réaliser des statistiques quantitatives de groupe. Néanmoins, l’appréciation des données selon une approche d’étude de cas multiples permet de mettre en évidence la présence d’une réponse placebo sur les capacités d’inhibition suite à un entraînement en NF. Finalement, les implications de la taille de l’échantillon, ainsi que les limites et les critiques de ces études sont discutées au Chapitre 4.

La quétiapine dans le traitement des troubles liés à l’utilisation de substances psychoactives.

Contexte Les troubles liés à l’utilisation de substances psychoactives (TUS) sont associés à une variété de troubles psychiatriques entre autre une instabilité comportementale et affective. Plusieurs études suggèrent que les antipsychotiques atypiques peuvent être utiles dans le traitement de la toxicomanie. L’objectif principal de la présente étude à devis ouvert est d’évaluer l’efficacité de la quétiapine sur les variables reliés à la toxicomanie chez des poly-toxicomanes sans psychose comorbide entrant en désintoxication. Méthodes Dans le cadre d’une étude pharmacologique à devis ouvert d’une durée de 12 semaines, trente-trois polytoxicomanes entrant en désintoxication et répondant à un ou plusieurs critères d’abus/dépendance à une substance du DSM-IV ont été recrutés. Les patients présentant un autre trouble comorbide à l’Axe I ont été exclus. Les envies de consommer, les quantités consommées, les jours de consommation ainsi que la sévérité de la toxicomanie ont été évalués au point de départ (semaine 0) et à la fin de l’étude (semaine 12). Les symptômes psychiatriques et dépressifs furent aussi évalués. Résultats 26 des 33 patients complétèrent plus de 9 semaines de traitement. Les résultats relatifs à la dernière observation reportée (LOCF) ont montré une amélioration significative des envies de consommer, des quantités consommées, des jours de consommation, de la sévérité de la toxicomanie et des symptômes psychiatriques et dépressifs. Conclusions Nos résultats ne peuvent être attribués en soi aux effets pharmacologiques de la quétiapine, et ce compte tenu d’abord du type d’étude à devis ouvert à laquelle nous avons procédée, ainsi que le petit nombre de sujets impliqués et enfin le fait que les participants étaient impliqués dans une thérapie intensive. Ceci dit, nos résultats suggèrent quand même que la quétiapine peut être bénéfique dans le traitement des toxicomanes entrant en désintoxication. Des études randomisées sont de mises pour déterminer la pertinence de ces résultats.