bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peer Responses to Stuttering in the Preschool Setting
Authors: Langevin Marilyn , Packman Ann , Onslow Mark 
Published: July 2009

Purpose
This study investigated peer responses to preschoolers' stuttering in preschool and sought to determine whether specific characteristics of participants' stuttering patterns elicited negative peer responses.

Method
Four outdoor free-play sessions of 4 preschoolers age 3–4 years who stutter were videotaped. Stutters were identified on transcripts of the play sessions. Peer responses to stuttered utterances were judged to be negative or neutral/positive. Thereafter, participants' stuttering behaviors, durations of stutters, and judgments of the meaningfulness of peer-directed stuttered utterances were analyzed.

Results
Between 71.4% and 100% of peer responses were judged to be neutral/positive. In the negative responses across 3 participants, peers were observed to react with confusion or to interrupt, mock, walk away from, or ignore the stuttered utterances. Utterances that elicited negative responses were typically meaningless and contained stutters that were behaviorally complex and/or of longer duration. Other social interaction difficulties also were observed—for example, difficulty leading peers in play, participating in pretend play, and resolving conflicts.

Conclusions
Results indicate that the majority of peer responses to stuttered utterances were neutral/positive; however, results also indicate that stuttering has the potential to elicit negative peer responses and affect other social interactions in preschool.
Using Family Paradigms to Improve Evidence-Based Practice
Authors: Hidecker Mary Jo Cooley , Jones Rebecca S. , Imig David R. , Villarruel Francisco A. 
Published: July 2009

PurposeEvidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client’s family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP.MethodThis article describes the family paradigms framework: 4 classic paradigms of “closed,” “random,” “open,” and “synchronous.” Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples.ResultsA family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions.ConclusionsFamily and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.
The Effects of Color Cues on Typically Developing Preschoolers' Speed of Locating a Target Line Drawing: Implications for Augmentative and Alternative Communication Display Design
Authors: Thistle Jennifer J. , Wilkinson Krista 
Published: July 2009

Purpose
This research examined how the presence of color in relation to a target within an augmentative and alternative communication array influenced the speed with which typically developing preschoolers located a target line drawing.

Method
Fifteen children over the age of 4 years (from 4;2 [years;months] to 5;4) and 15 children under the age of 4 years (2;10–3;11) participated. Participants were asked to find a target line drawing of foods (e.g., banana and tomato) among an array of 12. The reaction time of locating the target was measured across 4 conditions in which the foreground color and the background color of the line drawing were manipulated.

Results
For all participants, line drawings featuring foreground color provided greater advantages in the speed of locating the target compared with drawings featuring only background color. Younger participants demonstrated faster reaction times when color was limited to the foreground.

Conclusion
Clinicians should consider incorporating color in the foreground of the line drawing when constructing visual displays. Targets that contain only background color but no foreground color appear to have a negative effect on the speed with which younger children can locate a target. Further research is needed to determine the effects in children with disabilities.
Phonological Accuracy and Intelligibility in Connected Speech of Boys With Fragile X Syndrome or Down Syndrome
Authors: Barnes Elizabeth , Roberts Joanne , Long Steven H. , Martin Gary E. , Berni Mary C. , Mandulak Kerry C. , Sideris John 
Published: July 2009

PurposeTo compare the phonological accuracy and speech intelligibility of boys with fragile X syndrome with autism spectrum disorder (FXS-ASD), fragile X syndrome only (FXS-O), Down syndrome (DS), and typically developing (TD) boys.MethodParticipants were 32 boys with FXS-O (3–14 years), 31 with FXS-ASD (5–15 years), 34 with DS (4–16 years), and 45 TD boys of similar nonverbal mental age. We used connected speech samples to compute measures of phonological accuracy, phonological process occurrence, and intelligibility.ResultsThe boys with FXS, regardless of autism status, did not differ from TD boys on phonological accuracy and phonological process occurrence but produced fewer intelligible words than did TD boys. The boys with DS scored lower on measures of phonological accuracy and occurrence of phonological processes than all other groups and used fewer intelligible words than did TD boys. The boys with FXS and the boys with DS did not differ on measures of intelligibility.ConclusionsBoys with FXS, regardless of autism status, exhibited phonological characteristics similar to those of younger TD children but were less intelligible in connected speech. Boys with DS showed greater delays in all phonological measures than the boys with FXS and the TD boys.
Effects of Directional Exercise on Lingual Strength
Authors: Clark Heather M. , O’Brien Katy , Calleja Aimee , Newcomb Corrie Sarah 
Published: July 2009

Purpose
To examine the application of known muscle training principles to tongue strengthening exercises and to answer the following research questions: (a) Did lingual strength increase following 9 weeks of training? (b) Did training conducted using an exercise moving the tongue in one direction result in strength changes for tongue movements in other directions? (c) Were differential training effects observed for participants completing exercises sequentially (in isolation) versus concurrently (several exercises in combination)? (d) Were strength gains maintained after exercise was discontinued?

Methods
Participants were 39 healthy adults assigned to sequential or concurrent lingual strength training. Lingual exercise (elevation, protrusion, and/or lateralization) was conducted for 9 weeks, with lingual strength and cheek strength (control variable) assessed weekly.

Results
All lingual strength measures increased with training, but cheek strength remained unchanged. Training effects were not related to training condition (sequential vs. concurrent), nor were specificity effects observed for direction of exercise. Significant decreases in lingual strength were noted 2–4 weeks after exercise was discontinued.

Conclusions
The findings replicate those of earlier studies demonstrating that lingual strength may be increased with a variety of exercise protocols and confirm that detraining effects may be observed when training is discontinued. The findings further suggest that the lingual musculature may demonstrate less dramatic training specificity than what has been reported for skeletal muscles.
Patients' Beliefs and Perceptions of Their Participation to Increase Healthcare Worker Compliance with Hand Hygiene
Authors: Longtin Yves , Sax Hugo , Allegranzi Benedetta , Hugonnet Stéphane , Pittet Didier 
Published: July 2009

Background.Research suggests that patients could improve healthcare workers' compliance with hand hygiene recommendations by reminding them to cleanse their hands.Objective.To assess patients' perceptions of a patient-participation program to improve healthcare workers' compliance with hand hygiene.Design.Cross-sectional survey of patient knowledge and perceptions of healthcare-associated infections, hand hygiene, and patient participation, defined as the active involvement of patients in various aspects of their health care.Setting.Large Swiss teaching hospital.Results.Of 194 patients who participated, most responded that they would not feel comfortable asking a nurse (148 respondents [76%]) or a physician (150 [77%]) to perform hand hygiene, and 57 (29%) believed that this would help prevent healthcare-associated infections. In contrast, an explicit invitation from a healthcare worker to ask about hand hygiene doubled the intention to ask a nurse (from 34% to 83% of respondents; P < .001) and to ask a physician (from 30% to 78%; P < .001). In multivariate analysis, being nonreligious, having an expansive personality, being concerned about healthcare-associated infections, and believing that patient participation would prevent healthcare-associated infections were associated with the intention to ask a nurse or a physician to perform hand hygiene (P < .05). Being of Jewish, Eastern Orthodox, or Buddhist faith was associated also with increased intention to ask a nurse (P < .05), compared with being of Christian faith.Conclusions.This study identifies several sociodemographic characteristics associated with the intention to ask nurses and physicians about hand hygiene and underscores the importance of a direct invitation from healthcare workers to increase patient participation and foster patient empowerment. These findings could guide the development of future hand hygiene-promotion strategies.
Primary Care Guidelines for the Management of Persons Infected with Human Immunodeficiency Virus: 2009 Update by the HIV Medicine Association of the Infectious Diseases Society of America
Authors: Aberg Judith A. , Kaplan Jonathan E. , Libman Howard , Emmanuel Patricia , Anderson Jean R. , Stone Valerie E. , Oleske James M. , Currier Judith S. , Gallant Joel E. 
Published: July 2009

AbstractEvidence-based guidelines for the management of persons infected with human immunodeficiency virus (HIV) were prepared by an expert panel of the HIV Medicine Association of the Infectious Diseases Society of America. These updated guidelines replace those published in 2004. The guidelines are intended for use by health care providers who care for HIV-infected patients or patients who may be at risk for acquiring HIV infection. Since 2004, new antiretroviral drugs and classes have become available, and the prognosis of persons with HIV infection continues to improve. However, with fewer complications and increased survival, HIV-infected persons are increasingly developing common health problems that also affect the general population. Some of these conditions may be related to HIV infection itself and its treatment. HIV-infected persons should be managed and monitored for all relevant age- and gender-specific health problems. New information based on publications from the period 2003–2008 has been incorporated into this document.
Particle Size Effects on the Quality of Flour Tortillas Enriched with Whole Grain Waxy Barley
Authors: Prasopsunwattana Naruemon , Omary María Botero , Arndt Elizabeth A. , Cooke Peter H. , Flores Rolando A. , Yokoyama Wallace , Toma Ayako , Chongcham Sutida , Lee Sylvia P. 
Published: July 2009

ABSTRACTWheat tortillas were enriched with whole barley flour (WBF) of different particle sizes including 237 μm (regular [R]), 131 μm (intermediate [IM]), and 68 μm (microground [MG]). Topographical and fluorescent microstructure images of flours, doughs, and tortillas were examined. Flours and tortillas were analyzed for color, protein, ash, starch, moisture, and β‐glucan content. Farinograph testing was conducted on the flour blends. Water activity and texture analyses of tortillas were conducted. A 9‐point hedonic scale was used by 95 untrained panelists to evaluate tortilla appearance, color, flavor, texture, and overall acceptability. Two commercial products (CP) were included in some analyses. As WBF particle size decreased, color was lighter; protein, moisture content and mixing stability decreased; ash, starch content, water absorption and farinograph peak time increased; and β‐glucan content was constant. WBF tortillas were darker than the control (C), while IM and MG tortillas had lower peak forces than C. No flavor differences were reported among C, R, and MG tortillas but higher scores were given to both CP in all attributes tested. Tortillas made with the largest WBF particle size (R) were the most similar in protein content, texture and flavor when compared with C tortillas made with refined bread flour.
Impact of Genotype and Environment on the Quality of Amber Durum Wheat Alkaline Noodles
Authors: Hatcher D. W. , Dexter J. E. , Bellido G. G. , Clarke J. M. , Anderson M. J. 
Published: July 2009

ABSTRACTCanada Western Amber Durum wheat cultivars (4), Canada Western Red Spring (1), and Canada Western Hard White Spring (1) wheat were grown at three sites in 2007 to evaluate the effect of genotype (G) and environment (E) on the quality of yellow alkaline noodles (YAN). YAN were evaluated for color, appearance, and cooked texture. Brightness (L*) and yellowness (b*) of YAN made from durum cultivars were significantly higher than common wheat. Durum flour yellow pigment content was approximately fourfold greater than common wheat while noodle speckiness was approximately half of CWRS at 2 hr with environment accounting for >75% of the variance for each parameter. Resistance to compression (RTC) and recovery (REC) of cooked durum alkaline noodles were equivalent or superior to common wheat noodles even when lower grade durum wheat flour was used. In conclusion, cooked durum noodle texture parameters were all significantly influenced by genotype and environment, with environment accounting for 66–71% of their variance.
Size‐Exclusion HPLC of Protein Using a Narrow‐Bore Column for Evaluation of Breadmaking Quality of Hard Spring Wheat Flours
Authors: Ohm Jae‐Bom , Hareland Gary , Simsek Senay , Seabourn Bradford 
Published: July 2009

ABSTRACTThe objective of this study was to investigate whether a narrow‐bore column (NBC) (300 × 4.5 mm, i.d.) improved analyses of unreduced proteins in flour by size‐exclusion HPLC (SE‐HPLC) and subsequent evaluation of breadmaking quality of hard spring wheat flours. Total protein extracts and SDS buffer extractable and unextractable proteins were analyzed by SE‐HPLC. NBC separated proteins in 10 min at a flow rate of 0.5 mL/min with similar resolution to a regular column (300 × 7.8 mm, i.d.) which took 30 min. SE‐HPLC absorbance area (AA) data obtained from an NBC showed comparable or superior repeatability and correlations with flour breadmaking characteristics when compared with those of a regular column. AA values of total protein that were calculated by adding AA values of SDS extractable and unextractable proteins showed greater repeatability and correlations with quality characteristics than those of actual total protein extracts. The improvements including employment of an NBC in SE‐HPLC provide enhancement of rapid quality evaluation and decreased consumption of hazardous organic solvents.
A Comparative Study Between the McGill #2 Laboratory Mill and Commercial Milling Systems
Authors: Graves A. M. , Siebenmorgen T. J. , Saleh M. I. 
Published: July 2009

ABSTRACTThe degree of similarity between rice milled in a McGill #2 laboratory mill and commercial milling processes was evaluated using eight physical, physicochemical, and end‐use properties. There was no statistical difference between the two milling systems with respect to color parameters L* and a*, final viscosity, texture, and end‐use cooking properties (α = 0.05). Overall, the kernel dimensions of length, width, and thickness were less in the McGill #2 laboratory‐milled rice than the same rice milled commercially. The incidence of bran streaks and peak viscosity values were each higher when the rice sample was milled commercially in 27, and 28, respectively, of the 29 samples by means comparison. The decrease in kernel dimensions and incidence of bran streaks were attributed to the more aggressive nature of the single‐pass, batch milling system of the McGill #2 laboratory mill as compared with multipass, continuous milling systems that are used commercially. Finally, as surface lipid content (SLC) decreased, L* increased and a*, b*, and the incidence of bran streaks decreased for both milling systems.
Effects of Flour Extraction Rate, Added Water, and Salt on Color and Texture of Chinese White Noodles
Authors: Ye Yili , Zhang Yan , Yan Jun , Zhang Yong , He Zhonghu , Huang Sidi , Quail Kenneth J. 
Published: July 2009

ABSTRACTBoth cultivar and noodle composition and preparation have important effects on noodle quality. In this study, the effects of flour extraction rate (50, 60, and 70%), added water (33, 35, and 37%), and salt concentration (0, 1, and 2%, w/w) on color and texture of Chinese white noodle (CWN) were investigated using flour samples from five leading Chinese wheat cultivars. The five samples showed large variations in protein content, ash content, flour color, farinograph, and extensigraph parameters, and starch pasting properties. Analyses of variance indicated that cultivar, flour extraction rate, level of water addition, salt concentration, and the interactions had significant effects on color of raw noodle sheets and color and textural properties of CWN. Cultivar and water addition were more important sources of variation than flour extraction rate and salt concentration. The brightness (L*) and redness (a*) values of raw noodle sheets were significantly reduced and increased, respectively, as flour extraction rate increased from 50 to 70%, and noodle scores were slightly higher at flour extraction rates of 50%. Water addition showed different effects on raw noodle sheet color at 2 and 24 hr, and a significant improvement was observed for noodle appearance, firmness, viscoelasticity, smoothness, and total score as water addition increased from 33 to 37%. L* of raw noodle sheets, and firmness and viscoelasticity of cooked noodles, were significantly improved, but noodle flavor significantly deteriorated as salt concentration increased from 0 to 2%; 1% salt produced the highest noodle score. Thus, the recommended composition for laboratory preparation of CWN is 60% flour extraction, 35% water addition, and 1% salt concentration.
Renal function predicts cardiovascular outcomes in southern Italian postmenopausal women
Authors: Perticone Francesco , Sciacqua Angela , Maio Raffaele , Perticone Maria , Laino Irma , Bruni Rosamaria , Cello Serena Di , Leone Giulia Galiano , Greco Laura , Andreozzi Francesco , Sesti Giorgio 
Published: July 2009

BackgroundPostmenopausal women have an increased risk of adverse cardiovascular (CV) events. Similarly, chronic kidney disease (CKD) is a well established risk factor for CV disease and mortality.DesignWe evaluated the effect of renal function on the risk of death and CV events in 1500 southern Italian postmenopausal women.Methods and resultsRenal function was estimated (e) by glomerular filtration rate (e-GFR) by Modification of Diet in Renal Disease equation. We classified postmenopausal women in two groups of e-GFR (ml/min per 1.73 m2): ≥ 60 (group 1) and less than 60 (group 2). The primary endpoint was major adverse CV events (MACE). The secondary endpoints were total events (MACE + death from any cause), coronary events, and stroke. During the follow-up (mean = 72.6 months), there were 200 new CV morbid events. The rate of MACE (per 100 patient-years) was 1.88 and 2.98 in the two groups of e-GFR ( P < 0.0001). On univariate analysis, the incident risk of CV events was inversely related with the e-GFR values; similarly, in multiple Cox regression model, only the e-GFR maintained an independent association with MACE and secondary end-points.ConclusionFor the first time, we demonstrated that the reduction of e-GFR was associated with the increased risk of death and CV events, independently of traditional CV risk factors, menopause duration, and presence of metabolic syndrome.
Vitality and recurrent event risk in acute myocardial infarction survivors
Authors: Williams Brent A. , Dorn Joan M. , Donahue Richard P. , Hovey Kathleen M. , Rafalson Lisa B. , Trevisan Maurizio 
Published: July 2009

Background Low vitality, characterized by fatigue and lack of energy, is common among survivors of acute myocardial infarction (AMI) and has been shown to be associated with increased risk of primary and secondary cardiac events. The goal of this study was to determine whether an association between vitality and recurrent cardiac events (nonfatal MI, cardiac death) among acute MI survivors persists after controlling for possible physiological and psychological confounders. Design and methods Incident AMI survivors ( n = 1328) from Erie and Niagara (New York) county hospitals were enrolled and followed up to 9 years. Vitality was measured by the Short Form-36 on a 0–100 scale approximately 4 months post-AMI. Cox proportional hazards models were developed to assess the vitality-recurrent event association controlling for traditional cardiovascular disease risk factors, index MI severity, and psychological correlates of vitality. Results Low-vitality individuals at baseline were more likely females, of higher BMI, smoking, diabetic, less physically active, and to have worse depression scores. Vitality was not strongly associated with MI severity markers. Lower vitality scores were associated with increased risk of recurrent cardiac events: adjusted hazard ratios (95% CI) for vitality scores 51–79, 21–50, and ≤ 20 (compared with ≥ 80) were 1.2 (0.8, 1.8), 1.4 (0.9, 2.2), and 2.9 (1.5, 5.4), respectively ( Ptrend = 0.005). Conclusion Low vitality was associated with increased risk of recurrent cardiac events among AMI survivors after controlling for physiological and psychological confounders. Mechanistic links with vitality should be sought as interventional targets.