Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP

Implementing Elements of The Physics Suite at a Large Metropolitan Research University

A key question in physics education is the effectiveness of the teaching methods. A curriculum that has been investigated at the University of Central Florida (UCF) over a period of two years is the use of particular elements of The Physics Suite. Select sections of the introductory physics classes at UCF have made use of Interactive Lecture Demonstrations as part of the lecture component of the class. The lab component of the class has implemented the RealTime Physics curriculum, again in select sections. The remaining sections have continued with the teaching methods traditionally used. Using pre- and post-semester concept inventory tests, a student survey, student interviews, and a standard for successful completion of the course, the data indicates improved student learning

The limits of social class in explaining ethnic gaps in educational attainment

This paper reports an analysis of the educational attainment and progress between age 11 and age 14 of over 14,500 students from the nationally representative Longitudinal Study of Young People in England (LSYPE). The mean attainment gap in national tests at age 14 between White British and several ethnic minority groups were large, more than three times the size of the gender gap, but at the same time only about one-third of the size of the social class gap. Socio-economic variables could account for the attainment gaps for Black African, Pakistani and Bangladeshi students, but not for Black Caribbean students. Further controls for parental and student attitudes, expectations and behaviours indicated minority ethnic groups were on average more advantaged on these measures than White British students, but this was not reflected proportionately in their levels of attainment. Black Caribbean students were distinctive as the only group making less progress than White British students between age 11 and 14 and this could not be accounted for by any of the measured contextual variables. Possible explanations for the White British-Black Caribbean gap are considered

An approach to propagate streamflow statistics along the river network

Streamflow at ungauged sites is often predicted by means of regional statistical procedures. The standard regional approaches do not preserve the information related to the hierarchy among gauged stations deriving from their location along the river network. However, this information is important when estimating runoff at a site located immediately upstream or downstream of a gauging station. We propose here a novel approach, referred to as the Along-Stream Estimation (ASE) method, to improve runoff estimation at ungauged sites. The ASE approach starts from the regional estimate at an ungauged (target) site, and corrects it based on regional and sample estimates of the same variable at a donor site, where sample data are available. A criterion to define the domain of application around each donor site of the ASE approach is proposed, and the uncertainty inherent in the estimates obtained is evaluated. This allows one to compare the variance of the along-stream estimates to that of other models that eventually become available for application (e.g. regional models), and thus to choose the most accurate method (or to combine different estimates). The ASE model was applied in the northwest of Italy in connection with an existing regional model for flood frequency analysis. The analysed variables are the first L-moments of the annual discharge maxima. The application demonstrates that the ASE approach can be used effectively to improve the regional estimates for the L-moment of order one (the index flood), particularly when the area ratio of a pair of donor-target basins is less than or equal to ten. However, in this case study, the method does not provide significant improvements to the estimation of higher-order L-moment

The Academics Athletics Trade-off: Universities and Intercollegiate Athletics

This analysis focuses on several key issues in the Football Bowl Subdivision (FBS). The intrinsic benefits of athletic programs are discussed in the first section. Trends in graduation rates and academic performance among athletes and how they correlate with the general student body are discussed in the second section. Finally, an overview of the revenues and expenses of athletic department budgets are discussed in an effort to gain a better understanding of the allocation of funds to athletics. In spite of recent growth in revenues and expenses, the athletic department budget comprises on average only 5 percent of the entire university budget at an FBS school, though spending and revenues have increased dramatically in recent years. In the grand scheme of things, American higher education faces several other, arguably more pressing, areas of reform. However, athletics is a significant and growing dimension of higher education that warrants in-depth examination

A partition functional and thermodynamic properties of the infinite-dimensional Hubbard model

An approximate partition functional is derived for the infinite-dimensional Hubbard model. This functional naturally includes the exact solution of the Falicov-Kimball model as a special case, and is exact in the uncorrelated and atomic limits. It explicitly keeps spin-symmetry. For the case of the Lorentzian density of states, we find that the Luttinger theorem is satisfied at zero temperature. The susceptibility crosses over smoothly from that expected for an uncorrelated state with antiferromagnetic fluctuations at high temperature to a correlated state at low temperature via a Kondo-type anomaly at a characteristic temperature $T^\star$. We attribute this anomaly to the appearance of the Hubbard pseudo-gap. The specific heat also shows a peak near $T^\star$. The resistivity goes to zero at zero temperature, in contrast to other approximations, rises sharply around $T^\star$ and has a rough linear temperature dependence above $T^\star$.Comment: 18 pages, 6 figures upon request, latex, (to appear in Phys. Rev. B

Future directions for the management of pain in osteoarthritis.

Osteoarthritis (OA) is the predominant form of arthritis worldwide, resulting in a high degree of functional impairment and reduced quality of life owing to chronic pain. To date, there are no treatments that are known to modify disease progression of OA in the long term. Current treatments are largely based on the modulation of pain, including NSAIDs, opiates and, more recently, centrally acting pharmacotherapies to avert pain. This review will focus on the rationale for new avenues in pain modulation, including inhibition with anti-NGF antibodies and centrally acting analgesics. The authors also consider the potential for structure modification in cartilage/bone using growth factors and stem cell therapies. The possible mismatch between structural change and pain perception will also be discussed, introducing recent techniques that may assist in improved patient phenotyping of pain subsets in OA. Such developments could help further stratify subgroups and treatments for people with OA in future

Investigation of initiation of gigantic jets connecting thunderclouds to the ionosphere

The initiation of giant electrical discharges called as "gigantic jets" connecting thunderclouds to the ionosphere is investigated by numerical simulation method in this paper. Using similarity relations, the triggering conditions of streamer formation in laboratory situations are extended to form a criterion of initiation of gigantic jets. The energy source causing a gigantic jet is considered due to the quasi-electrostatic field generated by thunderclouds. The electron dynamics from ionization threshold to streamer initiation are simulated by the Monte Carlo technique. It is found that gigantic jets are initiated at a height of ~18-24 km. This is in agreement with the observations. The method presented in this paper could be also applied to the analysis of the initiation of other discharges such as blue jets and red sprites.Comment: 12th International Congress on Plasma Physics, 25-29 October 2004, Nice (France

Angle of Incidence Effects on Far-Field Positive and Negative Phase Blast Parameters

The blast overpressure acting on a rigid target is known to vary between the normally reflected overpressure and the incident overpressure as a function of the angle between the target and the direction of travel of the blast wave. Literature guidance for determining the exact effects of angle of incidence are unclear, particularly when considering the negative phase. This paper presents the results from a series of well controlled experiments where pressure transducers are used to record the pressure-time history acting on the face of a large, rigid target at various angles of incidence for varying sizes of hemispherical PE4 charge and stand-off distances. The test data demonstrated remarkable repeatability, and excellent agreement with semi-empirical predictions for normally reflected overpressures. The oblique results show that peak overpressure, impulse and duration are highly dependent on angle of incidence for the positive phase, and are invariant of angle of incidence for the negative phase