Facebook : a 24 hour studio environment for contemporary architectural education

The popularity of Web 2.0 technology amongst tertiary students has become an increased talking point due to its pedagogical capabilities. The purpose of this research was to incorporate the social network Facebook within an architectural design studio to reintroduce the social interaction that was once generated within the traditional, 24 hour setting. This interaction has proven vital to an architect’s future as here they develop the initial peer network within the industry. The study draws upon existing literature to gage the effectiveness of introducing Facebook within the contemporary university environment, further, a case study was established within a second year architectural class. The correspondence was monitored at five intervals across the semester, with the information that was shared, quantified. The aim of this research was to provide the necessary foundation for the feasibility on the possible inclusion of Facebook within architectural tertiary education.

Diurnal variation of corneal shape and thickness

Purpose: To investigate associations between the diurnal variation in a range of corneal parameters, including anterior and posterior corneal topography, and regional corneal thickness. ----- Methods: Fifteen subjects had their corneas measured using a rotating Scheimpflug camera (Pentacam) every 3-7 hours over a 24-hour period. Anterior and posterior corneal axial curvature, pachymetry and anterior chamber depth were analysed. The best fitting corneal sphero-cylinder from the axial curvature, and the average corneal thickness for a series of different corneal regions were calculated. Intraocular pressure and axial length were also measured at each measurement session. Repeated measures ANOVA were used to investigate diurnal change in these parameters. Analysis of covariance was used to examine associations between the measured ocular parameters. ----- Results: Significant diurnal variation was found to occur in both the anterior and posterior corneal curvature and in the regional corneal thickness. Flattening of the anterior corneal best sphere was observed at the early morning measurement (p < 0.0001). The posterior cornea also underwent a significant steepening (p < 0.0001) and change in astigmatism 90/180° at this time. A significant swelling of the cornea (p < 0.0001) was also found to occur immediately after waking. Highly significant associations were found between the diurnal variation in corneal thickness and the changes in corneal curvature. ----- Conclusions: Significant diurnal variation occurs in the regional thickness and the shape of the anterior and posterior cornea. The largest changes in the cornea were typically evident upon waking. The observed non-uniform regional corneal thickness changes resulted in a steepening of the posterior cornea, and a flattening of the anterior cornea to occur at this time.

Measuring voluntary dietary change in response to exercise : a focus on dietary fat

Traditional treatments for weight management have focussed on prescribed dietary restriction or regular exercise, or a combination of both. However recidivism for such prescribed treatments remains high, particularly among the overweight and obese. The aim of this thesis was to investigate voluntary dietary changes in the presence of prescribed mixed-mode exercise, conducted over 16 weeks. With the implementation of a single lifestyle change (exercise) it was postulated that the onerous burden of concomitant dietary and exercise compliance would be reduced, leading to voluntary lifestyle changes in such areas as diet. In addition, the failure of exercise as a single weight loss treatment has been reported to be due to compensatory energy intakes, although much of the evidence is from acute exercise studies, necessitating investigation of compensatory intakes during a long-term exercise intervention. Following 16 weeks of moderate intensity exercise, 30 overweight and obese (BMI≥25.00 kg.m-2) men and women showed small but statistically significant decreases in mean dietary fat intakes, without compensatory increases in other macronutrient or total energy intakes. Indeed total energy intakes were significantly lower for men and women following the exercise intervention, due to the decreases in dietary fat intakes. There was a risk that acceptance of the statistical validity of the small changes to dietary fat intakes may have constituted a Type 1 error, with false rejection of the Null hypothesis. Oro-sensory perceptions to changes in fat loads were therefore investigated to determine whether the measured dietary fat changes were detectable by the human palate. The ability to detect small changes in dietary fat provides sensory feedback for self-initiated dietary changes, but lean and overweight participants were unable to distinguish changes to fat loads of similar magnitudes to that measured in the exercise intervention study. Accuracy of the dietary measurement instrument was improved with the effects of random error (day-to-day variability) minimised with the use of a statistically validated 8-day, multiple-pass, 24 hour dietary recall instrument. However systematic error (underreporting) may have masked the magnitude of dietary change, particularly the reduction in dietary fat intakes. A purported biomarker (plasma Apolipoprotein A-IV) (apoA-IV) was subsequently investigated, to monitor systematic error in self-reported dietary intakes. Changes in plasma apoA-IV concentrations were directly correlated with increased and decreased changes to dietary fat intakes, suggesting that this objective marker may be a useful tool to improve the accuracy of dietary measurement in overweight and obese populations, who are susceptible to dietary underreporting.

Clinical utility of exhaled nitric oxide

Lower airway inflammation is generally classified as eosinophilic or neutrophilic. In conditions where eosinophilic inflammation predominates such as asthma in children, corticosteroids are usually beneficial. Traditionally, lower airway eosinophilia is measured using cellular count (through bronchoalveolar lavage or induced sputum). Both methods have limited applicability in children. When instruments to measure fractional exhaled nitric oxide (FeNO) became available, it presented an attractive option as it provided a non-invasive method of measuring eosinophilic inflammation suitable for children and adult. Not surprisingly, proposals have been made that FeNO measurement can be clinically used in many scenarios including monitoring the response to anti-inflammatory medications, to verify the adherence to treatment, and to predict upcoming asthma exacerbations. This thesis addresses the utility of FeNO levels in various scenarios, specifically in relation to asthma control and cough, a contentious aspect of the diagnosis of asthma. The thesis consists of a series of systematic reviews (related to the main question) and original studies in children. The over-arching aim of the thesis is to determine if FeNO is a clinically useful tool in the management of asthma and common asthma symptoms. The specific aims of the thesis were, to: 1. Determine if children with asthma have more severe acute respiratory symptoms at presentation with an asthma exacerbation and at days 7, 10 and 14 using validated scales. We also examined if children with asthma were more likely to have a persistent cough on day 14 than children with protracted bronchitis and/or controls. 2. Evaluate the efficacy of tailoring asthma interventions based on sputum analysis in comparison to clinical symptoms (with or without spirometry/peak flow) for asthma related outcomes in children and adults. 3. Evaluate the efficacy of tailoring asthma interventions based on exhaled nitric oxide in comparison to clinical symptoms (with or without spirometry/peak flow) for asthma related outcomes in children and adults. 4. Determine if adjustment of asthma medications based on FeNO levels (compared to management based on clinical symptoms) reduces severe exacerbations in children with asthma. 5. Examine the relationship between FeNO and exercise induced broncho-constriction and cough in children The aims above are addressed in respective chapters and all but one has been published/submitted. A synopsis of the findings are: In study-1 (Aim 1), we found that children with protracted bronchitis had the most severe acute respiratory infection symptoms and higher percentage of respiratory morbidity at day 14 in comparison to children with asthma and healthy controls. The systematic review of study-2 (Aim 2) included 246 randomised adult participants (no children) with 221 completing the trials. In the meta-analysis, a significant reduction in number of participants who had one or more asthma exacerbations occurred when treatment was based on sputum eosinophils in comparison to clinical symptoms. In the systematic review of study-3 (Aim 3), we found no significant difference between the intervention group (treatment adjusted based on FeNO) and control group (treatment adjusted based on clinical symptoms) for the primary outcome of asthma exacerbations or for the other outcomes (clinical symptoms, FeNO level and spirometry). In post-hoc analysis, a significant reduction in mean final daily dose ICS per adult was found in the group where treatment was based on FeNO in comparison to clinical symptoms. In contrast, in the paediatric studies, there was a significant increase in ICS dose in the FeNO strategy arm. Thus, controversy remains of the benefit or otherwise of utilising exhaled nitric oxide (FeNO) in routine clinical practice. FeNO levels are dependent on atopy and none of the 7 published trials have considered atopic status in FeNO levels when medications were adjusted. In study-4 (Aim 4), 64 children with asthma were recruited. Their asthma medications were adjusted according to either FeNO levels or usual clinical care utilising a management hierarchy taking into account atopy. It was concluded that tailoring of asthma medications in accordance to FeNO levels (compared to usual management), taking into account atopy status, reduced the number of children with severe exacerbations. However, a FeNO-based strategy resulted in higher daily ICS doses and had no benefit on asthma control. In study-5 (Aim 5), 33 children with cough and 17 controls were recruited. They were randomised to undertake an exercise challenge on day 1, or dry powder mannitol challenge on day 1 (with alternative challenge being done on day 2). In addition, a 24 hour cough meter, skin prick test, capsaicin cough sensitivity test and cough diary were undertaken. The change in cough frequency post exercise was significantly increased in the children with cough. FeNO decreases post exercise regardless of whether EIB is present or not. Limitations in the studies were addressed in the respective chapters. In summary, the studies from this thesis have provided new information on: • The severity of respiratory symptoms was increased in the early phase of the asthma exacerbation but not in the later recovery phase when compared with controls. • The utility of FeNO in the management of children with asthma. • The relationship of FeNO, cough and EIB in children. • Systematic reviews on the efficacy of tailoring asthma interventions based on eosinophilic inflammatory markers (sputum analysis and FeNO) in comparison to clinical symptoms.

Rainfall variability drives interannual variation in N2O emissions from a humid, subtropical pasture

Variations in interannual rainfall totals can lead to large uncertainties in annual N2O emission budget estimates from short term field studies. The interannual variation in nitrous oxide (N2O) emissions from a subtropical pasture in Queensland, Australia, was examined using continuous measurements of automated chambers over 2 consecutive years. Nitrous oxide emissions were highest during the summer months and were highly episodic, related more to the size and distribution of rain events than soil water content. Over 48% of the total N2O emitted was lost in just 16% of measurement days. Interannual variation in annual N2O estimates was high, with cumulative emissions increasing with decreasing rainfall. Cumulative emissions averaged 1826.7 ± 199.9 g N2O-N ha−1 yr−1 over the two year period, though emissions from 2008 (2148 ± 273 g N2O-N ha−1 yr−1) were 42% higher than 2007 (1504 ± 126 g N2O-N ha−1 yr−1). This increase in annual emissions coincided with almost half of the summer precipitation from 2007 to 2008. Emissions dynamics were chiefly driven by the distribution and size of rain events which varied on a seasonal and annual basis. Sampling frequency effects on cumulative N2O flux estimation were assessed using a jackknife technique to inform future manual sampling campaigns. Test subsets of the daily measured data were generated for the pasture and two adjacent land-uses (rainforest and lychee orchard) by selecting measured flux values at regular time intervals ranging from 1 to 30 days. Errors associated with weekly sampling were up to 34% of the sub-daily mean and were highly biased towards overestimation if strategically sampled following rain events. Sampling time of day also played a critical role. Morning sampling best represented the 24 hour mean in the pasture, whereas sampling at noon proved the most accurate in the shaded rainforest and lychee orchard.

Diurnal variation of anterior scleral and conjunctival thickness

Purpose To examine whether anterior scleral and conjunctival thickness undergoes significant diurnal variation over a 24-hour period. Methods Nineteen healthy young adults (mean age 22 ± 2 years) with minimal refractive error (mean spherical equivalent refraction -0.08 ± 0.39 D), had measures of anterior scleral and conjunctival thickness collected using anterior segment optical coherence tomography (AS-OCT) at seven measurement sessions over a 24-hour period. The thickness of the temporal anterior sclera and conjunctiva were determined at 6 locations (each separated by 0.5 mm) at varying distances from the scleral spur for each subject at each measurement session. Results Both the anterior sclera and conjunctiva were found to undergo significant diurnal variations in thickness over a 24-hour period (both p <0.01). The sclera and conjunctiva exhibited a similar pattern of diurnal change, with a small magnitude thinning observed close to midday, and a larger magnitude thickening observed in the early morning immediately after waking. The amplitude of diurnal thickness change was larger in the conjunctiva (mean amplitude 69 ± 29 μm) compared to the sclera (21 ± 8 μm). The conjunctiva exhibited its smallest magnitude of change at the scleral spur location (mean amplitude 56 ± 17 μm) whereas the sclera exhibited its largest magnitude of change at this location (52 ± 21 μm). Conclusions This study provides the first evidence of diurnal variations occurring in the thickness of the anterior sclera and conjunctiva. Studies requiring precise measures of these anatomical layers should therefore take time of day into consideration. The majority of the observed changes occurred in the early morning immediately after waking and were of larger magnitude in the conjunctiva compared to the sclera. Thickness changes at other times of the day were of smaller magnitude and generally not statistically significant.

Characterisation of the impact of open biomass burning on urban air quality in Brisbane, Australia

Open biomass burning from wildfires and the prescribed burning of forests and farmland is a frequent occurrence in South-East Queensland (SEQ), Australia. This work reports on data collected from 10-30 September 2011, which covers the days before (10-14 September), during (15-20 September) and after (21-30 September) a period of biomass burning in SEQ. The aim of this project was to comprehensively quantify the impact of the biomass burning on air quality in Brisbane, the capital city of Queensland. A multi-parameter field measurement campaign was conducted and ambient air quality data from 13 monitoring stations across SEQ were analysed. During the burning period, the average concentrations of all measured pollutants increased (from 20% to 430%) compared to the non-burning period (both before and after burning), except for total xylenes. The average concentration of O3, NO2, SO2, benzene, formaldehyde, PM10, PM2.5 and visibility-reducing particles reached their highest levels for the year, which were up to 10 times higher than annual average levels, while PM10, PM2.5 and SO2 concentrations exceeded the WHO 24-hour guidelines and O3 concentration exceeded the WHO maximum 8-hour average threshold during the burning period. Overall spatial variations showed that all measured pollutants, with the exception of O3, were closer to spatial homogeneity during the burning compared to the non-burning period. In addition to the above, elevated concentrations of three biomass burning organic tracers (levoglucosan, mannosan and galactosan), together with the amount of non-refractory organic particles (PM1) and the average value of f60 (attributed to levoglucosan), reinforce that elevated pollutant concentration levels were due to emissions from open biomass burning events, 70% of which were prescribed burning events. This study, which is the first and most comprehensive of its kind in Australia, provides quantitative evidence of the significant impact of open biomass burning events, especially prescribed burning, on urban air quality. The current results provide a solid platform for more detailed health and modelling investigations in the future.

When 'listeners can't talk' : comparing active listening in opening sequences of telephone and online counselling

While there is growing use of online counselling, little is known about its interactional organisation and how it compares to telephone counselling. This is despite past research suggesting that both counsellors and clients report the impact of the different modalities on the presentation and management of the counselling interaction. This paper compares the interactional affordances of telephone and online web counselling in opening sequences on Kids Help Line, a 24-hour Australian counselling service for children and young people up to the age of 25. We examine two ways that counsellors show active listening through response tokens and formulations. The analysis describes how counsellors’ use of minimal response tokens facilitate the clients’ problem presentation and are used in the management of turn taking and sequence organisation. For example, counsellors use the response token Mm hm to show that they understand that the client’s unit of talk to is not yet complete, and to affirm or invite the client to continue speaking. Formulations in phone and web counselling are another way that counsellors display active listening to re-present stretches of the clients’ preceding talk. In phone and web counselling, however, the respective modalities can complicate matters of turn transition and sequence organisation. By examining actual phone and online counselling sessions, this paper offers empirical demonstrations of the interactional affordances of phone and online counselling, and shows how the institutional practice of active listening is accomplished across different counselling modalities

Socioeconomic differences in takeaway food consumption and their contribution to inequalities in dietary intakes

Background Takeaway consumption has been increasing and may contribute to socioeconomic inequalities in overweight/obesity and chronic disease. This study examined socioeconomic differences in takeaway consumption patterns, and their contributions to dietary intake inequalities. Method Cross-sectional dietary intake data from adults aged between 25 and 64 years from the Australian National Nutrition Survey (n= 7319, 61% response rate). Twenty-four hour dietary recalls ascertained intakes of takeaway food, nutrients and fruit and vegetables. Education was used as socioeconomic indicator. Data were analysed using logistic regression and general linear models. Results Thirty-two percent (n = 2327) consumed takeaway foods in the 24 hour period. Lower-educated participants were less likely than their higher-educated counterparts to have consumed total takeaway foods (OR 0.64; 95% CI 0.52, 0.80). Of those consuming takeaway foods, the lowest-educated group was more likely to have consumed “less healthy” takeaway choices (OR 2.55; 95% CI 1.73, 3.77), and less likely to have consumed “healthy” choices (OR 0.52; 95% CI 0.36, 0.75). Takeaway foods made a greater contribution to energy, total fat, saturated fat, and fibre intakes among lower than higher-educated groups. Lower likelihood of fruit and vegetable intakes were observed among “less healthy” takeaway consumers, whereas a greater likelihood of their consumption was found among “healthy” takeaway consumers. Conclusions Total and the types of takeaway foods consumed may contribute to socioeconomic inequalities in intakes of energy, total and saturated fats. However, takeaway consumption is unlikely to be a factor contributing to the lower fruit and vegetable intakes among socioeconomically-disadvantaged groups.

Translation and news making : a study of contemporary arabic television

Arabic satellite television has recently attracted tremendous attention in both the academic and professional worlds, with a special interest in Aljazeera as a curious phenomenon in the Arab region. Having made a household name for itself worldwide with the airing of the Bin Laden tapes, Aljazeera has set out to deliberately change the culture of Arabic journalism, as it has been repeatedly stated by its current General Manager Waddah Khanfar, and to shake up the Arab society by raising awareness to issues never discussed on television before and challenging long-established social and cultural values and norms while promoting, as it claims, Arab issues from a presumably Arab perspective. Working within the meta-frame of democracy, this Qatari-based network station has been received with mixed reactions ranging from complete support to utter rejection in both the west and the Arab world. This research examines the social semiotics of Arabic television and the socio-cultural impact of translation-mediated news in Arabic satellite television, with the aim to carry out a qualitative content analysis, informed by framing theory, critical linguistic analysis, social semiotics and translation theory, within a re-mediation framework which rests on the assumption that a medium “appropriates the techniques, forms and social significance of other media and attempts to rival or refashion them in the name of the real" (Bolter and Grusin, 2000: 66). This is a multilayered research into how translation operates at two different yet interwoven levels: translation proper, that is the rendition of discourse from one language into another at the text level, and translation as a broader process of interpretation of social behaviour that is driven by linguistic and cultural forms of another medium resulting in new social signs generated from source meaning reproduced as target meaning that is bound to be different in many respects. The research primarily focuses on the news media, news making and reporting at Arabic satellite television and looks at translation as a reframing process of news stories in terms of content and cultural values. This notion is based on the premise that by its very nature, news reporting is a framing process, which involves a reconstruction of reality into actualities in presenting the news and providing the context for it. In other words, the mediation of perceived reality through a media form, such as television, actually modifies the mind’s ordering and internal representation of the reality that is presented. The research examines the process of reframing through translation news already framed or actualized in another language and argues that in submitting framed news reports to the translation process several alterations take place, driven by the linguistic and cultural constraints and shaped by the context in which the content is presented. These alterations, which involve recontextualizations, may be intentional or unintentional, motivated or unmotivated. Generally, they are the product of lack of awareness of the dynamics and intricacies of turning a message from one language form into another. More specifically, they are the result of a synthesis process that consciously or subconsciously conforms to editorial policy and cultural interpretive frameworks. In either case, the original message is reproduced and the news is reframed. For the case study, this research examines news broadcasts by the now world-renowned Arabic satellite television station Aljazeera, and to a lesser extent the Lebanese Broadcasting Corporation (LBC) and Al- Arabiya where access is feasible, for comparison and crosschecking purposes. As a new phenomenon in the Arab world, Arabic satellite television, especially 24-hour news and current affairs, provides an interesting area worthy of study, not only for its immediate socio-cultural and professional and ethical implications for the Arabic media in particular, but also for news and current affairs production in the western media that rely on foreign language sources and translation mediation for international stories.

Evaluation of fruit and vegetable intakes of Australian adults: the nutrition survey 1995

Objective: To evaluate the fruit and vegetable intakes of Australian adults aged 19-64 years. Methods: Intake data were collected as part of the National Nutrition Survey 1995 representing all Australian States and Territories, including city, metropolitan, rural and remote areas. Dietary intake of 8,891 19-to-64 year-olds was assessed using a structured 24-hour recall. Intake frequency was assessed as the proportion of participants consuming fruit and vegetables on the day prior to interview and variety was assessed as the number of subgroups of fruit and vegetables consumed. Intake levels were compared with the recommendations of the Australian Guide to Healthy Eating (AGHE). Results: Sixty-two per cent of participants consumed some fruit and 89% consumed some vegetables on the day surveyed. Males were less likely to consume fruit and younger adults less likely to consume fruit and vegetables compared with females and older adults respectively. Variety was primarily low (1 subcategory) for fruit and medium (3-4 subcategories) for vegetables. Thirty-two per cent of adults consumed the minimum two serves of fruit and 30% consumed the minimum five serves of vegetables as recommended by the AGHE. Eleven per cent of adults met the minimum recommendations for both fruit and vegetables. Conclusion: A large proportion of adults have fruit and vegetable intakes below the AGHE minimum recommendations. Implications: A nationally integrated, longterm campaign to increase fruit and vegetable consumption, supported by policy changes to address structural barriers to consumption, is vital to improve fruit and vegetable consumption among adults

Journalists in film : heroes and villains

In November 2010, the world watched as 33 Chilean miners were rescued from the depths of the earth where they had been stranded since July. We were able to watch because the world’s news media were there, drawn by the human drama, the suspense, the spectacle. It was a great news story, ideally suited for the 24-hour news culture we live in today, and the globalised audience that consumes it. Nothing much happened for 68 of those 69 days, until that final 24 hours when the miners emerged. But we were transfixed, engrossed, immersed in the story.

Intermittent access to 20% ethanol induces high ethanol consumption in Long-Evans and Wistar rats

BACKGROUND: There has been some difficulty getting standard laboratory rats to voluntarily consume large amounts of ethanol without the use of initiation procedures. It has previously been shown that standard laboratory rats will voluntarily consume high levels of ethanol if given intermittent-access to 20% ethanol in a 2-bottle-choice setting [Wise, Psychopharmacologia 29 (1973), 203]. In this study, we have further characterized this drinking model. METHODS: Ethanol-naïve Long-Evans rats were given intermittent-access to 20% ethanol (three 24-hour sessions per week). No sucrose fading was needed and water was always available ad libitum. Ethanol consumption, preference, and long-term drinking behaviors were investigated. Furthermore, to pharmacologically validate the intermittent-access 20% ethanol drinking paradigm, the efficacy of acamprosate and naltrexone in decreasing ethanol consumption were compared with those of groups given continuous-access to 10 or 20% ethanol, respectively. Additionally, ethanol consumption was investigated in Wistar and out-bred alcohol preferring (P) rats following intermittent-access to 20% ethanol. RESULTS: The intermittent-access 20% ethanol 2-bottle-choice drinking paradigm led standard laboratory rats to escalate their ethanol intake over the first 5 to 6 drinking sessions, reaching stable baseline consumption of high amounts of ethanol (Long-Evans: 5.1 +/- 0.6; Wistar: 5.8 +/- 0.8 g/kg/24 h, respectively). Furthermore, the cycles of excessive drinking and abstinence led to an increase in ethanol preference and increased efficacy of both acamprosate and naltrexone in Long-Evans rats. P-rats initiate drinking at a higher level than both Long-Evans and Wistar rats using the intermittent-access 20% ethanol paradigm and showed a trend toward a further escalation in ethanol intake over time (mean ethanol intake: 6.3 +/- 0.8 g/kg/24 h). CONCLUSION: Standard laboratory rats will voluntarily consume ethanol using the intermittent-access 20% ethanol drinking paradigm without the use of any initiation procedures. This model promises to be a valuable tool in the alcohol research field.

Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study

Background: Distal-to-proximal technique has been recommended for anti-cancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous uncomplicated venous puncture proximal to the administration site. Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anti-cancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anti-cancer therapy via an administration site distal to at least one previous uncomplicated venous puncture on the same arm in a tertiary cancer centre in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was one incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and two incidents of phlebitis at the administration site. Conclusions: A 24 hour delay is unnecessary if an alternative vein can be accessed for anti-cancer therapy after a proximal venous puncture. Implications for practice: Extravasation can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anti-cancer therapy at a distal site if the nurse can confidently determine the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.