Successes and failures in assessing acquired language disorders using an Internet-based telerehabilitation system

We have used a telerehabilitation system (eREHAB) to remotely assess acquired language disorders via the Internet. The system was used to establish a 128 kbit/s videoconference between two sites and allowed a remote language assessment to be conducted using the standardized Boston Diagnostic Aphasia Examination (BDAE). The system had the capacity to display text and images, and could play pre-recorded instructions to the participant via various built-in tools. A touch screen allowed tasks involving picture identification to be completed easily. Eighteen participants with a diagnosis of an acquired language disorder were simultaneously assessed using the eREHAB system, and in the traditional face-to-face manner by two speech pathologists. There was very high agreement between the two assessors, with weighted kappa scores of 0.8–1.0 for 88% of the sub-tests of the BDAE. There was also high agreement (80–100%) and high kappa scores (0.67–0.90) between assessors on the six rating scales relating to language characteristics. The agreement between the two assessors for the diagnosis of the type of aphasia was 83%. Limitations of the system related mainly to problems inherent in IP videoconferencing. The inability to maintain the preferred speed of 128 kbit/s for the duration of the videoconference and the resultant increase in video and audio breakup and latency affected the clinician’s ability to administer the BDAE with the same ease and accuracy as in face-to-face administration. These difficulties were exacerbated when participants presented with a moderate to severe language disorder, auditory comprehension deficits or significant hearing loss. Despite these limitations, a valid assessment of language disorder was found to be feasible via this telerehabilitation application.

An evaluation of tobacco brief intervention training in three Indigenous health care settings in north Queensland

Objective: To evaluate the pilot phase of a tobacco brief intervention program in three Indigenous health care settings in rural and remote north Queensland. Methods: A combination of in-depth interviews with health staff and managers and focus groups with health staff and consumers. Results: The tobacco brief intervention initiative resulted in changes in clinical practice among health care workers in all three sites. Although health workers had reported routinely raising the issue of smoking in a variety of settings prior to the intervention, the training provided them with an additional opportunity to become more aware of new approaches to smoking cessation. Indigenous health workers in particular reported that their own attempts to give up smoking following the training had given them confidence and empathy in offering smoking cessation advice. However, the study found no evidence that anybody had actually given up smoking at six months following the intervention. Integration of brief intervention into routine clinical practice was constrained by organisational, interpersonal and other factors in the broader socio-environmental context. Conclusions/implications: While modest health gains may be possible through brief intervention, the potential effectiveness in Indigenous settings will be limited in the absence of broader strategies aimed at tackling community-identified health priorities such as alcohol misuse, violence, employment and education. Tobacco and other forms of lifestyle brief. intervention need to be part of multi-level health strategies. Training in tobacco brief intervention should address both the Indigenous context and the needs of Indigenous health care workers.

Physicochemical and structural characterization of mesoporous aluminosilicates synthesized from leached saponite with additional aluminum incorporation

A thorough investigation was performed on the physical (mechanical, thermal, and hydrothermal stability) and chemical (ion exchange capacity and silanol number) characteristics of aluminosilicate FSMs, synthesized via a new successful short-time synthesis route using leached saponite and a low concentration of CTAB. Moreover, the influence of an additional Al incorporation, utilizing different aluminum sources, on the structure of the FSM derived from saponite is studied. A mesoporous aluminosilicate with a low Si/Al ratio of 12.8 is synthesized, and still has a very large surface area of 1130 m(2)/g and pore volume of 0.92 cm(3)/g. The aluminum-containing samples all have a high cation exchange capacity of around 1 mmol/9 while they still have a silanol number of about 0.9 OH/nm(2); both characteristics being interesting for high-yield postsynthesis modification reactions. Finally, a study is performed on the transformation of the aluminosilicates into their Bronsted acid form via the exchange with ammonium ions and a consecutive heat treatment.

Characterization of the acidic properties of mesoporous aluminosilicates synthesized from leached saponite with additional aluminum incorporation

The acidic properties of hexagonal mesoporous aluminosilicates synthesized via a new successful short time synthesis route using leached saponite and a low concentration of surfactant are thoroughly investigated. The resulting aluminosilicate mesoporous materials with high Si/Al ratios of around 11 have a maximal surface area of 1130 m(2)/g, a pore volume of 0.92 cm(3)/g, and a narrow pore size distribution at around 3 nm. The replacement of the sodium ions, present as counterions in the synthesized aluminosilicates, with protons imparts useful catalytic acidity. This acidity is extensively studied with FTIR spectroscopy after adsorption of ammonia and cyclohexylamine, while deuterated acetonitrile differentiates between Bronsted and Lewis acidity. Al-27 NMR spectroscopy determined the coordination of the aluminum in the FSM materials. Simultaneously the effect of an additional Al incorporation, utilizing sodium aluminate, aluminum nitrate, and aluminum isopropoxide is studied. From an acidic point of view, the incorporation with Al(NO3)(3) appears to be the most optimal, as the sample has a very high amount of acid sites (1.3 mmol/g). Investigating the nature of the acid sites it is found that in all samples except the one incorporated with Al(NO3)(3), more Bronsted than Lewis sites are present, both sites being quite acidic as they resist desorption temperatures up to 300 degreesC. Probing the coordination and location of the Al atoms, all the catalysts appeared to have mostly tetrahedral aluminum, up to 95% of the total Al amount for the proton exchanged AI(NO3)(3) incorporated sample.

Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK

Objective: To evaluate the cost of atrial fibrillation (AF) to health and social services in the UK in 1995 and, based on epidemiological trends, to project this estimate to 2000. Design, setting, and main outcome measures: Contemporary estimates of health care activity related to AF were applied to the whole population of the UK on an age and sex specific basis for the year 1995. The activities considered ( and costs calculated) were hospital admissions, outpatient consultations, general practice consultations, and drug treatment ( including the cost of monitoring anticoagulant treatment). By adjusting for the progressive aging of the British population and related increases in hospital admissions, the cost of AF was also projected to the year 2000. Results: There were 534 000 people with AF in the UK during 1995. The direct'' cost of health care for these patients was pound 244 million (similar toE350 million) or 0.62% of total National Health Service ( NHS) expenditure. Hospitalisations and drug prescriptions accounted for 50% and 20% of this expenditure, respectively. Long term nursing home care after hospital admission cost an additional pound46.4 million (similar toE66 million). The direct cost of AF rose to pound459 million (similar toE655 million) in 2000, equivalent to 0.97% of total NHS expenditure based on 1995 figures. Nursing home costs rose to pound111 million (similar toE160 million). Conclusions: AF is an extremely costly public health problem.

Addressing internet training issues for people with Parkinson's disease

The Internet enables access to information, services, support and participation in leisure opportunities. Some populations, including people with disabilities, lack access to these opportunities through the Internet. Barriers may include finances, physical access, lack of resources and inaccessible websites. Limited access to Internet training is an additional barrier for people with communication impairments. People with Parkinson's disease (PD) may have difficulty accessing usual Internet training due to high-level language, cognitive and physical limitations. Aphasia-friendly Internet training materials were trialed with this population to investigate if participants could learn to use the Internet and would benefit from Internet training. The tutors' experience was also investigated using qualitative measures. Seven people with PD were matched with volunteer tutors. These pairs met for six Internet training lessons using training materials available as a free download from: http://dexter.shrs.uq.edu.au/cdaru/aphasiagroups/. Pre and post-test Internet skills assessments and attitudinal questionnaires were conducted. Significant differences between pre and post-test scores were found. Participants reached varying levels of independence on Internet tasks. Favorable outcomes were reported by participants, and tutors reported a positive experience. Further investigation is recommended to determine the efficacy of this approach compared with other training avenues and with other communication-impaired populations. Practical and theoretical implications for speech pathology practice are discussed.

An ESR study of the radiolysis of semi-crystalline ethylene-propylene copolymers containing DOP mobilizer

The radiolysis of a poly(ethylene-co-propylene), Elpro, marketed by Thai Polypropylene Co. Ltd for the manufacture of medical goods has been investigated at 77 K. Calcium stearate was blended with the Elpro as a processing aid; and dioctyl phthalate, DOP, was added in various amounts as a radiation stabilizer. The ESR spectra of Elpro and Elpro+Ca were very similar and characterized principally by the presence of PP a-carbon radicals. The spectra of the samples containing DOP were similar to those for Elpro but with an additional narrow singlet arising from DOP radicals. On annealing the irradiated polymers to higher temperatures, the singlet was lost between 250 and 270 K, and at room temperature the principal radicals remaining were allyl radicals. The G-values for radical formation at 77 K for Elpro and Elpro+Ca at 77 K were 3.0 and 3.2, respectively, but incorporation of DOP resulted in lower G-values, ranging from 1.6 to 1.4 for 0.5 and 2.5 phr DOP, respectively.(c) 2005 Wiley Periodicals, Inc.

An inverse method for designing loaded RF coils in MRI

Radio-frequency ( RF) coils are designed such that they induce homogeneous magnetic fields within some region of interest within a magnetic resonance imaging ( MRI) scanner. Loading the scanner with a patient disrupts the homogeneity of these fields and can lead to a considerable degradation of the quality of the acquired image. In this paper, an inverse method is presented for designing RF coils, in which the presence of a load ( patient) within the MRI scanner is accounted for in the model. To approximate the finite length of the coil, a Fourier series expansion is considered for the coil current density and for the induced fields. Regularization is used to solve this ill-conditioned inverse problem for the unknown Fourier coefficients. That is, the error between the induced and homogeneous target fields is minimized along with an additional constraint, chosen in this paper to represent the curvature of the coil windings. Smooth winding patterns are obtained for both unloaded and loaded coils. RF fields with a high level of homogeneity are obtained in the unloaded case and a limit to the level of homogeneity attainable is observed in the loaded case.

Defective p53 response and apoptosis associated with an ataxia-telangiectasia-like phenotype

Ataxia-telangiectasia mutated (ATM), the protein defective in ataxia-telangiectasia, plays a central role in DNA damage response and signaling to cell cycle checkpoints. We describe here a cell line from a patient with an ataxia-telangiectasia-like clinical phenotype defective in the p53 response to radiation but with normal ATM activation and efficient downstream phosphorylation of other ATM substrates. No mutations were detected in ATM cDNA. A normal level of interaction between p53 and peptidyl-prolyl-isomerase Pin1 suggests that posttranslational modification was intact in these cells but operating at reduced level. Defective p53 stabilization was accompanied by defective induction of p53 effector genes and failure to induce apoptosis in response to DNA-damaging agents. Continued association between p53 and murine double minute-2 (Mdm2) occurred in irradiated ATL2ABR cells in response to DNA damage, and incubation with Mdm2 antagonists, nutlins, increased the stabilization of p53 and its transcriptional activity but failed to induce apoptosis. These results suggest that ATM-dependent stabilization of p53 and induction of apoptosis by radiation involve an additional factor(s) that is defective in ATL2ABR cells.

The discriminative bilateral filter: An enhanced denoising filter for electron microscopy data

Advances in three-dimensional (313) electron microscopy (EM) and image processing are providing considerable improvements in the resolution of subcellular volumes, macromolecular assemblies and individual proteins. However, the recovery of high-frequency information from biological samples is hindered by specimen sensitivity to beam damage. Low dose electron cryo-microscopy conditions afford reduced beam damage but typically yield images with reduced contrast and low signal-to-noise ratios (SNRs). Here, we describe the properties of a new discriminative bilateral (DBL) filter that is based upon the bilateral filter implementation of Jiang et al. (Jiang, W., Baker, M.L., Wu, Q., Bajaj, C., Chin, W., 2003. Applications of a bilateral denoising filter in biological electron microscopy. J. Struc. Biol. 128, 82-97.). In contrast to the latter, the DBL filter can distinguish between object edges and high-frequency noise pixels through the use of an additional photometric exclusion function. As a result, high frequency noise pixels are smoothed, yet object edge detail is preserved. In the present study, we show that the DBL filter effectively reduces noise in low SNR single particle data as well as cellular tomograms of stained plastic sections. The properties of the DBL filter are discussed in terms of its usefulness for single particle analysis and for pre-processing cellular tomograms ahead of image segmentation. (c) 2006 Elsevier Inc. All rights reserved.

The effect of music therapy services on classroom behaviours of newly arrived refugee students in Australia

This pilot study examined the effects of a short-term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive 'English as a Second Language' secondary school. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one or two times per week. Data from the Behaviour Assessment Scale for Children were used to evaluate a range of positive and negative school behaviours. A significant decrease in externalising behaviours was found with particular reference to hyperactivity and aggression. No significant differences were found in other behaviours. Explanations and implications of these findings are discussed.

Consumer search of the web: An exploratory analysis of antecedents of web search satisfaction

This article explores consumer Web-search satisfaction. It commences with a brief overview of the concepts consumer information search and consumer satisfaction. Consumer Web adoption issues are then briefly discussed and the importance of consumer search satisfaction is highlighted in relation to the adoption of the Web as an additional source of consumer information. Research hypotheses are developed and the methodology of a large scale consumer experiment to record consumer Web search behaviour is described. The hypotheses are tested and the data explored in relation to post-Web-search satisfaction. The results suggest that consumer post-Web-search satisfaction judgments may be derived from subconscious judgments of Web search efficiency, an empirical calculation of which is problematic in unlimited information environments such as the Web. The results are discussed and a future research agenda is briefly outlined.

An anisotropic viscous representation of Mohr-Coulomb failure for use is modelling coupled mantle-continent dynamics

In mantle convection models it has become common to make use of a modified (pressure sensitive, Boussinesq) von Mises yield criterion to limit the maximum stress the lithosphere can support. This approach allows the viscous, cool thermal boundary layer to deform in a relatively plate-like mode even in a fully Eulerian representation. In large-scale models with embedded continental crust where the mobile boundary layer represents the oceanic lithosphere, the von Mises yield criterion for the oceans ensures that the continents experience a realistic broad-scale stress regime. In detailed models of crustal deformation it is, however, more appropriate to choose a Mohr-Coulomb yield criterion based upon the idea that frictional slip occurs on whichever one of many randomly oriented planes happens to be favorably oriented with respect to the stress field. As coupled crust/mantle models become more sophisticated it is important to be able to use whichever failure model is appropriate to a given part of the system. We have therefore developed a way to represent Mohr-Coulomb failure within a code which is suited to mantle convection problems coupled to large-scale crustal deformation. Our approach uses an orthotropic viscous rheology (a different viscosity for pure shear to that for simple shear) to define a prefered plane for slip to occur given the local stress field. The simple-shear viscosity and the deformation can then be iterated to ensure that the yield criterion is always satisfied. We again assume the Boussinesq approximation - neglecting any effect of dilatancy on the stress field. An additional criterion is required to ensure that deformation occurs along the plane aligned with maximum shear strain-rate rather than the perpendicular plane which is formally equivalent in any symmetric formulation. It is also important to allow strain-weakening of the material. The material should remember both the accumulated failure history and the direction of failure. We have included this capacity in a Lagrangian-Integration-point finite element code and will show a number of examples of extension and compression of a crustal block with a Mohr-Coulomb failure criterion, and comparisons between mantle convection models using the von Mises versus the Mohr-Coulomb yield criteria. The formulation itself is general and applies to 2D and 3D problems, although it is somewhat more complicated to identify the slip plane in 3D.

Can and may: Monosemy or polysemy?

This paper argues, on the basis of a corpus-based study of the meanings of can and may in contemporary British, American and Australian English, that a polysemy-based analysis is applicable to both modals. With may, epistemic possibility is the dominant meaning, but the dynamic and deontic possibility meanings still account for over 16.5% of tokens. By contrast the meanings of can, apart from a small percentage (1.1%) of epistemic cases, are united through the concept of potentiality. Nevertheless there are signs that the epistemic possibility meaning is becoming established, as it sheds its syntactic/semantic restriction to non-affirmative contexts.