Measuring the ability of school children with a history of otitis media to understand everyday speech

The present study compared the ability of school-aged children with and without a history of otitis media (OM) to understand everyday speech in noise using the University of Queensland Understanding of Everyday Speech Test (UQUEST). Participants were 484 children (246 boys, 238 girls) attending Grade 3 (272, mean age = 8.25 yr., SD = 0.43) and Grade 4 (212, mean age = 9.28 yr., SD = 0.41) at 19 primary schools in Brisbane metropolitan and Sunshine Coast schools. Children selected for inclusion were native speakers of English with normal hearing on the day of testing and had no reported physical or behavioral impairments. The children were divided into three groups according to the number of episodes of OM since birth. The results showed no significant differences in speech scores across the participant groups. However, a significant difference in mean speech scores was found across the grades and the noise conditions. Although children with a history of OM performed equally well at a group level when compared to the controls, they exhibited a large range of abilities in speech comprehension within the same group.

Aphasia websites: An examination of their quality and communicative accessibility

Background: Studies have examined Internet use as a source of information by various populations, however no study has examined the quality and accessibility of websites for people with aphasia, or their use of such sites. Aims: This study aimed to describe the quality, communicative accessibility, and readability of a sample of aphasia websites and to determine whether sites preferred by people with aphasia were those rated highly on measures of accessibility and quality. The perceptions of people with aphasia regarding the accessibility of the sites were compared with those of speech pathologists. The relationship between the quality and communicative accessibility of websites was analysed. Factors that may influence use of the Internet by people with aphasia and speech pathologists were explored. Methods & Procedures: Tools for measuring quality and communicative accessibility were developed and a sample of five websites was selected. Two participant groups (18 speech pathologists and 6 people with aphasia) assessed aphasia websites in terms of communicative accessibility. Speech pathologists also rated website quality. Spearman's rho was used to determine levels of agreement between variables. Outcomes & Results: People with aphasia and speech pathologists showed minimal agreement on their perceptions of communicative accessibility. However, when the preferences of websites (Aphasia Help and Speakability) were of a very high standard. There was a weak relationship between quality and communicative accessibility, however it was not statistically significant. Conclusions: Accessible websites are not necessarily of high quality, and quality websites are not guaranteed to be easily accessible. People with aphasia did not agree with speech pathologists as to what makes a good aphasia website. Therefore, people with aphasia should be involved in the design of aphasia websites since they are often the intended users. If Internet use by people with aphasia increases in line with other health populations, speech pathologist need to have the skills and confidence to recommend appropriate sites to their clients.

Equivalence of the Peleg, Pilosof and Singh-Kulshrestha models for water absorption in food

The similarity between the Peleg, Pilosof –Boquet–Batholomai and Singh–Kulshrestha models was investigated using the hydration behaviours of whey protein concentrate, wheat starch and whey protein isolate at 30 °C in 100% relative humidity. The three models were shown to be mathematically the same within experimental variations, and they yielded parameters that are related. The models, in their linear and original forms, were suitable (r2 > 0.98) in describing the sorption behaviours of the samples, and are sensitive to the length of the sorption segment used in the computation. The whey proteins absorbed more moisture than the wheat starch, and the isolate exhibited a higher sorptive ability than the concentrate.

Analysis of stroke patients' and carers' reading ability and the content and design of written materials: Recommendations for improving written stroke information

Objective: This study (a) evaluated the reading ability of patients following stroke and their carers and the reading level and content and design characteristics of the written information provided to them, (b) explored the influence of sociodemographic and clinical characteristics on patients' reading ability, and (c) described an education package that provides well-designed information tailored to patients' and carers' informational needs. Methods: Fifty-seven patients and 12 carers were interviewed about their informational needs in an acute stroke unit. Their reading ability was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). The written information provided to them in the acute stroke unit was analysed using the SMOG readability formula and the Suitability Assessment of Materials (SAM). Results: Thirteen (22.8%) patients and 5 (41.7%) carers had received written stroke information. The mean reading level of materials analysed was 11th grade while patients read at a mean of 7-8th grade. Most materials (89%) scored as only adequate in content and design. Patients with combined aphasia read significantly lower (4-6th grade) than other patients (p = 0.001). Conclusion: Only a small proportion of patients and carers received written materials about stroke and the readability level and content and design characteristics of most materials required improvement. Practice implications: When developing and distributing written materials about stroke, health professionals should consider the reading ability and informational needs of the recipients, and the reading level and content and design characteristics of the written materials. A computer system can be used to generate written materials tailored to the informational needs and literacy skills of patients and carers. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

A metacognitive contextual intervention to enhance error awareness and functional outcome following traumatic brain injury: A single-case experimental design

Very few empirically validated interventions for improving metacognitive skills (i.e., self-awareness and self-regulation) and functional outcomes have been reported. This single-case experimental study presents JM, a 36-year-old man with a very severe traumatic brain injury (TBI) who demonstrated long-term awareness deficits. Treatment at four years post-injury involved a metacognitive contextual intervention based on a conceptualization of neuro-cognitive, psychological, and socio-environmental factors contributing to his awareness deficits. The 16-week intervention targeted error awareness and self-correction in two real life settings: (a) cooking at home: and (b) volunteer work. Outcome measures included behavioral observation of error behavior and standardized awareness measures. Relative to baseline performance in the cooking setting, JM demonstrated a 44% reduction in error frequency and increased self-correction. Although no spontaneous generalization was evident in the volunteer work setting, specific training in this environment led to a 39% decrease in errors. JM later gained paid employment and received brief metacognitive training in his work environment. JM's global self-knowledge of deficits assessed by self-report was unchanged after the program. Overall, the study provides preliminary support for a metacognitive contextual approach to improve error awareness and functional Outcome in real life settings.

Physical activity and the occupations of children: Perspectives of parents and children

There is concern that children’s health is being compromised by a decline in physical activity occurring as a result of the changing nature of the occupations of childhood. This article reports the findings of in-depth interviews conducted with six children and their parents when the children were between 7 and 8 years and then again when they were between 9 and 10 years. This longitudinal perspective highlighted features associated with children remaining engaged in physical occupations. Factors found to contribute to continued involvement in exercise and sports were: the initial introduction to the activity being pleasurable; same-sex parents or older siblings being directly involved; and the skills required by the occupations being commensurate with children’s developmental level. These findings help inform occupational scientists about the nature of recreational and leisure occupations, and how they are introduced and framed within the context of children’s occupational roles.

The development of self-awareness and relationship to emotional functioning during early community reintegration after traumatic brain injury

Impaired self-awareness may affect clients' emotional status, engagement in rehabilitation and community reintegration following traumatic brain injury (TBI). The study aimed to investigate the relationship between self-awareness, emotional distress and community integration in adults with TBI during the transition from hospital to the community. Thirty-four rehabilitation clients with TBI were assessed in the week before and 2 months after discharge home. Measures of self-awareness and emotional functioning were administered predischarge and repeated at follow-up along with a measure of community integration. Nonparametric tests were used to compare levels of self-awareness and emotional distress pre- and postdischarge, their interrelationships and association with community integration. Self-awareness significantly increased following discharge, and a trend towards increased depression was found. There were no consistent relationships found between level of self-awareness, emotional functioning, and community integration. The development of self-awareness in the immediate postdischarge phase suggests this is an important time for clinical interventions targeting compensation strategies and adjustment to disability.

Objective and behavioural assessment of the emergence from post-traumatic amnesia (PTA)

Primary objective: To determine the profile of resolution of typical PTA behaviours and describe new learning and improvements in self-care during PTA. Research design: Prospective longitudinal study monitoring PTA status, functional learning and behaviours on a daily basis. Methods and procedures: Participants were 69 inpatients with traumatic brain injury who were in PTA. PTA was assessed using the Westmead or Oxford PTA assessments. Functional learning capability was assessed using a routine set of daily tasks and behaviour was assessed using an observational checklist. Data was analysed using descriptive statistics. Main outcomes and results: Challenging behaviours that are typically associated with PTA, such as agitation, aggression and wandering resolved in the early stages of PTA and incidence rates of these behaviours were less than 20%. Independence in self-care and bowel and bladder continence emerged later during resolution of PTA. New learning in functional situations was demonstrated by patients in PTA. Conclusions: It is feasible to begin active rehabilitation focused on functional skills-based learning with patients in the later stages of PTA. Formal assessment of typically observed behaviours during PTA may complement memory-based PTA assessments in determining emergence from PTA.

Changes in joint stability with muscle contraction measured from transmission of mechanical vibration

A non-invasive in vivo technique was developed to evaluate changes in wrist joint stability properties induced by increased co-activation of the forearm muscles in a gripping task. Mechanical vibration at 45, 50 and 55 Hz was applied to the radial head in ten healthy volunteers. Vibrations of the styloid process of the radius and the distal end of the metacarpal bone of the index finger were measured with triaxial accelerometers. Joint stability properties were quantified by the transfer function gain between accelerations on either side of the wrist-joint. Gain was calculated with the muscles at rest and at five force levels ranging from 5% to 25% of maximum grip force (%MF). During contraction the gain was significantly greater than in control trial (0%MF) for all contractions levels at 45 and 50 Hz and a trend for 15%MF and higher at 55 Hz. Group means of contraction force and gain were significantly correlated at 45 (R-2 = 0.98) and 50 Hz (R-2 = 0.72), but not at 55 Hz (R-2 = 0.10). In conclusion, vibration transmission gain may provide a method to evaluate changes in joint stability properties. (c) 2005 Published by Elsevier Ltd.

Symptom reporting and associations with compensation status, self-awareness, causal attributions, and emotional wellbeing following traumatic brain injury

Individuals seeking compensation following traumatic brain injury (TBI) are often found to report a disproportionately high level of symptoms relative to objective indicators of impairment. Previous studies highlight that level of symptom reporting is also related to self-awareness, causal attribution, and emotional wellbeing. Therefore, the reasons for high symptom reporting in the context of compensation are generally unclear. This study aimed to identify whether self-awareness, causal attribution, and emotional wellbeing are significantly associated with level of symptom reporting after controlling for compensation status. A sample of 54 participants with TBI comprised two groups, namely, claimants (n = 27) and non-claimants (n = 27), who were similar in terms of demographic and neuro-cognitive variables. Participants completed the Symptom Expectancy Checklist, Hospital Anxiety Depression Scale, Awareness Questionnaire and a causal attribution scale. A series of independent t tests and Pearson's correlations identified that a higher level of symptom reporting was associated with the following: seeking compensation, less severe TBI, increased age, greater self-awareness, increased post-injury changes reported by relatives, a higher level of mood symptoms, and a tendency to blame other people. Multivariate analysis identified that after controlling for demographic, injury, and compensation status variables, level of mood symptoms and self-awareness were significantly associated with level of symptom reporting. The findings suggest that mood symptoms and heightened self-awareness are significantly related to high symptom reporting independent of compensation status, thus supporting the need for clinicians to interpret symptom reporting within a biopsychosocial context.