In-session processes in online counselling with young people : an exploratory approach

Aims : The aim of this study was to conduct an exploratory investigation into the in-session processes and behaviours that occur between therapists and young people in online counseling. Method: The Consensual Qualitative Research method was employed to identify in-session behaviours and a coding instrument was developed to determine their frequency of use and assess whether nuances carried in the meaning of text messages have an influential effect during sessions. Eighty-five single-session transcripts were examined in total by two independent coders. Results: Sample statistics revealed that, on average, rapport-building processes were used more consistently across cases with both types of processes having a moderately strong positive effect on young people. However, closer examination of these processes revealed weaker positive effects for in-session behaviours that rely more heavily on verbal and non-verbal cues to be accurately interpreted. Implications for Practice and Future Research: These findings imply that therapists may focus more on building rapport than accomplishing tasks with young people during online counselling sessions due to the absence of verbal and non-verbal information when communicating via text messages.

Assessment of lifetime cumulative sun exposure using a self-administered questionnaire : reliability of two approaches

Few studies have evaluated the reliability of lifetime sun exposure estimated from inquiring about the number of hours people spent outdoors in a given period on a typical weekday or weekend day (the time-based approach). Some investigations have suggested that women have a particularly difficult task in estimating time outdoors in adulthood due to their family and occupational roles. We hypothesized that people might gain additional memory cues and estimate lifetime hours spent outdoors more reliably if asked about time spent outdoors according to specific activities (an activity-based approach). Using self-administered, mailed questionnaires, test-retest responses to time-based and to activity-based approaches were evaluated in 124 volunteer radiologic technologist participants from the United States: 64 females and 60 males 48 to 80 years of age. Intraclass correlation coefficients (ICC) were used to evaluate the test-retest reliability of average number of hours spent outdoors in the summer estimated for each approach. We tested the differences between the two ICCs, corresponding to each approach, using a t test with the variance of the difference estimated by the jackknife method. During childhood and adolescence, the two approaches gave similar ICCs for average numbers of hours spent outdoors in the summer. By contrast, compared with the time-based approach, the activity-based approach showed significantly higher ICCs during adult ages (0.69 versus 0.43, P = 0.003) and over the lifetime (0.69 versus 0.52, P = 0.05); the higher ICCs for the activity-based questionnaire were primarily derived from the results for females. Research is needed to further improve the activity-based questionnaire approach for long-term sun exposure assessment. (Cancer Epidemiol Biomarkers Prev 2009;18(2):464–71)

Audio visual automatic speech recognition in vehicles

Acoustically, car cabins are extremely noisy and as a consequence, existing audio-only speech recognition systems, for voice-based control of vehicle functions such as the GPS based navigator, perform poorly. Audio-only speech recognition systems fail to make use of the visual modality of speech (eg: lip movements). As the visual modality is immune to acoustic noise, utilising this visual information in conjunction with an audio only speech recognition system has the potential to improve the accuracy of the system. The field of recognising speech using both auditory and visual inputs is known as Audio Visual Speech Recognition (AVSR). Continuous research in AVASR field has been ongoing for the past twenty-five years with notable progress being made. However, the practical deployment of AVASR systems for use in a variety of real-world applications has not yet emerged. The main reason is due to most research to date neglecting to address variabilities in the visual domain such as illumination and viewpoint in the design of the visual front-end of the AVSR system. In this paper we present an AVASR system in a real-world car environment using the AVICAR database [1], which is publicly available in-car database and we show that the use of visual speech conjunction with the audio modality is a better approach to improve the robustness and effectiveness of voice-only recognition systems in car cabin environments.

Exploring visual features through Gabor representations for facial expression detection

Gabor representations have been widely used in facial analysis (face recognition, face detection and facial expression detection) due to their biological relevance and computational properties. Two popular Gabor representations used in literature are: 1) Log-Gabor and 2) Gabor energy filters. Even though these representations are somewhat similar, they also have distinct differences as the Log-Gabor filters mimic the simple cells in the visual cortex while the Gabor energy filters emulate the complex cells, which causes subtle differences in the responses. In this paper, we analyze the difference between these two Gabor representations and quantify these differences on the task of facial action unit (AU) detection. In our experiments conducted on the Cohn-Kanade dataset, we report an average area underneath the ROC curve (A`) of 92.60% across 17 AUs for the Gabor energy filters, while the Log-Gabor representation achieved an average A` of 96.11%. This result suggests that small spatial differences that the Log-Gabor filters pick up on are more useful for AU detection than the differences in contours and edges that the Gabor energy filters extract.

Cascading appearance-based features for visual voice activity detection

The detection of voice activity is a challenging problem, especially when the level of acoustic noise is high. Most current approaches only utilise the audio signal, making them susceptible to acoustic noise. An obvious approach to overcome this is to use the visual modality. The current state-of-the-art visual feature extraction technique is one that uses a cascade of visual features (i.e. 2D-DCT, feature mean normalisation, interstep LDA). In this paper, we investigate the effectiveness of this technique for the task of visual voice activity detection (VAD), and analyse each stage of the cascade and quantify the relative improvement in performance gained by each successive stage. The experiments were conducted on the CUAVE database and our results highlight that the dynamics of the visual modality can be used to good effect to improve visual voice activity detection performance.

In vitro cultivation of adult human chondrocytes : importance of culture system, oxygen and zonal differences

Articular cartilage exhibits limited intrinsic regenerative capacity and focal tissue defects can lead to the development of osteoarthritis (OA), a painful and debilitating loss of cartilage tissue. In Australia, 1.4 million people are affected by OA and its prevalence is increasing in line with current demographics. As treatment options are limited, new therapeutic approaches are being investigated including biological resurfacing of joints with tissue-engineered cartilage. Despite some progress in the field, major challenges remain to be addressed for large scale clinical success. For example, large numbers of chondrogenic cells are required for cartilage formation, but chondrocytes lose their chondrogenic phenotype (dedifferentiate) during in vitro propagation. Additionally, the zonal organization of articular cartilage is critical for normal cartilage function, but development of zonal structure has been largely neglected in cartilage repair strategies. Therefore, we hypothesised that culture conditions for freshly isolated human articular chondrocytes from non-OA and OA sources can be improved by employing microcarrier cultures and a reduced oxygen environment and that oxygen is a critical factor in the maintenance of the zonal chondrocyte phenotype. Microcarriers have successfully been used to cultivate bovine chondrocytes, and offer a potential alternative for clinical expansion of human chondrocytes. We hypothesised that improved yields can be achieved by propagating human chondrocytes on microcarriers. We found that cells on microcarriers acquired a flattened, polygonal morphology and initially proliferated faster than monolayercultivated cells. However, microcarrier cultivation over four weeks did not improve growth rates or the chondrogenic potential of non-OA and OA human articular chondrocytes over conventional monolayer cultivation. Based on these observations, we aimed to optimise culture conditions by modifying oxygen tension, to more closely reflect the in vivo environment. We found that propagation at 5% oxygen tension (moderate hypoxia) did not improve proliferation or redifferentiation capacity of human osteoarthritic chondrocytes. Moderate hypoxia increased the expression of chondrogenic markers during redifferentiation. However, osteoarthritic chondrocytes cultivated on microcarriers exhibited lower expression levels of chondrogenic surface marker proteins and had at best equivalent redifferentiation capacities compared to monolayer-cultured cells. This suggests that monolayer culture with multiple passaging potentially selects for a subpopulation of cells with higher differentiation capacity, which are otherwise rare in osteoarthritic, aged cartilage. However, fibroblastic proteins were found to be highly expressed in all cultures of human osteoarthritic chondrocytes indicating the presence of a high proportion of dedifferentiated, senescent cells with a chondrocytic phenotype that was not rescued by moderate hypoxia. The different zones of cartilage support chondrocyte subpopulations, which exhibit characteristic protein expression and experience varying oxygen tensions. We, therefore, hypothesised that oxygen tension affects the zonal marker expression of human articular chondrocytes isolated from the different cartilage layers. We found that zonal chondrocytes maintained these phenotypic differences during in vitro cultivation. Low oxygen environments favoured the expression of the zonal marker proteoglycan 4 in superficial cells, most likely through the promotion of chondrogenesis. The putative zonal markers clusterin and cartilage intermediate layer protein were found to be expressed by all subpopulations of human osteoarthritic chondrocytes ex vivo and, thus, may not be reliable predictors of in vitro stratification using these clinically relevant cells. The findings in this thesis underline the importance of considering low oxygen conditions and zonal stratification when creating native-like cartilaginous constructs. We have not yet found the right cues to successfully cultivate clinically-relevant human osteoarthritic chondrocytes in vitro. A more thorough understanding of chondrocyte biology and the processes of chondrogenesis are required to ensure the clinical success of cartilage tissue engineering.

Animal Control - What constitutes a reliable cue to stop animal movement ?

Controlling free-ranging livestock requires low-stress cues to alter animal behaviour. Recently modulated sound and electric shock were demonstrated to be effective in controlling free-ranging cattle. In this study the behaviour of 60, 300 kg Belmont Red heifers were observed for behavioural changes when presented cues designed to impede their movement through an alley. The heifers were given an overnight drylot shrink off feed but not drinking water prior to being tested. Individual cattle were allowed to move down a 6.5 m wide alley towards a pen of peers and feed located 71 m from their point of release. Each animal was allowed to move through the alley unimpeded five times to establish a basal behavioural pattern. Animals were then randomly assigned to treatments consisting of sound plus shock, vibration plus shock, a visual cue plus shock, shock by itself and a control. The time each animal required to reach the pen of peers and feed was recorded. If the animal was prevented from reaching the pen of peers and feed by not penetrating through the cue barrier at set points along the alley for at least 60 sec the test was stopped and the animal was returned to peers located behind the release pen. Cues and shock were manually applied from a laptop while animals were observed from a 3.5 m tower located outside the alley. Electric shock, sound, vibration and Global Position System (GPS) hardware were housed in a neck collar. Results and implications will be discussed.

Poster : Understanding interactions between autonomous animal control and temperament when cattle are subjected to virtual fencing applications

Virtual fencing has the potential to control grazing livestock. Understanding and refi ning the cues that can alter behaviour is an integral part of autonomous animal control. A series of tests have been completed to explore the relationship between temperament and control. Prior to exposure to virtual fencing control the animals were scored for temperament using fl ight speed and a sociability index using contact logging devices. The behavioural response of 30, Belmont Red steers were observed for behavioural changes when presented with cues prior to receiving an electrical stimulation. A control and four treatments designed to interrupt the animal’s movement down an alley were tested. The treatments consisted of sound plus electrical stimulation, vibration plus electrical stimulation, a visual cue plus electrical stimulation and electrical stimulation by itself. The treatments were randomly applied to each animal over fi ve consecutive trials. A control treatment in which no cues were applied was used to establish a basal behavioural pattern. A trial was considered completed after each animal had been retained behind the cue barrier for at least 60 sec. All cues and electrical stimulation were manually applied from a laptop located on a portable 3.5 m tower located immediately outside the alley. The electric stimulation consisted of 1.0 Kv of electricity. Electric stimulation, sound and vibration along with the Global Position System (GPS) hardware to autonomously record the animal’s path within the alley were recorded every second.

The effects of L1 orthography on processing an artificial logographic script

To date, studies have focused on the acquisition of alphabetic second languages (L2s) in alphabetic first language (L1) users, demonstrating significant transfer effects. The present study examined the process from a reverse perspective, comparing logographic (Mandarin-Chinese) and alphabetic (English) L1 users in the acquisition of an artificial logographic script, in order to determine whether similar language-specific advantageous transfer effects occurred. English monolinguals, English-French bilinguals and Chinese-English bilinguals learned a small set of symbols in an artificial logographic script and were subsequently tested on their ability to process this script in regard to three main perspectives: L2 reading, L2 working memory (WM), and inner processing strategies. In terms of L2 reading, a lexical decision task on the artificial symbols revealed markedly faster response times in the Chinese-English bilinguals, indicating a logographic transfer effect suggestive of a visual processing advantage. A syntactic decision task evaluated the degree to which the new language was mastered beyond the single word level. No L1-specific transfer effects were found for artificial language strings. In order to investigate visual processing of the artificial logographs further, a series of WM experiments were conducted. Artificial logographs were recalled under concurrent auditory and visuo-spatial suppression conditions to disrupt phonological and visual processing, respectively. No L1-specific transfer effects were found, indicating no visual processing advantage of the Chinese-English bilinguals. However, a bilingual processing advantage was found indicative of a superior ability to control executive functions. In terms of L1 WM, the Chinese-English bilinguals outperformed the alphabetic L1 users when processing L1 words, indicating a language experience-specific advantage. Questionnaire data on the cognitive strategies that were deployed during the acquisition and processing of the artificial logographic script revealed that the Chinese-English bilinguals rated their inner speech as lower than the alphabetic L1 users, suggesting that they were transferring their phonological processing skill set to the acquisition and use of an artificial script. Overall, evidence was found to indicate that language learners transfer specific L1 orthographic processing skills to L2 logographic processing. Additionally, evidence was also found indicating that a bilingual history enhances cognitive performance in L2.

Constructing the hallucinations of psychosis in Virtual Reality

Schizophrenia is a mental disorder affecting 1-2% of the population and it is estimated 12-16% of hospital beds in Australia are occupied by patients with psychosis. The suicide rate for patients with this diagnosis is higher than that of the general population. Any technique which enhances training and treatment of this disorder will have a significant societal and economic impact. A significant research project using Virtual Reality (VR), in which both visual and auditory hallucinations are simulated, is currently being undertaken at the University of Queensland. The virtual environments created by the new software are expected to enhance the experiential learning outcomes of medical students by enabling them to experience the inner world of a patient with psychosis. In addition the Virtual Environment has the potential to provide a technologically advanced therapeutic setting where behavioral, exposure therapies can be conducted with exactly controlled exposure stimuli with an expected reduction in risk of harm. This paper reports on the current work of the project, previous stages of software development and future educational and clinical applications of the Virtual Environments. (C) 2004 Elsevier Ltd. All rights reserved.

The theatre programme : a public discourse at a staging of Maxwell Anderson's "Anne of the Thousand Days"

The term ’public discourses’ describes a range of texts or signifiers that inform the conditions of audience reception. Public discourses include myriad written, visual, spatial, auditory and sensory texts experienced by an audience at a particular theatrical event. Ric Knowles first introduced this term in his recent work Reading the Material Theatre. Whereas Knowles was interested in how public discourses modified the conditions of reception, my broader research is to explore how these public discourses become texts in themselves. This paper will discuss one public discourse, the theatre programme, as it related to a staging of Maxwell Anderson’s Anne of the Thousand Days at the Brisbane Powerhouse in June 2006. The significance of the programme was explored at symposiums held after the performances. Audiences generally view programmes before a performance and after a performance and its significance as a written text changes. The program became a sign vehicle that worked to expound and explicate the meaning of the play for the audience. This public discourse became a significant written text contributing to the textual whole of the theatrical event.

Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

Adherence to medicines in the older-aged with chronic conditions : does an intervention concerning adherence by an allied health professional help?

Adherence to medicines is a major determinant of the effectiveness of medicines. However, estimates of non-adherence in the older-aged with chronic conditions vary from 40 to 75%. The problems caused by non-adherence in the older-aged include residential care and hospital admissions, progression of the disease, and increased costs to society. The reasons for non-adherence in the older-aged include items related to the medicine (e.g. cost, number of medicines, adverse effects) and those related to person (e.g. cognition, vision, depression). It is also known that there are many ways adherence can be increased (e.g. use of blister packs, cues). It is assumed that interventions by allied health professions, including a discussion of adherence, will improve adherence to medicines in the older aged but the evidence for this has not been reviewed. There is some evidence that telephone counselling about adherence by a nurse or pharmacist does improve adherence, short- and long-term. However, face-to-face intervention counselling at the pharmacy, or during a home visit by a pharmacist, has shown variable results with some studies showing improved adherence and some not. Education programs during hospital stays have not been shown to improve adherence on discharge, but education programs for subjects with hypertension have been shown to improve adherence. In combination with an education program, both counselling and a medicine review program have been shown to improve adherence short-term in the older-aged. Thus, there are many unanswered questions about the most effective interventions to promote adherence. More studies are needed to determine the most appropriate interventions by allied health professions, and these need to consider the disease state, demographics, and socio-economic status of the older-aged subject, and the intensity and duration of intervention needed.