Assessment of motor speech disorders online: A pilot study

We have conducted a preliminary validation of an Internet-based telehealth application for assessing motor speech disorders in adults with acquired neurological impairment. The videoconferencing module used NetMeeting software to provide realtime videoconferencing through a 128 kbit/s Internet link, as well as the transfer of store-and-forward video and audio data from the participant to the clinician. Ten participants with dysarthria following acquired brain injury were included in the study. An assessment of the overall severity of the speech disturbance was made for each participant face to face (FTF) and in the online environment, in addition, a 23-item version of the Frenchay Dysarthria Assessment (FDA) (which measures motor speech function) and the Assessment of Intelligibility of Dysarthric Speech (ASSIDS) (which gives the percentage word and sentence intelligibility, words per minute and a rating of communication efficiency) were administered in both environments. There was a 90% level of agreement between the two assessment environments for the rating of overall severity of dysarthria. A 70-100% level of agreement was achieved for 17 (74%) of the 23 FDA variables. On the ASSIDS there was a significant difference between the FTF and online assessments only for percentage word intelligibility. These findings suggest that Internet-based assessment has potential as a reliable method for assessing motor speech disorders.

SARAH POULTON KALLEY (1825-1907): Professora, Missionária e Poetisa

Sarah Poulton Kalley é conhecida, em quase todos os segmentos do protestantismo do Brasil, devido à organização e compilação d e Salmos e Hinos, o mais antigo hinário protestante editado no vernáculo em nosso país. Seus hinos, ainda em uso em muitas igrejas, marcaram por mais de um século a teologia do protestantismo no Brasil. Apesar desta notoriedade, sua influência na gênese do protestantismo brasileiro nunca foi objeto de estudo. Assim, o objetivo desta pesquisa é resgatar e visibilizar áreas e estratégias de atuação que conferem a esta mulher um perfil de atuação relativamente autônomo. Contudo, centrada no estudo da trajetória intelectual e biográfica de um sujeito histórico, a investigação se defronta com um universo de personagens anônimos, envoltos numa complexa teia de relações, através das quais o protestantismo se insere no Brasil em um contexto especifico: huguenotes, puritanos, luddistas, famílias não-conformistas inglesas, líderes políticos e eclesiásticos, exilados madeirenses, brasileiros, portugueses, imigrantes alemães e, principalmente, a mulher protestante brasileira. A busca por informações sobre este universo relegado ao anonimato pela historiografia do protestantismo no Brasil, reve lou alguns documentos inéditos, inclusive um livro escrito por Sarah Poulton Kalley, em 1866: o A Alegria da Casa. Muito além do papel de esposa de um missionário e médico, Sarah Poulton Kalley emerge de uma rede de relações e práticas como professora, missionária e poetisa. Nestes três campos de atuação e através do desenvolvimento de múltiplos contatos e relacionamentos, procurava transformar e influenciar atitudes e crenças de seus interlocutores. Junto com a nova fé divulgava uma cosmovisão própria da cultura anglo-saxã, protestante e puritana, adaptando-a seletivamente ao universo cultural e social de seus interlocutores.(AU)

Is pregnancy a teachable moment for diet and physical activity behaviour change? An interpretative phenomenological analysis of the experiences of women during their first pregnancy

OBJECTIVES: Pregnancy may provide a 'teachable moment' for positive health behaviour change, as a time when women are both motivated towards health and in regular contact with health care professionals. This study aimed to investigate whether women's experiences of pregnancy indicate that they would be receptive to behaviour change during this period. DESIGN: Qualitative interview study. METHODS: Using interpretative phenomenological analysis, this study details how seven women made decisions about their physical activity and dietary behaviour during their first pregnancy. RESULTS: Two women had required fertility treatment to conceive. Their behaviour was driven by anxiety and a drive to minimize potential risks to the pregnancy. This included detailed information seeking and strict adherence to diet and physical activity recommendations. However, the majority of women described behaviour change as 'automatic', adopting a new lifestyle immediately upon discovering their pregnancy. Diet and physical activity were influenced by what these women perceived to be normal or acceptable during pregnancy (largely based on observations of others) and internal drivers, including bodily signals and a desire to retain some of their pre-pregnancy self-identity. More reasoned assessments regarding benefits for them and their baby were less prevalent and influential. CONCLUSIONS: Findings suggest that for women who conceived relatively easily, diet and physical activity behaviour during pregnancy is primarily based upon a combination of automatic judgements, physical sensations, and perceptions of what pregnant women are supposed to do. Health professionals and other credible sources appear to exert less influence. As such, pregnancy alone may not create a 'teachable moment'. Statement of contribution What is already known on this subject? Significant life events can be cues to action with relation to health behaviour change. However, much of the empirical research in this area has focused on negative health experiences such as receiving a false-positive screening result and hospitalization, and in relation to unequivocally negative behaviours such as smoking. It is often suggested that pregnancy, as a major life event, is a 'teachable moment' (TM) for lifestyle behaviour change due to an increase in motivation towards health and regular contact with health professionals. However, there is limited evidence for the utility of the TM model in predicting or promoting behaviour change. What does this study add? Two groups of women emerged from our study: the women who had experienced difficulties in conceiving and had received fertility treatment, and those who had conceived without intervention. The former group's experience of pregnancy was characterized by a sense of vulnerability and anxiety over sustaining the pregnancy which influenced every choice they made about their diet and physical activity. For the latter group, decisions about diet and physical activity were made immediately upon discovering their pregnancy, based upon a combination of automatic judgements, physical sensations, and perceptions of what is normal or 'good' for pregnancy. Among women with relatively trouble-free conception and pregnancy experiences, the necessary conditions may not be present to create a 'teachable moment'. This is due to a combination of a reliance on non-reflective decision-making, perception of low risk, and little change in affective response or self-concept.

The Italian Response to the Growing U.S. Wine Demand

Americans are learning more about wines and consuming them in increasingly greater quantities. Italian wines have experienced a tremendous growth in their share of the U. S. market during the last decade. This article analyzes the marketing and success of the wines of Italy with the American consumer.

The Role of Theme Parks in Tourism

Although the theme park has been a major tourism destination in the United States, little research has been done in this industry. The growing economic significance and competition of the theme park industry ensure that the study of theme parks will emerge as a more popular research topic in the years to come. The authors review related articles and identify potential research topics in the theme park industry.

A heavy metal P-type ATPase OsHMA4 prevents copper accumulation in rice grain

Acknowledgements We thank B. Lahner, E. Yakubova and S. Rikiishi for ICP-MS analysis, N. Komiyama, Iowa State University Plant Transformation Facility and Prashant Hosmani for generation of transgenic rice, K. Wang for providing pTF101.1 vector and N. Verbruggen for providing pYES2 and pYEC2/CT-GFP vectors. We also thank Rice T-DNA Insertion Sequence Database center for providing the T-DNA insertion line and X. Wang, T. Zheng and Z. Li for accessing 3 K rice genome sequence, and Graeme Paton for helpful discussions on Cu bioavailability in water-logged soils. This research was supported by a Grant-in-Aid for Specially promoted Research (JSPS KAKENHI Grant Number 16H06296 to J.F.M), and the US National Science Foundation, Plant Genome Research Program (Grant #IOS 0701119 to D.E.S., M.L.G. and S.R.M.P.).

Le rôle du sublime dans le système critique kantien

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Effet d'un appareil d'avancement mandibulaire sur la genèse du bruxisme lors du sommeil

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The incidence of postoperative venous thrombosis among patients with ulcerative colitis

Background: Patients with Ulcerative Colitis (UC) have inherent prothrombotic tendencies. It is unknown whether this necessitates the use of additional perioperative anti-thrombotic prophylaxis when such patients require major surgery. Methods: The postoperative courses of 79 patients with UC undergoing 180 major abdominal and pelvic operations were examined for clinical and radiological evidence of venous thrombosis. Eighteen patients with Familial Adenomatous Polyposis (FAP) having surgery (35 operations) of similar magnitude were also studied. Standard anti-thrombosis prophylaxis was utilised in all patients. Results: Nine patients with UC were clinically suspected of developing postoperative venous thrombosis, but only three (3.8%) had their diagnosis confirmed radiologically (all had a pulmonary embolus). Therefore, the overall postoperative thrombosis rate, on an intention to treat basis, was 1.7% (3/180). No patient with FAP developed significant venous thrombosis. Conclusion: Standard perioperative antithrombotic modalities are sufficient to maintain any potential increase in postoperative thrombotic risk at an acceptable level in patients with UC undergoing operative intervention.

The impact of routine open nonsuction drainage on fluid accumulation after thyroid surgery: a prospective randomised clinical trial.

Background: Thyroid drains following thyroid surgery are routinely used despite minimal supportive evidence. Our aim in this study is to determine the impact of routine open drainage of the thyroid bed postoperatively on ultrasound-determined fluid accumulation at 24 hours. Methods: We conducted a prospective randomised clinical trial on patients undergoing thyroid surgery. Patients were randomly assigned to a drain group (n = 49) or a no-drain group (n = 44) immediately prior to wound closure. Patients underwent a neck ultrasound on day 1 and day 2 postoperatively. After surgery, we evaluated visual analogue scale pain scores, postoperative analgesic requirements, self-reported scar satisfaction at 6 weeks and complications. Results: There was significantly less mean fluid accumulated in the drain group on both day 1, 16.4 versus 25.1 ml (P-value = 0.005), and day 2, 18.4 versus 25.7 ml (P-value = 0.026), following surgery. We found no significant differences between the groups with regard to length of stay, scar satisfaction, visual analogue scale pain score and analgesic requirements. There were four versus one wound infections in the drain versus no-drain groups. This finding was not statistically significant (P = 0.154). No life-threatening bleeds occurred in either group. Conclusions: Fluid accumulation after thyroid surgery was significantly lessened by drainage. However, this study did not show any clinical benefit associated with this finding in the non-emergent setting. Drains themselves showed a trend indicating that they may augment infection rates. The results of this study suggest that the frequency of acute life-threatening bleeds remains extremely low following abandoning drains. We advocate abandoning routine use of thyroid drains. Trial registration: ISRCTN94715414.

Electropermanent magnetic anchoring for surgery and endoscopy

The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet OFF when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a center lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18 Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

Vibration based health monitoring of civil infrastructure using energy harvesting techniques

The use of structural health monitoring of civil structures is ever expanding and by assessing the dynamical condition of structures, informed maintenance management can be conducted at both individual and network levels. With the continued growth of information age technology, the potential arises for smart monitoring systems to be integrated with civil infrastructure to provide efficient information on the condition of a structure. The focus of this thesis is the integration of smart technology with civil infrastructure for the purposes of structural health monitoring. The technology considered in this regard are devices based on energy harvesting materials. While there has been considerable focus on the development and optimisation of such devices using steady state loading conditions, their applications for civil infrastructure are less known. Although research is still in initial stages, studies into the uses associated with such applications are very promising. Through the use of the dynamical response of structures to a variety of loading conditions, the energy harvesting outputs from such devices is established and the potential power output determined. Through a power variance output approach, damage detection of deteriorating structures using the energy harvesting devices is investigated. Further applications of the integration of energy harvesting devices with civil infrastructure investigated by this research includes the use of the power output as a indicator for control. Four approaches are undertaken to determine the potential applications arising from integrating smart technology with civil infrastructure, namely • Theoretical analysis to determine the applications of energy harvesting devices for vibration based health monitoring of civil infrastructure. • Laboratory experimentation to verify the performance of different energy harvesting configurations for civil infrastructure applications. • Scaled model testing as a method to experimentally validate the integration of the energy harvesting devices with civil infrastructure. • Full scale deployment of energy harvesting device with a bridge structure. These four approaches validate the application of energy harvesting technology with civil infrastructure from a theoretical, experimental and practical perspective.

Le rôle du sublime dans le système critique kantien

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Effet d'un appareil d'avancement mandibulaire sur la genèse du bruxisme lors du sommeil

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.