Spiral drawing during self-rated dyskinesia is more impaired than during self-rated off

Background: A mobile device test battery, consisting of a patient diary collection section with disease-related questions and a fine motor test section (including spiral drawing tasks), was used by 65 patients with advanced Parkinson's disease (PD)(treated with intraduodenal levodopa/carbidopa gel infusion, Duodopa®, or candidates for this treatment) on 10439 test occasions in their home environments. On each occasion, patients traced three pre-drawn Archimedes spirals using an ergonomic stylus and self-assessed their motor function on a global Treatment Response Scale (TRS) ranging from -3 = very 'off' to 0 = 'on' to +3 = very dyskinetic. The spirals were processed by a computer-based method that generates a "spiral score" representing the PD-related drawing impairment. The scale for the score was based on a modified Bain & Findley rating scale in the range from 0 = no impairment to 5 = moderate impairment to 10 = extremely severe impairment. Objective: To analyze the test battery data for the purpose to find differences in spiral drawing performance of PD patients in relation to their self-assessments of motor function. Methods: Three motor states were used in the analysis; OFF state (including moderate and very 'off'), ON state ('on') and a dyskinetic (DYS) state (moderate and very dyskinetic). In order to avoid the problem of multiple test occasions per patient, 200 random samples of single test occasions per patient were drawn. One-way analysis of variance, ANOVA, test followed by Tukey multiple comparisons test was used to test if mean values of spiral test parameters, i.e. the spiral score and drawing completion times (in seconds), were different among the three motor states. Statistical significance was set at p<0.05. To investigate changes in the spiral score over the time-of-day test sessions for the three motor states, plots of statistical summaries were inspected. Results: The mean spiral score differed significantly across the three self-assessed motor states (p<0.001, ANOVA test). Tukey post-hoc comparisons indicate that the mean spiral score (mean ± SD; [95% CI for mean]) in DYS state (5.2 ± 1.8; [5.12, 5.28]) was higher than the mean spiral score in OFF (4.3 ± 1.7; [4.22, 4.37]) and ON (4.2 ± 1.7; [4.17, 4.29]) states. The mean spiral score was also significantly different among individual TRS values of slightly 'off' (4.02 ± 1.63), 'on' (4.07 ± 1.65) and slightly dyskinetic (4.6 ± 1.71), (p<0.001). There were no differences in drawing completion times among the three motor states (p=0.509). In the OFF and ON states, patients drew slightly more impaired spirals in the afternoon whereas in the DYS state the spiral drawing performance was more impaired in the morning. Conclusion: It was found that when patients considered themselves as being dyskinetic spiral drawing was more impaired (nearly one unit change in a 0-10 scale) compared to when they considered themselves as being 'off' and 'on'. The spiral drawing at patients that self-assessed their motor state as dyskinetic was slightly more impaired in the morning hours, between 8 and 12 o'clock, a situation possibly caused by the morning dose effect.

A Computer Vision Framework For Finger-Tapping Evaluation In Parkinson's Disease

Objective: To define and evaluate a Computer-Vision (CV) method for scoring Paced Finger-Tapping (PFT) in Parkinson's disease (PD) using quantitative motion analysis of index-fingers and to compare the obtained scores to the UPDRS (Unified Parkinson's Disease Rating Scale) finger-taps (FT). Background: The naked-eye evaluation of PFT in clinical practice results in coarse resolution to determine PD status. Besides, sensor mechanisms for PFT evaluation may cause patients discomfort. In order to avoid cost and effort of applying wearable sensors, a CV system for non-invasive PFT evaluation is introduced. Methods: A database of 221 PFT videos from 6 PD patients was processed. The subjects were instructed to position their hands above their shoulders besides the face and tap the index-finger against the thumb consistently with speed. They were facing towards a pivoted camera during recording. The videos were rated by two clinicians between symptom levels 0-to-3 using UPDRS-FT. The CV method incorporates a motion analyzer and a face detector. The method detects the face of testee in each video-frame. The frame is split into two images from face-rectangle center. Two regions of interest are located in each image to detect index-finger motion of left and right hands respectively. The tracking of opening and closing phases of dominant hand index-finger produces a tapping time-series. This time-series is normalized by the face height. The normalization calibrates the amplitude in tapping signal which is affected by the varying distance between camera and subject (farther the camera, lesser the amplitude). A total of 15 features were classified using K-nearest neighbor (KNN) classifier to characterize the symptoms levels in UPDRS-FT. The target ratings provided by the raters were averaged. Results: A 10-fold cross validation in KNN classified 221 videos between 3 symptom levels with 75% accuracy. An area under the receiver operating characteristic curves of 82.6% supports feasibility of the obtained features to replicate clinical assessments. Conclusions: The system is able to track index-finger motion to estimate tapping symptoms in PD. It has certain advantages compared to other technologies (e.g. magnetic sensors, accelerometers etc.) for PFT evaluation to improve and automate the ratings

Assessment of PD Speech Anomalies @ Home

Background: Voice processing in real-time is challenging. A drawback of previous work for Hypokinetic Dysarthria (HKD) recognition is the requirement of controlled settings in a laboratory environment. A personal digital assistant (PDA) has been developed for home assessment of PD patients. The PDA offers sound processing capabilities, which allow for developing a module for recognition and quantification HKD. Objective: To compose an algorithm for assessment of PD speech severity in the home environment based on a review synthesis. Methods: A two-tier review methodology is utilized. The first tier focuses on real-time problems in speech detection. In the second tier, acoustics features that are robust to medication changes in Levodopa-responsive patients are investigated for HKD recognition. Keywords such as Hypokinetic Dysarthria , and Speech recognition in real time were used in the search engines. IEEE explorer produced the most useful search hits as compared to Google Scholar, ELIN, EBRARY, PubMed and LIBRIS. Results: Vowel and consonant formants are the most relevant acoustic parameters to reflect PD medication changes. Since relevant speech segments (consonants and vowels) contains minority of speech energy, intelligibility can be improved by amplifying the voice signal using amplitude compression. Pause detection and peak to average power rate calculations for voice segmentation produce rich voice features in real time. Enhancements in voice segmentation can be done by inducing Zero-Crossing rate (ZCR). Consonants have high ZCR whereas vowels have low ZCR. Wavelet transform is found promising for voice analysis since it quantizes non-stationary voice signals over time-series using scale and translation parameters. In this way voice intelligibility in the waveforms can be analyzed in each time frame. Conclusions: This review evaluated HKD recognition algorithms to develop a tool for PD speech home-assessment using modern mobile technology. An algorithm that tackles realtime constraints in HKD recognition based on the review synthesis is proposed. We suggest that speech features may be further processed using wavelet transforms and used with a neural network for detection and quantification of speech anomalies related to PD. Based on this model, patients' speech can be automatically categorized according to UPDRS speech ratings.

Motion Cues Analysis for Parkinson Gait Recognition

Background: Previous assessment methods for PG recognition used sensor mechanisms for PG that may cause discomfort. In order to avoid stress of applying wearable sensors, computer vision (CV) based diagnostic systems for PG recognition have been proposed. Main constraints in these methods are the laboratory setup procedures: Novel colored dresses for the patients were specifically designed to segment the test body from a specific colored background. Objective: To develop an image processing tool for home-assessment of Parkinson Gait(PG) by analyzing motion cues extracted during the gait cycles. Methods: The system is based on the idea that a normal body attains equilibrium during the gait by aligning the body posture with the axis of gravity. Due to the rigidity in muscular tone, persons with PD fail to align their bodies with the axis of gravity. The leaned posture of PD patients appears to fall forward. Whereas a normal posture exhibits a constant erect posture throughout the gait. Patients with PD walk with shortened stride angle (less than 15 degrees on average) with high variability in the stride frequency. Whereas a normal gait exhibits a constant stride frequency with an average stride angle of 45 degrees. In order to analyze PG, levodopa-responsive patients and normal controls were videotaped with several gait cycles. First, the test body is segmented in each frame of the gait video based on the pixel contrast from the background to form a silhouette. Next, the center of gravity of this silhouette is calculated. This silhouette is further skeletonized from the video frames to extract the motion cues. Two motion cues were stride frequency based on the cyclic leg motion and the lean frequency based on the angle between the leaned torso tangent and the axis of gravity. The differences in the peaks in stride and lean frequencies between PG and normal gait are calculated using Cosine Similarity measurements. Results: High cosine dissimilarity was observed in the stride and lean frequencies between PG and normal gait. High variations are found in the stride intervals of PG whereas constant stride intervals are found in the normal gait. Conclusions: We propose an algorithm as a source to eliminate laboratory constraints and discomfort during PG analysis. Installing this tool in a home computer with a webcam allows assessment of gait in the home environment.

Metaphors are good mirrors: reflecting on change for teacher educators

In this paper we discuss the use of metaphor as an educative tool for reflection. In the instance of this paper we use metaphor to reflect on the personal images of change that were used by some women teacher educators to make sense of their professional lives and practices over the last decade. This last decade in teacher education has seen significant institutional and cultural change. The paper discusses the strengths and limitations of the use of metaphor. The different interpretations of these metaphors illustrates how these women have used metaphor for explaining facets of change in their professional lives. The challenge of professional renewal is apparent in the metaphors in the ways that complexity, change, journeys, and movement are indicated. Reflection on change in professional practice needs to be continuous. Use of metaphor in the way described in this paper encourages that ongoing process.

A new voice in a new place: musical encounters with a difference

Australian education providers at the university level are being challenged to be more inclusive of cultural diversity and associated knowledge systems in their curricula. This article reports on some findings of a research study that aimed to evaluate the introduction of African music to primary teacher education students and to provide them with a context for assimilating African music into their own teaching practice. This paper reports on my work as a music educator in sharing my different worlds of experience ‘with one voice’ in order to expand students’ local knowledge base. It also discusses the nature and applications of African music and demonstrates some aspects that correlate with Western music. Through a study of both Western and African pedagogies and repertoire, students were able to gain a more holistic perspective of the role of music in society and were able to contextualize and transfer epistemological and pedagogical insights from one society to another.

Different rhythms to similar tunes: African beats in action across two continents

In this article I present some theoretical perspectives on reflective practice and African music. As reflection is a voyage of on-going self-discovery and change, and most challenging, I consider the teaching of African music across two continents and institutions. After a recent visit to South Africa (August-October 2006), I describe and discuss some similarities that I as a music educator at Deakin University, share with a music educator from the University of the North West, South Africa regarding the teaching and learning of African music. Through observation and interview data with my colleague, I offer some thoughts on what is African music and why we teach different rhythms to similar tunes across two continents at our tertiary institutions. I see this as a way forward to transmit and promote togetherness in a multicultural society where we respect diversity and the notion of 'other'.

Triangulation in organizational research : a re-presentation

This paper extends the discussion of postmodern thinking in organizational theory through a re-presentation of the concept of triangulation in organizational research. Initially triangulation is defined through the contrasting lenses of positivism and post-positivism/postmodernism and analysed as a metaphor for fixing and capturing the research subject. Subsequently triangulation is ‘re-presented’ as ‘metaphorization’—in terms of process and movement between researcher-subject positions. Rethinking the lines and angles of enquiry in triangulation, the paper suggests a shift from the ‘triangulation of distance’ tradition to a more reflexive consideration of ‘researcher stance’. This movement is represented across three perspectives: the researcher as a follower of nomothetic lines; the researcher as the taker of an ideographic overview; and the researcher as the finder of a particular angle. The implications of this re-presentation are then discussed in terms of perspective, data capture, reflexivity and metatriangulation.

Team teaching in teacher education: towards an interdisciplinary approach

‘Team teaching’ across disciplines at Australian universities is rare. Academics are rigorous in developing specific disciplinary expertise that often prevents collaboration outside of their disciplinary area. In pre-service primary education courses, academics often teach in traditional and exclusive disciplinary approaches. This separation is at odds however with the impetus for a pedagogical move forward towards an interdisciplinary approach in primary schools. The authors contend that primary
teacher educators must model effective interdisciplinary practice to their student teachers and unpack the processes of how to make meaningful connections together. This paper presents the work of two teacher educators who are involved in a broader, innovative, team teaching, field based collaboration with schools and non-school settings for the Bachelor of Teaching (Postgraduate) at Deakin University. In this paper, the authors firstly discuss their rationale for adopting a team teaching approach and describe how they are working towards an interdisciplinary model, bringing together the two areas; music and literacy and providing examples from their team teaching experience. The paper concludes with reflections and recommendations for future team teaching at the tertiary level.

Verdi's Settings of Shakespeare : from Play to Liberetto to Opera

As a Senior Scholar pursuing the topic, Verdi's Settings of Shakespeare: From Play to Libretto to Opera, I have endeavoured to study a project relevant to my majors, Music and English. During first semester, I carefully analysed Shakespeare's plays, Macbeth, Othello and Falstaff. The highlight of my project was in January when I travelled to New York City and spent the day working with the Metropolitan Opera Guild. I was also able to see a performance of Verdi's Othello with Jon Vickers in the lead role. During the second semester, I studied the musical aspects of the compositions. I spent time analysing musical passages and relating them to the plays and the operas. I was also able to continue my study of Italian, which I find extremely beneficial while studying Verdi's libretti. On Monday, 13th May, 1974, I gave a lecture presentation of my project. At this time, I showed slides of Metropolitan productions of the operas, presented my own rendition of five arias (in costume) and talked about comparisions between the plays and the operas. I applied for a Rotary Fellowship to take my project to Europe and am presently waiting to hear the results. If I do receive the fellowship, I am planning to spend a year studying the plays and operas in England and Italy. Afterwards, I hope to publish a paper explaining my findings. The paper is divided into six sections. The first section is an introduction which explains the period of Romanticism and its relationship to Shakespeare and Verdi. The second section is devoted to discussing the librettist for Macbeth, Francesco Piave. Following this section the opera Macbeth is discussed. Arrigo Boito, the librettist for Otello and Falstaff is discussed in the fourth section. The last two sections deal with Otello and Falstaff. I have also included a number of musical selections to better explain certain passages. My project has been invaluable to me. My Senior Scholar project has allowed me the freedom of independent study as well as a means of tying my majors together.

On animal distributions in dynamic landscapes

Few landscapes are static and patterns of resource distribution can vary markedly in time and space. Patterns of movement and dispersal in response to environmental change are equally diverse and occur on a broad range of temporal scales. For patterns of movement and dispersal that vary spatially and temporally throughout the life-time of an individual, the concepts of home range and geographic range alone do not adequately describe the observed patterns of distribution of individuals, populations or species. Here we further simplify Gauthreaux (1982) classification of movement types into a simple bipartite system and link movements (or lack thereof) to a similarly simple classification of ranges. In addition, we introduce two new indices that describe the relationship of an individual's life-time movements to its distribution as described by home and geographic range. Our interest in this subject arose from endeavouring to interpret local changes in waterbird abundance in the arid interior of the Australian continent and to understand these changes in relation to patterns of resource distribution and movement. In this discussion we focus on terrestrial vertebrates capable of multiple breeding events throughout an extended life-time.

Spatial ecology of a root parasite : from pattern to process

Occurrence patterns of parasitic plants are constrained by the distribution of suitable hosts and movement patterns of seed vectors and, accordingly, represent a simplified system to study many aspects of spatial ecology and determinants of distribution. Previous work has focused on the aerially hemiparasitic mistletoes, and it is unclear whether root parasites are affected by similar factors. Here, we evaluate spatial patterns in the root parasitic Santalum lanceolatum in an arid shrubland in north-western New South Wales, central Australia. In this region, the principal host is a long-lived nitrogen fixing shrub Acacia tetragonophylla closely associated with ephemeral creek-lines. The location of 765 individuals of both species was mapped along a 250-m section of creek-line using a total survey station, and occurrence patterns of the root parasite related to host distribution and landscape context. We used Ripley's K-function and the O-ring statistic to determine whether the distribution of S. lanceolatum was random, aggregated or regular; the spatial scales at which these patterns occurred; and to quantify any spatial associations between the parasite and its host, A. tetragonophylla. While acacias were closely associated with the creek-line, S. lanceolatum plants were more tightly clustered, displaying significant clustering at two spatial scales (1.2 m and 8.8 m). We suggest that host quality may act as an important constraint, with only those acacias growing in or near the creek-line being physiologically capable of supporting a parasite to maturity. Insights gained from spatial analysis are used to guide ongoing research in this system, and highlight the utility of the O-ring statistic for understanding patterns of distribution affected by multiple processes operating at critical scales.

Analogue stress

Made from reworked and reanimated found industrial and discarded personal footage. The main focus is the soundtrack which has been reconstructed from scratches, pen marks, Letraset strips and the music and phrases of found films.

Published versions: #1, #2, #3 are all slightly different to each other.

Towards an integration of theories of achievement motivation

This thesis investigated children's school achievement in terms of an integration of three theories of achievement motivation. The three theoretical outlooks were expectancy-value theory (EVT), implicit theories of intelligence (ITI), and flow theory (FT). The first of two studies was an exploratory investigation of the effectiveness of each theory independently and combined to predict children's achievement in four school subjects. The subject areas were maths, reading, instrumental music and sport. Participants were 84 children (40 females and 44 males) aged 9 to 10 years, one of each child's parents, and school teachers of each child in the four subject areas. All data were collected through questionnaires based on the three models. The results indicated that EVT and FT but not ITI accounted for a significant amount of the variance in children's achievement, including effects for subject area and gender. A second confirmatory study tested EVT, FT and an integrated model for the prediction of achievement in maths, reading and instrumental music. The participants were a further 141 children (74 females and 67 males) aged 10 to 11 years, and a parent and teachers of each child. Data collection using questionnaires occurred early in the school year (Timel) and approximately five months later (Time2). For EVT, children and parents’ competence beliefs were significant predictors of children's achievement in each subject area. Females tended to believe themselves more competent at reading and instrumental music and also valued these subjects more highly than boys. Modeling results for flow theory indicated that children's emotional responses to classes (happiness and confusion) were significant predictors of achievement, the type of emotion varying between subject areas and time periods. Females generally had a more positive emotional reaction to reading and instrumental music classes than males did. The integrated model results indicated significant relationships between EVT and flow theories for each subject area, with EVT explaining most achievement variance in the integrated model. Children's and parents’ competence beliefs were the main predictors of achievement at Timel and 2, Subject area and gender differences were found which provide direction for future research. Anecdotal reports of parents and teachers often attest to individual differences in children's involvement in various school domains. Even among children of apparently similar intelligence, it is not uncommon to find one who likes nothing better than to work on a mathematics problem while another much prefers to read a novel or play a musical instrument Some children appear to achieve good results for most of the activities in which they are engaged while others achieve in a less consistent manner, sometimes particularly excelling in one activity. Some children respond to failure experiences with a determination to improve their performance in the future while others react with resignation and acceptance of their low ability. Some children appear to become totally absorbed in the activity of playing sport while others cannot wait for the game to end. The primary research objective guiding the current thesis is how children's thoughts and feelings about school subjects differ and are related to their school achievement. A perusal of the achievement motivation literature indicates several possible models and concepts that can be applied to explain individual differences in children's school achievement. Concepts such as academic self-concept, multiple intelligences, intrinsic and extrinsic motivation, self-beliefs, competence beliefs, subjective task values, mastery and performance goals, ‘Flow’ experiences and social motivation are just some of the constructs used to explain children's achievement motivation, both within and between various activity domains. These constructs are proposed by researchers from different theoretical perspectives to achievement motivation. Although there is much literature relevant to each perspective, there is little research indicating how the various perspectives may relate to each other. The current thesis will begin by reviewing three currently popular theoretical orientations cited in achievement motivation research: subjective beliefs and values; implicit theories of intelligence, and flow experience and family complexity. Following this review, a framework will be proposed for testing the determinants of children's school achievement, both within each of the three theoretical perspectives and also in combination.