The Artisan Teacher: A Field Guide to Skillful Teaching

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the College of Education at Morehead State University by Michael A. Rutherford on March 26, 2013

Computational Intelligence in Electromyography Analysis

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG may be used clinically for the diagnosis of neuromuscular problems and for assessing biomechanical and motor control deficits and other functional disorders. Furthermore, it can be used as a control signal for interfacing with orthotic and/or prosthetic devices or other rehabilitation assists. This book presents an updated overview of signal processing applications and recent developments in EMG from a number of diverse aspects and various applications in clinical and experimental research. It will provide readers with a detailed introduction to EMG signal processing techniques and applications, while presenting several new results and explanation of existing algorithms. This book is organized into 18 chapters, covering the current theoretical and practical approaches of EMG research

Amygdala Neurofeedback Training in Borderline Personality Disorder: Capturing Improvements in Emotion Regulation

The way we regulate emotions is a powerful determinant of behavior and directly impacts affect and physiology. Many mental disorders, such as borderline personality disorder, are in large part disorders of emotion dysregulation. Because of its important role in mental health, research has endeavored to understand the mechanisms and biological underpinnings of emotion regulation and to create trainings and specific clinical programs that aim to augment the ability to regulate emotions. The assessment of psychophysiological responses represents an important complementary method to quantify emotion regulation in both studies on healthy individuals and studies assessing clinical emotion regulation trainings. However, psychophysiological effects have been inconsistent across literature, which impedes informed decisions about suitable psychophysiological variables of emotion regulation experiments and clinical trainings. A new technique assumed to improve emotion regulation is amygdala neurofeedback training. Because patients with borderline personality disorder show hyperreactivity of the amygdala likely underlying the severe emotion regulation problems they suffer from, amygdala neurofeedback training may be a candidate training to improve emotion regulation in these patients. Until now, it has been unclear which aspects of psychopathology and emotion regulation may change with neurofeedback-aided amygdala downregulation in borderline personality disorder, which is urgently needed to determine a primary outcome measure for future randomized controlled trails. To fill these gaps, the present doctoral thesis identified the effects of psychophysiological responses of emotion regulation as well as important moderators and identified primary outcome measures of emotion dysregulation after neurofeedback training in patients with borderline personality disorder. In total, three studies were conducted. In Study I, a total of 1353 studies on psychophysiological responses of emotion regulation were screened through a systematic search of articles and meta-analyses were used to evaluate effect sizes of instructed downregulation strategies on common autonomic and electromyographic measures. Following this, Study II systematically tested effects of the startle probe timing on startle responses during emotion regulation in 47 healthy individuals. Study II aimed at optimizing emotion regulation assessment with the emotion-modulated startle that was then used in Study III. In Study III, a four-session amygdala neurofeedback training was tested in 24 female patients with borderline personality disorder. Before and after the neurofeedback training, as well as at a 6-week follow-up assessment, measures of emotion dysregulation and borderline personality disorder psychopathology were tested at diverse levels of analysis. Results from Study I demonstrate that effects of emotion regulation on autonomic measures, even if significant, were small and heterogeneous across studies, while electromyographic measures were more homogeneous and revealed medium effect sizes. Important study characteristics such as the study design, control instruction and trial duration moderated some autonomic effects of suppression and reappraisal. Study II demonstrated a significant inhibition of the startle response with emotion downregulation. Startle probes delivered at >7 seconds into the regulation phase were useful to quantify reappraisal effects, although earlier probes did not yield significantly smaller effects. Finally, Study III demonstrated that the inhibition of the startle with emotion downregulation increased after the training, suggesting improved emotion regulation abilities. In addition, we could demonstrate that general BPD psychopathology as well as affective instability and negative affect in daily life improved after training. However, after correction for multiple comparisons, observed effect sizes did not surpass the significance level and some effects (e.g., startle) faded to the 6-week follow-up assessment. In sum, the present thesis provides the groundwork for future randomized controlled trials of amygdala neurofeedback training and enables future laboratory and clinical studies to gain more stable effects in psychophysiological measurements of emotion regulation. In particular, the findings implicate that with regard to emotion regulation research, autonomic measures appear to be highly variable and thus should be selected carefully. In addition, we need more comparable psychophysiological set-ups in the empirical study of emotion regulation. The emotion-modulated startle not only proved to be a robust measure to quantify emotion regulation effects in general, but also appeared to be suitable to track improvements in emotion regulation in the context of a neurofeedback training targeting emotion dysregulation. With respect to emotion regulation outcome measures for future amygdala neurofeedback studies, further improvement of the specific paradigms is needed. In addition, the neurofeedback training itself should be optimized in terms of e.g. training time and booster sessions. Future placebo-controlled trials must then confirm that the treatment is effective in improving emotion regulation in those with borderline personality disorder

Intelligent technologies for the aging brain: opportunities and challenges

Intelligent computing is rapidly reshaping healthcare. In light of the global burden of population aging and neurological disorders, dementia and elderly care are among the healthcare sectors that are most likely to benefit from this technological revolution. Trends in artificial intelligence, robotics, ubiquitous computing, neurotechnology and other branches of biomedical engineering are progressively enabling novel opportunities for technology-enhanced care. These Intelligent Assistive Technologies (IATs) open the prospects of supporting older adults with neurocognitive disabilities, maintain their independence, reduce the burden on caregivers and delay the need for long-term care (1, 2). While technology develops fast, yet little knowledge is available to patients and health professionals about the current availability, applicability, and capability of existing IATs. This thesis proposes a state-of-the-art analysis of IATs in dementia and elderly care. Our findings indicate that advances in intelligent technology are resulting in a rapidly expanding number and variety of assistive solutions for older adults and people with neurocognitive disabilities. However, our analysis identifies a number of challenges that negatively affect the optimal deployment and uptake of IATs among target users and care institutions. These include design issues, sub-optimal approaches to product development, translational barriers between lab and clinics, lack of adequate validation and implementation, as well as data security and cyber-risk weaknesses. Additionally, in virtue of their technological novelty, intelligent technologies raise a number of Ethical, Legal and Social Implications (ELSI). Therefore, a significant portion of this thesis is devoted to providing an early ethical Technology Assessment (eTA) of intelligent technology, hence contributing to preparing the terrain for its safe and ethically responsible adoption. This assessment is primarily focused on intelligent technologies at the human-machine interface, as these applications enable an unprecedented exposure of the intimate dimension of individuals to the digital infosphere. Issues of privacy, integrity, equality, and dual-use were addressed at the level of stakeholder analysis, normative ethics and human-rights law. Finally, this thesis is aimed at providing evidence-based recommendations for guiding participatory and responsible development in intelligent technology, and delineating governance strategies that maximize the clinical benefits of IATs for the aging world, while minimizing unintended risks

Proceedings of the Seventeenth Annual Conference on Manual Control

Manual control is considered, with concentration on perceptive/cognitive man-machine interaction and interface

Aufmerksamkeitsverzerrungen in militärischen Einsatzkräften mit posttraumatischer Belastungsstörung und deren Veränderlichkeit nach Bereitstellung einer internet-basierten kognitiv-behavioralen Intervention

Posttraumatic stress disorder (PTSD) is a prevalent and highly disturbing mental health condition that occurs in response to extremely distressing events during the lifetime. First, military personnel represent a high-risk population for the development of posttraumatic stress symptoms (PTSS) or the full-diagnostic spectrum of the disorder due to deployment- and combat-related stressors during their military career. Despite the existence of well established and efficacious psychotherapy treatments for PTSD, access to trauma-focused psychotherapy is limited and veterans in particular experience high barriers to accessing help from the mental health care system. A substantial proportion of affected veterans receive no or inadequate treatment, increasing the risk of secondary adverse mental and somatic health outcomes, reduced social and occupational functioning, and of the condition becoming chronic. Second, internet-based interventions (IBI), particularly internet-based cognitive behavioral therapies (iCBT), have been shown to be efficacious and widely accepted for the treatment of a range of psychiatric disorders, including PTSD. IBI can already be seen as playing a potentially important role in supplementing the landscape and provision of psychotherapeutic interventions, and this is set to grow further in the future. Indeed, IBI should be particularly beneficial for patients in rural areas with a restricted psychotherapy infrastructure, for patients with restricted mobility, and for patients who desire greater anonymity and more independence regarding the time and location of psychotherapy access. Third, the systematic and reliable assessment of objective indicators of symptom expression and symptom change is of increasing interest and relevance for psychotherapy research. This dissertation thesis aims at incorporating these three pillars in four studies: First, a diagnostic identification of PTSD in veterans of the German Armed Forces (GAF) according to the main diagnostic manuals the International Classification of Diseases and Related Health Problems (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM); second, a meta-analytical evaluation of the efficacy of IBI in PTSD; third, an assessment of patterns of visual attentional bias in (traumatized) veterans (with PTSS); and fourth, an exploration of the modifiability of attentional bias in veterans after receiving iCBT. STUDY 1 investigated the concordance of PTSD prevalence rates when transiting between the diagnostic criteria of the DSM-IV, DSM-5, ICD-10, and proposed ICD-11 in a sample of service members of the GAF. High levels of agreement emerged between the DSM-IV and the DSM-5, and between the DSM-5 and the proposed ICD-11. Prevalence rates were significantly higher according to the proposed ICD-11 compared to the ICD-10, mainly due to the deletion of the time criterion. STUDY 1 provides support for the identification of six ‘core’ PTSD symptoms according to the proposed ICD-11, presenting a high agreement rate with the set of twenty qualifiers according to the DSM-5. STUDY 2 provided meta-analytical evidence for the efficacy of IBI for the treatment of PTSD. Twenty randomized controlled trials (RCT) encompassing 21 comparisons were included, evaluating either iCBT or internet-based expressive writing (iEW) with passive or active control conditions. The results revealed that iCBT was more efficacious than passive control conditions at post-treatment assessment (0.66 ≤ g ≤ 0.83). No superiority of either iCBT or iEW was found in contrast to active control conditions. Subgroup analyses revealed no significant moderators of iCBT efficacy. More research is needed to prove the efficacy of IBI in contrast to active control treatments and further explore the impact of moderators on treatment efficacy. STUDY 3 measured patterns of attentional bias in GAF veterans with PTSS, traumatized veterans without PTSS, and unexposed healthy veterans. In a free-viewing task, participants were presented with pairs of combat-related and neutral pictures, of more general threat-related and neutral pictures, and of emotional and neutral faces, while their eye gazes were tracked. Further, the internal consistency of attentional bias indicators was calculated. The findings provide support for the maintenance hypothesis in PTSS. There was no robust evidence to support the hypothesis of hypervigilant behavior in PTSS. Findings on attentional bias variability remain unclear. Internal consistency varied across attentional bias indicators, highlighting the need for future research in this regard. STUDY 4 investigated the modifiability of attentional bias in veterans with PTSS through the provision of iCBT. In a free-viewing task, participants were presented with combat-related, general threat-related, and neutral pictures, and with faces with negative emotional valence and neutral facial expressions while their eye gazes were tracked. Attentional bias was examined pre- and post-intervention and at a three-month follow-up. No modifications in attentional bias were observable over time. Future investigations are warranted to systematically investigate objective measures of symptom expression and symptom change together with subjective symptom reporting and symptom change in response to psychotherapeutic treatment options. In summary, this dissertation thesis provides a threefold contribution to the current landscape of psychotherapy research: First, it supports the concordance between the DSM-5 and the ICD-11 diagnostic criteria for PTSD. Second, it proves the efficacy of IBI for PTSD. In view of the growing relevance of IBI as a supplement to psychotherapeutic care, future research needs to examine its long-term efficacy, whether it shows equal or superior efficacy compared to other active (control) treatments, potential side effects, and whether it may lead to a deterioration of symptoms. Moreover, studies should focus on tailoring IBI to the specific needs of different patient populations to ensure patients’ safety and satisfaction with IBI. Third, the present thesis underlines the need for systematic and reliable assessments of objective indicators of symptom presentation and of symptom change, in addition to subjective reports. Moreover, methodological approaches need to be extended to measure diverse dimensions of symptom presentation and symptom change and gain a better understanding of their interplay. A multidimensional diagnostic approach and treatment evaluation will be of key relevance for future intervention research and evidence-based practice

Influence of genetic variability on the clinical pharmacology of carbamazepine and lamotrigine

This research programme investigates the influence of genetic variability on the clinical pharmacology of carbamazepine (CBZ) and lamotrigine (LTG). Common polymorphisms in genes that may influence the response to CBZ and LTG include CYP3A4 g.-392A>G, CYP3A5 g.6986A>G, CYP1A2 g.5734C>A, EPHX1 c.337T>C, EPHX1 c.416A>G, UGT2B7 c.802C>T, ABCB1 c.1236C>T, ABCB1 c.2677G>T/A, ABCB1 c.3435C>T and SCN2A c.56G>A. The prevalence of these common polymorphisms was evaluated in a 400-strong study population from a single research unit. Minor allele frequency ranged between 3.5% (CYP3A4 -392G) and 48.0% (ABCB1 1236T). Allele and genotype distributions were comparable to published data for other Caucasian populations. The influence of common polymorphisms in drug metabolising enzyme (DME) and sodium channel genes on the optimal dose of CBZ was assessed in a cohort of 70 patients. This study revealed that age and common polymorphisms in the EPHX1 gene (c.337T>C and c.416A>G) are potential predictors for optimal dose of CBZ. The significant effects of EPHX1 variants may be explained by their significant contribution to the inactivation of CBZ. These potential predictors explain approximately 15% of the inter-individual variation in CBZ dose requirements. Preliminary findings suggest that common polymorphisms in DME genes do not form a unique profile which increases the risk of developing intolerable CBZ adverse effects. It is unlikely that common polymorphisms in ABCB1 and SCN2A genes influence the expression and/or activity of their respective proteins to the level at which they can dictate response to LTG therapy. The influence of common polymorphisms in ABCB1 and SCN2A genes on the optimal dose of LTG was assessed in a cohort of 94 patients. Optimal dose in this study was defined as the final dose given to the patients that successfully maintained seizure freedom for at least 1 year with LTG monotherapy. Several basic clinical factors such as age and gender were also examined as potential predictors. The effect of predictors on the optimal dose of LTG was investigated using linear regression analysis. This study revealed that gender and common polymorphisms in the ABCB1 gene (c.1236C>T and c.3435C>T) are potential predictors for optimal dose of LTG. These predictors explain approximately 17% of the inter-individual variation in LTG dose requirement. These findings further highlight the potential role of P-gp in the management of epilepsy. The final study investigated the influence of ABCB1 c.1236C>T and ABCB1 c.3435C>T polymorphisms on the pharmacokinetics of LTG. A total of 156 blood samples from 50 patients receiving LTG monotherapy were available for analysis. The influence of ABCB1 variants was evaluated by population pharmacokinetics. This approach successfully estimated the oral clearance of LTG monotherapy at steady-state. However, the absorption rate constant (Ka) and volume of distribution (Vd) of LTG were poorly estimated. The inclusion of common polymorphisms in the ABCB1 gene in the pharmacokinetic model did not improve the estimation of oral clearance. This may indicate that common variants of ABCB1 do not influence clearance of LTG

Gesture and Speech in Interaction - 4th edition (GESPIN 4)

International audienceThe fourth edition of Gesture and Speech in Interaction (GESPIN) was held in Nantes, France. With more than 40 papers, these proceedings show just what a flourishing field of enquiry gesture studies continues to be. The keynote speeches of the conference addressed three different aspects of multimodal interaction:gesture and grammar, gesture acquisition, and gesture and social interaction. In a talk entitled Qualitiesof event construal in speech and gesture: Aspect and tense, Alan Cienki presented an ongoing researchproject on narratives in French, German and Russian, a project that focuses especially on the verbal andgestural expression of grammatical tense and aspect in narratives in the three languages. Jean-MarcColletta's talk, entitled Gesture and Language Development: towards a unified theoretical framework,described the joint acquisition and development of speech and early conventional and representationalgestures. In Grammar, deixis, and multimodality between code-manifestation and code-integration or whyKendon's Continuum should be transformed into a gestural circle, Ellen Fricke proposed a revisitedgrammar of noun phrases that integrates gestures as part of the semiotic and typological codes of individuallanguages. From a pragmatic and cognitive perspective, Judith Holler explored the use ofgaze and hand gestures as means of organizing turns at talk as well as establishing common ground in apresentation entitled On the pragmatics of multi-modal face-to-face communication: Gesture, speech andgaze in the coordination of mental states and social interaction.Among the talks and posters presented at the conference, the vast majority of topics related, quitenaturally, to gesture and speech in interaction - understood both in terms of mapping of units in differentsemiotic modes and of the use of gesture and speech in social interaction. Several presentations explored the effects of impairments(such as diseases or the natural ageing process) on gesture and speech. The communicative relevance ofgesture and speech and audience-design in natural interactions, as well as in more controlled settings liketelevision debates and reports, was another topic addressed during the conference. Some participantsalso presented research on first and second language learning, while others discussed the relationshipbetween gesture and intonation. While most participants presented research on gesture and speech froman observer's perspective, be it in semiotics or pragmatics, some nevertheless focused on another importantaspect: the cognitive processes involved in language production and perception. Last but not least,participants also presented talks and posters on the computational analysis of gestures, whether involvingexternal devices (e.g. mocap, kinect) or concerning the use of specially-designed computer software forthe post-treatment of gestural data. Importantly, new links were made between semiotics and mocap data