Measuring cognitive assessment and intervention burden in patients with acquired brain injured: Development of the "How Much is Too Much" questionnaire

Objective: To design and preliminarily test a questionnaire intended to measure patient treatment burden resulting from participation in cognitive assessments and interventions. Methods: An expert consensus process was used to develop the concept of patient treatment burden and to determine the first set of questionnaire items and administration protocol. The pilot questionnaire was administered to 20 patients with mild to severe acquired brain injuries on completion of a 2-h or longer neuropsychological assessment. Following preliminary testing, the questionnaire was revised and re-evaluated by a second expert panel and content validity was assessed. Results: Burden was defined as psychologically and/or physically aversive symptoms in response to cognitive assessment or intervention. The first questionnaire contained 21 items assigned to 3 categories: physical, cognitive, and emotional. Eightyfive percent of patients endorsed symptom level increases, with "tired/fatigued" the most frequently endorsed item (80% of patients). Instructions and test items were easily understood, and the questionnaire was quick to administer. Content validity ratio (CVR) of the revised questionnaire yielded 23 acceptable items and a subset met the highest CVR threshold (>0.78). Conclusion: This patient-reported outcome will ultimately help patients give voice to aversive experiences, and help clinicians and researchers to monitor and adapt assessments/treatments appropriately. Future steps in development are described

Analysis of Natural Scene Derived Spatial Frequency Responses for Estimating Camera ISO12233 Slanted-edge Performance

The Natural Scene derived Spatial Frequency Response (NS-SFR) framework automatically extracts suitable step-edges from natural pictorial scenes and processes these edges via the edge-based ISO12233 (e-SFR) algorithm. Previously, a novel methodology was presented to estimate the standard e-SFR from NS-SFR data. This paper implements this method using diverse natural scene image datasets from three characterized camera systems. Quantitative analysis was carried out on the system e-SFR estimates to validate accuracy of the method. Both linear and non-linear camera systems were evaluated. To investigate how scene content and dataset size affect system e-SFR estimates, analysis was conducted on entire datasets, as well as subsets of various sizes and scene group types. Results demonstrate that system e-SFR estimates strongly correlate with results from test chart inputs, with accuracy comparable to that of the ISO12233. Further work toward improving and fine-tuning the proposed methodology for practical implementation is discussed

Estimation of ISO12233 Edge Spatial Frequency Response from Natural Scene Derived Step-Edge Data

The Natural Scene derived Spatial Frequency Response (NS-SFR) is a novel camera system performance measure that derives SFRs directly from images of natural scenes and processes them using ISO12233 edge-based SFR (e-SFR) algorithm. NS-SFR is a function of both camera system performance and scene content. It is measured directly from captured scenes, thus eliminating the use of test charts and strict laboratory conditions. The effective system e-SFR can be subsequently estimated from NS-SFRs using statistical analysis and a diverse dataset of scenes. This paper first presents the NS-SFR measuring framework, which locates, isolates, and verifies suitable step-edges from captures of natural scenes. It then details a process for identifying the most likely NS-SFRs for deriving the camera system e-SFR. The resulting estimates are comparable to standard e-SFRs derived from test chart inputs, making the proposed method a viable alternative to the ISO technique, with potential for real-time camera system performance measurements

Just add water: colonisation, water governance, and the Australian inland

Water has played a key role in the development of the Australian inland and the nation. For European colonists, the dry and variable landscape challenged ideas about nature imported from northern temperate regions. I argue first, that colonists brought with them ideas for ordering nature and tools for transforming landscapes that led to inappropriate and destructive water management and the silencing of local voices and knowledge systems. Secondly, colonial patterns of ordering and transforming landscapes are ongoing, but new ways of governing water, which challenge colonialism, are emerging. In the first section of the paper I discuss colonial relationships with water; in particular the methods of irrigation, river diversion, and bore drilling. In the second section I consider contemporary manifestations of colonial relationships between humans and water, focusing on the bureaucratic separation of land and water, the problematic definition of a river, and the ongoing desire to drought-proof the inland. In the third section I examine emerging ways of governing Australian water, which emphasise knowledge and interconnection, and in so doing challenge ongoing colonial relationships. I describe these two ways of governing water as existing in tension; a tension between engineering-based and knowledge-based approaches to water governance

A rehabilitation tool for functional balance using altered gravity and virtual reality

<p>Abstract</p> <p>Background</p> <p>There is a need for effective and early functional rehabilitation of patients with gait and balance problems including those with spinal cord injury, neurological diseases and recovering from hip fractures, a common consequence of falls especially in the elderly population. Gait training in these patients using partial body weight support (BWS) on a treadmill, a technique that involves unloading the subject through a harness, improves walking better than training with full weight bearing. One problem with this technique not commonly acknowledged is that the harness provides external support that essentially eliminates associated postural adjustments (APAs) required for independent gait. We have developed a device to address this issue and conducted a training study for proof of concept of efficacy.</p> <p>Methods</p> <p>We present a tool that can enhance the concept of BWS training by allowing natural APAs to occur mediolaterally. While in a supine position in a 90 deg tilted environment built around a modified hospital bed, subjects wear a backpack frame that is freely moving on air-bearings (cf. puck on an air hockey table) and attached through a cable to a pneumatic cylinder that provides a load that can be set to emulate various G-like loads. Veridical visual input is provided through two 3-D automultiscopic displays that allow glasses free 3-D vision representing a virtual surrounding environment that may be acquired from sites chosen by the patient. Two groups of 12 healthy subjects were exposed to either strength training alone or a combination of strength and balance training in such a tilted environment over a period of four weeks.</p> <p>Results</p> <p>Isokinetic strength measured during upright squat extension improved similarly in both groups. Measures of balance assessed in upright showed statistically significant improvements only when balance was part of the training in the tilted environment. Postural measures indicated less reliance on visual and/or increased use of somatosensory cues after training.</p> <p>Conclusion</p> <p>Upright balance function can be improved following balance specific training performed in a supine position in an environment providing the perception of an upright position with respect to gravity. Future studies will implement this concept in patients.</p