camperdown manual 2010

camperdown manual 2010

You can filter on reading intentions from the list, as well as view them within your profile. It makes it easy to scan through your lists and keep track of progress. Here's an example of what they look like. Create one here Primary outcomeSecondary outcomes were number of sessions,Data were collectedGroup mean stuttering frequency wasMinimal anxiety was evident either pre- or post-treatment.Suggestions for future stuttering treatment developmentNew York: Palgrave.Austin, TX: Pro-Ed. This study investigated if using Scenari-Aid improves maintenance of stuttering therapy outcomes. An ABAB single subject design (A: pre-access and withdrawal; B: Scenari-Aid access) was used. Post-treatment gains in communication attitude and social participation were maintained 6-months post-treatment. Some improvements in weekly measures were present from A1 to B1 but there were no changesfrom B1 to A2 or A2 to B2. The participant reported using Scenari-Aid to aid initial desensitisation and then only occasionally. Further research is necessary to clarify the role of Scenari-Aid in the maintenance of treatment gains. Previous article in issue Next article in issue Keywords online simulation treatment maintenance stutter modification Camperdown Program Download full text in PDF Recommended articles Citing articles (0). Peer-review under responsibility of the Scientific Committee of ODC 2014. Published by Elsevier Ltd. Recommended articles No articles found. Citing articles Article Metrics View article metrics About ScienceDirect Remote access Shopping cart Advertise Contact and support Terms and conditions Privacy policy We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. This bibliography was generated on Cite This For Me on Saturday, November 14, 2015 Int J Lang Commun Disord, 45(1), pp.108-120. J Speech Lang Hear Res, 53(4), p.887. NeuroImage, 52(4), pp.1495-1504. J Speech Lang Hear Res, 55(1), p.306.http://erboka.org/userfiles/browning-bl-22-manual.xml

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Journal of Speech, Language, and Hearing Research, 46(4), pp.933-946. Journal of Speech Language and Hearing Research, 39(4), p.734. Journal of Fluency Disorders, 37(4), pp.225-233. Journal of Speech Language and Hearing Research, 37(4), p.724. Disability and Rehabilitation, 22(1-2), pp.65-79. Journal of Fluency Disorders, 25(4), pp.369-375. Brenda Carey is a research collaborator with The Australian Stuttering Research Centre, a clinical educator at La Trobe University and the director of a stuttering treatment centre in Melbourne. Sue O’Brian is a senior research fellow at The Australian Stuttering Research Centre with special interest in stuttering treatment and measurement. Mark Onslow is the director of The Australian Stuttering Research Centre at The University of Sydney. Helgadottir, F. D. (n.d.). Welcome to the Social Anxiety Treatment Program of the ASRC. You can change your cookie settings at any time. The Treasury may make an order adding a body to the list of qualifying bodies. Bodies added by Treasury order may include bodies resident overseas. (Such bodies can be designated if they are similar in nature to one of the sorts of UK body listed above. This ensures that UK and non UK based subcontractors are treated in the same way). In the public version the date from which the body in this list is prescribed can be found immediately below the body, and not in column 4); We’ll send you a link to a feedback form. It will take only 2 minutes to fill in. Don’t worry we won’t send you spam or share your email address with anyone. Please try again.The cemetery was founded in 1848 and was for twenty years the main general cemetery for Sydney, with the total number of burials being about 18,000. Many people who were important to the early history of colonial Australia are buried there. It is the only one of Sydney's three main early cemeteries that still exists.http://datatech-int.com/userfiles/browning-blr-308-manual.xml

As well as historic monuments, the cemetery also preserves important elements of landscape gardening of the mid 19th century, and examples of native flora, which are now rare in the built-up inner city. St Stephen's Anglican Church is located within the present bounds of the cemetery. The site, with St Stephen's Church, is listed by the Heritage Council of New South Wales and the National Register as site of national importance. Camperdown Cemetery is associated with numerous sensational stories, several reputed ghosts and a murder. It is used regularly for historical and genealogical research. Because of its historical importance and convenient location, it is also a venue for excursions by schools and historical societies. Camperdown Cemetery is valued by the residents of Newtown as providing a major greenspace located in the immediate vicinity of a busy commercial centre. In a densely populated area of small terrace houses without substantial gardens, the cemetery functions as a recreational area and a venue for many family and social activities. Description Camperdown CemeteryCamperdown. Then you can start reading Kindle books on your smartphone, tablet, or computer - no Kindle device required. Get your Kindle here, or download a FREE Kindle Reading App.Amazon calculates a product's star ratings based on a machine learned model instead of a raw data average. The model takes into account factors including the age of a rating, whether the ratings are from verified purchasers and factors that establish reviewer trustworthiness. All work type s Show minimum salary refinements. Enjoy warm calls with customers and provide a consultative approach. Inbuilt career progression and commission scheme. Be a part of a professional team and business with great tenure and benefits. Kick-start your career in the financial services industry. An opportunity to move into Account Management or Inside Sales. Build partnerships with corporate Australia and education providers.

Full-time role (including Sundays). All rights reserved. Instead, the treatment was conducted remotely with contact occurring only by telephone and e-mail. We will present details of these studies in Chapter 10. Although designed to be used with the adult population, the programme has also been trialled with adolescents. Hearne et al. (2008) conducted a Phase I trial with three adolescents aged 13, 14 and 16 years. In this trial, no significant adaptations were made to accommodate the younger population. The oldest of the three children responded very well, reducing his stuttering to below 1% and maintaining this result for at least 12 months. However, the younger two children did not perform as well. Subsequent modifications have recently been made to the programme to make it more suitable for this age group. A recent Phase I trial of a Skype Internet version (Carey et al., in press) shows significantly improved outcomes for adolescents, with a group mean percent stuttering reduction of 92% at 6 months post-treatment. Finally, a clinical trial of the treatment with adults but delivered by students under supervision (Cocomazzo et al., in press) has confirmed that similar results can be achieved under those conditions. The 12 participants in this trial achieved a mean 62% reduction in stuttering 12 months after treatment. In summary, there is strong evidence from Phase I and Phase II clinical trials with adults and adolescents that the CP can produce significant reductions in stuttering regardless of the delivery format. That evidence is robust because outcomes have been collected from both objective and self-report measures, supported by speech naturalness data, in everyday speaking situations, independent of the treatment environment and for up to 12 months after treatment. Outcomes have been shown to be socially valid during this research. Advantages and disadvantages Advantages The CP has a number of advantages over traditional speech restructuring programmes.

The most obvious is the reduced clinician time required to achieve comparable outcomes. This is a substantial saving compared to the 50 or even 100 plus hours required for more traditional intensive group programmes that may even include a residential component. The CP allows for flexibility of treatment delivery. For example, it can be administered entirely at a distance, using phone or webcam technology allowing equity of access particularly for remotely located people. It can also be offered in group or individual format, hence catering for different client preferences and infrastructure needs. The programme has been manualised for implementation by generalist clinicians. It requires no specialist skills, no equipment and it can be delivered by whatever method is suited to a clinician’s caseload. Taking the service away from specialist centres again allows for greater access to treatment for the general population. Disadvantages The disadvantages of the programme are those that are inherent to all speech restructuring programmes. The learning of a new speech pattern requires effort and focus to maintain over long periods. Relapse is common and speech that sounds and feels unnatural to some extent seems inevitable. The limitations to the CP evidence also need to be acknowledged. There has been no replication of these findings independently of our research group. As such, it is likely that the effect sizes have been overestimated (Kunz and Oxman, 1998). There have been no long-term follow-up studies past 12 months and given the well-acknowledged relapse rates with adult stuttering treatments, this is also a caveat to the findings. Conclusions and future direction In conclusion, the CP is a speech restructuring treatment for which there is reasonable empirical evidence for both its treatment processes and its efficacy. So what does the future hold for the programme.

We are just completing a Phase I trial of a completely clinician-free, Internet-based version that clients complete in their own time, and in their own environments (Erickson et al., 2012). This version retains all the concepts of the original programme but clients work through the programme at their own pace. This will obviously not be the solution for all clients; however, preliminary data have shown that it is a viable model for some. Hopefully in the future, we will be able to report on a model that makes treatment accessible to anyone, wherever and whenever they need it. How satisfying that would be for both the stuttering population and for speech pathologists. Discussion Ann Packman Our group was interested that you reported variable outcomes for clients in the trials. Sue O’Brian I don’t know whether many of you noticed that the outcomes for the earlier trials were better than the outcomes for the later trials. What happened from the first trials to the later trials is that we changed the way we measured outcomes. If participants are able to initiate their own assessment situations, then they can potentially manipulate outcomes. Surprise is a bit of a loose term. Obviously, they are not surprise calls in the sense that participants did not know they were coming, but they were surprise calls in the sense that they did not know when they would come. We always have to establish a convenient window of time for when the participants can take the calls so there is some known element. These surprise calls are from two strangers, who are researchers at the Australian Stuttering Research Centre. The procedure has the advantage that participants cannot rehearse before an assessment phone call and they cannot choose who the call will be from. And most importantly, they cannot remake a recording if they are not happy with the first recording. Now I don’t know if that has ever happened, but we sometimes wondered with the way we used to collect outcome recordings.

So the way that we are now collecting objective stuttering-count assessments is a much more valid way of doing it. So for that reason I think probably the outcomes the later trials provide are a more valid effect size estimate than the earlier trials. Ann Packman I wonder if you could give some idea of predictors of those outcomes. How useful were severity or previous treatment, or other factors, as predictors. Sue O’Brian There have been no studies to date that have specifically explored predictors of outcome. However, for a number of the trials we have explored correlates of outcome. None of our studies so far have recruited enough subjects to allow statistically useful predictors of outcome, but we have at least looked at correlates. Nothing has come up. Severity, previous treatment and family history have not been correlates of outcome for our trials. But of course you need to take that as a preliminary finding only. Sophisticated regression modelling, when we have sufficient numbers, may provide a different result. Sheena Reilly Sue, I think the first comment our group made was what a great example it was of building evidence about a programme and approach, so congratulations from the group. During the Instatement Stage, how do you get from the imitation task during the Practice Phase to shaping speech naturalness during the Trial Phase. How do you decide which speech components you’re going to work on to make speech natural. Sue O’Brian The way it’s taught in the first place is just by exposure to the video model during the Practice Phase. What we do clinically is play the video or the audio for clients, get them to listen to it a few times and try to imitate it. It is easy to break the video model into small bits and compare that small bit with the attempted client production. Can you make yourself sound more like that?

’ What we find is that clients don’t have any problem with that, as long as the model is broken down into smaller bits and they copy it bit by bit. We don’t insist clinically that clients imitate the model exactly (unless they want to) because that would fly in the face of the underlying assumptions of the programme. Joseph Attanasio Is there a resistance to go into an unnatural speech pattern, and if so how do you overcome that. Sue O’Brian No, because what we want the clients to do during the Practice Phase is to develop their own individual pattern that completely controls their stuttering. If they are using a speech restructuring technique well they will not stutter at all. When we get that far then we go into the Trial Phase where the cycles happen and they start to shape more natural-sounding speech while retaining control of stuttering. Sheena Reilly Can you just clarify the procedures. Sue O’Brian Clients cycle through the three phases: Practice, Trial and Evaluation. During Trial Phase they move from imitation of the video to monologue and conversation with the clinician, and they are told to use any features of the pattern that they think they need to control stuttering while attempting to make their speech sound more natural. There is no programmed instruction. In other words, we don’t use the traditional approach of starting at, say, 40 syllables a minute and moving to 70 syllables a minute to 100 syllables a minute, and so on, or starting at naturalness 9, and moving systematically from naturalness 8, to 7, to 6, and so on. Instead, we allow clients to just use the features as they please. They set their own speech naturalness targets. So every client does it differently. You will get those clients who want to play it safe and they’ll stay at a very unnatural level for quite a long time. Then you get others who pace themselves evenly throughout the cycles and move progressively from higher to lower naturalness scores during the Trial Phases.

You mention in your presentation and in your publications that the CP is not based on any theoretical model and the group was wondering might it be incorrect to say that. Surely motor control theory underlies CP because after all you are slowing down speech, you are changing motoric aspects of speech, and might not that be at the core of this and so might it be theoretically driven. Sue O’Brian First of all, there is evidence for how speech restructuring might work. There’s evidence to show that, for example, the variability of vowel duration decreases with speech restructuring patterns. And if you consider theories such as those I mention, they would explain why the speech restructuring process works. The thing I am keen to promote is that it was not a theory that drove the development of the programme; empirical studies drove the development of the programme. We did so looking at the laboratory evidence I mentioned, in particular the Packman et al. (1994) study. Ann Packman Sue, our group was interested that you mentioned using cognitive behaviour therapy procedures during the Problem Solving Stage. Could you elaborate on what they are and do you think that an unskilled or an untrained therapist could do them. Sue O’Brian The first thing I need to say is that the primary CP goal is to reduce or eliminate stuttering. But of course that does not mean that speech-related anxiety should be overlooked. That would just be silly, considering the evidence about the number of adults who stutter and seek speech treatment that have speech-related anxiety. I imagine most speech pathologists would assess speech-related anxiety when they do an assessment. We use a couple of different tools for assessing anxiety, one being the UTBAS scale that is an acronym for Unhelpful Thoughts and Beliefs about Stuttering (Iverach et al., 2011; St Clare et al., 2008). The UTBAS scale is a 60-item checklist, which was developed by psychologists working with adults who stutter.

It was taken from a file audit of clinical cases and established the unhelpful thoughts and beliefs that adults who stutter typically present in a treatment environment. I think it is a useful tool, not for diagnosing anxiety but for finding out what sort of anxiety, the levels of anxiety and what sort of situations clients fear. Those unhelpful cognitions are used during the Problem Solving Stage of the CP. The other tool that we often use is the fear of negative evaluation scale (Watson and Friend, 1969). So those tools give you a lot of information to use during the treatment process. A publication by Menzies et al. (2009) provides basic cognitive behaviour therapy strategies for use by those who feel professionally qualified to do so. But the caveat here is that cognitive behaviour therapy is the domain of clinical psychologists, not speech pathologists. That being said, I do think many adults who stutter who seek stuttering control would benefit from cognitive behaviour therapy. How speech pathologists might present those services is a topic to which I don’t think time will allow me to digress. Sheena Reilly Our group discussed the advantages of the CP flexibility for individual clients. Obviously you are an experienced clinician and your team developed the programme. But how suitable is it for generalist clinicians, particularly in the telehealth and Internet-based versions you mentioned. Sue O’Brian The short answer is that the manual has been written with generalist clinicians in mind, so it’s written as a simplistic step-by-step programme. The skills required are not those of a specialist clinician. First, there is no counting of stuttering moments. The CP just uses a severity rating scale. And second, because the video model is provided, it is possible for a clinician to do the treatment without having to constantly provide perfect demonstrations of the target speech pattern; the video model does that.

I also think that telehealth is no problem, but we will get to that later (see Chapter 10). Sheena Reilly I think the question was more about if you didn’t have access to a clinician and you were simply doing a standalone Internet-based version. Our Phase I trial (Erickson et al., 2012) show that some clients can use the Internet version satisfactorily. Joe Attanasio Our group had a concern about your comment that the CP can be done without specialised training. And there was also a concern about how outcomes were judged. We queried the reliability and freedom from bias in the outcome assessment process and that is an issue that you might want to clarify at some point. Sue O’Brian Hopefully, at some time we will have an empirical response to your first concern. Regarding the second concern, all of us who conduct stuttering treatment research are tarred by that brush. References Bothe, A. K. (2008) Identification of children’s stuttered and nonstuttered speech by highly experienced judges: Binary judgements and comparisons with disfluency-types definitions. Language Speech and Hearing Services in Schools. International Journal of Language and Communication Disorders. Manuscript in preparation. Papers from the 2nd Asia Pacific Conference on Speech, Language and Hearing, Part IV.Log In or Register to continue. We are conducting a user survey and would appreciate yourThis survey should take 3 minutes.As answering these takes time away from processing submissions, please email only if absolutely necessary. We are working hard to process registration and update requests as quickly as possible. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this information for consumers Placebo is administered intranasally and consists of the preservatives found in the active oxytocin nasal spray (i.e., chlorobutanol hemihydrate, E216, and E218).

Time-line follow back for assessing cannabis and alcohol consumption These tasks are conducted using a computer and eye gaze technology. Nasal obstruction, discharge, or bleeding Cardiovascular problems (e.g., heart disease, history of heart attacks), high blood pressure (hypertension) Habitually drink large volumes of water Pregnancy Allocation randomised by compounding chemist. The person deciding on participant inclusion will use numbered containers to allocate medication. It is hypothesised that participants randomised to the oxytocin condition, compared to participants randomised to the placebo condition will have a higher rate of treatment completion, experience reduced number, severity, and duration of cannabis and alcohol withdrawal symptoms and will report fewer days of cannabis and alcohol use at one month follow-up. Layer 1 0 0 close icon Brought from a dealership in 2017. Mainly used in the hwy. Great on fuel, 600ks to a tank. Easy to keep clean. Never been in an acciden.New tyres with 2 spare wheels. Heavy duty tray with canopy. Redarc electric trailer brakes. Airbags and heavy duty springs. A panel of Australasian sleep professionals developed the commentary. Each member was tasked with reviewing an assigned section and reporting back with potential AASM Manual clarifications and alterations. These suggestions were evaluated by the panel and ultimately resulted in the recommendations in this document. The panel recognised that the AASM manual significantly advanced the standardisation of polysomnography recording, analysis, and reporting; however, there were sections of the AASM Manual where the panel determined there were clarifications, additions, or alterations required. While it is anticipated that the recommendations will improve standardisation across Australasian sleep services many of the recommendations are also relevant in a global setting and should be considered for inclusion in future updates of the AASM Manual.

The 2007 AASM Manual was found to have a number of alternatives, disparities and priorities which in some cases had little or no relevance to Australasian patient management practices. If applied without local interpretation it would in some cases affect diagnoses and potential access to treatment. The challenges to local implementation were particularly evident in the classification of respiratory events. Since the original release in 2007 there have been several revisions to the AASM Manual. The guidelines included the reasonable assumption that the majority of Australian and New Zealand sleep disorder services had moved forward to routinely employ the recommendations of the revised 2012 AASM Manual. In doing so, the need for alignment with a broadly accepted international standard was again recognised, and therefore, a goal of this review was to align with the latest AASM Manual wherever possible. In addition to facilitating Australasian practice consistency it was hoped that this review could also provide guidance to future AASM standards. Materials and methods This review and commentary was developed via a collaboration of ASA Clinical Committee members and Australian and New Zealand Sleep Science Association (ANZSSA, formerly ASTA) members. This panel first convened in April 2017 at the request of the Clinical Committee of ASA and met by teleconference during 2017 and 2018. Sections of the AASM Manual were divided between panel members; each member was tasked with reviewing their assigned sections, and reporting back with suggestions for AASM Manual clarifications and alterations. These suggestions were discussed and ultimately resulted in the recommendations that follow in this document.

Approach and principles The general approaches and principles taken by the panel in reviewing the AASM Manual were as follows: This principle underpins practice standardisation based on quantifiable and reproducible measurements across services and supports consistent interpretation of disorders identified by polysomnography. Where deviations from the AASM Manual were recommended, explanations were provided. User guide The panel recommend that the AASM Manual, version 2.6 be read and considered in conjunction with this commentary, as the reference and accreditation standard for scoring and reporting sleep investigations performed in Australia and New Zealand. If not otherwise stated, the guidelines and recommendations provided in the AASM Manual V2.6 are supported by the panel and should be adhered to. The AASM Manual identifies RECOMMENDED, ACCEPTABLE and OPTIONAL types of criteria. The panel supports and uses these terms in this document. The core of this document refers to full laboratory polysomnography. A separate section (IX) in the AASM Manual describes Home Sleep Apnea Testing which in many cases does not align well with portable device monitoring in Australasia. General commentary is included and some recommendations are made in this document, where practices align and where monitoring technology is consistent. This commentary aligns with the sections and subsections of the AASM Manual and was considered by the panel as the most efficient way to convey local recommendations without adding additional complication to the interpretation and also to support consistency of practice. Patient video monitoring and recording The AASM Manual did not identify low-light video monitoring as a General Parameter until version 2.6, however, did identify it within the Technical and Digital Specifications section.Recording the maximum value at treatment levels is considered OPTIONAL.

Reporting the maximum level of snoring sound during the investigation (in dB if employing a sound level meter), with identification of the patient position and sleep stage at the time, is RECOMMENDED. Similar to the reporting of RERAs and the ODI the panel consensus is that these snoring inclusions sufficiently aid clinical interpretation and recording measurement standards. ABG sampling and a simultaneous TcCO 2 reading taken prior to Lights Off allows TcCO 2 values throughout the PSG to be aligned more closely to arterial values through the use of equipment correction options.See the Discussion for details of these considerations. The rationale for departure from the AASM Manual relates to the internal contradiction arising from the counting arousals in awake and sleep epochs, and dividing only by the sleep time. Apply the following criteria to classify arousal types: However, the panel note that the clinical benefit of routinely scoring alternating leg muscle activation (ALMA), hypnagogic foot tremor (HFT), hypnagogic foot tremor (HFT) events is limited and is not routine in Australasian laboratories. However, for routine polysomnography, classification and scoring of bruxism is considered OPTIONAL while reporting the presence of bruxism if identified is RECOMMENDED. Classification and scoring of bruxism according to the AASM criteria listed is RECOMMENDED if the goal of the investigation is to determine the clinical significance of the disorder. Snoring (Item A.8) Objective measures of snoring sound level using a calibrated sound level meter are RECOMMENDED. Baseline definition (Additional Item B.4) The panel noted that the AASM Manual does not provide a baseline breathing definition in defining apnoeas, hypopnoeas, or event durations.It remains possible, however, that an event starts and ends in an awake epoch but overlaps a sleep epoch. If the apnoea or hypopnoea occurs entirely during epochs scored as wake, it should not be scored or counted towards the AHI.