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Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral / Validation of the portuguese version of the telephone interview for cognitive status - modified (tics-m) among post-stroke patientsBaccaro, Alessandra Fernandes 04 June 2014 (has links)
Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indivíduos acometidos por AVC, foi realizada tradução para o Português do Brasil e adaptação transcultural da versão original da TICS-M em uma amostra de 30 sujeitos não clínicos. Após esta fase, um subgrupo de 61 pacientes com AVC, participantes do Estudo da Mortalidade e Morbidade do AVC (EMMA) que ocorre no Hospital Universitário da Universidade de São Paulo, foram convidados a participar da validação da TICS-M, seis meses após o evento agudo. A TICS-M foi aplicada em três momentos: avaliação inicial (entrevista presencial), uma e duas semanas após a primeira avaliação. Na avaliação inicial, além da TICS-M, questionários adicionais foram aplicados para avaliar a cognição: MoCA (Montreal Cognitive Assessment), MEEM (Mini Exame do Estado Mental); e para a depressão, HDRS (Hamilton Depression Rating Scale). Todos os questionários foram aplicados por duas entrevistadoras treinadas para o estudo. A confiabilidade intra-observador da TICS-M foi testada através dos coeficientes de Pearson, Intraclasse e alfa de Cronbach. As características internas do TICS-M também foram avaliadas através de uma análise exploratória utilizando o método Análise de Componentes Principais. A validade discriminatória do instrumento para rastreamento de demência pós-AVC foi avaliada em comparação a MEEM pela análise da área sob a curva (AUC) determinada pela curva ROC. Foram calculadas sensibilidade e especificidade para o ponto de corte ideal para rastrear demência. Resultados: De maneira geral, a TICS-M traduzida para o português apresentou um bom entendimento dos itens na mostra de indivíduos não clínicos. Foi observada uma frequência de 23% sugestiva de demência pós-AVC. O nível de escolaridade esteve positivamente associado ao estado demencial rastreado pelo MEEM. O estado depressivo assim como outras características de base não se associou à demência sugerida pelo MEEM. A confiabilidade teste-reteste intra-observador revelou taxas quase totais nos três momentos avaliados (Pearson Coeficiente > 0,85, Coeficientes de Correlação Intraclasse > 0,85 e Coeficiente alfa de Cronbach: 0,96). A análise fatorial determinou três domínios: memória de trabalho e atenção; memória recente e de evocação e orientação. A área sob a curva (AUC) determinada para a TICS-M em comparação com MEEM foi de 0,89 (intervalo de confiança 95%: 0,80-0,98). O ponto de corte sugerido para TICS-M foi de 14 pontos (escala de 0-39 pontos) para rastrear demência com sensibilidade de 91,5% e especificidade de 71,4%. Resultados semelhantes foram observadas com o MoCA. Conclusão: A versão brasileira da TICS-M sugere ser um instrumento de pesquisa útil e confiável para rastrear demência em pacientes pós-AVC / Introduction: Stroke is one most important cause of neuropsychological disorders. An initial cognitive assessment performed by telephone resulting in an early diagnosis of cognitive impairment and dementia, reducing costs and time. Objective: To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status Assessment (TICS-M) for assessment of dementia in post-stroke patients. Methods: Prior to validation of TICS-M in post-stroke patients, translation was performed for the Brazilian-Portuguese and cross-cultural adaptation of the original version of TICS-M in a non-clinical sample of 30 subjects. After this phase, 61 stroke patients enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) that occurs at the University Hospital of the University of São Paulo, were invited to participate in this sub-study to validate the TICS-M six months after the acute event. The TICS-M was applied in three moments: first evaluation (personal interview), one and two weeks after of the first evaluation. At the first evaluation, beyond the TICS-M, additional questionnaires were applied to assess cognition: MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental Status Examination), and for depression, HDRS (Hamilton Depression Rating Scale). All questionnaires were administered by two trained interviewers for the study. Reliability of the TICS-M was tested by intra-observer rates using Pearson, Intraclass and Cronbach´s alpha coefficients. The internal characteristics of TICS-M were also evaluated by an exploratory analysis using Principal Component Analysis. The discrimination validity of the instrument to assess dementia was evaluated by comparison to the MMSE analysis of the area under the curve (AUC) determined by the ROC curve. Sensitivity and specificity for the ideal cutoff to assess dementia were calculated. Results: In general, the TICS-M translated into Portuguese version showed a good understanding of the items in non-clinical individuals. A frequency of 23% suggestive of post-stroke dementia was observed. The level of education was positively associated with dementia status assessed by MMSE. The depressive status, as well as, other baseline characteristics was not associated with dementia suggested by MMSE. Test-retest reliability intra-observer revealed almost total rates in the three evaluation moments (Pearson coefficient > 0.85, Intraclass Correlation Coefficient > 0.85 and Cronbach\'s alpha coefficient: 0.96). The factorial analysis determined three domains: working memory and attention, recent and recall memory and orientation. The area under the curve (AUC) determined by TICS-M compared to MMSE was 0.89 (95% confidence interval: 0.80-0.98). The cutoff suggested for TICS-M was equal or greater than 14 points (range 0-39 points) to assess dementia (91.5% sensitivity, 71.4 % specificity). Similar results were observed with the MoCA. Conclusion: The Brazilian version of TICSM suggests being a useful and reliable research instrument to evaluate dementia in poststroke patients in epidemiological studies
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HANDSFREE-ENHET FÖR MOBIL TRYGGHETSTELEFON / HANDS-FREE UNIT FOR SAFETY MOBILE TELEPHONESundberg, Daniel January 2009 (has links)
<p>Cnior Mobile AB i Lindesberg utvecklar en mobil trygghetstelefon för äldre. Detta examensarbete går ut på att utforma en handsfree-enhet för denna. Handsfree-enheten ska integreras i larmknappen, som bärs av användaren runt handleden, och har kontakt med telefonen via blåtandsradio. I examensarbetet ingår att välja ut lämplig högtalare och mikrofon, hitta lösningar för smuts- och vattentålighet samt att lösa problem med ekon och bakgrundsstörningar.</p><p>En högtalare hittades som uppfyllde kraven för smuts- och vattentålighet samtidigt som den hade utmärkt frekvensgång för återgivning av tydligt tal. Vattenavrinning från högtalaren löstes genom att ett sinussvep sänds ut från högtalaren varje gång ett samtal ska kopplas upp. På så sätt pressar ljudtrycket ut vattnet från handledsknappens kavitet. Olika utformningar av ljudhålen i handledsknappens skal provades. Den bästa lösningen för vattenavrinningen var att använda sju stycken runda hål med 1,3 mm i diameter. En ljudtrycksmätning säkerställde att ljudtrycket inte blev lidande av denna utformning av ljudhålen.</p><p>Ekosläckning och bakgrundsstörningsundertryckning sköts av GSM-modulen i trygghetsmobilen. I ekosläckningens manual finns beskrivet hur ekosläckningens 24 parametrar kan justeras för att passa olika applikationer. Endast en mindre ändring av de rekommenderade parametervärdena behövdes för att ekosläckning och bakgrundsstörningsundertryckning skulle fungera tillfredställande.</p><p>Eftersom mikrofonernas datablad visade på så snarlika egenskaper överlämnades mikrofonvalet till företaget, då det kan vara klokt att låta priset avgöra.</p>
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Channel Modeling Applied to Robust Automatic Speech RecognitionSklar, Alexander Gabriel 01 January 2007 (has links)
In automatic speech recognition systems (ASRs), training is a critical phase to the system?s success. Communication media, either analog (such as analog landline phones) or digital (VoIP) distort the speaker?s speech signal often in very complex ways: linear distortion occurs in all channels, either in the magnitude or phase spectrum. Non-linear but time-invariant distortion will always appear in all real systems. In digital systems we also have network effects which will produce packet losses and delays and repeated packets. Finally, one cannot really assert what path a signal will take, and so having error or distortion in between is almost a certainty. The channel introduces an acoustical mismatch between the speaker's signal and the trained data in the ASR, which results in poor recognition performance. The approach so far, has been to try to undo the havoc produced by the channels, i.e. compensate for the channel's behavior. In this thesis, we try to characterize the effects of different transmission media and use that as an inexpensive and repeatable way to train ASR systems.
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Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral / Validation of the portuguese version of the telephone interview for cognitive status - modified (tics-m) among post-stroke patientsAlessandra Fernandes Baccaro 04 June 2014 (has links)
Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indivíduos acometidos por AVC, foi realizada tradução para o Português do Brasil e adaptação transcultural da versão original da TICS-M em uma amostra de 30 sujeitos não clínicos. Após esta fase, um subgrupo de 61 pacientes com AVC, participantes do Estudo da Mortalidade e Morbidade do AVC (EMMA) que ocorre no Hospital Universitário da Universidade de São Paulo, foram convidados a participar da validação da TICS-M, seis meses após o evento agudo. A TICS-M foi aplicada em três momentos: avaliação inicial (entrevista presencial), uma e duas semanas após a primeira avaliação. Na avaliação inicial, além da TICS-M, questionários adicionais foram aplicados para avaliar a cognição: MoCA (Montreal Cognitive Assessment), MEEM (Mini Exame do Estado Mental); e para a depressão, HDRS (Hamilton Depression Rating Scale). Todos os questionários foram aplicados por duas entrevistadoras treinadas para o estudo. A confiabilidade intra-observador da TICS-M foi testada através dos coeficientes de Pearson, Intraclasse e alfa de Cronbach. As características internas do TICS-M também foram avaliadas através de uma análise exploratória utilizando o método Análise de Componentes Principais. A validade discriminatória do instrumento para rastreamento de demência pós-AVC foi avaliada em comparação a MEEM pela análise da área sob a curva (AUC) determinada pela curva ROC. Foram calculadas sensibilidade e especificidade para o ponto de corte ideal para rastrear demência. Resultados: De maneira geral, a TICS-M traduzida para o português apresentou um bom entendimento dos itens na mostra de indivíduos não clínicos. Foi observada uma frequência de 23% sugestiva de demência pós-AVC. O nível de escolaridade esteve positivamente associado ao estado demencial rastreado pelo MEEM. O estado depressivo assim como outras características de base não se associou à demência sugerida pelo MEEM. A confiabilidade teste-reteste intra-observador revelou taxas quase totais nos três momentos avaliados (Pearson Coeficiente > 0,85, Coeficientes de Correlação Intraclasse > 0,85 e Coeficiente alfa de Cronbach: 0,96). A análise fatorial determinou três domínios: memória de trabalho e atenção; memória recente e de evocação e orientação. A área sob a curva (AUC) determinada para a TICS-M em comparação com MEEM foi de 0,89 (intervalo de confiança 95%: 0,80-0,98). O ponto de corte sugerido para TICS-M foi de 14 pontos (escala de 0-39 pontos) para rastrear demência com sensibilidade de 91,5% e especificidade de 71,4%. Resultados semelhantes foram observadas com o MoCA. Conclusão: A versão brasileira da TICS-M sugere ser um instrumento de pesquisa útil e confiável para rastrear demência em pacientes pós-AVC / Introduction: Stroke is one most important cause of neuropsychological disorders. An initial cognitive assessment performed by telephone resulting in an early diagnosis of cognitive impairment and dementia, reducing costs and time. Objective: To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status Assessment (TICS-M) for assessment of dementia in post-stroke patients. Methods: Prior to validation of TICS-M in post-stroke patients, translation was performed for the Brazilian-Portuguese and cross-cultural adaptation of the original version of TICS-M in a non-clinical sample of 30 subjects. After this phase, 61 stroke patients enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) that occurs at the University Hospital of the University of São Paulo, were invited to participate in this sub-study to validate the TICS-M six months after the acute event. The TICS-M was applied in three moments: first evaluation (personal interview), one and two weeks after of the first evaluation. At the first evaluation, beyond the TICS-M, additional questionnaires were applied to assess cognition: MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental Status Examination), and for depression, HDRS (Hamilton Depression Rating Scale). All questionnaires were administered by two trained interviewers for the study. Reliability of the TICS-M was tested by intra-observer rates using Pearson, Intraclass and Cronbach´s alpha coefficients. The internal characteristics of TICS-M were also evaluated by an exploratory analysis using Principal Component Analysis. The discrimination validity of the instrument to assess dementia was evaluated by comparison to the MMSE analysis of the area under the curve (AUC) determined by the ROC curve. Sensitivity and specificity for the ideal cutoff to assess dementia were calculated. Results: In general, the TICS-M translated into Portuguese version showed a good understanding of the items in non-clinical individuals. A frequency of 23% suggestive of post-stroke dementia was observed. The level of education was positively associated with dementia status assessed by MMSE. The depressive status, as well as, other baseline characteristics was not associated with dementia suggested by MMSE. Test-retest reliability intra-observer revealed almost total rates in the three evaluation moments (Pearson coefficient > 0.85, Intraclass Correlation Coefficient > 0.85 and Cronbach\'s alpha coefficient: 0.96). The factorial analysis determined three domains: working memory and attention, recent and recall memory and orientation. The area under the curve (AUC) determined by TICS-M compared to MMSE was 0.89 (95% confidence interval: 0.80-0.98). The cutoff suggested for TICS-M was equal or greater than 14 points (range 0-39 points) to assess dementia (91.5% sensitivity, 71.4 % specificity). Similar results were observed with the MoCA. Conclusion: The Brazilian version of TICSM suggests being a useful and reliable research instrument to evaluate dementia in poststroke patients in epidemiological studies
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HANDSFREE-ENHET FÖR MOBIL TRYGGHETSTELEFON / HANDS-FREE UNIT FOR SAFETY MOBILE TELEPHONESundberg, Daniel January 2009 (has links)
Cnior Mobile AB i Lindesberg utvecklar en mobil trygghetstelefon för äldre. Detta examensarbete går ut på att utforma en handsfree-enhet för denna. Handsfree-enheten ska integreras i larmknappen, som bärs av användaren runt handleden, och har kontakt med telefonen via blåtandsradio. I examensarbetet ingår att välja ut lämplig högtalare och mikrofon, hitta lösningar för smuts- och vattentålighet samt att lösa problem med ekon och bakgrundsstörningar. En högtalare hittades som uppfyllde kraven för smuts- och vattentålighet samtidigt som den hade utmärkt frekvensgång för återgivning av tydligt tal. Vattenavrinning från högtalaren löstes genom att ett sinussvep sänds ut från högtalaren varje gång ett samtal ska kopplas upp. På så sätt pressar ljudtrycket ut vattnet från handledsknappens kavitet. Olika utformningar av ljudhålen i handledsknappens skal provades. Den bästa lösningen för vattenavrinningen var att använda sju stycken runda hål med 1,3 mm i diameter. En ljudtrycksmätning säkerställde att ljudtrycket inte blev lidande av denna utformning av ljudhålen. Ekosläckning och bakgrundsstörningsundertryckning sköts av GSM-modulen i trygghetsmobilen. I ekosläckningens manual finns beskrivet hur ekosläckningens 24 parametrar kan justeras för att passa olika applikationer. Endast en mindre ändring av de rekommenderade parametervärdena behövdes för att ekosläckning och bakgrundsstörningsundertryckning skulle fungera tillfredställande. Eftersom mikrofonernas datablad visade på så snarlika egenskaper överlämnades mikrofonvalet till företaget, då det kan vara klokt att låta priset avgöra.
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The replacement of the doctrine of pith and marrow by the catnic test in English Patent Law : a historical evaluationZondo, Raymond Mnyamezeli Mlungisi 02 1900 (has links)
This dissertation is a historical evaluation of the movement of the English courts from the doctrine of pith and marrow to the Catnic test in the determination of non-textual infringement of patents. It considers how and why the doctrine was replaced with the Catnic test. It concludes that this movement occurred as a result of the adoption by a group of judges of literalism in the construction of patents while another group dissented and maintained the correct application of the doctrine. Although the Court of Appeal and the House of Lords initially approved the literalist approach, they, after realising its untennability, adopted the dissenters’ approach, but, ultimately, adopted the Catnic test in which features of the dissenters’ approach were included. The dissertation concludes that the doctrine of pith and marrow, correctly applied, should have been retained as the Catnic test creates uncertainty and confusion. / Mercantile Law / LL. M.
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All the Pieces Matter: Fragmentation-as-Agency in the Novels of Edwidge Danticat, Michelle Cliff, and Shani MootooMorguson, Alisun 30 January 2013 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / The fragmented bodies and lives of postcolonial Caribbean women examined in Caribbean literature beget struggle and psychological ruin. The characters portrayed in novels by postcolonial Caribbean writers Edwidge Danticat, Michelle Cliff, and Shani Mootoo are marginalized as “Other” by a Western patriarchal discourse that works to silence them because of their gender, color, class, and sexuality. Marginalization participates in the act of fragmentation of these characters because it challenges their sense of identity. Fragmentation means fractured; in terms of these fictive characters, fragmentation results from multiple traumas, each trauma causing another break in their wholeness. Postcolonial scholars have identified the causes and effects of fragmentation on the postcolonial subject, and they argue one’s need to heal because of it. Danticat, Cliff, and Mootoo prove that wholeness is not possible for the postcolonial Caribbean woman, so rather than ruminate on that truth, they examine the journey of the postcolonial Caribbean woman as a way of making meaning of the pieces of her life. This project contends that fragmentation – and the fracture it produces – does not bind these women to negative existences; in fact, the female subjects of Danticat, Cliff, and Mootoo locate power in their fragmentation. The texts studied include Danticat’s "Breath, Eyes, Memory" (1994) and "The Farming of Bones" (1999), Cliff’s "Abeng" (1984) and "No Telephone to Heaven" (1987), and Mootoo’s "Cereus Blooms at Night" (1996) and "He Drown She in the Sea" (2005).
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