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Speech-Language Pathology/Stuttering/Beyond Fluency-Shaping

Fluency shaping stuttering therapy was developed before much was known about motor learning and control. Some speech clinics have not refined their therapy programs to reflect advances in the field.

Improving Cognitive Stage Speech Motor Learning
In the first or cognitive stage of motor learning, you observe an instructor perform a motor skill that is new to you.

But speech-language pathologists may be the wrong people to model fluent speech motor skills. When learning a new motor skill, novices learn best by observing another novice making mistakes, then getting it right.

In contrast, observing a skilled person perform the task flawlessly doesn't do you much good. For example, millions of people watch Michael Jordan play basketball. Few of those people could go out on a basketball court and repeat his moves. The exceptions are people who are already skilled and want to get even better, e.g., college basketball players can improve their game by watching the pros.

A stutterer watching a speech-language pathologist model gentle onsets or pull-outs or whatever is like Joe Sixpack watching Micheal Jordan. The stutterer might learn more if the speech-language pathologist modeled the mistakes her other clients have made, e.g., two-second stretched words instead of two-second stretched vowels, and then showed how to correct those mistakes. Or the speech-language pathologist could prepare a video of her previous clients making mistakes, and then learning to correct their mistakes.

Improving Associative Stage Speech Motor Learning
In the second or associative stage of motor learning, you learn to perform and refine a new motor skill. But are there better fluent speech motor skills than the five (or seven) skills taught in fluency shaping stuttering therapy programs?

Lower Vocal Pitch
Speaking at a lower vocal pitch requires relaxing one's vocal folds, and reduces stuttering. Unlike other fluency-enhancing techniques such as a slow speaking rate or gentle onsets, listeners like the sound of a lower vocal pitch. A lower vocal pitch communicates confidence and relaxed authority. Some listeners even say that a lower vocal pitch sounds "sexy." Speaking with a lower vocal pitch makes one feel relaxed and confident. Yet this technique is not a target behavior in any fluency shaping stuttering therapy program.

According to multichannel processing theory, performing two different tasks is easier if you can integrate the tasks. E.g., dancing while playing the saxophone is easier than playing tennis while playing the sax. Using fluency shaping motor skills while paying attention to a conversation should be easier if the fluency shaping motor skills relate to the conversation. E.g., if your friend asks you what you've learned in stuttering therapy, and you reply that you learned slow speech with stretched vowels and gentle onsets, you can easily perform slow speech with stretched vowels and gentle onsets while responding. If you're trying to communicate that you're relaxed and confident, then using a "slow normal" speaking rate with a lower vocal pitch should be easier than using gentle onsets.

This technique can be trained by using relaxed, diaphragmatic breathing while feeling (with your fingers or your throat) and/or listening to your vocal fold vibrations. Begin by humming or saying "ahhhh." Bring the pitch up, then down, then up again, then down further. Repeat until your feel and hear yourself humming at a very low pitch. Now speak slowly, stretching vowels, while keeping your vocal pitch low.

Notice that your vocal volume drops as you lower your vocal pitch. Don't try to speak loudly with a low vocal pitch, you may damage your vocal folds. A lower vocal volume is usually acceptable unless you're speaking in a noisy environment or to a person with hearing loss.

Frequency-shifted auditory feedback (FAF) induces a lower vocal pitch in non-stutterers. Only one study tested whether FAF changes stutterers' vocal pitch, with negative results. However, anecdotal evidence suggests that a lower FAF setting than was used in the study induces a lower vocal pitch in stutterers. If you have an FAF device, set it for one-half or one octave down, and use the best-quality headphones you have. Then say "ahhhh" or speak slowly with stretched vowels, trying to slow your vocal fold vibrations to match the frequency you hear in the headphones.

Lower vocal pitch may be difficult for women speech-language pathologists to model, or for children or women stutterers to use (Lauren Bacall might contradict that statement!). Adult men are more capable of lowering their vocal pitch. Listen to an audio book read by a male actor and then listen to another audio book read by a female actor: you'll likely hear that the male actor can perform a wider variety and range of character voices.

Improving Autonomous Stage Speech Motor Learning
The third or autonomous stage of motor learning moves you from closed-loop motor control to open-loop motor control. In stuttering therapy, the autonomous stage makes fluent speech automatic and effortless.

Autonomous stage motor learning results from:

 Practicing target muscle movements faster and harder, While making no errors, In stressful situations, With an ideal practice schedule, For about three million repetitions.

For example, you take tennis lessons. Your coach shows you how to grip the racket properly, and swing at the ball. At first you execute this movement slowly, with little force. As your skill improves, you swing faster, and hit the ball harder. Whenever you make a mistake, your coach stops you and makes you begin again, slowly. At first your coach hits you easy balls. Then he hits harder balls to you, making the game stressful. Then you play tennis regularly. Over several years your game improves.

Where Stuttering Therapy Fails

Most stuttering therapy programs do little to train autonomous motor learning:

 Your speech-language pathologist tells you to make a conscious effort to speak fluently. You're told that if your fluency fails, it's your fault for not concentrating on your speech. All practice is done with relaxed speech-production muscles. You never increase muscle tension.

All practice is done at slow speaking rates.

All practice is done in the speech clinic, or at home alone. You don't do practice in high-stress situations.

Increasing Force and Speed

Stuttering therapy programs fail to train the autonomous stage of speech motor learning because of a counterintuitive aspect of stuttering. Stuttering is characterized by excessive speech-production muscle activity. The obvious but wrong treatment for stuttering is to reduce speech-production muscle activity, i.e., to speak with relaxed breathing, vocal folds, and articulation muscles.

As noted earlier, speech-language pathologists see that slowing down and switching to closed-loop speech motor control eliminates stuttering. They reach the obvious but wrong conclusion that stutterers must slow their speaking rate.

Fluency shaping therapy begins by training slow, relaxed, fluent speech motor skills. Similarly, golf and tennis instruction begins with slow, relaxed, correct movements. Golf and tennis instructors then have you increase your force and speed. In contrast, speech-language pathologists tell you not to increase your force and speed. It may seem counterintuitive, but after you master slow, relaxed fluent speech, you must increase both the speed and force of your speech, without making errors, to train automatic, effortless fluency.

Increasing Force

The force of your speech is indicated by volume. Work on getting loud. But don't shout or yell. Instead, project your voice. Vocal volume is a factor of both exhalation volume and vocal fold tension. Increase your exhalation volume while keeping your vocal folds relatively relaxed. This result is high volume with the intonations of normal conversational speech. Stage actors do this.

Increase your onset speed while maintaining long syllable duration. Pretend that your forearm is a sports car's accelerator. When your fist is up, your vocal volume is quiet. As you push your fist down, your volume increases. When your fist is all the way down, you're at maximum volume. Listeners one hundred feet away can hear you.

Slowly lower your fist to produce a gentle onset. Then slam your fist down fast to go from silence to maximum volume. Then hold that volume while stretching the vowel. Pull your fist up fast to end the word with speed. This is slow speech with maximum effort.

Be careful not to damage your vocal folds. Stop if you feel hoarse or start to lose your voice.

Increasing Speed

Shorten syllable duration from two seconds, to one second, to one-half second, to one-quarter second. Practice this both with relaxed, quiet speech, and with loud, forceful speech.

Using the practice word lists say each word four times:

Slow and relaxed (quietly).

Slow and projecting your voice (loudly).

Relaxed (quietly) with a quick onset.

Loudly projecting the word with a hard onset.

Where to Practice Force and Speed

It's hard to practice loud speech in a small room. The ideal place to practice is an empty auditorium. Have your speech-language pathologist sit in the back row. Stand on stage and project your voice to her. She yells, "Can't hear you!" until you reach ideal volume.

Another place to practice is near a building that produces an echo. A third place to practice is on a freeway overpass. Demosthenes, the stutterer who became the greatest orator of ancient Greece, projected his voice over breaking waves at the seashore. Work on projecting your voice over the cars.

Reinforcing On-Target Speech

Increasing speed and force myelinates or reinforces neural pathways in your brain. A mistake reinforces the wrong neural pathways.

Learning to talk fluently requires talking fluently 100% of the time. That sounds like circular advice, and it is. Reinforcing motor skills is a "virtuous cycle." Using target skills reinforces the skills, making the skills easier to use.

Conversely, stuttering reinforces undesirable speech motor skills (core behaviors) and bad communication habits (secondary behaviors). Stuttering sets up a "vicious cycle" instead of a "virtuous cycle."

Swimming Analogy

I wanted to improve my swimming. At first I could swim only one length of the pool. But I got in that pool three times a week. I found that a flotation device helped me swim five or ten laps. After two months something "clicked" in my brain and I swam half a mile. It was easy, almost effortless. I didn't need the flotation device any more.

Then I moved to a building without a swimming pool, stopped swimming, and now I swim as poorly as I did before that summer.

Similarly, stutterers go to speech therapy three times a week for months. Then suddenly one day they find themselves talking fluently, without effort. If they discontinue speech therapy, this "lucky" fluency disappears and they go back to stuttering.

Stutterers' brains have two sets of speech motor programs. Sometimes our brains pick the fluent speech motor programs. At other times our brains pick the stuttering speech motor programs. Speech therapy reinforces the fluent speech motor programs. Eventually this fluent speech becomes habitual. But during "lucky" fluency this habit is precariously balanced. One stressful day, in which you allow yourself to stutter, can reinforce the stuttering motor programs, and your "lucky" fluency is gone.

Speech Buddies

Children learn grammar by listening to other people talking, then speaking, then having their parents correct their grammar. You may not remember this, but after a family vacation to the seashore you told your mother's friend, "We went nearly to the beach every day," and your mother corrected you, "No, dear, we went to the beach nearly every day."

Your mom was your speech buddy. You need another speech buddy now, to correct your speech when you're dysfluent.

Ask your speech-language pathologist to let you organize a practice group with her other clients. Meet once a week to practice fluent speech. Exchange telephone numbers and arrange to call a speech buddy every day.

Here's an idea that'll get you talking fluently. If you have a spare bedroom in your house, call a local university and offer to let a speech-language pathology student live rent-free, in return for reminding you to use fluency shaping skills. If you don't have a university with a communication sciences department, call your school district and see if they have a speech-language pathologist who'd go for free rent.

Train your spouse, housemates, and the people you work with to remind you to use fluency skills. If you're a parent with a child in speech therapy, ask your child's speech-language pathologist to train you to correct your child at home (see SLPs vs. Parents vs. Computers).

Your spouse can come with you to speech therapy, or you can tell her what you're learning. You can tell your housemates or co-workers. But there's a problem. Suppose you wear a sign offering to pay $1 whenever a listener hears you stutter. Listeners are too polite to do that. They'd feel like they were getting paid to kick a paraplegic in his wheelchair.

And you can't wear a sign around your neck offering to pay $1 whenever anyone catches you doing a hard onset, or using thoracic breathing. No one but a speech-language pathologist knows what those behaviors are. Non-stutterers have no idea what they do to speak fluently. They don't know how to correct you or tell you what you did wrong.

My Romantic Disaster of 1996

''In eighth grade I had a teacher with a forceful personality and a large ego. He decided to cure my stuttering. Whenever I stuttered he stopped me, then told me to say it without stuttering. I hadn't had speech therapy and had no idea what to do. His method was as effective as teaching me Chinese by stopping me from speaking English and telling me to speak in Chinese. Twenty years later I'd completed several speech therapy programs. I dated a young woman who disliked my stuttering. Whenever I started to block, she'd give me a certain look. I'd stop, relax my breathing and vocal folds, and speak fluently. Within a few days with her I was talking fluently all the time. The relationship crashed and burned shortly after that.''--Thomas David Kehoe 05:13, 28 March 2006 (UTC)

For an individual who hasn't completed a speech therapy program, a person pointing out their stuttering is the worst thing. Such an individual doesn't have any control over his speech. Telling him to talk fluently increases his stress and his stuttering. (See the section Modeling.)

But for an individual who has mastered fluent speech skills, pointing out his disfluencies and reminding him to use fluent speech skills will help him. When you're at that stage, find someone to do this for you.

Or pay listeners $1 whenever you stutter. I tried this and never stuttered. I'm not sure if that was a success or a failure.

Start a Virtuous Cycle

Do whatever you need to get into the virtuous cycle. You may have to do things that are difficult or embarrassing—e.g., telling your co-workers that you stutter (hint: they've probably already figured that out!).

Once you're in the virtuous cycle, fluent speech will become easier and easier with less and less effort. The difficult things will become easier, and the embarrassing things won't be embarrassing (or necessary). Done right, you'll only have to do these things for a few days or weeks.

Getting into the virtuous cycle may require:

Using closed-loop speech motor control (very slow speech).

Using an electronic anti-stuttering device.

Taking a dopamine-antagonist medication.

Talking in uncomfortable situations, e.g., to strangers or to telemarketers.

For a high-testosterone kickstart, see The Predator Approach.

Practicing Under Stress

Autonomous motor learning requires practicing a new motor skill in stressful situations.

Design a hierarchy of stressful situations. The first might be leaving a message on your speech-language pathologist's answering machine. When you can do that comfortably and fluently, you might talk to telemarketers using closed-loop speech motor control (slow, fluent speech). Then you could join Toastmasters and make a series of speeches to your club. More about this in the chapter Speech-Related Fears and Anxieties.

Practice Scheduling

The United States Postal Service studied workers learning to type on mail-sorting machines (similar to typewriters). All subjects received 60 hours of training. The scheduling varied between four groups.

One group had two two-hour sessions per day, for 15 days. A second group had one two-hour session per day, for 30 days. A third group had two one-hour sessions per day, for 30 days. The fourth group had one one-hour session per day, for 60 days.

The first group (two two-hour sessions per day) learned fastest, but in the long run had the worst performance. The fourth group (one one-hour session per day) took the longest to get "up to speed," but eventually had the best performance.

Surprisingly, the postal workers preferred the two-hour/two-session schedule, even though they had the worst performance. People are impatient. They don't want to spend 60 days learning something, if they think there's a 15-day shortcut.

Extinguishing Maladaptive Motor Skills

We could simplistically conclude that you should practice stuttering therapy no more than one hour per day. But there's an essential difference between speech therapy and mail sorting. The postal workers were learning a new motor skill. Stutterers have to learn a new motor skill and extinguish an old motor skill. As noted earlier, coaches often prefer to work with individuals who have never played a sport and haven't learned bad habits, rather than work with experienced athletes and have to break their bad habits.

To extinguish an old motor skill you must stop doing it. Perhaps the ideal stuttering therapy is done one hour per day, and then you take a vow of silence the rest of the day. But that's unrealistic. To burn new fluent neural pathways, and extinguish old stuttering neural pathways, you must use fluent speech every time you talk. You must never stutter. Each disfluency weakens your new fluent neural pathways and strengthens your old stuttering neural pathways.

Extinguishing a maladaptive motor skill isn't the same as "breaking" a bad habit. Maladaptive motor skills enable you to perform a desirable behavior, but not as a well as another motor skill. E.g., touchtyping is better than two-fingered typing, but two-fingered typing also gets the job done. In contrast, picking my nose is an undesirable behavior. I wish that a teacher had taught me to touchtype when I was a child. I don't wish that a teacher had taught me a better way to pick my nose.

Because maladaptive motor skills enable you to perform a desirable behavior, it's hard to unlearn them and replace them with optimal motor skills. Stuttering isn't like picking your nose. Your mother could slap your hand and stop you whenever you pick your nose. If she stopped you every time you stuttered, you wouldn't be able to talk.

Extinguishing a maladaptive motor skill may involve "one step forward, one step back" temporarily. To speak fluently, you may have to speak much slower, or not respond immediately while you focus on your speech motor skills.

Intensive Residential Speech Therapy Programs

Some stutterers go to intensive residential speech therapy programs. These programs typically last three weeks. You're surrounded by speech-language pathologists and other stutterers, and isolated from the real world. For the first two weeks, you use two-second stretch all the time. In the third week, you move to one-second stretch, then half-second, and finally quarter-second slow normal.

Intensive residential speech therapy programs are like the postal workers who did the "short cut" training. In three weeks of intensive therapy you learned to talk fluently. But many stutterers find that long-term results are disappointing.

Your Ideal Practice Schedule

Work with your speech-language pathologist to develop a practice schedule. A severe stutterer may have to spend many hours a day doing "homework."

Don't practice sitting alone in a room reading endless word lists. This isn't going to produce carryover fluency to stressful situations.

A one-hour daily practice could have the following three elements:

After breakfast, twenty minutes of high intensity (using projection and hard onsets) practice, using practice word lists.

During the day, a stressful twenty-minute session while using a biofeedback device to keep your vocal folds relaxed. This could be calling strangers for your job.

After supper, twenty minutes of very slow closed-loop speech motor control conversation. You could call another stutterer in your support group. Or you could talk to telemarketers or call infomercial toll-free numbers.

How Long Does Autonomous Learning Take?

Gymnasts practice daily for about eight years to become proficient.

Motor learning researchers studied the manual (hand) skills of cigar-makers. Beginner cigar-makers worked three times slower than experienced cigar-makers. Becoming fully skilled required making three million cigars.

Three million repetitions were also needed for Japanese pearl handlers to become proficient. The Suzuki method of teaching violin to children requires the production of about 2.5 million notes. Basketball, football, and baseball throws require about a million practice throws.

This suggests that making fluent speech automatic and effortless requires saying about three million syllables. At five syllables per second, talking four hours a day (just your time talking, not combined talking and listening), you could produce three million syllables in six weeks.

If you got a job answering telephone calls, and you did your stuttering therapy skills on every call, and you connected a biofeedback device into your telephone to alert you when you missed a therapy target, and you spent your free time at Toastmasters clubs making speeches or volunteering at a hospital's information desk, fluent speech might become automatic for you in six weeks.

But most stutterers practice between ten minutes and one hour per day. If they were silent the rest of the day, they'd say three million syllables somewhere between six months and three years.

No one has studied whether using undesirable motor skills cancels out on-target practice. I.e., does a half-hour of on-target practice get cancelled out by not using fluency skills the rest of the day? Such a practice schedule might take years to produce automatic fluent speech—or might never work.


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Biblical Studies/Christianity/Christian Theology/Atonement

Atonement refers to the reconciliation of God and humanity that was brought about by the redemptive life and death of the Christian saviour Jesus Christ.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


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Speech-Language Pathology/Stuttering/Computers and Electronics for Fluency-Shaping

The associative stage of motor learning requires feedback. In sports this is called knowledge of results. E.g., in golf or tennis you see where the ball goes after you hit it. Playing golf or tennis on a dark, foggy night would be impossible.

Feedback quality is affected by speed. If you hit ten golf balls on a dark, foggy night, then the next day find one of the balls 150 yards away, you'll have no memory of what you did right to hit it so far.

Feedback quality is also affected by accuracy. If you and your buddy each hit a golf ball, and one ball goes 150 yards but you don't know whose ball it was, you have inaccurate feedback.

Or the observer gets bored. If you hit golf balls for hours, and have a person telling you how far the balls go, sooner or later the person will stop paying attention.

Which Fluency Skills Need Feedback?
When you're learning fluent speech motor skills, you need knowledge of results. Some skills are easy to observe. E.g., resting your hand on your stomach tells you whether you're using diaphragmatic (relaxed) breathing or thoracic (speech) breathing.

Your articulators (lips, jaw, and tongue) are a little harder to be aware of, as you can't see them. But you have good proprioceptive awareness of these muscles, so developing awareness and control isn't hard.

Your vocal folds are another story. These muscles are deep in your throat. You can't touch them or see them. Most people don't even know they have vocal folds.

The most difficult feedback is with the timing of all this. E.g., your speech-language pathologist tells you to exhale a little air and then increase your vocal fold tension. You do this slowly and correctly. Then she tells you to increase the speed. You must execute these movements within hundredths of a second. You can't tell whether you're doing it right, and most speech-language pathologists can't either.

A fluency specialist who's helped hundreds of stutterers has better-trained ear and visual skills and gives better quality of feedback than a speech-language pathologist who's never treated a stutterer.

Biofeedback Devices
Biofeedback is the measurement and display (to the user) of a physiological activity, to enable the user to improve awareness and control of the activity.

Biofeedback machines provide:

 Faster, more precise, and more reliable feedback than a human observer. Machines can provide feedback in real-time, beeping the instant you make a mistake. Machines can accurately measure things humans can't see or hear. And machines never get bored, even after hours of practice. With the computer training the physical speech motor skills, the speech pathologist can spend more time on the psychological aspects of stuttering. If you learn visually rather than aurally, you may learn faster with the computer displays than by listening to your speech on a tape recorder. Some devices are designed for home practice use as well as clinical use.

But biofeedback devices aren't a "miracle cure" for stuttering. Stuttering therapy works on many motor skills, so you might need several devices. And you still need a speech-language pathologist to train you to do the target motor skills (cognitive stage). The machines can only help you to refine your skills (associative stage).

 * Wikipedia article about biofeedback

CAFET and Dr. Fluency
The Computer-Aided Fluency Establishment and Trainer (CAFET) and Dr. Fluency are computer-based stuttering biofeedback systems. Both use a microphone to monitor vocal volume, as a surrogate for vocal-fold activity, and a chest-strap to monitor breathing. Dr. Fluency uses two chest straps, to differentiate diaphragmatic (relaxed) breathing from thoracic (upper chest) breathing.

You see your breathing and vocal volume displayed on the computer screen, along with instructions or error messages. The two computer systems train similar speech motor skills:

Relaxed, diaphragmatic breathing.

Continuous breathing. The computer alerts you if you hold your breath more than 1/3 of a second.

Gradual exhalation, as opposed to the rapid, uncontrolled exhalation associated with stuttering.

Pre-voice exhalation, or letting a little air out before you begin tensing your vocal folds.

Gentle onset, or gradually increase vocal volume. The computer alerts you if your vocal volume changes too rapidly. The computer also alerts you if your voice is too quiet for your air flow (which sounds breathy).

Continuous phonation. Breaks in vocal volume are shown on the computer monitor.

Adequate breath support. The computer alerts you if you continue to talk after the point at which you should take another breath.

Phrasing. Each of the above seven speech targets is taught first with vowels, then progressing to monosyllabic words, then to marked-length phrases.

An unpublished study of the CAFET program with 197 adults and teenagers reported that 82% met fluency criteria six months after completing the program; 89% were fluent after twelve months; and 92% were fluent two years post-therapy.

Electromyography (EMG)
EMG measures muscle activity via electrodes taped to your skin. Several studies found EMG to be effective for treating stuttering. These include the large study that found computers to be more effective than speech-language pathologists.

EMG surface electrodes tape to your skin. They are excellent for monitoring your masseter (jaw muscle) or orbicular oris (lips); pretty good for monitoring your tongue or respiration muscles; and useless for monitoring your vocal folds. Your vocal folds are deep in your neck, surrounded by other muscles. A single-channel EMG is usually set up with one electrode on the jaw and the other electrode at the base of the throat, which monitors all muscle activity from thoracic respiration to articulation. This set-up monitors all speech-production muscles (including vocal fold activity) at once. When the red light goes on (indicating high muscle activity) it may not be apparent which muscle is tense. Also smiling and swallowing are indicated as high muscle activity. These problems could be avoided by using a multichannel EMG, but those are costly and time-consuming to set up.

Vocal Frequency Biofeedback
The CAFET and Dr. Fluency monitor vocal fold activity indirectly via vocal volume, which assumes that a quiet voice means relaxed vocal folds, and loud voice means tense vocal folds. Another method is to monitor the frequencies of the stutterer's voice. Relaxed vocal folds generally produce a deep-pitched voice; tense vocal folds generally produce a high-pitched voice. Vocal volume and vocal frequency biofeedback use a microphone; no electrodes are needed.

Kay Elemetrics' Visi-Pitch device monitors both vocal volume and vocal frequency, separately. Casa Futura Technologies has devices that monitor a combination of vocal volume and frequency.


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Orthopaedic Surgery/Hand:Clinical Practice

One of the most important therapeutic things we do as physicians is to affect the patients attitude about their problem. For example, if the patient presents with a painful complaint and we provide a diagnosis and more importantly a prognosis, the patient experiences a significant change in their experience of the pain without the physician actually doing a thing. In particular what is removed is the unchecked anxiety that accompanies the experience of pain especially pain of unknown source. Even pain of known source however can produce anxiety enough, specifically anxiety about how bad and how long. With the worst of the anxiety removed there is an opportunity to engage the patient in the process of improving their condition.

Communication

There is something of the original shamanistic symbolic exchanges which seems to happen with every day patient encounters in the office practice. Shamans and traditional healers seem to employ a strategy of symbolic exchange whereby a totem of object, an herb, an mark on the body, is delivered to the patient and the problem, the disease is removed. This basic exchange paradigm seems to be at work in our offices, whereby a successful encounter is judged by whether or not such an exchange has taken place, regardless really as to the efficacy of what was presented to the patient in exchange for their problem. The use of antibiotics for viral illnesses is just one example.

The therapeutic effect of laying on of hands can constitute a symbolic therapeutic exchange. It is conceivable that many techniques osteopathic and chiropractic techniques may work in this way even if they do not impart a physical change to the patient by virtue of the method, just the laying on on hands in a ritualistic process can succeed as a therapeutic exchange. This is not to say that what is offered to the patient is entirely arbitrary. The object of exchange must have certain attributes, but actual efficacy is not necessarily required. What is equally important is that the patient believes the item of exchange will allow the patient to leave behind the problem they came in with. The placebo effect then looms large in any patient encounter and extends well beyond what we provide in pill form.

It is not surprising then that you can talk to a patient on a rational level, offering in essence information, certainly from the point of view useful information, even powerful information to the patient, and yet, from the patient's point of view, the encounter with you the physician is unsatisfactory. Is this a failure to communicate or is the problem that the patient did not really come so much for information as for some other purpose, some sort of healing magic. We tend to assume that something is wrong in the manner of delivery, perhaps overestimating the patients ability to absorb all that is said, perhaps insufficient metaphorical power, talking too fast, failing ot verify the understanding or simply limitations upon what a patient can recall 5 minutes after the encounter.

Communication is a process. When we consider this process we tend to emphasize the role of the provider of information rather than the role played by the target in the process. Without the participation of the target there is no communication but only utterances. Much of what we think of as communication in our offices consists of utterances on our part. An example would be the notion of informed consent. When studied it is evident that in the case of a complex medical decision the patient actually understands what he is consenting to only 17% of the time. Improving upon this while maintaining some efficiency in the process will be aided by simplifying our information making it understandable in terms which reflect the life experiences of the patient rather than jargon filled information requiring a life experience includes a working knowledge of physiology and anatomy which is likely lacking in our patients.

An understanding of the information needs of our patients and the hierarchy of those needs based on their circumstance is helpful in delivering the information when it is relevant to the immediate needs of the patient at any particular time in the process. As an example, a patient in acute pain with a fracture dislocation of the wrist has need of coping information which relates to what is immediately to be done to relieve the pain and correct the severe deformity. Leave discussions as to the length of recovery the nuances of anatomy and such for later.

coping information helping information empowering information enlightening information edifying information

http://chiron.valdosta.edu/whuitt/col/regsys/maslow.html

It may make more sense to keep the information as simple as possible rather that showboating the depth and sophistication of our understanding as to the complex interplay of anatomy and physiology and disease. If we spend the whole encounter this way the patient is liable to feel dissatisfied. We would be better off to ensure first that a human to human connection has been made, and then set about the process of providing a conceptual framework just sufficient to allow the patient to segregate themselves from their problem. This is the power of a diagnosis, no matter how nebulous, no matter how accurate in many cases. The encounter then moves on to seek to validate what has been said verbally and to enable the patient to potentially leave their problem behind, at least in part. It takes more than just voluminous information dump.

How can a diagnostic process such as a physical exam alone be therapeutic? The answer perhaps is that the process, narrows the scope of the problem for the patient. Conceptually a mysterious entity that the patient arrives with becomes, a spur or a bursa or whatever else the exam allows for the physician to apply as a specific name for the problem. The problem is then objectified, segregated and seems all together closer to being eliminated simply by this process.

This concept presumes an attitude toward disease which most of us in western culture hold to which is that when we have an affliction we have some "thing". We objectify the problem, compartimentalize it and separate it from us, as something separate from "us". This follows from the fact that since Descartes we have a body, rather than we are a body, tends to be how we think of things. We tend to approach our health problems in this dualistic way. The enlightenment philosophy which leads to the science which leads to the technology tends to fall short when the problem is an undesirable emotional state, wherein it becomes difficult to separate the problem from the self. Obviously if you cannot separate the problem from the self it is difficult to leave the problem behind.

There is logic then in the notion of conceptualizing problems of this sort, behavioral, psychiatric, as the patient being possessed by an intrusive entity, a malefactor to be extricated. The symbolic exchange of the therapeutic encounter is one strategy to accomplish this extrication. Even the somatic problems which lend themselves to the heuristic approach which objectifies the problem then extricates it fail in accomplishing the same success in resolving that aspect of the problem which cannot be readily extricated, and that remains a part of the self, be it, the emotional imprint of the traumatic experience, or the seamless interaction of intent and function with which we customarily interface with our bodies, consider here the loss of physical capacity of a parkinsons patient struggling to consciously do what for all of their life has flowed effortlessly. Consider too the impact of body image which a post surgical patient or traumatically deformed patient must reestablish to once again feel fully integrated. Until this reintegration is accomplished our results fall short of establishing wellness even if they have successfully healed the problem, and the patient is no longer really sick.

The encounter between a healer and a patient then is characterized here as an interaction which alters the relationship between a patient and the disease process they are dealing with. The healer is a helpful ally, but the primary conflict is between patient and disease. What we call a change in attitude on the part of the patient may appear to have psychological benefit, might be characterized as a placebo effect, but one day we may understand the net effect to be more substantive than that as the manner in which changes in central nervous system function influences metabolic immunologic hemodynamic or other processes within the body in a way which can favor resolution of the problem.

Communication is most likely to occur when utterances (information) are delivered when a patient is about to encounter a transition point in the process of their care and when that information is of immediate practical use in negotiating that transition. All clinicians develop efficient litanies of information that dispel immediate confusion and then adumbrate the future course of treatment to begin the process of dispelling the penumbra in which the patient and family find themselves as they work through the system, and the injury or disease process.

http://www.annals.org/cgi/content/abstract/136/11/817?maxtoshow=&HITS=&hits=&RESULTFORMAT=1&andorexacttitle=and&fulltext=clinical+medicine+and+ritual+exchange&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT


text:
Orthopaedic Surgery/Anaesthesia

While beginning an incision following a bier block the patient states that he can feel you working. You ask for the local and inject to achieve a digital block and soon can proceed with appropriate patient comfort. The procedure complete the splint applied the tourniquet comes down, and low and behold the finger stays white.

This is not the right time to check the bottle, but alas as our assiduous adherence to the trust now one habits of residency slide we ask to see the bottle and note the red label marcaine with epinephrine. The nurse stares blankly as you ask her to fill out an incident report. Another nurse checks the card which indeed calls for plain marcaine.

The finger still pale sorry looking, accusatory, the adjacent fingers mocking in their robust post tourniquet rubor and pulchritudinous splendor. The mind ponders the best approach applying a dab of nitropaste, injecting a bit of papaverine and submerging the finger in warm water as the patient snores away sedated fortunately oblivious to the precarious state of his finger. Finally pink the pulp regains turgor and a bullet dodged.

We return alas to old habits and ask next time to be shown the bottle prior to injecting.

http://emj.bmjjournals.com/cgi/content/full/21/3/387

title: Orthopaedic Surgery/Anaesthesia


text:
Wikibooks:Alphabetical classification

Welcome to the Alphabetical classification page. All the books on Wikibooks are listed here according to the first letter of their title. Navigate to the appropriate subpage to find the book you are looking for.

To properly alphebetize a book, add to the book's table of contents, where  is the first character from the title of the book.

is:Wikibooks:Bókasafnið

title: Wikibooks:Alphabetical classification


text:
PHP and MySQL Programming/Creating a Database

Introduction
MySQL is a relational database. In a relational database, data is stored as a collection of fields called a row. Like fields, rows are in turn collectively stored as a table. Tables are stored collectively in a database. One MySQL server can store multiple databases, and have users who have various rights to each database.

Nowadays, MySQL is one of the most popular relational databases among others as it is simple, free (open source), easy to maintain, and cost-effective.

In order to store data into MySQL, we will need to prepare a space in MySQL for a database.

SQL Code
The code for creating such a database in SQL (Structured Query Language) is a simple query: mysql> CREATE DATABASE `database_name`;

(Without the ' ' single quotes around the database name)

Using the Database
After a database has been created, you have to tell MySQL that to make it the active database before you can start running further queries on it. You do this as follows:

mysql> USE `database_name`;


text:
PHP and MySQL Programming/Creating a Table

Before creating a table, please read the previous section on ../Creating a Database/.

A Table resides inside a database. Tables contain rows, which are made up of a collection of common fields or columns. Here is a sample output for a SELECT * query:

mysql> SELECT * FROM `books`; ++--+--+--+ | ISBN | Author       | Title                        | Year | ++--+--+--+ | 1234567890 | Poisson, R.W | Programming PHP and MySQL   | 2006 | | 5946253158 | Wilson, M   | Java Secrets                 | 2005 | | 8529637410 | Moritz, R   | C from Beginners to Advanced | 2001 | ++--+--+--+

As you can see, We have rows (horizontal collection of fields), as well as columns (the vertical attributes and values).

Creating a Table
The SQL code for creating a table is as follows:

mysql> CREATE TABLE `table_name` (       `field1` type NOT NULL|NULL default 'default_value',        `field2` type NOT NULL|NULL default 'default_value',        ...        );

Example
Here is an example of creating a table called `books`:

mysql> CREATE TABLE `books` (       `ISBN` varchar(35) NOT NULL default ,        `Author` varchar(50) NOT NULL default  ,        `Title` varchar(255) NOT NULL default '' ,        `Year` int(11) NOT NULL default '2000'        );

Getting Information about Tables
To get a list of tables:

mysql> SHOW TABLES;

Which produces the following output:

+---+ | Tables_in_library | +---+ | books            | +---+ 1 row in set (0.19 sec)

To show the CREATE query used to create the table:

mysql> SHOW CREATE TABLE `books`;

Which produces the following output:

+---++ | Table | Create Table +---++ | books | CREATE TABLE `books` (  `ISBN` varchar(35) NOT NULL default ,   `Author` varchar(50) NOT NULL default  ,   `Title` varchar(255) NOT NULL default '' ,   `Year` int(11) NOT NULL default '2000' ) TYPE=MyISAM | +---++ 1 row in set (0.05 sec)

And then to show the same information, in a tabulated format:

mysql> DESCRIBE `books`;

Which produces the following output:

++--+--+-+-+---+ | Field | Type         | Null | Key | Default | Extra | ++--+--+-+-+---+ | ISBN | varchar(35)  |      |     |         |       | | Author | varchar(50) |      |     |         |       | | Title | varchar(255) |      |     |         |       | | Year  | int(11)      |      |     | 2000    |       | ++--+--+-+-+---+ 4 rows in set (0.18 sec)


text:
PHP and MySQL Programming/Basic Queries

Introduction
Here are a few basic queries to get you going. For more detailed information, have a look at the online documentation on the MySQL website http://dev.mysql.com/doc/refman/5.1/en/index.html.

SELECT
The SELECT query is the standard means by which to retrieve information from the database. The syntax for the SELECT query is as follows:

mysql> SELECT field1, field2, ...        FROM table_name [WHERE condition1 AND condition2 ...       [ORDER BY field1, field2, etc...] [LIMIT number]];

Example:

mysql> SELECT * FROM books; mysql> SELECT Title, Author FROM books WHERE Year > 2001 AND Year < 2006 ORDER BY Author ASC LIMIT 100;

INSERT
The INSERT statement is used to insert data into a particular table of a database. The Syntax is as follows:

mysql> INSERT INTO table_name (field1, field2, etc...) VALUES ('val1', 'val2', etc...);

Example:

mysql> INSERT INTO books (ISBN, Title, Author, Year) VALUES ('1234567890', 'Programming PHP and MySQL', 'Poisson, R.W', 2006);

DELETE
The DELETE statement is used to remove row(s) from a table. The syntax is as follows:

mysql> DELETE FROM table_name [WHERE condition1, condition2 etc...];

Example:

mysql> DELETE FROM books WHERE ISBN = '1234567890';

ALTER
ALTER is used to modify the structure of a table. Here is the syntax for ALTER:

ALTER [IGNORE] TABLE tbl_name alter_specification [, alter_specification] ...   alter_specification: ADD [COLUMN] column_definition [FIRST | AFTER col_name ] | ADD [COLUMN] (column_definition,...) | ADD INDEX [index_name] [index_type] (index_col_name,...) | ADD [CONSTRAINT [symbol]] PRIMARY KEY [index_type] (index_col_name,...) | ADD [CONSTRAINT [symbol]] UNIQUE [INDEX] [index_name] [index_type] (index_col_name,...) | ADD FULLTEXT [INDEX] [index_name] (index_col_name,...) [WITH PARSER parser_name] | ADD SPATIAL [INDEX] [index_name] (index_col_name,...) | ADD [CONSTRAINT [symbol]] FOREIGN KEY [index_name] (index_col_name,...) [reference_definition] | ALTER [COLUMN] col_name {SET DEFAULT literal | DROP DEFAULT} | CHANGE [COLUMN] old_col_name column_definition [FIRST|AFTER col_name] | MODIFY [COLUMN] column_definition [FIRST | AFTER col_name] | DROP [COLUMN] col_name | DROP PRIMARY KEY | DROP INDEX index_name | DROP FOREIGN KEY fk_symbol | DISABLE KEYS | ENABLE KEYS | RENAME [TO] new_tbl_name | ORDER BY col_name | CONVERT TO CHARACTER SET charset_name [COLLATE collation_name] | [DEFAULT] CHARACTER SET charset_name [COLLATE collation_name] | DISCARD TABLESPACE | IMPORT TABLESPACE | table_options | partition_options | ADD PARTITION (partition_definition) | DROP PARTITION partition_names | COALESCE PARTITION number | REORGANIZE PARTITION partition_names INTO (partition_definitions) | ANALYZE PARTITION partition_names | CHECK PARTITION partition_names | OPTIMIZE PARTITION partition_names | REBUILD PARTITION partition_names | REPAIR PARTITION partition_names | REMOVE PARTITIONING

DROP
DROP is used to completely remove a table or database. The syntax is as follows:

mysql> DROP table_name;

TRUNCATE
TRUNCATE is used when you want to remove the data, but not the structure of a table. The syntax is as follows:

mysql> TRUNCATE table_name;

title: PHP and MySQL Programming/Basic Queries


text:
PHP and MySQL Programming/Common Functions and Operators

COUNT
mysql_query(" SELECT COUNT(*|`field_name`) FROM `table_name` ");

SUM
mysql> SELECT SUM(`field_name`) FROM `table_name`;


text:
User talk:80.49.182.76

Please, could you not just add the 'false friends' in question on the respective page yourself? Sorry, but I haven't got the time to make edits other people want to make. The idea of a Wiki is that people can edit it themselves. Apart from that, you will see that you have to enter more information than you gave me, e.g. the Polish word for 'to fuck' and the Czech word for 'to wag the tail'. Thanks! --Daniel Bunčić 09:00, 25 March 2006 (UTC)

title: User talk:80.49.182.76


text:
User talk:202.162.56.29

Please stop. If you continue to blank pages, you will be blocked from editing.

title: User talk:202.162.56.29


text: User talk:202.56.213.118

title: User talk:202.56.213.118


text:
User talk:Lthurma1

Image copyright
Image Copyright Problem: Image:D2l.jpg

Thanks for uploading Image:D2l.jpg. The Wikimedia Foundation is very careful about the images included in Wikibooks because of copyright law. We need you to specify two things on the image description page:
 * The copyright holder, and
 * The copyright status

The copyright holder is usually the creator. If the creator was paid to make this image, then their employer may be the copyright holder. If several people collaborated, then there may be more than one copyright holder. If you created this image, then you are the copyright holder.

Because of the large number of images on Wikibooks, we've sorted them using image copyright tags. Just find the right tag corresponding to the copyright status of this image, and paste it onto the image description page like this:.

There are 2 basic ways to licence an image on Wikibooks:
 * 1) An open content licence
 * Public Domain

 * The copyright holder gets the best protection of his work by licencing their work under an open content license like the Creative Commons Attribution-ShareAlike licence. If you have the express permission of the copyright holder to licence their work under the above licence, use the image copyright tag: cc-by-sa-2.5.  The GNU Free Documentation License is another choice for licencing one's work.  Again, if you have the express permission of the copyright holder, use the tag: GFDL.

 * The copyright holder can also release his work into the public domain, see here for images released into the public domain.
 * Images from certain sources are automatically release into the Public Domain. This is true for most governments like the federal United States government. However not all governments release their work into the public domain, such as the UK government .  Non-free licence governments are listed here.

For any other sources of for more information see Image copyright tags. Please remember that if you don't tag your images, they will be deleted.

 * P.S. If you have uploaded other images without including copyright tags, please go back and tag them.  Also, please tag all images that you upload in the future.

If you have any questions, just leave a message on my talk page. Thanks again. --Derbeth talk 09:23, 25 March 2006 (UTC)

title: User talk:Lthurma1


text:
User talk:Conica

Wecome
Hello and welcome to Wikibooks!

Here are some tips to help you get started:
 * You can sign your name on Talk and vote pages using four tildes, like this: ~~~~.
 * Remember to conduct any editing experiments in the sandbox.
 * Check out our help page if you need additional help.
 * Eventually, you might want to read the Manual of Style and Policies and Guidelines.
 * Take a look at Naming policy
 * See list of templates which can save your time
 * Remember to maintain a Neutral point of view.
 * Explore, be bold in editing pages, and have fun!

You will find more resources in Community Portal. If you want to ask a question, visit the Study help desk, the Staff lounge, IRC channel or ask me personally on my talk page.

Good luck! --Derbeth talk 09:29, 25 March 2006 (UTC)

Image:Firefoxrss3.PNG
Please correct licence of your images like I've done for this one. --Derbeth talk 09:29, 25 March 2006 (UTC)

title: User talk:Conica


text:
User talk:Pardus

Welcome
Hello and welcome to Wikibooks!

Here are some tips to help you get started:
 * You can sign your name on Talk and vote pages using four tildes, like this: ~~~~.
 * Remember to conduct any editing experiments in the sandbox.
 * Check out our help page if you need additional help.
 * Eventually, you might want to read the Manual of Style and Policies and Guidelines.
 * Take a look at Naming policy
 * See list of templates which can save your time
 * Remember to maintain a Neutral point of view.
 * Explore, be bold in editing pages, and have fun!

You will find more resources in Community Portal. If you want to ask a question, visit the Study help desk, the Staff lounge, IRC channel or ask me personally on my talk page.

Good luck! --Derbeth talk 09:30, 25 March 2006 (UTC)

Image:The Stock Monitor.pdf
This file is not used on any page and will be soon deleted if this won't change. Is this file useful for you? --Derbeth talk 09:30, 25 March 2006 (UTC)

title: User talk:Pardus


text:
User talk:Tpgc03

Image Copyright Problem: Image:Nicksbaseball.jpg

Thanks for uploading Image:Nicksbaseball.jpg. The Wikimedia Foundation is very careful about the images included in Wikibooks because of copyright law. We need you to specify two things on the image description page:
 * The copyright holder, and
 * The copyright status

The copyright holder is usually the creator. If the creator was paid to make this image, then their employer may be the copyright holder. If several people collaborated, then there may be more than one copyright holder. If you created this image, then you are the copyright holder.

Because of the large number of images on Wikibooks, we've sorted them using image copyright tags. Just find the right tag corresponding to the copyright status of this image, and paste it onto the image description page like this:.

There are 2 basic ways to licence an image on Wikibooks:
 * 1) An open content licence
 * Public Domain

 * The copyright holder gets the best protection of his work by licencing their work under an open content license like the Creative Commons Attribution-ShareAlike licence. If you have the express permission of the copyright holder to licence their work under the above licence, use the image copyright tag: cc-by-sa-2.5.  The GNU Free Documentation License is another choice for licencing one's work.  Again, if you have the express permission of the copyright holder, use the tag: GFDL.

 * The copyright holder can also release his work into the public domain, see here for images released into the public domain.
 * Images from certain sources are automatically release into the Public Domain. This is true for most governments like the federal United States government. However not all governments release their work into the public domain, such as the UK government .  Non-free licence governments are listed here.

For any other sources of for more information see Image copyright tags. Please remember that if you don't tag your images, they will be deleted.

 * P.S. If you have uploaded other images without including copyright tags, please go back and tag them.  Also, please tag all images that you upload in the future.

If you have any questions, just leave a message on my talk page. Thanks again. --Derbeth talk 09:34, 25 March 2006 (UTC)

title: User talk:Tpgc03


text:
Muggles' Guide to Harry Potter/Characters/Alastor Moody

Overview
Alastor "Mad-Eye" Moody is a former Auror. His profession has apparently been rather hard on him, as he has a wooden leg, a magical artificial eye, and a large chunk taken out of his nose. He has developed a deep distrust of nearly everyone and everything. His nickname is derived from his magical eye, which is forever swiveling, totally independently of his real eye.

Goblet of Fire
Alastor Moody is introduced when Amos Diggory contacts Arthur Weasley. It seems that muggles witnessed Mad-Eye's garbage cans attacking an intruder at his house; Arthur was summoned to deal with the fall-out.

Moody becomes the new Defence Against the Dark Arts teacher during Harry's fourth year, replacing Remus Lupin. Students notice that rather than drinking from the pitcher of pumpkin juice during the Welcoming Feast, he instead drinks only from his hip flask.

When Moody sees Draco Malfoy throw a curse at Harry Potter, he reprimands him by Transfiguring him into a ferret and bouncing him off the floor; Professor McGonagall warns Moody, quite strongly, that Transfiguration is never used as punishment. Moody then takes Malfoy to see the Head of Slytherin House, Professor Snape.

In his first Defence Against the Dark Arts class, Moody demonstrates the three Unforgivable Curses: the Imperius curse, the Cruciatus curse, and the killing curse. Neville Longbottom, whose parents were tortured into insanity with the Cruciatus curse, is understandably upset at the demonstration; Moody takes him up to his office and calms him down, giving him a book on Mediterranean aquatic magical plants.

Moody's teaching methods are unconventional but effective. He puts every member of the class under the Imperius curse, to show them what the effects are, and is quite pleased to find that Harry is able to resist. Over the next few classes, he puts Harry repeatedly under the Imperius curse to teach him how to resist it. We assume he is also attempting to teach the same ability to the rest of the class, as Ron is described as suffering the after effects of dealing with that curse at one point.

In the confusion surrounding Harry unexpectedly becoming a Triwizard champion, Moody intimidates Igor Karkaroff into accepting four champions instead of three. Moody takes a liking to Harry and helps guide him through the Tournament.

After Harry emerges from the third Task with Cedric Diggory's body, Moody takes him to his office. There he starts sounding more like a Death Eater than an Auror. Realizing the danger, Harry distracts him long enough for Professor Dumbledore, Professor McGonagall, and Professor Snape to break in and Stun him. When a dose of Polyjuice potion wears off, Moody is revealed to be Barty Crouch Jr.. Professor Snape administers Veritaserum and Crouch confesses he is working under Voldemort's orders. Crouch says he intended to kill Harry to gain his Master's favor. Moody's trunk is opened, and the real Alastor Moody is discovered within, weak but still alive. Cornelius Fudge is summoned, who arrives with a Dementor. The Dementor administers the "Dementor's Kiss" (sucking out Crouch's soul) before Crouch can confess to Fudge.

Order of the Phoenix
Alastor Moody is a member of the Order, and effectively the leader of the Advance Guard who escort Harry from the Dursley's house to Headquarters. Moody cannot recognize Harry, having been unconscious for Harry's entire previous school year, but calls upon Remus Lupin, another member of the Advance Guard, to identify him. Moody then Disillusions Harry to conceal him, and after waiting for a signal, they take off, Wizards and Witches of the Order acting to shield Harry from any evil wizards who might be prepared to attack. Many other members of the Advance Guard seem to feel that Moody's caution is a bit over-blown; he says they should circle around to lose any pursuit, but is overruled by Tonks, who says that they are all freezing up there.

On landing, Moody uses Dumbledore's Deluminator to put out all the streetlights at Grimmauld Place, then shows Harry a piece of paper. The paper, being written by Dumbledore, who is the Secret-Keeper for the Order, allows Harry to see Headquarters, and enter it. Once all the wizards have entered Headquarters, Moody uses the Deluminator to restore the streetlights.

At the party for Ron and Hermione following their appointment as Prefects, Moody remarks that Dumbledore must have thought Ron was good at dealing with jinxes; authority figures are often the targets of unprovoked attacks. Moody's magical eye finds that the unknown thing inside a writing desk in the parlour was only a Boggart. Harry points out to Mundungus Fletcher, who is working on a shady deal with Fred and George Weasley, that Moody could be observing them with his magical eye; Mundungus immediately stops haggling with the twins and gives them the goods they are dickering for at the twins' offer price, half of what he was originally asking. And finally, Moody shows Harry an old picture of the Order; Harry feels rather upset at having this sudden reminder of his parents, and how they had died, thrust upon him.

Moody is part of the Guard that escorts Harry to King’s Cross Station. He is irritated that Sturgis Podmore hasn’t shown up.

Moody and Tonks escort Harry and the Weasleys to St. Mungo's, for the Weasley children's first visit after their father is injured. Afterwards, Mr. and Mrs. Weasley, Moody, and Tonks confer as to how exactly Harry was able to perceive the attack on Arthur; Moody suggests that Voldemort might have been possessing him. This suggestion, which the Weasleys and Harry overheard by means of the twins' Extendable Ears, echoes Harry's private thoughts, but until now it had been too frightening a thought for him to entertain. Now that all of the Weasleys have heard it, he has to deal with it.

Moody is later one of the members of the Order who arrive in to rescue Harry from the Death Eaters in the Department of Mysteries along with Sirius, Remus, Tonks, and Kingsley. During the battle he engages Antonin Dolohov in a duel where he is defeated and injured. Despite his injuries, he is later seen crawling over to make sure Tonks is okay after she is defeated by Bellatrix Lestrange.

Moody meets Harry at the train station after the end of school, along with Tonks, Arthur and Molly Weasley. The four of them, plus Ron and Hermione, confront Harry's Uncle Vernon and Aunt Petunia, telling them that they will want to be reassured that Harry is having a good summer, or else they will come and visit to find out why not. Mad-Eye, with his magical eye, intimidates Vernon to the point that he nearly falls over a luggage cart.

Half-Blood Prince
Alastor Moody does not play a significant part in this book. We can safely assume that he is working with the Order, but he does not seem to visit The Burrow or the school while Harry is there.

Deathly Hallows
Alastor "Mad-Eye" Moody leads the Order of the Phoenix's operation of transporting Harry Potter from Privet Drive to The Burrow. The Order has decided to disguise Hermione, Ron, Fred, George, Fleur Delacour and Mundungus Fletcher as Harry Potter by using Polyjuice Potion. Moody dies during the flight, as the Death Eaters and Lord Voldemort had been tipped off as to the date, though not the details, of Harry's escape. Confronted with multiple possible Harry Potters, Voldemort selects the Harry who was sharing a broom with the most powerful Auror, attacking Moody and Mundungus. Mundungus Disapparates to avoid a curse, which caught Moody instead.

We later find that Dolores Umbridge has mounted Moody's magical eye on her office door as a sort of trophy. Harry removes it, and later gives it decent burial under a tree. Nothing else of Moody is recovered.

Strengths
Mad-Eye's greatest asset is his "Mad" eye, the magical artificial eye he uses after losing his real eye in battles against Death Eaters. This electric-blue eye gives him 360 degree vision – he can see through the back of his own head – as well as being able to look through invisibility cloaks and closed doors.

Another strength is his formidable character. He has great strength of will, and apparently has need of it to persevere in the face of criticism about his apparent paranoia.

It is also likely that he is a very powerful wizard, as more than a small amount of skill is required to become an Auror. It is for this reason, we are told, that Voldemort chose to attack Moody's broom before any of the other departing Potters.

Weaknesses
A lifetime of fighting Dark magic has left him with an extreme paranoia that causes him to distrust everyone and everything. He is accused at one point of having destroyed a gift sent to him because he thought the ticking indicated a Cockatrice egg; in fact, it had been a carriage clock.

Relationships with Other Characters
Moody has a good friendship with Ron's father, Arthur Weasley, and was also close to Albus Dumbledore. It is also shown in Harry Potter and the Deathly Hallows that Tonks is very close to Moody, as shown by her reaction when he is killed.

Analysis
Not an intimately friendly person, Moody deeply distrusts most people or things since his "Auror" days, in which he lost an eye, part of his nose, and a leg. We are led to believe that Evan Rosier blasted some of his nose off.

He rarely believes anyone and always suspects that a spell could have been cast with malafide intentions by the "Dark Side." This also explains his apparent motto, "Constant Vigilance".

Questions

 * 1) Why is Moody so paranoid?
 * 2) How does Moody interact with other people?
 * 3) Is Moody's eye unique, or are there any other similarly magical eyes?
 * 4) How did Moody lose his eye and leg?

Greater Picture
Many actions and details described under the Harry Potter and the Goblet of Fire section were not actually done by the real Alastor Moody, but rather Barty Crouch Jr., who kidnapped Moody and used Polyjuice Potion (which he keeps in his hip flask) to impersonate him. Because these events are not revealed until the book's conclusion when Crouch is under the influence of Veritaserum, they appear under the listing for that character. As he managed to deceive even Albus Dumbledore with his impersonation, it must have been very close to the true Alastor Moody; his outward actions, mimicking what Moody would have done in a similar situation, have been included here on that basis.

It should be noted that Moody's death at the beginning of Harry Potter and the Deathly Hallows was required by the plot. As noted in the article on Albus Dumbledore, Harry could not have been the hero if he had another hero at his back. It is a staple of heroic fiction that the hero's teacher, older and apparently stronger than the hero, must fall to allow the hero to take his place and defeat the villain. At the end of the previous book, Harry Potter and the Half-Blood Prince, Dumbledore dies. We have not seen as much of Moody, and Harry does not have any particular feeling for him, he quite clearly isn't the father figure Dumbledore was for Harry. However, he remains an older and supposedly stronger wizard than Harry, and so seems poised to fill Dumbledore's place in the hierarchy of heroes. In order to prevent that happening, Moody must be quickly incapacitated, preferably before the readers have started to care about him too much. It is unsure why the author does not allow the characters to find Moody's body; Umbridge having his magical eye on her door does imply quite strongly that Moody is dead, but denies us any real closure. It is possible, though unlikely, that the author wanted to leave the faint possibility that Moody could return to assist later in the story, if the plot developed to need that.

We note that while there are other potential father figures in the story, notably Arthur Weasley and Remus Lupin, none of them are as magically powerful as Dumbledore or Moody, and so they can remain alive.


text:
User talk:24.16.34.45

bartending format
admin jguk deleted a lot of redirects, ive asked him to restore them but hes taking his time deciding what he wants to do. Discordance 13:53, 25 March 2006 (UTC)

I've made an account, if anyone else should wish to leave me a message, please leave it to: --Xyzzyplugh 14:24, 25 March 2006 (UTC)

title: User talk:24.16.34.45


text:
Easy Ido/Lesson seven

Lesson six | Lesson eight

Verb + Infinitive
The English sentence 'I need to go home' is in the form Verb ('I need') + Infinitive ('to go'). Ido uses the same construction. Here are some verbs which can be found in sentences like this:

 * povar - to be able (to do something)
 * mustar - to have to (by necessity)
 * bezonar - to need (to)
 * volar - to want (to)
 * devar - to have a duty (to), 'should'

Times
One can talk about time using words such as the following:

 * hiere - yesterday
 * hodie - today
 * morge - tomorrow
 * horo - hour
 * kloko - o'clock
 * dio - day
 * semano - week
 * monato - month
 * yaro - year

Short words
Like in many languages, the hardest to learn can be the short words. To make matters worse, some words in Ido are very similar while their translations in English are quite different. The converse can also be true. Here are a few sets of words which need special attention.

That

 * ta - used when 'that' is an adjective, e.g. it precedes a noun. Ta libro esas granda, 'That book is big'.
 * to - used when 'that' is a pronoun, e.g. it precedes a verb. To esas libro, 'That is a book'.
 * ke - used when 'that' is a conjunction, e.g. it joins two clauses. Me pensas ke hundi esas animali, 'I think that dogs are animals'.

N words

 * nek - neither and nor. Me manjas nek frukti nek legumi, 'I eat neither fruits nor vegetables'.
 * nur - only. Me havas nur un frato, 'I have only one sibling'.
 * nun - now. Me mustas irar nun, 'I must go now'.
 * nam - for, since. Me skribis la vorto, nam me ne savis olu, 'I wrote the word, for I did not know it'.

Ul words

 * ulo - something. Forsan ulo plu bona venos., 'Perhaps something better will come.'
 * ulu - anyone, someone. Kad ulu savas ube ol esas?, 'Does anyone know where it is?'
 * ula - any, some. Kad vu havas ula libri pri cienco?, 'Do you have any books about science?'

Tr words

 * tra - through. Me marchis tra la parko., 'I walked through the park.'
 * tro - too. Mea libro esas tro olda., 'My book is too old.'
 * tre - very. Ta libro esas tre interesanta., 'This book is very interesting.'

Others
Once you have mastered the words above, try learning these last few. Also, try using them in sentences.

 * dum - during
 * yen - here is/are, there is/are (as in 'There is the train!')
 * do - so, consequently
 * ma - but
 * ja - already
 * se - if
 * ya - indeed, truly
 * tante - so (as in 'so big', 'so quickly')

Lesson six | Top | Lesson eight

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title: Easy Ido/Lesson seven


text:
User talk:169.244.143.115

Come introduce yourself at the new users page. If you have any questions, you can ask there or contact me personally.

I'm not exactly sure what sort of guidance you are seeking here, but I would like to strongly recommend that you look at Welcome, newcomers. Keep in mind that very short pages like the one you made at Quik Mart are likely to be deleted simply because there is no content there, and no real possibility of become a new module. It is much harder to write a good Wikibook than to do a comparable Wikipedia article. --Rob Horning 14:53, 25 March 2006 (UTC)

title: User talk:169.244.143.115


text:
Engineering Acoustics/Filter Design and Implementation

Introduction
Acoustic filters, or mufflers, are used in a number of applications requiring the suppression or attenuation of sound. Although the idea might not be familiar to many people, acoustic mufflers make everyday life much more pleasant. Many common appliances, such as refrigerators and air conditioners, use acoustic mufflers to produce a minimal working noise. The application of acoustic mufflers is mostly directed to machine components or areas where there is a large amount of radiated sound such as high pressure exhaust pipes, gas turbines, and rotary pumps.

Although there are a number of applications for acoustic mufflers, there are really only two main types which are used. These are absorptive and reactive mufflers. Absorptive mufflers incorporate sound absorbing materials to attenuate the radiated energy in gas flow. Reactive mufflers use a series of complex passages to maximize sound attenuation while meeting set specifications, such as pressure drop, volume flow, etc. Many of the more complex mufflers today incorporate both methods to optimize sound attenuation and provide realistic specifications.

In order to fully understand how acoustic filters attenuate radiated sound, it is first necessary to briefly cover some basic background topics. For more information on wave theory and other material necessary to study acoustic filters please refer to the references below.

Basic Wave Theory
Although not fundamentally difficult to understand, there are a number of alternate techniques used to analyze wave motion which could seem overwhelming to a novice at first. Therefore, only 1-D wave motion will be analyzed to keep most of the mathematics as simple as possible. This analysis is valid, with not much error, for the majority of pipes and enclosures encountered in practice.

Plane-Wave Pressure Distribution in Pipes
The most important equation used is the wave equation in 1-D form (See [1],[2], 1-D Wave Equation, Vibrations of Strings for information).

Therefore, it is reasonable to suggest, if plane waves are propagating, that the pressure distribution in a pipe is given by:

$$\mathbf{p}=\mathbf{Pi}e^{j[\omega t-kx]}+\mathbf{Pr}e^{j[\omega t+kx]}$$

where Pi and Pr are incident and reflected wave amplitudes respectively. Also note that bold notation is used to indicate the possiblily of complex terms. The first term represents a wave travelling in the +x direction and the second term, -x direction.

Since acoustic filters or mufflers typically attenuate the radiated sound power as much as possible, it is logical to assume that if we can find a way to maximize the ratio between reflected and incident wave amplitude then we will effectively attenuated the radiated noise at certain frequencies. This ratio is called the reflection coefficient and is given by:

$$\mathbf{R}=\left( \frac{\mathbf{Pr}}{\mathbf{Pi}} \right)$$

It is important to point out that wave reflection only occurs when the impedance of a pipe changes. It is possible to match the end impedance of a pipe with the characteristic impedance of a pipe to get no wave reflection. For more information see [1] or [2].

Although the reflection coefficient isn't very useful in its current form since we want a relation describing sound power, a more useful form can be derived by recognizing that the power intensity coefficient is simply the magnitude of reflection coefficient squared [1]:

$$R_{\pi}=\left|\mathbf{R}\right|^2$$

As one would expect, the power reflection coefficient must be less than or equal to one. Therefore, it is useful to define the transmission coefficient as it said:

$$T_{\pi}=\left(1-R_{\pi}\right)$$

which is the amount of power transmitted. This relation comes directly from conservation of energy. When talking about the performance of mufflers, typically the power transmission coefficient is specified.

Basic Filter Design
For simple filters, a long wavelength approximation can be made to make the analysis of the system easier. When this assumption is valid (e.g. low frequencies) the components of the system behave as lumped acoustical elements. Equations relating the various properties are easily derived under these circumstances, see Lumped Elements for further information.

The following derivations assume long wavelength. Practical applications for most conditions are given later.

Low-Pass Filter

These are devices that attenuate the radiated sound power at higher frequencies. This means the power transmission coefficient is approximently 1 across the band pass at low frequencies(see figure to right).

This is equivalent to an expansion in a pipe, with the volume of gas located in the expansion having an acoustic compliance (see figure to right). Continuity of acoustic impedance (see Java Applet at: Acoustic Impedance Visualization) at the junction, see [1], gives a power transmission coefficient of:

$$T_{\pi}=\left(\frac{1}{1+\left(\frac{S_{1}-S}{2S}\right)kL}\right)$$

where k is the wavenumber (see Wave Properties), L & $$S_{1}$$ are length and area of expansion respectively, and S is the area of the pipe.

The cut-off frequency is given by:

$$f_{c}=\left(\frac{Sc}{\pi L(S_{1}-S)}\right)$$

High-Pass Filter

These are devices that attenuate the radiated sound power at lower frequencies. Like before, this means the power transmission coefficient is approximately 1 across the band pass at high frequencies (see figure to right).

This is equivalent to a short side branch (see figure to right) with a radius and length much smaller than the wavelength (lumped element assumption). This side branch acts like an acoustic mass and applies a different acoustic impedance to the system than the low-pass filter. Again using continuity of acoustic impedance at the junction yields a power transmission coefficient of the form [1]:

$$T_{\pi}=\left(\frac{1}{1+\left(\frac{\pi a^2}{2SLk}\right)^2}\right)$$

where a and L are the radius and effective length of the small tube, respectively, and S is the area of the pipe.

The cut-off frequency is given by:

$$f_{c}=\left(\frac{ca^2}{2SL}\right)$$

Band-Stop Filter

These are devices that attenuate the radiated sound power over a certain frequency range (see figure to right). Like before, the power transmission coefficient is approximently 1 in the band pass region.

Since the band-stop filter is essentially a cross between a low and high pass filter, one might expect to create one by using a combination of both techniques. This is true in that the combination of a lumped acoustic mass and compliance gives a band-stop filter. This can be realized as a helmholtz resonator (see Helmholtz Resonator or figure to right). Again, since the impedance of the helmholtz resonator can be easily determined, continuity of acoustic impedance at the junction can give the power transmission coefficient as [1]:

$$T_{\pi}=\left(\frac{1}{1+\left(\frac{c/2S}{\omega L/S_{b}-c^2/\omega V}\right)^2}\right)$$

where $$S_{b}$$ is the area of the neck, L is the effective length of the neck, V is the volume of the helmholtz resonator, and S is the area of the pipe. It is interesting to note that the power transmission coefficient is zero when the frequency is that of the resonance frequency of the helmholtz. This can be explained by the fact that at resonance the volume velocity in the neck is large with a phase such that all the incident wave is reflected back to the source [1].

The zero power transmission coefficient location is given by:

$$f_{c}=\left(\frac{c}{2\pi}\right)\sqrt{\left(\frac{S_{b}}{LV}\right)}$$

This frequency value has powerful implications. If a system has the majority of noise at one frequency component, the system can be "tuned" using the above equation, with a helmholtz resonator, to perfectly attenuate any transmitted power (see examples below).

Design
If the long wavelength assumption is valid, typically a combination of methods described above are used to design a filter. A specific design procedure is outlined for a helmholtz resonator, and other basic filters follow a similar procedure (see 1).

Two main metrics need to be identified when designing a helmholtz resonator [3]:

(1) - Resonance frequency desired: $$f_{c}=\frac{c}{2\pi}\frac{\sqrt{C_{o}}}{V}$$ where $$C_{o}=\frac{S}{L}$$.

(2) - Transmission loss: $$\frac{\sqrt{C_{o}V}}{2S}=const$$ based on TL level. This constant is found from a TL graph (see HR pp. 6).

This will result in two equations with two unknowns which can be solved for the unknown dimensions of the helmholtz resonator. It is important to note that flow velocities degrade the amount of transmission loss at resonance and tend to move the resonance location upwards [3].

In many situations, the long wavelength approximation is not valid and alternative methods must be examined. These are much more mathematically rigorous and require a complete understanding acoustics involved. Although the mathematics involved are not shown, common filters used are given in the section that follows.

Actual Filter Design
As explained previously, there are two main types of filters used in practice: absorptive and reactive. The benefits and drawback of each will be briefly expained, along with their relative applications (see Absorptive Mufflers.

Absorptive
These are mufflers which incorporate sound absorbing materials to transform acoustic energy into heat. Unlike reactive mufflers which use destructive interference to minimize radiated sound power, absorptive mufflers are typically straight through pipes lined with multiple layers of absorptive materials to reduce radiated sound power. The most important property of absorptive mufflers is the attenuation constant. Higher attenuation constants lead to more energy dissipation and lower radiated sound power.

Examples

There are a number of applications for absorptive mufflers. The most well known application is in racecars, where engine performance is desired. Absorptive mufflers don't create a large amount of back pressure (as in reactive mufflers) to attenuate the sound, which leads to higher muffler performance. It should be noted however, that the radiate sound is much higher. Other applications include plenum chambers (large chambers lined with absorptive materials, see picture below), lined ducts, and ventilation systems.

Reactive
Reactive mufflers use a number of complex passages (or lumped elements) to reduce the amount of acoustic energy transmitted. This is accomplished by a change in impedance at the intersections, which gives rise to reflected waves (and effectively reduces the amount of transmitted acoustic energy). Since the amount of energy transmitted is minimized, the reflected energy back to the source is quite high. This can actually degrade the performance of engines and other sources. Opposite to absorptive mufflers, which dissipate the acoustic energy, reactive mufflers keep the energy contained within the system. See Reactive Mufflers for more information.

Examples

Reactive mufflers are the most widely used mufflers in combustion engines 1. Reactive mufflers are very efficient in low frequency applications (especially since simple lumped element analysis can be applied). Other application areas include: harsh environments (high temperature/velocity engines, turbines, etc.), specific frequency attenuation (using a helmholtz like device, a specific frequency can be toned to give total attenuation of radiated sound power), and a need for low radiated sound power (car mufflers, air conditioners, etc.).

Performance
There are 3 main metrics used to describe the performance of mufflers; Noise Reduction, Insertion Loss, and Transmission Loss. Typically when designing a muffler, 1 or 2 of these metrics is given as a desired value.

Noise Reduction (NR)
Defined as the difference between sound pressure levels on the source and receiver side. It is essentially the amount of sound power reduced between the location of the source and termination of the muffler system (it doesn't have to be the termination, but it is the most common location) [3].

$$NR = \left(L_{p1}-L_{p2}\right)$$

where $$L_{p1}$$ and $$L_{p2}$$ is sound pressure levels at source and receiver respectively. Although NR is easy to measure, pressure typically varies at source side due to standing waves [3].

Insertion Loss (IL)
Defined as difference of sound pressure level at the receiver with and without sound attenuating barriers. This can be realized, in a car muffler, as the difference in radiated sound power with just a straight pipe to that with an expansion chamber located in the pipe. Since the expansion chamber will attenuate some of the radiate sound power, the pressure at the receiver with sound attenuating barriers will be less. Therefore, a higher insertion loss is desired [3].

$$IL = \left(L_{p,without}-L_{p,with}\right)$$

where $$L_{p,without}$$ and $$L_{p,with}$$ are pressure levels at receiver without and with a muffler system respectively. Main problem with measuring IL is that the barrier or sound attenuating system needs to be removed without changing the source [3].

Transmission Loss (TL)
Defined as the difference between the sound power level of the incident wave to the muffler system and the transmitted sound power. For further information see Transmission Loss [3].

$$TL = 10log\left(\frac{1}{\tau}\right)$$ with $$\tau =\left(\frac{I_{t}}{I_{i}} \right)$$

where $$I_{t}$$ and $$I_{i}$$ are the transmitted and incident wave power respectively. From this expression, it is obvious the problem with measure TL is decomposing the sound field into incident and transmitted waves which can be difficult to do for complex systems (analytically).

Examples
(1) - For a plenum chamber (see figure below):

$$TL = -10log\left(S\left(\frac{cos\theta}{2\pi d^2}+\frac{1-\alpha}{\alpha S_{w}}\right)\right)$$ in dB

where $$\alpha$$ is average absorption coefficient.

(2) - For an expansion (see figure below):

$$NR = 10log\left[ \frac{1}{2}\left| e^{-ikx_{s}}+\left( \frac{1-S}{1+S} \right)e^{ikx_{s}} \right|^2\left( 1+S \right)^2 \right]$$

$$IL = 10log\left[ \frac{\left( 1+S \right)^2}{4} \right]$$

$$TL = 10log\left[ \frac{\left( 1+S \right)^2}{4S} \right]$$

where $$S=\left( \frac{A_{2}}{A_{1}} \right)$$

(3) - For a helmholtz resonator (see figure below):

$$TL = 10log\left[ 1+\left( \frac{\left( \frac{c}{2S_{b}} \right)}{\omega L/S - \left( \frac{c^2}{\omega V} \right)} \right)^2 \right]$$ in dB

Links
[1] - Muffler/silencer applications and descriptions of performance criteria Exhaust Silencers

[2] - Engineering Acoustics, Purdue University - ME 513.

[3] - Sound Propagation Animations

[4] - Exhaust Muffler Design

[5] - Project Proposal & Outline


text:
User talk:Tlustulimu

Help with German Wikibook
Hello I was wondering if you like to help with the development of the German Wikibook, it need much help and more activity, and since you area native German speaker, from Germany, would you like to help?

--German Men92 17:42, 25 March 2006 (UTC)

title: User talk:Tlustulimu


text:
User talk:Joystick~enwikibooks

Help with German Wikibook
Hello I was wondering if you like to help with the development of the German Wikibook, it need much help and more activity, and since you area native German speaker, would you like to help?

--German Men92 17:45, 25 March 2006 (UTC)
 * I will have a look at it in the next days, but the most time i am at WP DE.--Joystick 20:38, 19 April 2006 (UTC)

Your account will be renamed
Hello,

The developer team at Wikimedia is making some changes to how accounts work, as part of our on-going efforts to provide new and better tools for our users like cross-wiki notifications. These changes will mean you have the same account name everywhere. This will let us give you new features that will help you edit and discuss better, and allow more flexible user permissions for tools. One of the side-effects of this is that user accounts will now have to be unique across all 900 Wikimedia wikis. See the announcement for more information.

Unfortunately, your account clashes with another account also called Joystick. To make sure that both of you can use all Wikimedia projects in future, we have reserved the name Joystick~enwikibooks that only you will have. If you like it, you don't have to do anything. If you do not like it, you can pick out a different name.

Your account will still work as before, and you will be credited for all your edits made so far, but you will have to use the new account name when you log in.

Sorry for the inconvenience.

Yours, Keegan Peterzell Community Liaison, Wikimedia Foundation 23:18, 17 March 2015 (UTC)

Renamed
 This account has been renamed as part of single-user login finalisation. If you own this account you can |log in using your previous username and password for more information. If you do not like this account's new name, you can choose your own using this form after logging in: . -- Keegan (WMF) (talk) 05:06, 19 April 2015 (UTC)

title: User talk:Joystick~enwikibooks