Instructions Of Use Research Articles

Adapting Leading Practices and Associated Tools

The purpose of the demonstration of WERF Strategic Asset management (SAM) decision support tools is to provide users with insight into the efforts and impacts of applying the various asset management concepts. To accomplish this, the research team identified four different utilities with asset management program at various stages. These utilities agreed to implement and integrate the tools into their existing programs. The tools that were demonstrated are the Levels of Service, Condition Assessment, Life Cycle Cost Projection, and Capital Project Validation and Prioritization.The research indicated that all four utilities were able to successfully integrate the WERF SAM tools and their principles into their existing asset management programs. However, each utility needed to make adjustments to the tools and methodologies to varying degrees to ensure proper integration. This is in line with the WERF instructions of use. The research also found that the implementation and integration of new asset management tools were far reaching, having impacts to organization structure, technology in use, and the asset management practices. Ultimately the WERF SAM tools were found to be beneficial by all four demonstration teams and therefore adapted permanently in varying degrees to their existing asset management programs.This title belongs to WERF Research Report Series.ISBN: 9781780405377 (eBook)

Chemical Scalp Burns After Hair Highlights

Hair highlighting using chemical solutions to alter the pigmentation of hair is a popular procedure. Given their chemical properties, these solutions also are potentially caustic to the scalp. However, the actual incidence and range of injuries is not well reported in the American literature. We report a representative case from the severe end of the injury spectrum, that of a full-thickness chemical burn as a result of direct contact from hair-lightening solution. We review the composition and potential side effects of the chemicals used. Meticulous attention to the instructions of use is recommended to prevent these injuries. To our knowledge, this is the first case report of a full-thickness chemical scalp burn as a result of highlighting in the American literature, and we hope that it will serve as an educational resource with respect to the potential risks of this very common procedure.

Titles, Uses and Instructions of Use: The Status of Intention in Art and Artefacts

Titles, Uses and Instructions of Use: The Status of Intention in Art and Artefacts

Tool use and mechanical problem solving in apraxia

Moorlaas (1928) proposed that apraxic patients can identify objects and can remember the purpose they have been made for but do not know the way in which they must be used to achieve that purpose. Knowledge about the use of objects and tools can have two sources: It can be based on retrieval of instructions of use from semantic memory or on a direct inference of function from structure. The ability to infer function from structure enables subjects to use unfamiliar tools and to detect alternative uses of familiar tools. It is the basis of mechanical problem solving. The purpose of the present study was to analyze retrieval of instruction of use, mechanical problem solving, and actual tool use in patients with apraxia due to circumscribed lesions of the left hemisphere. For assessing mechanical problem solving we developed a test of selection and application of novel tools. Access to instruction of use was tested by pantomime of tool use. Actual tool use was examined for the same familiar tools. Forty two patients with left brain damage (LBD) and aphasia, 22 patients with right brain damage (RBD) and 22 controls were examined. Only LBD patients differed from controls on all tests. RBD patients had difficulties with the use but not with the selection of novel tools. In LBD patients there was a significant correlation between pantomime of tool use and novel tool selection but there were single cases who scored in the defective range on one of these tests and normally on the other. Analysis of LBD patients’ lesions suggested that frontal lobe damage does not disturb novel tool selection. Only LBD patients who failed on pantomime of object use and on novel tool selection committed errors in actual use of familiar tools. The finding that mechanical problem solving is invariably defective in apraxic patients who commit errors with familiar tools is in good accord with clinical observations, as the gravity of their errors goes beyond what one would expect as a mere sequel of loss of access to instruction of use.

Therapy of Activities of Daily Living in Patients with Apraxia

A test of three activities of daily living (ADL) was administered to 35 patients who had aphasia and right-sided hemiplegia after left hemisphere stroke. The number of errors correlated strongly with clinical measures of limb apraxia. Evaluation of the test distinguished between fatal errors, which prevented successful completion of the activity, and reparable errors. Fifteen patients who had made fatal errors on at least two of the three activities were admitted to a therapy study: each week they completed an ADL test. Between tests, one of the three activities was trained whereas maximal support but no therapeutic advice was given when the patients had to perform the other activities in their daily routines. In the following week anotheractivity was trained, and in the thirdweek the remaining activity. The cycle was repeated if there were still fatal errors after a first run. At the end of therapy, 10 of the patients could perform all three activities without fatal errors, and three made only one fatal error. Fatal errors were eliminated exclusively in the weeks when an activity was trained. The absence of any simultaneous improvement in non-trained activities indicates that there was no generalisation of training effects from trained to non-trained activities. We were able to re-examine seven patients more than six months later. The success of ADL training was preserved only in those patients who had practised the activities in their daily routines at home. The results are discussed in relation to a distinction between knowledge about prototypical use of familiar objects and the ability to infer directly function from structure. We believe that ADL training taught the patients “instructions of use” adapted to the constraints posed by hemiplegia but did not restore their ability to solve mechanical problems by inferring functions from structure.