A Promise is a Promise PDF book by Robert Munsch Read Online or Free Download in ePUB, PDF or MOBI eBooks. Published in 1988 the book become immediate popular and critical acclaim in childrens, picture books books. The main characters of A Promise is a Promise novel are John, Emma. How to download the “The Beekeeper’s Promise by Fiona Valpy” eBook online from the US, UK, Canada, and the rest of the world? If you want to fully download the book online first you need to visit our download link then you must need signup for free trials.
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Author: Robert Munsch Submitted by: Maria Garcia 1513 Views View Chapter List Add a Review
A Promise is a Promise PDF book by Robert Munsch Read Online or Free Download in ePUB, PDF or MOBI eBooks. Published in 1988 the book become immediate popular and critical acclaim in childrens, picture books books.
The main characters of A Promise is a Promise novel are John, Emma. The book has been awarded with Booker Prize, Edgar Awards and many others.
One of the Best Works of Robert Munsch. published in multiple languages including English, consists of 32 pages and is available in Paperback format for offline reading.
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A Promise is a Promise PDF Details
|Original Title:||A Promise is a Promise|
|Number Of Pages:||32 pages|
|First Published in:||1988|
|Generes:||Childrens, Picture Books, Childrens, Cultural, Canada, Fiction, Fantasy, Folk Tales, Fantasy, Mythology, Kids, Childrens, Juvenile, Humor,|
|Formats:||audible mp3, ePUB(Android), kindle, and audiobook.|
The book can be easily translated to readable Russian, English, Hindi, Spanish, Chinese, Bengali, Malaysian, French, Portuguese, Indonesian, German, Arabic, Japanese and many others.
Please note that the characters, names or techniques listed in A Promise is a Promise is a work of fiction and is meant for entertainment purposes only, except for biography and other cases. we do not intend to hurt the sentiments of any community, individual, sect or religion
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0022.3956/93 $6.00 + .OO Pergamon Press Ltd
abnormalities are cardinal components of major depression. They always have been; they predictably always will be. Unfortunately, psychomotor symptoms receive too little attention from investigators. One reason for this neglect is that motor functions traditionally have been difficult to dissect and measure. As reflected by two articles in this issue of the Journal of Psychiatric Research (Flint, Black, Campbell-Taylor, Gailey, & Levinton, 1993; St. Kuny, & Stassen, 1993) we appear to be making progress in surmounting this barrier. “Psychomotor” is so generic a term that its usefulness may be limited. More than a decade ago, Greden and Carroll (1981) suggested that progress might be accelerated if researchers were to arbitrarily divide psychomotor functions into speech, facial expressions, and gross motility. The rationale was that while underlying neurobiological substrates might overlap or be the same, strategies for studying these parameters were quite different. Greden and Carroll also recommended that researchers adopt some of the new approaches made available by revolutionary advances in computer and electronic technology. Flint and colleagues and St. Kuny and Stassen have done so in their studies. Speech is conventionally characterized by dividing it into a number of components, including rate (“speed”), volume, inflections, tone, pitch, “timbre,” duration of pauses, placement of pauses, quality of articulation, and variations in these respective qualities over time (Greden, & Carroll, 1981; Nilsonne, 1988; Stassen, Bomben, & Gunther, 1991). Clinicians have long observed (Hargreaves, & Starkweather, 1964) that “normal” speech seems to become abnormal, sometimes markedly so, when individuals become depressed (Stassen, Bomben, & Gunther, 1991), and that speaking abnormalities appear to fluctuate over time with the overall severity of the condition (Greden, & Carroll, 1980). Most clinicians would be unable to describe in detail the specific speech components that are altered, however, with the possible exception of rate and volume. Despite this, speech has become an important descriptive feature in categorizing subtypes of depression. For example, slow, halting, monotonous, subdued, flat, low-volume speech generally is recognized as characteristic of “retarded” depression (Greden, & Carroll, 198 1), while tremulous, “jittery,” quivering, higher-pitched, staccato speech is associated with “agitation.” Clinical speech assessments unfortunately are limited by high variance and innate subjectivity. Most clinicians cannot be expected to listen to a patient’s speech, concentrate on content, and simultaneously dissect and quantify complicated, multiple speech components such as speech onset, pause times and quality of articulation that may vary by only milliseconds or decibels. Even if we possessed such remarkable skills, most of us could not accurately recall the patient’s speech from a distant time point, thus making comparisons over time extremely PSYCHOMOTOR
difficult. Subjective assessments of speech have served us well, but objective technologies are needed now. Flint and colleagues (1993) hypothesized that speech articulation in those with depression might be comparable to those with Parkinson’s Disease. Their hypothesis stemmed logically from prior reports showing similarities between Parkinson’s and depression (Mawdsley, & Gamsu, 1971), and from known effects of neuropharmacological interventions in both disorders. They found that patients with depression and those with Parkinson’s had significantly shortened voice onset time and that speech measures from both differed from normals but generally not from each other. Based on these observations, the authors suggested that nigrostriatal dysfunction might be the root cause of psychomotor slowing in both conditions. This study joins a traditional (Barbeau, 1972, 1974) and growing recent body of literature suggesting that the basal ganglia may play an important role in pathophysiological symptoms. St. Kuny and Stassen measured speaking behavior and voice sound characteristics throughout the course of recovery from depression, aiming to determine which might be correlated with severity of depression, whether speaking behavior and voice sound characteristics changed during the time course of recovery from depression, and whether speaking behavior and voice sound characteristics could be represented using a single multivariate vector. They observed that there were significant correlations between major speech parameters and global depression ratings, that changes in speech did indeed occur during improvement, and that these changes paralleled global clinical improvement. Further, they noted that if patients failed to improve, speech measures characteristically did not change. These reports suggest that safe, non-invasive, relatively reliable, and modestly inexpensive technologies are now available to measure speech components from patients with psychiatric disorders. Such measurements can also be repeated easily over time. The fun may have just started. During the past decade, the worldwide computer industry has been striving to develop technologies that would enable users to convey commands by speaking, and technological advances have been rather stunning. Desktop computer programs already enable speech dissection and quantification, and while not perfect. are quite good. Progress will be even more rapid during the next several years. Quality and feasibility thus are good, while start-up costs are minimal. Indeed, most investigators already possess the necessary equipment to conduct speech quantification (quiet rooms, computers and recording devices). By comparison with strategies such as positron emission tomography (PET), single photon emission computer tomography (SPECT), magnetic resonance imaging, and other “high tech” approaches, speech measurements are downright simple. We have progressed a long way since 198 1 (Greden, & Carroll, 1981). This editorial is intended to encourage investigators to enter the arena of psychomotor research. For those interested, several uweuts appear warranted. First, since psychomotor measures are already plagued by wide variances. the usual methodological clinical and demographic pitfalls must be addressed prior to launching studies if findings are to be meaningful. When studying speech, the most prominent variables to consider will be age, gender. medications, drug and alcohol use, and chronobiological factors. Controlling for these will not be easy. as exemplified by the fact that Flint et al. and St. Kuny and
Stassen were forced to study patients receiving medication. If concomitant medications are unavoidable, as is often the case, initial study designs should incorporate adequate sample sizes and sophisticated post hoc analyses to assess the potential variance being introduced by the medication. Other strategies also are indicated, such as conducting repeat assessments over time, ideally when subjects are no longer receiving the medication in question, or-as used by St. Kuny and Stassen-to compare those who improve and those who fail to improve despite receiving comparable type and dose of medication. Chronobiological variables should be documented for every subject. Circadian influences should be controlled, such as by collecting speech samples from subjects at the same time of day. Seasonality influences on motor function appear to be less well-established, but available data suggest it would be prudent to address this issue, especially if subjects are diagnosed as having mood disorders Potential investigators will note that the terms used in describing speech components are somewhat technical, a bit strange, and definitely not part of our usual lexicon. Such is the case when one enters unfamiliar territory. Hopefully the novelty will not deter interest. Speech elements are actually quite simple; the “language” should be learned rather quickly. In an earlier call for more research on speech, Greden and Carroll suggested that “by using new techniques . correlating findings with other established approaches such as . . . EMGs (Leanderson, Persson, & Ohman, 197 i 1, and by emphasizing pharmacological manipulation of transmitters known to influence speech, further breakthroughs in assessing this important function are likely” (Greden, & Carroll, 1981). The efforts of Flint et al. and St. Kuny and Stassen suggest that this promise might yet be fulfilled, hopefully sooner rather than later. John F. Greden, MD References Barbeau, A. (1974). Biology of the striatum. In G. E. Gaul1 (Ed.), Biology ofhrain dysfuncfiort. New York: Plenum Press. Barbeau, A. (1972). Dopamine and mental function. In S. Mali& (Ed.), L-Dopu und hehacior. New York: Raven Press. Flint, A. J., Black, S. E., Cambell-Taylor, I., Gailey, G. F., & Levinton, C. (1993). Abnormal speech articulation. psychomotor retardation. and subcortical dysfunction in major depression. Journal oj’ Rsychiutric Research, 27, 309-3 19. Greden, J. F., Albala. A. A., Smokier. 1. A., Gardner, R.. & Carroll, B. J. (1981). Speech pause time: a marker of psychomotoric retardation in endogenous depression. Biological Psychiatry, 16, 851-859. Greden, J. F., & Carroll, B. J. (1980). Decrease in speech pause times with treatment of endogenous depression. Biological Psychiatry, 15, 575.-587. &eden, J. F.. & Carroll, B. J. (1981). Psychomotor function in affective disorders: an overview of new monitoring techniques. American Journal of’Ps.vchiatry, 138, 144- 1447. Hargredves, W. A., & Starkweather, J. A. (1964). Voice quality changes in depression. Language and Speech. 7, 8488,218p220. Leanderson, R., Persson, A., & Ohman, S. (197 I). Electromyographic studies of facial muscle activity in speech. Acta Otolaryngology, 72, 361-369. Mawdsley, C., & Gamsu. C. V. (1971). Periodicity of speech in parkinsonism. Nature, 231, 315-316. Nilsonne, A. (1988). Speech characteristics as indicators of depressive illness. Acta Psychiutricu Scundinurica, 77, 253-263. Stassen, H. H., Bomben, G., & Giinther, E. (1991). Speech characteristics in depression. Psychopathology, 24, 88105. St. Kuny. & Stassen, H. H. (1993). Speaking behavior and voice sound characteristics in depressive patients during recovery. Journal qf Psychiatric Research, 27,289%307. Szabadi, E.. Bradshaw, C. M., & Besson, J. A. 0. (1976). Elongation of pause-time in speech: a simple objective measure of motor retardation in depression. British Journal of Psychiatry.129, 592-597.