Journal articles on the topic 'Aphasic persons – Language – Case studies'
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Johnson, Melissa A., Heather Coles, Laurie Keough, Betsey King, and Melissa Reed. "Co-Delivered Integrative Music and Language Therapy: Positive Outcomes Through Music Therapy and Speech-Language Pathology Collaboration." Perspectives of the ASHA Special Interest Groups 4, no. 2 (April 15, 2019): 261–68. http://dx.doi.org/10.1044/2019_pers-sig2-2018-0006.
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Purpose Persons with aphasia can sometimes retain the ability to sing, and several studies have shown the effectiveness of using music to improve speech and language output. The purposes of this article were to discuss the theoretical principles and observed speech-language outcomes of a co-delivered integrative music and language therapy (CIMaLT) methodology for adults with chronic aphasia in a college-based clinic, to describe the interprofessional clinical education model used at the clinic, and to present a case example of CIMaLT implementation. Conclusion CIMaLT is an effective and feasible methodology to implement interprofessional education and practice in a college-based clinic. Additionally, it results in meaningful change in speech and language for some clients with aphasia and apraxia. Additional research is needed to further explore its outcomes for students and persons with aphasia and other neurogenic communication impairments at various stages of recovery. Plain Language Summary Persons with aphasia can sometimes retain the ability to sing, which can help improve speech and language function. Music and speech-language pathology students from our college-based clinic work together to provide treatment for persons with aphasia. This results in improvements in both student learning and client speech and language. This article describes the theory approach, and client and student outcomes of this treatment.
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Tuomiranta, Leena, Petra Grönholm-Nyman, Francine Kohen, Pirkko Rautakoski, Matti Laine, and Nadine Martin. "Learning and maintaining new vocabulary in persons with aphasia: Two controlled case studies." Aphasiology 25, no. 9 (August 12, 2011): 1030–52. http://dx.doi.org/10.1080/02687038.2011.571384.
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Monish, V., and N. Sreedevi. "Speech and swallowing difficulties and rehabilitation in osmotic demyelination syndrome: A single case report." IP Journal of Otorhinolaryngology and Allied Science 4, no. 4 (January 15, 2022): 149–52. http://dx.doi.org/10.18231/j.ijoas.2021.031.
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: Aim of the work was to highlight the speech and swallowing difficulties that are associated with osmotic demyelination syndrome and also the importance of speech and language therapy in patients with osmotic demyelination syndrome. In this case report, a 68 years old female who developed osmotic demyelination syndrome as a result of hyponatremia correction has been described. The patient developed motor, speech and swallowing difficulties after 10 day of hyponatremia correction. For assessing speech and language skills, Bedside Screening Test for Persons with Aphasia was used. Gugging Swallowing Screen was used for assessing the swallowing skills.: The assessment results indicated that the patient’s auditory comprehension skills were preserved and other verbal skills were affected as the patient had mutism. Also the patient had slight dysphagia with lower risk of aspiration. With speech-language intervention, improvement was observed in swallowing and verbal communication skills. ODS is a rare clinical condition. In order to have a better perspective about speech, language and swallowing skills in individuals with ODS, replication of such studies are essential.
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Gill, Cindy, Laura Green, Sneha Bharadwaj, Tamby Allman, and Jyutika Mehta. "Identification of Word Retrieval Difficulties in the Normally Aging Population." Perspectives of the ASHA Special Interest Groups 6, no. 3 (June 25, 2021): 654–64. http://dx.doi.org/10.1044/2021_persp-20-00192.
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Purpose This study examined variations in performance on different verbal tasks completed by typically aging, non-neurologically impaired adults who self-identified as either having or not having word retrieval difficulties that frequently affected their lifestyle. Method Fifty-seven adults aged 54–71 years, who were recruited based on case history responses that indicated the presence or absence of word retrieval difficulties, completed two standardized, norm-referenced language tests, two naming tasks, and three verbal fluency measures. Results Although scores on standardized language tests fell within normal limits for all of the participants, significant differences between those with and those without self-reported word retrieval difficulties were found on the Expressive Vocabulary Test–Second Edition as well as on tasks of naming members of categories and producing procedural narratives. A significantly greater percentage of disfluencies in procedural narratives were found in the group that reported word retrieval difficulties. This fluency indicator was the only factor that was predictive of word retrieval difficulties. Conclusions Many studies have examined the differences in word retrieval in older versus younger populations or in persons with aphasia versus persons without aphasia, but they have not offered definitive pictures of the differences between those with and those without word retrieval difficulties in the normally aging population who have otherwise normal language. This study identified three tasks that appear to be sensitive to the word-finding difficulties experienced by some adults.
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Bailey, Dallin J., Christina Nessler, Kiera N. Berggren, and Julie L. Wambaugh. "An Aphasia Treatment for Verbs With Low Concreteness: A Pilot Study." American Journal of Speech-Language Pathology 29, no. 1 (February 7, 2020): 299–318. http://dx.doi.org/10.1044/2019_ajslp-18-0257.
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Purpose Verbs with low concreteness are frequent in discourse samples but rarely targeted in aphasia treatments for verbs. These verbs are an important part of functional communication, and recent studies have called for more research regarding aphasia and treatment stimuli with low concreteness. The aim of this study was to pilot the use of verbs with low concreteness in a novel sentence production intervention with persons with aphasia. Method The study took the form of a single-case experimental design with multiple baselines across behaviors and across participants. Three persons with chronic nonfluent aphasia and apraxia of speech participated in the study. Each participant received treatment designed to increase the semantic networks of verbs with high frequency and low concreteness. Sentence production was closely examined over the course of treatment for treated and untreated verbs of varying concreteness levels. Additional measures of language and cognitive functioning were also taken before and after treatment. Results Results indicated improved sentence production with target verbs attributable to the treatment in the 1st phase of 2 phases for 2 of the 3 participants. The increases corresponded with the application of treatment, despite the difference in number of baseline sessions for the participants. Where there were treatment effects, there was also considerable generalization to untreated sets of items during the 1st treatment phase. Word retrieval also improved for 2 participants. Conclusions The results suggest that the novel treatment may improve sentence production and word retrieval in persons with aphasia, even when using target verbs with low concreteness ratings. Future research is warranted into the use of low concreteness verbs. Supplemental Material https://doi.org/10.23641/asha.10870958
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Bunker, Lisa D., Christina Nessler, and Julie L. Wambaugh. "Effect Size Benchmarks for Response Elaboration Training: A Meta-Analysis." American Journal of Speech-Language Pathology 28, no. 1S (March 11, 2019): 247–58. http://dx.doi.org/10.1044/2018_ajslp-17-0152.
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Purpose With a number of single-case experimental design studies reporting the effects of treatment for response (and modified response) elaboration training (RET/M-RET), it is important to consolidate data over multiple participants to allow comparison within/between individuals and across similar treatments. The purpose of this study was to conduct a meta-analysis of single-case experimental design studies of RET/M-RET and to determine effect size (ES) benchmarks to allow comparison to “group” data. Method Database and bibliographical searches identified 20 investigations of RET/M-RET. Nine studies had sufficient experimental quality, compliance with the essential components of the RET protocol, and consistency in the dependent variable (i.e., accurate content production in response to picture stimuli) to be retained for the meta-analysis. Probe data for a total of 26 persons with aphasia (PWA) were extracted from published graphs (if raw data were not available) to calculate weighted ESs at the end of treatment and at follow-up for both treated and untreated stimuli. The first, second, and third quartiles of the distributions were used to serve at benchmarks for small, medium, and large effects. Results Nearly all participants demonstrated positive effects as a result of RET/M-RET, indicating an association with positive changes in content production for PWA. Small, medium, and large benchmarks are reported for treated items after treatment and at follow-up, as well as for untreated items after treatment and at follow-up. Conclusions With a larger sample of 26 participants, this analysis indicates that RET/M-RET are associated with positive changes in content production for PWA. ES benchmarks allow clinicians/researchers to compare an individual's performance across multiple applications of treatment to performance of other PWA and to other treatments with similar outcomes.
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Janečka, Martin. "Exploring Communicative Gestures in Czech Persons with Diagnosed Aphasia." Research in Language 19, no. 1 (March 30, 2021): 15–32. http://dx.doi.org/10.18778/1731-7533.19.1.02.
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In my investigation, I worked with 6 persons with diagnosed aphasia. I introduce some possible perspectives on the exploration of the extent of speech damage in persons with aphasia and the various ways in which they substitute for language deficiency with the aid of gestures.
From the viewpoint of data processing methods, on the one hand, I explore the parameters of spoken language, such as the quantity of words, and, on the other hand, the parameters of gestures, such as the quantity of gestures, diversity of gestures, etc. In aphasic persons speaking Czech, I verify the following assumption established by Jakob et al. (2011): the more speech-limited an aphasic person is, the more gestures he/she produces during the interpretation of a story.
It was found that the number of words produced by aphasic persons varies, partially dependent on the specific type of aphasia. This is particularly true on both ends of the scale – people with large speech distortion use the highest quantity of gestures, people with low speech distortion use gestures to a lesser extent. Within the classification of semantic gestures, I focus particularly on iconic and deictic gestures. In addition, I presume that symbolic gestures (i.e. emblems) do not occur in aphasic persons’ speech, because aphasic persons prefer gestures that display the plot in the most concrete way.
My data correlate with other studies dealing with this topic – aphasic persons do use gestures intentionally to substitute for their verbal deficiency. At the same time, they mostly use very concrete (iconic) gestures, which enable them to transmit a large volume of information.
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LAUTERBACH, MARTIN, ISABEL PAVÃO MARTINS, PAULA GARCIA, JOANA CABEÇA, ANA CRISTINA FERREIRA, and KLAUS WILLMES. "Cross linguistic aphasia testing: The Portuguese version of the Aachen Aphasia Test (AAT)." Journal of the International Neuropsychological Society 14, no. 6 (October 27, 2008): 1046–56. http://dx.doi.org/10.1017/s1355617708081253.
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AbstractWe report the adaptation of the Aachen Aphasia Test (AAT) to the Portuguese language (PAAT) and the results of its standardization in 125 persons with aphasia and 153 healthy controls. Patients with aphasia had a previous syndromic diagnosis, obtained through a Portuguese aphasia battery, which served as a reference. The control group was stratified by age and educational level. Hierarchical cluster analyses showed good construct validity. The increasing degree of difficulty and complexity throughout the item sets comprising subtests was confirmed. The discriminatory power of the PAAT for the selection of aphasic from non-aphasic persons proved to be as high as for the AAT versions in other languages. Classification of standard aphasic syndromes by means of discriminant analyses was good. Internal consistency, measured by means of Cronbach's alpha coefficient, was high to very high for the different PAAT subtests. Performance differences caused by age or educational level among the healthy control persons emphasized the need for correction factors. In conclusion, the PAAT showed robust psychometrical properties, comparable to the original German and to adaptations to other languages. It constitutes a useful tool for cross-linguistic and multicenter studies. (JINS, 2008, 14, 1046–1056.)
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Van Lancker Sidtis, Diana. "Formulaic Language and Language Disorders." Annual Review of Applied Linguistics 32 (March 2012): 62–80. http://dx.doi.org/10.1017/s0267190512000104.
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The importance of formulaic language is recognized by many branches of the language sciences. Second language learners acquire a language using a maturationally advanced neurological substrate, leading to a profile of formulaic language use and knowledge that differs from that of the prepuberty learner. Unlike the considerable interest in formulaic language seen in second language learning, attention paid to this theme in clinical communicative disorders has been limited. Historically, verbal expressions preserved in severe nonfluent aphasia, including counting, interjections, and memorized phrases, have been referred to asautomatic speech. Closer examination of all forms of aphasic speech reveals a high proportion of formulaic expressions, while speech samples from persons with right hemisphere and subcortical damage show a significant impoverishment. These findings are supported by studies of persons with Alzheimer's disease, who have intact subcortical nuclei and abnormally high proportions of formulaic expressions, and Parkinson's disease, which is characterized by dysfunctional subcortical systems and impoverished formulaic language. Preliminary studies of schizophrenic speech also reveal a paucity of formulaic language. A dissociation between knowledge and use of the expressions is found in some of these populations. Observations in clinical adult subjects lead to a profile of cerebral function underlying production of novel and formulaic language, known as the dual processing model. Whereas the left hemisphere modulates newly created language, production of formulaic language is dependent on a right hemisphere/subcortical circuit. Implications of the dual process model for evaluation and treatment of language disorders are discussed.
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E, Schultz, Churchill R, and Malina A. "A-174 Language Impairments Following Subcortical Infarct: An Aphasia Case Study." Archives of Clinical Neuropsychology 35, no. 6 (August 28, 2020): 968. http://dx.doi.org/10.1093/arclin/acaa068.174.
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Abstract Objective Subcortical aphasia associated with internal capsule and adjacent structure lesions often involve impaired naming, grammatical but slow dysarthric speech, impaired syntactic comprehension, repetition impairments, and apraxia. Furthermore, neuropsychiatric disturbances, such as diminished motivation and emotional dysregulation are additionally expected given connections to frontal lobe circuits. Overall, the type and severity of aphasia varies following subcortical stroke and the pattern of symptoms associated with subcortical aphasia have not been fully explored. Method The present case is a 34-year-old right-handed African-American female who sustained an acute infarct involving the left splenium, thalamus, and internal capsule, who was evaluated at bedside. Results Upon initial exam, the patient was aphasic, exhibiting difficulties with expression, fluctuating comprehension and frequent paraphasic errors. Repetition and single-step command following were impaired and apraxia was evident. She demonstrated poor insight and awareness into her current deficits. She additionally demonstrated low motivation and mild emotional dysregulation with heightened anxiety and depression. During recovery she demonstrated improved comprehension, verbal output, and reduced emotionality. Conclusions Consistent with previous studies, this case demonstrates the extreme variability of subcortical lesions in their aphasic manifestations and may suggest that subcortical aphasias are generally milder than that of cortical aphasias with generally faster symptom recovery.
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Boccato, Diana Michaela Amaral. "Aphasia in the context of the pandemic: language activities developed by Zoom and Whatsapp." Signo 47, no. 88 (January 3, 2022): 3–17. http://dx.doi.org/10.17058/signo.v47i88.17370.
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Abstract: Taking into account the difficulties faced by aphasic subjects in the utterances production and comprehension, both oral and written, this study aims at discussing the continuous work positive impacts, using Zoom and WhatsApp, during the pandemic period, while developing language activities with GB, a young aphasic woman, who attends the Center for Aphasic Individuals (Institute of Language Studies from the State University of Campinas, Unicamp). The longitudinal study is supported by an ongoing doctoral research, developed by the Group of Language Studies on Aging and Pathologies. The present article follows the theoretical-methodological principles based on enunciative-discursive neurolinguistics (Coudry, 1986, 1988) with focus on qualitative research and case studies. Based also on Luria’s (1981, 1986) and Vygotsky’s (2000 [1984]) neuropsychology, the brain is understood as a system that operates from the joint and integrated activity of functional units, emphasizing the social relations mediated by culturally developed symbols. In addition, Bakhtinian categories (Novaes-Pinto, 1999) allow us to analyze the dialogic processes, considering language production effective contexts, in order to understand the neurological damage impact on linguistic-cognitive functioning. For this, we bring some clippings of virtual interactions between the researcher (Idb) and GB, emphasizing the epi- and metalinguistic work that constitute discursive reorganization processes developed. By providing different features, the digital tools bring new possibilities for creating meaningful alternative strategies, generating a fundamental network that brings benefits to aphasics, while becoming an object of interest for research in several areas. Keywords: Aphasias; neurolinguistics; reading; writing; epilinguistics
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Marangolo, Paola, Valentina Fiori, Umberto Sabatini, Giada De Pasquale, Carmela Razzano, Carlo Caltagirone, and Tommaso Gili. "Bilateral Transcranial Direct Current Stimulation Language Treatment Enhances Functional Connectivity in the Left Hemisphere: Preliminary Data from Aphasia." Journal of Cognitive Neuroscience 28, no. 5 (May 2016): 724–38. http://dx.doi.org/10.1162/jocn_a_00927.
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Several studies have already shown that transcranial direct current stimulation (tDCS) is a useful tool for enhancing recovery in aphasia. However, no reports to date have investigated functional connectivity changes on cortical activity because of tDCS language treatment. Here, nine aphasic persons with articulatory disorders underwent an intensive language therapy in two different conditions: bilateral anodic stimulation over the left Broca's area and cathodic contralesional stimulation over the right homologue of Broca's area and a sham condition. The language treatment lasted 3 weeks (Monday to Friday, 15 sessions). In all patients, language measures were collected before (T0) and at the end of treatment (T15). Before and after each treatment condition (real vs. sham), each participant underwent a resting-state fMRI study. Results showed that, after real stimulation, patients exhibited the greatest recovery not only in terms of better accuracy in articulating the treated stimuli but also for untreated items on different tasks of the language test. Moreover, although after the sham condition connectivity changes were confined to the right brain hemisphere, real stimulation yielded to stronger functional connectivity increase in the left hemisphere. In conclusion, our data provide converging evidence from behavioral and functional imaging data that bilateral tDCS determines functional connectivity changes within the lesioned hemisphere, enhancing the language recovery process in stroke patients.
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Marangolo, Paola, Valentina Fiori, Carlo Caltagirone, Francesca Pisano, and Alberto Priori. "Transcranial Cerebellar Direct Current Stimulation Enhances Verb Generation but Not Verb Naming in Poststroke Aphasia." Journal of Cognitive Neuroscience 30, no. 2 (February 2018): 188–99. http://dx.doi.org/10.1162/jocn_a_01201.
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Although the role of the cerebellum in motor function is well recognized, its involvement in the lexical domain remains to be further elucidated. Indeed, it has not yet been clarified whether the cerebellum is a language structure per se or whether it contributes to language processing when other cognitive components (e.g., cognitive effort, working memory) are required by the language task. Neuromodulation studies on healthy participants have suggested that cerebellar transcranial direct current stimulation (tDCS) is a valuable tool to modulate cognitive functions. However, so far, only a single case study has investigated whether cerebellar stimulation enhances language recovery in aphasic individuals. In a randomized, crossover, double-blind design, we explored the effect of cerebellar tDCS coupled with language treatment for verb improvement in 12 aphasic individuals. Each participant received cerebellar tDCS (20 min, 2 mA) in four experimental conditions: (1) right cathodal and (2) sham stimulation during a verb generation task and (3) right cathodal and (4) sham stimulation during a verb naming task. Each experimental condition was run in five consecutive daily sessions over 4 weeks. At the end of treatment, a significant improvement was found after cathodal stimulation only in the verb generation task. No significant differences were present for verb naming among the two conditions. We hypothesize that cerebellar tDCS is a viable tool for recovery from aphasia but only when the language task, such as verb generation, also demands the activation of nonlinguistic strategies.
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Noll, Elizabeth. "Experiencing Literacy in and Out of School: Case Studies of Two American Indian Youths." Journal of Literacy Research 30, no. 2 (June 1998): 205–32. http://dx.doi.org/10.1080/10862969809547996.
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This case-study research focused on the role of multiple literacies in the lives of Lakota and Dakota (Sioux) young adolescents who lived and attended school in a predominately White, rural community in the upper Midwest. In addition to examining the participants' uses of reading and writing, this study explored the ways in which the participants constructed meaning through music, dance, and art. Also studied was the influence of multiple cultures - American Indian culture, school culture, and mainstream popular culture - on the adolescents' transactions with literacy. Data were collected both in and out of school over a period of 7 months. Primary collection techniques included participant observation and fieldnotes; interviews with the participants and their parents, peers, teachers, and administrators; and examination of artifacts. The findings of this study indicate that literacy supported important personal and social needs in the lives of the adolescents. Specifically, through literacy, they explored and expressed their sense of identity and examined critical issues related to prejudice, racism, and discrimination. Numerous questions remain as to the different ways persons experience literacy and illiteracy. How often is literacy defined in relation to illiteracy? How often does it actually signify academic literacy? How do diverse individuals become literate in an inequitable world? - Maxine Greene (1991, p. 129)
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van der Meulen, Marten. "The Importance of Denomination for the Civic Engagement of Migrant Congregations in Amsterdam and Beyond." Ecclesial Practices 5, no. 1 (July 28, 2018): 5–21. http://dx.doi.org/10.1163/22144471-00501005.
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In this article I argue that researchers studying migrant congregations should pay attention to the denominational arrangement in which these congregations find themselves. I compare two contrasting case studies: the case of African (Pentecostal) churches in Amsterdam Southeast and the case of the Spanish-language parish in the centre of Amsterdam. The case studies show that denominational structures can provide resources in the form of buildings, persons and trust. Migrant congregations which don’t have these resources available via denominations, have to find other ways to acquire them.
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LAVRILLIER, ALEXANDRA, and TATIANA YU SEM. "CONTEMPORARY “SHAMANISING PERSONS” AMONG THE TUNGUS-MANCHU (EVENKI, EVEN, AND NANAI): CASE STUDIES ABOUT COMMON COLLECTIVE SPIRITUAL REPRESENTATIONS." Study of Religion, no. 3 (2021): 32–51. http://dx.doi.org/10.22250/2072-8662.2021.3.32-51.
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This article studies common spiritual representations about contemporary Tungus-Manchu “shamanising persons”. It analyses ethnographic material gathered by the authors between 1994 and 2020 among the Evenki, Even, and Nanai of Yakutia, the Amur region, Kamchatka, Novorossiysk, and Khabarovskii krai, as well as the relevant scholarly literature. Under Soviet anti-religious policies, the traditional shamans of these peoples went into significant decline: the last traditional shamans passed away in the 2010s, thus potentially disrupting the transmission of the shamanic function. Nevertheless, according to collective representations, the spirits are still active and continue elect people to become shamans. Our paper argues that these peoples are enduring “ritual wanderings”, wedged between a lack of individuals able to transmit the knowledge required to become a traditional shaman and the fact they reject urban/western neo-shamanism (in contrast to other Siberian peoples like the Buriat, Tuva, Yakut, and Altai). Through the analysis of a mosaic of case studies on shamanising persons who are neither traditional shamans nor neo-shamans, we reveal many relationships with the spirits, the ways these people deal with shamanic election, and the common core of the spiritual representations of the Tungus-Manchu. This paper contributes to the study of contemporary shamanism, Tungus-Manchu cultures, and human-nature relationships.
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Kaniewska-Sęba, Aleksandra, and Beata Pająk-Patkowska. "Negative recommendation in social media – theoretical approach and case studies." Przegląd Politologiczny, no. 3 (September 15, 2017): 45–60. http://dx.doi.org/10.14746/pp.2017.22.3.4.
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The Internet, including the social media services, has considerably changed the manner in which consumers voice favourable or unfavourable recommendations about products and services. Development of social media allowed reaching a significantly greater number of persons in a quicker way. One may also notice that the range of thematic comments has been expanded – customers speak not only about the quality of the products, their prices, service levels, but also about other aspects of how marketing companies function. Finally, it is worth paying attention to the language of these opinions, which – in the case of a negative experience with a product or retailer advertising – is often aggressive. With the development and dissemination of social networking, PR and marketing communications managers must learn how to communicate and satisfy customers and those who express their discontent at different stages of the purchase funnel. This is especially important in the case of negative word of mouth (NWOM) because every negative opinion can become the nucleus of major problems within brand image and the brand crisis. The aim of the article is to show the specificity of word of mouth in social media (sWOM) as one of the forms of electronic word of mouth (eWOM) and to depict phenomenon of NWOM in social media basing on selected case studies from the Polish market.
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O'Nyangeri, Akungah, John Habwe, and Zaja Omboga. "Witness or Interpreter?" International Journal of Translation, Interpretation, and Applied Linguistics 4, no. 1 (January 1, 2022): 1–20. http://dx.doi.org/10.4018/ijtial.314790.
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This study demonstrates that self-interpretation does indeed occur in Kenyan courtroom proceedings, a situation that necessitates the use of a language other than the regular and official languages of Kenyan courts. Such language use rendered mostly in terms of self-interpretation has far-reaching ramifications on the content, facts, style, and meaning predispositions of a witness's testimony. Most studies in courtroom communicative interactions, language, and speech manifestations, have been largely and dominantly sociolinguistic in approach and there is so much that has been asserted in that dimension. However, this study's point of departure is that it seeks to adopt a Translation Studies approach to analyze self-interpreted presentations made by four witnesses in selected criminal cases at Kisii Law Courts in Kenya. Their self-interpreted testimonies which constitute the data used in this discussion were collected between October 2020 and June 2021. The testimonies rendered constituted: one murder case in the high court, one rape case, and two assault cases in the magistrate court. The overarching aim of this study is an attempt to show that, bilingual litigants, who have habitually and for a long time been regarded as persons of limited language competence, can in practical renditions be astute self-interpreting persons in testimony presentation. However, the confrontational experience they undergo throughout has adversarial effects on the facts of the case and the eventual outcomes of such cases, the disadvantages of their competence in L2 (the official language of the court) notwithstanding. Consequently, a translation studies approach, as applied in this paper, offers a framework of reference through which it is possible to analyze the encumbrances of comprehending legal procedures, terminology, and propriety which litigants undergo to accentuate meaning shifts, stem contextual meaning deviations besides the overall factual misrepresentations which emerge during and as a result of self-interpreted renditions as constrained by the contextual imperatives of traditional courtroom language.
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Manzo, Ciro, Jordi Serra-Mestres, Alberto Castagna, and Marco Isetta. "Behavioral, Psychiatric, and Cognitive Adverse Events in Older Persons Treated with Glucocorticoids." Medicines 5, no. 3 (August 1, 2018): 82. http://dx.doi.org/10.3390/medicines5030082.
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Background: Since the introduction of glucocorticoids (GCs) in the physician’s pharmacological arsenal, it has been known that they are a cause of behavioral or psychiatric adverse events (BPAE), as well as of cognitive problems. To the best of our knowledge, the relationship between these adverse events and GCs in older persons has never been evaluated, except through case-reports or series with few cases. In this paper, a review of the literature regarding BPAEs and cognitive disorders in older people treated with CSs is undertaken. Methods: A comprehensive literature search for BPAEs was carried out on the three main bibliographic databases: EMBASE, MEDLINE and PsycINFO (NICE HDAS interface). Emtree terms were: Steroid, steroid therapy, mental disease, mania, delirium, agitation, depression, behavior change, dementia, major cognitive impairment, elderly. The search was restricted to all clinical studies and case reports with focus on the aged (65+ years) published in any language since 1998. Results: Data on the prevalence of the various BPAEs in older patients treated with GCs were very scarse, consisting mainly of case reports and of series with small numbers of patients. It was hence not possible to perform any statistical evaluation of the data (including meta-analysis). Amongst BPAEs, he possibility that delirium can be induced by GCs has been recently been questioned. Co-morbidities and polypharmacy were additional risk factors for BPAEs in older persons. Conclusions: Data on BPAEs in older persons treated with GCs, have several unmet needs that need to be further evaluated with appropriately designed studies.
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Bernsten, Jan. "Lawrence B. Breitborde, Speaking and social identity: English in the lives of urban Africans. (Studies in anthropological linguistics, 11.) Berlin: Mouton de Gruyter, 1998. Pp. xii, 227. Hb DM 198.00." Language in Society 29, no. 1 (January 2000): 136–38. http://dx.doi.org/10.1017/s0047404500271030.
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In the introduction to this book, the reader follows Wilson Nyanforth, a 35-year-old Kru civil servant, through his morning in New Krutown, Monrovia, Liberia. As Nyanforth travels to work, he uses Kru and English separately and in combination, his language choices varying with the setting and the participants in the encounter. His greeting to his boss is an example: “Good morning Honorable Tarpeh, na kl[backwards c]ba (my chief)!” Breitborde's monograph on language choices of Kru-speaking inhabitants of New Krutown has many such specific case studies of language in use: these illustrate his claims and make the book accessible to readers. But his goal is to do more than provide descriptive case studies. He writes: “I ask how the choices urban Kru persons make to speak English embody certain aspects of contemporary social relations and cultural values, not simply within the community of speakers but also linking them to the Liberian national polity. In this sense, then, I attempt to integrate both the (societal) macrolevel and the (individual) microlevel in the exploration of the social meaning of English”.
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Ohito, Esther O. "“Blackness is not just a single definition”: multimodal composition as an exercise for surfacing and scaffolding student theorizing in a Black Studies classroom." English Teaching: Practice & Critique 20, no. 2 (July 12, 2021): 227–44. http://dx.doi.org/10.1108/etpc-05-2020-0047.
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Purpose This study aims to investigate multimodal composition as an exercise or tool for teaching students theory building. To illustrate, an analysis of artifacts comprising a student’s multimodal composition, which was created in response to a multipart literacy assignment on theorizing Blackness, is analyzed. Design/methodology/approach Afrocentricity served as both theoretical moor and research methodology. Qualitative case study, focusing on the case of an individual student, was the research method used. Findings Multimodal composition was an effective exercise for surfacing the multidimensionality of a student’s complex knowledge while simultaneously placing the student in the powerful position of theorist. The process of composing multimodally integrated reading, writing and speaking skills while revealing the focal student’s need for targeted writing intervention. Practical implications The study evidences multimodal composition as a useful exercise for capturing students’ nuanced interpretations or students’ critical theorizing as well as meaningfully incorporating and assessing students’ literacy skills. Originality/value Exposure to preexisting theory alone relegates students to the realm of passive knowledge consumers. This undermines the emancipatory and justice-oriented objectives of critical education, which ideally contributes to social change by challenging dominant power structures and distorted perspectives of marginalized persons. To be empowered agentic learners, students need to be both taught how to theorize and engaged as theorists. This study shows how multimodal composition can be used as a liberatory literacy tool for those intertwined pedagogical purposes.
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Ciccia, Angela, Jennifer P. Lundine, Katy H. O'Brien, Jessica Salley, Sarah Krusen, Bethany Wilson, Jasmin Kunz, and Juliet Haarbauer-Krupa. "Understanding Cognitive Communication Needs in Pediatric Traumatic Brain Injury: Issues Identified at the 2020 International Cognitive-Communication Disorders Conference." American Journal of Speech-Language Pathology 30, no. 2S (April 16, 2021): 853–62. http://dx.doi.org/10.1044/2020_ajslp-20-00077.
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Purpose In early 2020, the second International Cognitive-Communication Disorders Conference was held to provide an opportunity for researchers and clinician-scientists to discuss the most recent advances and pressing issues in the care of individuals with cognitive-communication disorders (CCDs). Presentations and discussions resulted in the identification of four areas in need of attention: (a) terminology, (b) training, (c) interdisciplinary teams, and (d) pediatrics. We will explore the four themes identified at ICCDC, specifically expanding on how terminology, training, and teams intersect in pediatric traumatic brain injury care. Additionally, we will provide two case studies to highlight the integration of these themes and suggest ways to advance clinical service provision across medical and educational settings for persons with CCDs through the lens of pediatrics. Conclusion While speech-language pathology has come a long way since the original discussion of CCD over 30 years ago, clinicians and researchers have ongoing opportunities to help advance the ways in which speech-language pathologists offer support to persons, specifically children, with CCDs and to continue to advance the profession.
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Meulenbroek, Peter, Therese M. O'Neil-Pirozzi, McKay Moore Sohlberg, Rik Lemoncello, Lindsey Byom, Bryan Ness, Sheila MacDonald, and Brian Phillips. "Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury." American Journal of Speech-Language Pathology 31, no. 1 (January 18, 2022): 188–202. http://dx.doi.org/10.1044/2021_ajslp-21-00129.
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Purpose: Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. Method: This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. Results: This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. Conclusions: SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.
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Kuhn-Treichel, Thomas. "A Man Completely Devoid of Falsehood?" Vigiliae Christianae 74, no. 3 (June 2, 2020): 289–302. http://dx.doi.org/10.1163/15700720-12341435.
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Abstract Gregory of Nazianzus is an important case study for the development of autobiography, not only because he is one of the first Christians to write extended autobiographical texts, but also because he does so in verse. This paper addresses two interwoven questions: which strategies does Gregory employ in his autobiographical poems in order to create credibility for his literary self, and which of the motifs that he uses are innovative or specific to his autobiographical poetry? I suggest that Gregory constructs credibility mainly through his relationships with different entities (persons, objects, ideas …) represented in the poems. In some of the relationships (e.g., with his opponents) one can find clear parallels with pagan poets while in others, specifically Christian elements come into play (sometimes blended with pagan traditions). Gregory’s most original idea appears in his relationship with his medium of communication, where one can find a justification for poetic autobiography as a genre.
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Hedtke, Lorraine, and John Winslade. "The Use of the Subjunctive in Re-Membering Conversations with Those Who are Grieving." OMEGA - Journal of Death and Dying 50, no. 3 (May 2005): 197–215. http://dx.doi.org/10.2190/u1wc-wha4-52ge-p2hh.
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The subjunctive voice is often disparaged as no longer of any use in the English language. Here it is argued to have a special place in the construction of possibility in therapeutic conversation with persons who are grieving. In particular, the subjunctive is illustrated in a case study of a re-membering conversation; that is, one in which relational and community membership is considered to live on in a narrative sense after biological death. The argument is that such conversations can produce more sustenance for people in a time of grief than the usual emphasis on confronting “reality” and accepting loss.
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Muratova, Nurie, and Zeynep Zafer. "Political and Scientific Persecutions – the Case of Hayrie Memova-Suleymanova." Balkanistic Forum 29, no. 3 (November 1, 2020): 9–56. http://dx.doi.org/10.37708/bf.swu.v29i3.1.
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The research is focussed on the scientific carrier and life destiny of Hayriye Süleymanoğlu Yenisoy, lecturer of Turkish language at Sofia University, interpreted in the wider frame of the policies of the communist regime to Turks in Bulgaria. We followed how the political events in the second half of the 20th century in communist Bulgaria played a decisive role for the professional carriers of Turkish scientists and lecturers in the country. Their destinies were not exceptions on the background of the persecutions of ideologically unhandy persons by the regime. Our research is related to the entirety of scientific life in the totalitarian Bulgaria, but is focussed on the mechanisms of repressions of Turkish intelligentsia in the context of the policy of the communist power to Turks and other Muslims in Bulgaria. The paper considers the means of destruction of the educated Turkish elite after 1944 and the efforts of the communist regime to create politically loyal new elite among the Turks. But the short flirt of the communist power with the Muslim minorities finished up with the persecution of the elite of the Turkish community who suffered mostly of the increasing assimilation efforts. The regime did away with many representatives of this elite requiring impossible loyalty from them – refusal of their ethnic identity, changing their Muslim names, falsification of scientific facts. The Bulgarian – Turkish thematic dictionary created by Hayriye Memova was convicted of being espionage order from Turkey. She was dismissed from the academic institutions and compelled to survive by working as cleaner in a factory for 4 years. Against her an investigation was initiated by the State Security which lasted for 7 years and included 19 secret agents most of them her colleagues, students and random acquaintances. Nevertheless she defended her PhD and habilitated in Bulgaria, in Turkey where she emigrated in 1989 with thousands of Turks who were expelled from the country, her scientific degrees were not acknowledged and she had to habilitate again in Baku. Following the scientific and personal trajectory of Hayriye Memova who is a representative example of the resistance we followed the policies of the regime to scientific community focussing on the control of the repressive apparat of the regime over the Sofia University.
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Glicksman, Allen, Lauren Ring, and Norah Keating. "Access and Barriers to Use of Long Term Services: Contextual Issues." Innovation in Aging 5, Supplement_1 (December 1, 2021): 426. http://dx.doi.org/10.1093/geroni/igab046.1655.
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Abstract The challenges that some older adults face in accessing both health and social services is a topic of continuing concern. This panel will focus on contextual issues that often shape specific challenges. These contextual issues usually emerge either from issues of diversity among the older persons themselves (for example, minority status or foreign born) and diversity between the ways in which services are offered (usually established at the national or in the case of the United States, at the state level). The intersection of these two forms of diversity often define the specific challenges faced by older persons in accessing health and social services. Further, unexpected events, such as the COVID pandemic, can affect both types of diversity (greater challenges for persons who do not speak the dominant language; inability of services to quickly adapt to radically changed environment). Our panel will address these issues through four presentations, each taking a different look at the ways in which diversity affects access. Our first paper, by Torres, will place this discussion in wider context by presenting results from a scoping review. Our second paper, by Diederich looks at access to services by immigrant generation (that being another source of diversity) in Germany. The third paper, by Thiamwong looks at how the COVID crisis affected older Hispanic women. Finally, Ring will examine how a national policy, here the definition of poverty, affects outcome and access for older person in the United States.
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Mamo, Sara K., Nicholas S. Reed, Carrie Price, Dona Occhipinti, Alexandra Pletnikova, Frank R. Lin, and Esther S. Oh. "Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review." Journal of Speech, Language, and Hearing Research 61, no. 10 (October 26, 2018): 2589–603. http://dx.doi.org/10.1044/2018_jslhr-h-18-0077.
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Purpose The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population. Method A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools. Results Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems. Conclusion Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.
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Molkov, Georgiy, and Miliausha Sharikhina. "Grammatical Features of the Moscow Edition of the Trebnik in the Middle of the 17th Century (on the Material of a Comparative Study of Trebnik by Nikon in 1658 and Trebnik by Peter Mohyla in 1646)." Slavistica Vilnensis 67, no. 1 (September 29, 2022): 23–40. http://dx.doi.org/10.15388/slavviln.2022.67(1).81.
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The paper studies the grammar features that characterize the Moscow revision of the Book of Needs (Trebnik), composed under patriarch Nikon (1658). The research is based on a comparison of Nikon’s and Peter Mogila’s (1646) Trebniks. The study confirmed the scientific statement that Nikonian editors revised the Trebnik in accordance with the recommendations of the Moscow edition of M. Smotritsky’s Grammar. This is shown, for example, in the use of certain endings in the nominal and adjective declension and of the imperative indicator (in the verbs of the first conjugation in the 1st and 2nd persons of the plural). The emergence of hyper-correct phenomena points at to obligatory character of the corrections. One of the main directions of the Nikonian edition was the elimination of grammatical variability and homonymy. To this end, editors fixed one form for expressing grammatical meaning in those cases when the grammar allowed variations, for example, the use of the ending -ѣхъ in the local masculine and neuter plurals, the elimination of the enclitic forms of personal pronouns in the dative case in the adnominal position and their replacement by possessive pronouns, the use of reflexive verbs to express passive in place of combinations of passive participles with the verb byti (быти).
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Trajman, Anete, Sophie Lachapelle-Chisholm, Théodora Zikos, Guilherme Loureiro Werneck, and Andrea Benedetti. "Efficacy and effectiveness of SARS-CoV-2 vaccines for death prevention: A protocol for a systematic review and meta-analysis." PLOS ONE 17, no. 7 (July 28, 2022): e0265414. http://dx.doi.org/10.1371/journal.pone.0265414.
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Background There is consistent evidence that SARS-CoV-2 vaccines have statistical and clinical significant efficacy to prevent incident and severe cases of COVID-19, although different outcomes were analyzed and different risk reductions were observed. However, randomized control trials (RCT) were not designed or powered to assess whether the vaccines prevent deaths, even though this was a secondary or exploratory outcome across many studies. Early real-world observational data suggest that these vaccines are highly effective in reducing hospitalization and all-cause mortality. Our objective is to summarize and appraise—the existing evidence on the efficacy and real-world effectiveness of all SARS-CoV-2 vaccines currently approved for full or limited use to prevent all-cause and COVID-19-attributed mortality. Methods The population consists of persons with a record of vaccination status and the outcome of interest. Randomized controlled trials, comparative cohort and case-control studies reporting vaccination with any of the vaccines approved (intervention) will be eligible. The primary outcome will be all cause deaths. COVID-19-attributed deaths and deaths attributable to the vaccination (adverse event deaths) will be secondary outcomes. We will compare deaths occurring in vaccinated persons versus those non-vaccinated or having received placebo. Studies in any language will be eligible. Two independent reviewers will screen for inclusion and assess quality of studies using the Cochrane Risk of Bias 2 and the ROBINS-1 tool, as appropriate. Hazard ratios will be calculated. Assessment of statistical heterogeneity amongst the studies will be done using I2 and prediction intervals, as well as visual inspection of the forest plots. Publication bias will be assessed using a funnel plot and Egger statistical test if we have more than 10 studies in a forest plot. We have followed the PRISMA-Protocol checklist for the current protocol, which is registered at Prospero (York University, CRD42021262211).
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MASTIN, J. DOUGLAS, and PAUL VOGT. "Infant engagement and early vocabulary development: a naturalistic observation study of Mozambican infants from 1;1 to 2;1." Journal of Child Language 43, no. 2 (June 19, 2015): 235–64. http://dx.doi.org/10.1017/s0305000915000148.
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AbstractThis study analyzes how others engage rural and urban Mozambican infants during naturalistic observations, and how the proportion of time spent in different engagements relates to infants' language development over the second year of life. Using an extended version of Bakeman and Adamson's (1984) categorization of infant engagement, we investigated to what extent a detailed analysis of infant engagement can contribute to our understanding of vocabulary development in natural settings. In addition, we explored how the different infant engagements relate to vocabulary size, and how these differ between the two communities. Results show that rural infants spend significantly more time in forms of solitary engagement, whereas urban infants spend more time in forms of triadic joint engagement. In regard to correlations with reported productive vocabulary, we find that dyadic persons engagement (i.e. interactions not about concrete objects) has positive correlations with vocabulary measures in both rural and urban communities. In addition, we find that triadic coordinated joint attention has a positive relationship with vocabulary in the urban community, but a contrasting negative correlation with vocabulary in the rural community. These similarities and differences are explained, based upon the parenting beliefs and socialization practices of different prototypical learning environments. Overall, this study concludes that the extended categorization provides a valuable contribution to the analysis of infant engagement and their relation to language acquisition, especially for analyzing naturalistic observations as compared to semi-structured studies. Moreover, with respect to vocabulary development, Mozambican infants appear to benefit strongest from dyadic Persons engagement, while they do not necessarily benefit from joint attention, as tends to be the case for children from industrial, developed communities.
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Hillis, Argye E., Peter Barker, Eric Aldrich, John A. Ulatowski, Norman J. Beauchamp, and Wityk Robert. "Improved function and perfusion with pharmacological blood pressure elevation." Stroke 32, suppl_1 (January 2001): 319. http://dx.doi.org/10.1161/str.32.suppl_1.319-c.
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20 A few studies have reported improved function in acute stroke with pharmacological elevation of mean arterial pressure (MAP), but statistical correlations between function and MAP have not been documented. We studied 10 acute-subacute stroke patients before, during, and after MAP elevation (using IV phenylephrine and oral agents), with detailed cognitive tests and serial MR perfusion and diffusion scans to identify relationships between MAP, deficits, and regional perfusion. Cognitive assessment included tests of word and sentence comprehension and naming (for dominant hemisphere stroke), and tests of copying and spatial attention (for nondominant stroke). Separate forms of each test, matched in difficulty, were administered daily. Blinded reviewers measured volume of hypoperfused regions on “time to peak” maps. Results: 5 patients showed striking correlations between MAP and 1 or more cognitive tests: in 4 aphasic patients MAP was highly correlated with both naming and word comprehension (r=.88–96; p<.0005-.002 across cases); in 1 case of nondominant stroke MAP was associated with copying score (r=.90; p<.04). Another 3 patients showed fairly high correlations between MAP and naming (r=.67; .78; .94, respectively) that did not reach significance (p=.06–0.12) likely due to too few data points. For each of these 8 cases increased MAP was associated with improved language or visuospatial function, and subsequent falls in MAP were associated with deterioration in function. The last 2 patients showed no significant MAP elevation with therapy and showed no substantial change in function. In 8/8 patients who showed increased MAP and improved cognition, serial MR perfusion scans demonstrated reduction of regional hypoperfusion while MAP (and function) increased. In 1 case, when MAP fell and function deteriorated, repeat perfusion scan showed reversal of the prior improved perfusion. Both (2/2) patients with no increase in MAP or function showed no improvement of perfusion with therapy. Conclusions: In selected patients with recent stroke, raising MAP can be associated both with improvement in specific domains of cognition and with improved regional cerebral perfusion.
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Foulidi, Xanthippi, Evangelos C. Papakitsos, and Terpsichori Gioka. "Counseling Skills in Intercultural Education: The Case of foreign seas immigrants in Greece." International Journal of research in Educational Sciences 5, no. 2 (March 15, 2022): 451–63. http://dx.doi.org/10.29009/ijres.5.2.8.
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This paper presents some points of view about the counseling psychology skills that are required in intercultural education context. This issue arises from the rather massive migration that has been observed in the European Union countries, since 2007, involving three million persons until 2015. Especially Greece has received directly the largest number of refugees, among the European countries, due to its proximity to Middle East as the Southeastern “Gate” of European Union, amounting to 1.8 million individuals. In addition, 60,000 illegal immigrants and refugees have been trapped in Greece for the last two years. This phenomenon causes extra considerations on behalf of the European and, in particular, Greek counseling agencies and experts. The intercultural education infrastructures of Greece are very limited compared to the existing needs. Less than 0.2% of schools are intercultural ones, while approximately 10% of the country’s pupils are foreigners. In this context, many teachers often discriminate against pupils from other countries and very few schools, besides intercultural ones, dare to organize counseling and support meetings for immigrant parents, usually with the help of volunteer teachers. However, there is also a significant number of teachers who are calling for better and more in-depth information on both general and intercultural counseling, as well as a clear reference to the relevant skills required for this purpose. In intercultural counseling, the counselor and the consulted come from different cultural contexts and have different perceptions. However, counseling can help them to deal with social exclusion. The needs of minority populations and vulnerable social groups, in general, are particularly high in terms of professional development, as they need the appropriate knowledge to lead their members in the search for educational opportunities, opportunities for social participation, vocational rehabilitation, but also clarification of professional goals. The effectiveness of a counselor on intercultural counseling is based on cultural awareness and sensitivity to accept and respect the cultural differences. A counselor must find a way to overcome any inhibitory obstacle, such as language, but the most important thing that needs to be understood is that counseling cannot be practiced in a mono-cultural direction, as it was the case until recently, but has to turn to methods of multicultural thinking and action.
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Morehouse, Sarah Nanami, Ashley Stripling, Kirenia Brunson, Jodie Maccarrone, Jessica Choe, Julian Garcia, and Nicholas Boston. "Adapting Psychotherapy for Comorbid Substance use and Bipolar Disorder in Older Sexual Minorities: A Case Study." Innovation in Aging 5, Supplement_1 (December 1, 2021): 990. http://dx.doi.org/10.1093/geroni/igab046.3556.
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Abstract Approximately 65 to 95% of individuals with bipolar disorder (BD) are diagnosed with an additional psychiatric condition (Kessler, 1999). Alcohol, the most commonly abused substance amongst individuals with BD (Xiao et al., 2016), has been linked to significant increases in suicide attempts, disability, hospitalizations, and mortality (Baldessarini et al., 2008; Goldberg et al., 1999; Mitchell et al., 2007; Nery & Soares, 2011). Despite these ill effects, little is known about how to effectively treat, or adapt existing treatment appropriately, for the growing numbers of individuals who are dually diagnosed with BD and alcohol use disorder (AUD) and hold the identity of lesbian, gay, bisexual, transgender, or queer (LGBTQ) in late life. Thus, the purpose of this study is to demonstrate how treatment was adapted to a self-identified gay man with comorbid BD and AUD from a relational, culturally sensitive perspective while simultaneously implementing two short-term interventions: cognitive behavioral therapy (CBT) and a behavioral substance use program. In line with Knight & Poon’s (2008) Contextual Life Span Theory for Adapting Psychotherapy with Older Adults (CALTAP) and a multicultural lens that incorporates relevant research on older LGBTQ individuals, modifications were made to the content, structure, language, and duration of therapy while cultivating a safe and empathic space. Idiographic data and progress monitoring measures suggests treatment resulted in substance use and distress reduction, as well as mood stabilization. However, additional booster sessions may be advantageous given the risk for substance abuse relapse and the compounding effect it may exert on persons with BD.
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Nsenga, Lauryn, Jonathan Kajjimu, Ronald Olum, Sandra Ninsiima, Andrew Peter Kyazze, Phillip Ssekamatte, Davis Kibirige, Joseph Baruch Baluku, Irene Andia-Biraro, and Felix Bongomin. "Cryptococcosis complicating diabetes mellitus: a scoping review." Therapeutic Advances in Infectious Disease 8 (January 2021): 204993612110147. http://dx.doi.org/10.1177/20499361211014769.
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Background: A better understanding of the epidemiology of cryptococcal infection in HIV-negative individuals is an international research interest. Immune dysfunction in diabetes mellitus (DM) significantly increases the risk of acquiring and reactivation of infection due to Cryptococcus neoformans. Risk factors and outcomes of cryptococcosis in DM are not well documented. Objective: The objective of this study was to determine the clinical characteristics and outcomes of cryptococcal infections in persons living with DM. Methods: MEDLINE (via PubMed), EMBASE, and the Cochrane Library databases were searched in November 2020. The searches covered the period between 1980 and 2020.We included studies that reported confirmed cryptococcosis in patients with DM. Reference lists of included articles were also searched, and additional studies were included if appropriate. No language restriction was applied. Single case reports, case series and original articles were included whereas review articles were excluded. Results: A total of 28 studies (24 single case reports, 4 retrospectives) were included involving 47 unique patients from Asia (17 cases), North America (six cases), South America (three cases) and Africa (two cases). Men constituted 75% ( n = 18) of the cases. Median age was 60.5 (range: 27–79) years. The majority of the patients had cryptococcal meningitis (68.1%, n = 32) followed by disseminated cryptococcosis (6.4%, n = 7), and others (isolated cutaneous disease one, peritonitis one, pleural one, thyroid one, adrenal one). Diagnosis was achieved through either culture and microscopy (38/47), cryptococcal antigen tests (9/47) or histopathology (9/47) singly or in a combination. All-cause mortality was 38.3% ( n = 18). Among those with meningitis mortality was 36.2%. Conclusion: A wide spectrum of cryptococcal infections with varying severity occurs in DM. Mortality remains unacceptably high. There is a need for more studies to characterize better cryptococcal disease in DM.
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Sanders, Robert E. "The representation of self through the dialogic properties of talk and conduct." Dialogue and Representation 2, no. 1 (May 12, 2012): 28–40. http://dx.doi.org/10.1075/ld.2.1.02san.
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It is a basic dialogical principle that the meaning of what is said or done is based on its similarities and especially its differences with other things that might have been said or done as relevantly instead, just then, just there. This makes what was actually said or done meaningful as a “choice” for all practical purposes, whether the actor made it consciously or not. And any choice a person makes (or is deemed to make) is revealing about what he or she had in mind — his or her intentions and wants, values and affects, character and qualities as a social being — that subjectively warranted producing what was said or done instead of one of the alternatives. What one’s talk and conduct reveal about what one had in mind constitutes a representation of one’s self as a social being. This representation is a persona, a “face” in Goffman’s sense. This representation is discursively, dialogically produced, such that actors’ talk and conduct will unavoidably produce a representation of themselves regardless of whether they intend it. Accordingly, persons who would not be expected to have such competence nonetheless produce representations of self, for example young children or impaired adults. Insofar as those representations are in the person’s self-interest, there is a warrant for considering that they have that competence after all. In contrast, persons who can be expected to have such competence may nonetheless produce representations that work against their self-interest by accident or deficiencies of performance. Arguably, it is an additional dimension of the representation of self that an actor produces, having to do with his or her competence, whether the representation seems to be intentional, and beyond that, artful or clever. I examine two cases to elaborate on the key propositions here: (a) that representations of self are produced whether intended or not, (b) that ones that seem to be intended because they are in the actor’s self-interest are evidence of his or her competence, and (c) that ones that seem unintentional because they are not in the actor’s self-interest are evidence of a performance lapse, or more broadly, deficiencies of competence. The first case is of two young children whose talk and conduct interactively produce representations of self that do serve their respective interests, and thus warrant reconsideration of the expressive and interactional competence of children of that age. The second is of a doctor in an urban clinic whose representation of self is not in his self-interest.
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Werner, Christian, Phoebe Ullrich, Milad Geravand, Angelika Peer, and Klaus Hauer. "Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review." Gerontology 62, no. 6 (2016): 644–53. http://dx.doi.org/10.1159/000444878.
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Background: Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application. Objective: The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies. Methods: A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language. Results: Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated. Conclusions: Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment strategies may additionally focus on specific functionalities of the robotic rollators allowing an individually tailored assessment of innovative features to document their added value.
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Allen, Anna A., and Howard C. Shane. "The Evaluation of Children with an Autism Spectrum Disorder: Adaptations to Accommodate a Telepractice Model of Clinical Care." Perspectives on Telepractice 4, no. 2 (September 2014): 42–51. http://dx.doi.org/10.1044/teles4.2.42.
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Telepractice is increasingly applied to assessment and intervention for persons with autism spectrum disorders (ASD), and the use of telepractice for delivering augmentative and alternative communication (AAC) services is expanding. To date, no studies have focused on the assessment of communication in children with ASD who are minimally verbal. This case exploration represents a first attempt to apply the clinical assessment approach (also known as Visual Immersion System) developed in the Autism Language Program in the Center for Communication Enhancement (CCE) at Boston Children's Hospital (BCH) through a telepractice service delivery model. In this paper we detail an on-site evaluation, and then describe the application of the various evaluation components to telepractice delivery. Our findings provide preliminary evidence that communication assessment information can be successfully obtained for this population via telepractice. The results demonstrated that the telepractice evaluation took greater time to complete than the on-site evaluation, likely due to both technical and cultural factors. Further study is warranted particularly in the delivery of family instruction materials prior to the evaluation and to quality assurance measures.
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Mulindwa, Frank, Habiba Kamal, Barbara Castelnuovo, Robert C. Bollinger, Jean-Marc Schwarz, and Nele Brussealers. "Association between integrase strand transfer inhibitor (INSTIs) use with insulin resistance and incident diabetes mellitus in persons living with HIV: A systematic review and meta-analysis protocol." PLOS ONE 17, no. 3 (March 2, 2022): e0264792. http://dx.doi.org/10.1371/journal.pone.0264792.
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Introduction Poeple living with HIV have higher prevalence of diabetes mellitus and metabolic perturbations compared to non-HIV populations. Diabetes and metabolic syndrome co-morbidities add significant burden to HIV care. Currently, WHO recommends integrase strand transfer inhibitors (INSTIs) as the first or second line therapy in people with HIV due to overall good tolerability and safety profile. However, whether INSTI use increases the risk of incident diabetes (with or without metabolic syndrome) compared to other anti-retroviral therapies (ART) is controversial. In this systematic review and meta-analysis, we aim to examine this risk in HIV-positive populations receiving INSTIs compared to other ART regimens (not containing INSTIs). Methods and analysis The study will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. This protocol adheres to the Standard Protocol Items for reporting systematic reviews and meta-analyses checklist. Eligibility criteria will be original peer-reviewed published articles and conference abstracts with no language or geographical restriction; that report the ocurrence of diabetes mellitus as a discrete outcome or part of metabolic syndrome, in adult PLWHIV receiving INSTIs compared to other ART regimens. PubMed/ Medline, Web of Science, Embase and Cochrane Database of Systematic Reviews will be searched from 1st- January-2000 to 31st—January-2022. Per our a priori, screening, inclusion and data extraction will be conducted separately by two investigators, and a senior researcher will be consulted in case of disagreement. The quality of included studies will be assessed by the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies and the revised Cochrane risk-of-bias tool (ROB2) for randomized controlled trials. The quantitative synthesis of the study outcomes will be explored in different subgroups and sensitivity analyses. Meta regression will also be performed to further test the predictors of the outcome. Ethics and dissemination Ethical approval is waived as the study is a review of published litterature. The analyses will be presented in conferences and published as a scientific article. Trial registrartion PROSPERO registration number is; CRD42021273040.
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Kessler, Rainer. "Debt and the Decalogue: The Tenth Commandment." Vetus Testamentum 65, no. 1 (January 28, 2015): 53–61. http://dx.doi.org/10.1163/15685330-12341181.
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This article seeks to demonstrate that the question of debt is present in the Decalogue. It is included in the last (or the last two) commandments: “You shall not covet your neighbour’s house; you shall not covet your neighbour’s wife etc.” (Exod 20:17). Obviously, this commandment must have a meaning that differs from the commandments not to commit adultery and not to steal. The main means for taking over possession of the goods of others, besides stealing them, was debt. The loan of goods or money involved the handing over of a pledge. If the debtor was unable to repay the debt he lost fields and houses. Mic 2:1-2, where the same word “to covet” is used as in the Decalogue, is best explained by such mechanisms of the old Israelite debt system: the rich and powerful who “covet fields” do “seize” fields and houses because their current owners are not able to refund their debt. What is true for mobile and immobile goods is also true for persons. Neh 5:1-5 demonstrates that daughters and sons had to be given away as slaves because parents were “having to borrow money”. In dire straights, it was also possible that a wife could become the slave of another. In Elephantine a case is documented in which the wife of one man at the same time is the slave of another. So the commandment of the Decalogue not to “covet your neighbor’s wife” has nothing to do with sexual relations. It forbids the desire to take one’s neighbour’s wife as a slave in one’s own household.
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Nah, Alice M. "Recognizing indigenous identity in postcolonial Malaysian law: Rights and realities for the Orang Asli (aborigines) of Peninsular Malaysia." Bijdragen tot de taal-, land- en volkenkunde / Journal of the Humanities and Social Sciences of Southeast Asia 164, no. 2 (2008): 212–37. http://dx.doi.org/10.1163/22134379-90003657.
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In Southeast Asia, the birth of postcolonial states in the aftermath of the Second World War marked a watershed in political relations between ethnic groups residing within emerging geo-political borders. Plurality and difference were defining characteristics of the social landscape in these nascent states. Colonial laws and policies that divided groups and territories for efficient control influenced the relations between linguistically and culturally distinct groups. The transfer of power to ‘natives’ during decolonization often resulted in indigenous minorities being sidelined politically and legally. Indigenous minorities in Southeast Asia continue to negotiate for more equitable inclusion in contemporary postcolonial states. In some cases, such as in Myanmar, Thailand, Indonesia and the Philippines, these have escalated into separatist movements. Other indigenous minorities however, struggle for the recognition of their identity and rights through – rather than apart from – existing state mechanisms of power, for example by lobbying for changes in existing laws and bringing cases to court. The struggle for recognition of the legal rights of indigenous minorities began, however, before the process of decolonization; colonial powers contended with politically dominant indigenous majorities as they tried to exert influence over territories, and this had impacts on indigenous minorities. The British method of colonization, in particular, which sought to attain ‘indirect rule’ without using military conquest, required the identification and recognition of native structures of power. British administrators exerted influence through the ‘invitation’ of local rulers, which meant that domestic laws and administrative policies were developed as a result of negotiation rather than through direct imposition of English laws and policies. As a result, the legal structures put in place during decolonization meant that some recognition of indigenous customary practices was already incorporated, albeit for certain indigenous groups and not for others. In order to recognize and protect the ‘special rights’ of indigenous persons, it became vital to define the legal identity of individuals. It was necessary for British administrators to determine which groups were ‘indigenous’, what specific criteria were required for demonstrating membership of these groups, and when disputes occurred, to determine which individuals possessed a legitimate claim of belonging. They also had to decide if the rights and privileges were accorded on a group or individual basis. These decisions are neither ahistorical nor apolitical. In this paper, I examine the contemporary case of the Orang Asli, the minority indigenous peoples of the Malay Peninsula. I begin by providing an outline of political developments that have resulted in the legal recognition of three groups of people as having indigenous status. I also review the evolution of the Malaysian legal system in order to provide a context for subsequent discussion. I then look at how Orang Asli are recognized in the Federal Constitution and in statutes, with reference to case law, as the meaning and weight of these written laws were elaborated in court judgements. I then look at three court cases, reviewing the right to engage in commercial activities in aboriginal places as decided in the Koperasi Kijang Mas Bhd & Ors v. Kerajaan Negeri Perak & Ors (1991), hereafter referred to as the Koperasi Kijang Mas case; the recognition of native title and usufructuary rights as recognized in Adong Kuwau & Ors v. Kerajaan Negeri Johor & Anor (1997), hereafter referred to as the Adong Kuwau case, a judgement upheld in the Court of Appeal (Kerajaan Negeri Johor & Anor v. Adong Kuwau & Ors (1998) and the Federal Court;2 as well as proprietary rights in and to the land which were recognized in the Sagong Tasi & Ors v. Kerajaan Negeri Selangor & Ors (2002) ruling, hereafter referred to as the Sagong Tasi case, upheld in the Court of Appeal (see Kerajaan Negeri Selangor & Ors v. Sagong Bin Tasi & Ors (2005) but currently under appeal in the Federal Court. These cases demonstrate how Orang Asli have drawn on international legal frameworks to claim special privileges in ways not possible for other Malaysians, on the basis of their identity.
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Gardner, Anne-Christine, Marianne Hundt, and Moira Kindlimann. "Digitization of the Mary Hamilton Papers." ICAME Journal 41, no. 1 (March 1, 2017): 83–110. http://dx.doi.org/10.1515/icame-2017-0004.
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Abstract Held at The John Rylands Library, Manchester, the Mary Hamilton Papers are a valuable, but still largely untapped resource for linguistic, cultural and literary studies focussing on the late eighteenth century. In her diaries Lady Mary Hamilton (1756-1816) documents daily life and friendships with intellectual figures of the time, for instance Horace Walpole and members of the Bluestocking circle, which included Elizabeth Montagu and Frances Burney. The archive also contains letters written to Lady Mary Hamilton by her family and other members of her social network. The aim of this project is to prepare a digital edition of materials from the Mary Hamilton Papers with TEI-conformant XML mark-up, in which both a facsimile of the manuscripts and their transliterations (preserving the original spelling, punctuation and layout) will be displayed. In addition, the edition will offer rich meta-data and mark-up of places, persons and literary works, as well as normalized spellings, which will assist searches for linguistic features differing from Present-day English such as (non-)capitalisation (e.g. english, Breakfast) and past tense spellings like dress’d and staid. Drawing on material from the Mary Hamilton Papers and the Corpus of Late Modern English Prose, we provide a case study to illustrate the usefulness of the Mary Hamilton Papers for the study of language change and social networks in the Late Modern period.
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Walsh, Mary, and Aideen Lawlor. "240 Assisted Decision Making (Capacity) Act 2015: Embracing the Paradigm Shift." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.144.
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Abstract Background In a conference 2018, Senator Kelleher said she concurred with the statement describing ADMA “…. as a paradigm shift…a major, major culture shift which has yet to work through our societal systems….”(1) In 2016, a senior and manager speech and language therapist (SLT) won the Dementia Elevator Innovation Award with the project “Empowering Persons with Dementia to Become More Active Participants in Decision Making Related to Their Present and Future Needs”. The IASLT Position Statement on the role of the speech and language therapist (SLT) in assessing Capacity and Facilitating Understanding to Support Decision Making for Adults with Communication Disabilities 2017 names training others in assisted decision making as a key SLT role. Talking Mats (TM) (2) may help address some training issues outlined. TM is discussed in NICE-Capacity Guidelines 2018. The Phase 1 project outlined recommends progression to Phase 2. Methods In 2018, the senior SLT trained SLTs working professionally with people with dementia across different service settings. They made a prior commitment to attend and complete the course and to trial TM with people with dementia. Results The Phase 1 report Dec 18 contains 16 brief case studies. Some initial findings: Facilitates strengths rather than deficits.Helpful for assisted decision-making when listeners are trained.Pictures help maintain attention and aid comprehension.Pictorial record of photographed TM viewed very positively, particularly for meetings.Video recording sessions, with consent, greatly enhances reflective practice.It helped address the unmet needs of one person with dementia who presented with responsive behaviour. Conclusion Talking Mats was strongly endorsed by all participants. Recommendations in Phase 1 report 2018 included progressing to Phase 2 i.e. training the six SLTs to become TM trainers and commence cascading through the system. We are currently awaiting funding approval.
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Kang, Eun-Hyeon. "Overview of the Revised Act on Private International Law Related to the International Jurisdiction of Kinship and Inheritance Relationship." Korea Association of the Law of Civil Procedure 26, no. 3 (October 31, 2022): 233–78. http://dx.doi.org/10.30639/cp.2022.10.26.3.233.
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The revised act on private international law was promulgated on January 4, 2022, by passing the plenary session of the National Assembly on December 9, 2021, and is implemented on July 5, 2022. This revision of private international law is intended to materialize Article 2 of the past private international law (Act No. 13759, before being fully amended as of January 4, 2022, hereinafter referred to as 'past private international law') about international judicial jurisdiction.
Many attempts have paid off, and this amendment contains new details and details of international judicial jurisdiction to the extent that it is a new enactment of the law. One thing to keep in mind when determining the international jurisdiction in domestic cases is that the person at procedural inferiority must be protected. In particular, in domestic non-litigation cases where there is no other party, the review must be made in terms of guaranteeing the basic procedural rights of persons who will become warded persons or minors who are not formal parties but are the actual parties who will receive the effect of the trial directly. Each case should be reviewed to determine the existence of international jurisdiction.
Since the revised private international law stipulates more political jurisdiction, especially in domestic cases, after the amended law goes into effect in the future, private international law is first applied to determine the existence of international judicial jurisdiction, and the In cases where the exercise is inappropriate, the case will be resolved in a way that faithfully embodies the idea of the distribution of international jurisdiction in individual cases by not exercising the jurisdiction as an exception. Through this, it is expected that the predictability of the court and the parties in international domestic cases can be greatly improved, and it is expected that it will greatly contribute to guaranteeing legal stability in the process. However, since international jurisdictional rules change with the times and circumstances, it is necessary to reexamine the international jurisdictional rules in the future.
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Latinytė, Rūta. "Not a Gift: Phenomenological Research of Everyday Experience." Tautosakos darbai 57 (June 1, 2019): 34–53. http://dx.doi.org/10.51554/td.2019.28426.
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By using approaches of phenomenological anthropology and research of everyday experience, the author of the article introduces a possibility to study practices of gift giving and receiving, occurring in modern social life. Special attention is paid to a peculiar case of the gift giving – when a gift is not given, and the act of gift giving does not take place.Every instance of gift giving or losing presents a unique moment in the life of an individual experiencing the world. The author analyzes descriptions of experience and qualitative unstructured interviews with commentaries, conducted especially for the purposes of this study, as well as her own experiences, which is typical for the method of phenomenological research. Various experiences of gift giving that did not take place are presented in the article. The first one can be defined as refusing of the gift – when an individual bringing a whiskey bottle in gratitude for his boss’s help was kicked out from the latter’s office. The second case comprises instances of memory loss from the perspective of the gift giver and the receivers. Numerous interviewees were not able to remember any gifts received from their spouses, although the gift exchange in the family was practiced during holidays every year. However, the gifts that some close persons had forgotten to give, or that were repeatedly given, present quite another matter from the point of view of the giver that still remembers them. The third case comprises the gift that was meant yet not given – a work of art dedicated to a well-known musician, but staying in the interviewee’s home. The fourth case centers on a dramatic story of a woman who abnormally accumulated stuff in her house during her whole life, but has not once given anything to her family. After her tragical demise in a fire, her family members found various things at her home and reshaped their personal attitude towards her, making the author to reconsider her attitude as well.The analysis reveals ways in which the ungiven gifts both reflect and affect the interpersonal relationships, and possible meaning and place of these experiences in people’s memory. The impossibility of the gift giving is recognized in every story as a state of uneasiness, as a certain lapse in time. It indicates a shift in perception of the interpersonal relationship and highlights the necessity of re-evaluation of the relationship that was supposed to be established by the ungiven gift.The ungiven gift puts people off their stride, depriving them of the possibility of time for a while: it makes them understand that the Other is actually different from that Other, who the subject imagined existing in their mutual relationship. The rational consciousness feels lost, and until it finds another “I” in relation to the Other, the only possible relationship is the one between “I” and “Myself”, which is separated from the world, time, and existence. However, the individual can move from the state of passive helplessness and adopt an active role in the mastership game. The concept of the mastership game presupposes an objective to influence the world that does not belong to the individual like the Other, but can be appropriated as a masterfully created game instead, subsumed by way of recognizing the meaning.The mastership game is a creative movement that presupposes searching for a new meaningful form. Thus, the gift is also a creative act: while being unable to influence the Other, the subject becomes engaged in a game and replaces the intersubjective relationship with a connection between the subject and the object (gift). Therefore, two mutually immanent subjects are related by the gift that makes their interrelationship meaningful; or, likewise, become separated, when the gift is not given.
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Gerpott, Torsten J., and Nima Ahmadi. "Use levels of electronic government services among German citizens." Transforming Government: People, Process and Policy 10, no. 4 (October 17, 2016): 637–68. http://dx.doi.org/10.1108/tg-05-2016-0025.
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Purpose To better understand the use intensity of e-government service offerings among citizens, a considerable number of studies have examined correlations between various attitudinal constructs related to such offerings and citizens’ service adoption (intentions). This investigational paper aims to take a different angle by exploring associations between a set of 11 objectively identifiable household and individual behavioral and socio-demographic characteristics on the one side and three levels of e-government services use on the other. Design/methodology/approach The empirical analysis is based on survey responses of a random sample of 17,012 individuals residing in Germany. Findings Ordinal logistic regression analysis suggests that citizens with low use levels of public e-service offerings are most likely younger male persons with low levels of computer literacy, internet affinity and education, who have a migration background and live in small mid-level-income households located in rural communities. Practical implications The findings imply that public institutions may find it difficult to rapidly raise e-government acceptance by distributing only “technocratic” information explaining various service options. Public authorities should consider supplementing “pure” information programs by measures which ensure that the software of e-government service platforms is designed in a way guaranteeing a very high level of “usability”. Furthermore, they should analyze whether the benefits of providing e-government services in specific foreign languages outweigh the costs of such a service extension. If this is the case, an easy-to-use software menu item should be introduced which enables citizens to switch to another common foreign language. Originality/value The contribution of this paper results from the analysis of a set of objective predictors of e-government service use in a large random sample of citizens residing in Germany, whereas most prior studies are based on surveys of small convenience samples in other countries.
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Wang, Michael, Anissa Cyhaniuk, David L. Cooper, and Neeraj N. Iyer. "Identification of Persons with Acquired Hemophilia in a Large Electronic Health Record Database." Blood 126, no. 23 (December 3, 2015): 3271. http://dx.doi.org/10.1182/blood.v126.23.3271.3271.
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Abstract Background: Electronic health records (EHR) capture rich clinical information on a patient's encounter with their health care system. Studying national EHRs has the potential to provide epidemiological and granular clinical insights of the patient's diagnosis, treatment patterns and clinical outcomes. Acquired hemophilia (AH) occurs in 1:1-1.5 million people and is characterized by anti-factor VIII autoantibodies, and bleeding in elderly and post-partum patients often in the absence of prior bleeding history. The AH literature includes case reports and registries of known patients; no study to date has attempted to extract population-level information using a large EHR. Objective: This study aimed to identify patients with AH using a large EHR for the purposes of studying treatment patterns. Methods: This retrospective study attempts to identify AH patients by combining standard identification methods used in secondary database analysis along with clinical information from the EHR, and a text search of physician notes using Natural Language Processing (NLP) output. Records were accessed from a large, national, de-identified, longitudinal EHR database (Humedica) between January 1, 2007 and July 31, 2013. Given the rare nature of the disease, broader selection criteria were initially applied by using an ICD-9 code for hemorrhagic disorder due to intrinsic circulating anticoagulants (286.5 and all sub-codes), and confirmation of records in the EHR, 6 months before and 12 months after first (index) diagnosis. Additional selection criteria were: no anticoagulant use, not having a diagnosis of systemic lupus erythematosus, accessible physician notes, membership in an integrated delivery network (IDN), mention of "bleeding" within physician notes, and a normal prothrombin test (PT) but an elevated activated partial thromboplastin time (aPTT). Results: From 6,348 patients with a diagnosis code of 286.5 or any sub-codes, there were 20 males and 18 females who met selection criteria. The median age was 78.5 years (age top coded at 89 years). Table 1.Total usable patients13,000,000100%ICD-9 286.5*6,3480.049%With pre/post diagnosis records4,2120.032%Without anticoagulant1,1670.009%Without lupus/SLE1,1250.009%With physician notes and IDN3990.003%NLP "Bleeding"2550.002%NLP "Bleeding" and PT/aPTT1140.001%NLP "Bleeding" and normal PT/elevated aPTT380.0003% All 38 had a note for "pain" (most commonly chest [66%] and back [50%]), 21 (55%) had a note for "bruising", while none of the females had an ICD-9 code for abnormal menstruation or pregnancy. All 286* diagnoses for the 38 patients included: Table 2.286.0Congenital hemophilia A3 (8%)286.5Hemorrhagic disorder due to intrinsic circulating anticoagulants26 (68%)286.52Acquired hemophilia1 (3%)286.59Other intrinsic anticoagulant, antibody or inhibitor5 (13%)286.7Acquired factor deficiency3 (8%)286.9Other and unspecified5 (13%) No patients received typical AH treatment for bleeding (factor VIII, bypassing agent or DDAVP). The most common prescriptions were azithromycin (34%) and prednisone (32%). Data review: Individual Signs, Diseases, and Symptoms (SDS) associated with the patient via NLP key word extracts were randomly reviewed to validate if the identified cohort indeed had AH. (1) >89-year-old male; ~6 months of bruising and ecchymoses, "suspect" "clotting factor deficiency". (2) 70-year-old female breast cancer patient; isolated mention of hematemasis from Mallory-Weiss tear, multiple mentions of hematuria, hemorrhagic cystitis, and paradoxically a renal pelvis blood clot in the SDS on the same date. (3) A 32-year-old pregnant female reports bruising and irregular menses, and conflicting mention of venous thrombosis and blot clots. NLP output included FVIII deficiency, and there was mention of congenital and FVIII inhibitor. All 3 had bleeding symptoms, normal PT and elevated aPTT, but none had AH diagnosis or hemostatic treatment. Conclusions: NLP approaches to analysis of EHRs hold promise and have demonstrated utility in population-based studies for some disorders. However, in this study, ICD-9 codes, lab results, NLP output, and treatments were not consistently aligned. This study highlights that in ultra-rare disorders, ICD-9 coding alone may not be sufficient to identify cohorts, and multimodal analysis combined with in-depth reviews of physician notes might be more effective. Disclosures Wang: Novo Nordisk: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees; Biogen: Membership on an entity's Board of Directors or advisory committees; Baxalta: Membership on an entity's Board of Directors or advisory committees. Cyhaniuk:Novo Nordisk Inc.: Consultancy. Cooper:Novo Nordisk Inc.: Employment. Iyer:Novo Nordisk Inc.: Employment.
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Edgar, Debra L., and Peggy L. Bargmann. "Clinical Study of the Effectiveness of Constant Therapy in the Treatment of Clients With Dementia: Implications for Telepractice." Perspectives of the ASHA Special Interest Groups 6, no. 3 (June 25, 2021): 691–703. http://dx.doi.org/10.1044/2021_persp-20-00123.
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Purpose The purpose of this clinical focus article was to advance interventions for person living with dementia by exploring the implications of integrating technology through telepractice to strengthen memory in clients with dementia. This study focused on individualized treatment plans using the software Constant Therapy (CT) for clients with dementia. Method This study utilizes an exploratory research design with nonprobability sampling of existing data analyzing the frequency, duration, and percent correct of CT exercises completed from two case studies of persons living with dementia. This study received exempt status for institutional review board approval from the Florida Department of Health, since it is secondary research. One participant had been diagnosed with Alzheimer's disease, and the other participant had vascular dementia. Both clients utilized CT as part of the clinical services provided by the University of Central Florida's Communication Sciences and Disorders Clinic at Brain Fitness Academy. Results The results of this exploratory research study indicate that both participants demonstrated an increase in percentage correct on CT exercises from baseline to current (Participant 1, 70%, and Participant 2, 50%). A substantial disparity of exercises completed confirms the necessity of an individualized treatment plan based on a specific type of dementia. Both participants demonstrated a 631% and 632% increase respectively in exercises completed at home versus in the clinic. This finding is especially significant as it relates to telepractice. Conclusion This study adds to the literature that clients with dementia demonstrate substantial improvement in global cognitive function when speech-language pathologists provide skilled individualized services using the digital software CT, whether in traditional or remote clinic settings.
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Džekčioriūtė-Medeišienė, Vita. "Scaring of Children in the Traditional Lithuanian Worldview." Tautosakos darbai 51 (June 27, 2016): 177–94. http://dx.doi.org/10.51554/td.2016.28890.
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By scaring, the author means short phrases uttered by the grown-ups in order to encourage acceptable behavior of kids, e.g. ‘If you walk by the rye field, rusalka will come out and take you away’ (LII ES 508/77 p. 153). This phenomenon of Lithuanian folklore, pedagogics and culture in general has hitherto attracted not enough scholarly attention; therefore, this article aims at elucidating its most important features and forms of expression.It is not entirely clear, to what folklore genre these forms of scaring should belong. They are close to folk beliefs in terms of their typical structure and manifestations of mythical worldview. However, the scaring presents reaction to certain situations and circumstances, thus being similar to situational sayings. Quite frequently, such occurrences stem from a broader social and mythological background, therefore being capable of evolving into folk legends or ritual-like imitation practices.The scaring of children functions on a twofold basis. Since scaring describes the surroundings and the applicable rules of behavior, it embodies the sensual experience. Children can experience some scary subjects directly (seeing them), while perceiving others through their mythical dwelling places (darkness, reflection in the well, the wavy rye, etc.) or sounds. The diminished possibilities of sensual experience and the obscurity determine the mythical code present in the scaring of children. The opposition between one’s own vs. foreign also plays an important role here: the foreign things tend to be more mythologized and frightening. The relation to reality makes scaring effective here and now, while mythical level encourages children’s imagination and curiosity, making the scaring remarks very catchy.The scaring very much depends on the situation and changes easily; therefore, classifying these instances according to a single criterion is difficult. This article lists four ways of classifying the scaring of children: according to form (the way of presenting the scary things to kids), to the scary subject (what the kids are intimidated with), to the space (how scary things are located in the living surroundings), and to the purpose (what scaring is meant to achieve). Formally, children can be scared with songs (phrases inserted into the lyrics of lullabies), rhymed situational phrases or simple verbal warnings. According to the subject, the material falls into four groups: scaring with no subject (threatening children with physical destruction or some unpleasant physical consequences); threatening with really existing, although mythologized persons (foreigners, beggars, wizards); threatening with mythologized animals; and threatening with mythical beings. According to space, there are also four groups of scaring instances, i.e. those associated with home, yard, close extraneous space, and distant extraneous space. Such scaring reflects psychophysical development of children and their range of spatial movement. The purpose of scaring may include appropriate everyday behavior of children or their ritually meaningful conduct. In the first case, children have to behave appropriately in terms of physiology or social meaning. Besides, by use of such scaring children are kept away from dangerous places (like wells, water pools, forests) or places important to the social welfare are safeguarded from them (including orchids, gardens, crops). The ritually meaningful scaring depends either on the stage of the child’s development or on the festive periods that require certain norms of behavior.The scaring of children constituted an inherent part of the Lithuanian peasant life in the second half of the 19th – the first half of the 20th century. Its prime purpose was forming appropriate social behavior of children. The secondary, although no less important, function was shaping their practical knowledge and mythical worldview. The patterns of scaring altered along with the child’s development, adjusting to the circumstances and the child’s physiologic capacities, yet in turn stimulating the psychophysical development of children as well.
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Foster, Talia S., Jeffrey D. Miller, Mark E. Boye, and Mason W. Russell. "Review of Current Patterns of Treatment and Costs in Follicular Non-Hodgkin’s Lymphoma." Blood 112, no. 11 (November 16, 2008): 4676. http://dx.doi.org/10.1182/blood.v112.11.4676.4676.
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Abstract Introduction Follicular non-Hodgkin’s lymphoma (FNHL) comprises about 15–30% of all incident NHL in developed countries. US SEER data show that the annual incidence rate per 100,000 persons is 3.0 and 1.3 (white and black males, respectively) and 2.7 and 0.9 (white and black females, respectively). Patients with this slow-growing malignancy may live for 10 years or more, but it is considered incurable with standard treatment. The common disease pattern is a series of relapses and remissions, with each relapse responding less to treatment, and each remission shorter than the preceding one. Little is known about patterns and costs of current treatment for FNHL. Methods. We conducted a systematic review of the English-language, MEDLINE-indexed literature on FNHL published during the 10-year period beginning in May 1997 and ending in May 2007. The following search algorithm was used, with keywords in the title or abstract: (nodular OR follicular) AND non-Hodgkin‘s AND lymphoma[ti] NOT PCR NOT „case reports“[pt]. Government and organization-sponsored websites also were searched using these keywords. No geographic restrictions were used. Results: Literature identified. We manually reviewed the initial search results of 375 articles to identify those relevant to this research on FNHL treatment patterns and costs. Authors of 16 primary research studies reported treatment patterns (5) and/or costs (15). The 5 studies of treatment patterns were conducted in the UK (2), Canada (1), the Netherlands (1), and the US (1); the 15 economic studies were conducted in the US (5), UK (3), Canada (2), Spain (2), France (1), Germany (1), and the Netherlands (1). Nine of the 16 studies were published as abstracts from professional meetings (1 reporting treatment, all 9 reporting costs). Results: Treatment patterns. Studies reporting primary data on FNHL treatment patterns tended to assess these data during the 1990s, prior to the adoption of rituximab + chemotherapy as the current standard of treatment. No more than 13 patients received rituximab in each of these studies. Of the 5 studies of treatment patterns we identified, 1 collected data through 1998, 2 through 2001, and 1 did not collect drug-specific data. One UK study reported treatment patterns through August 2003, by which date 6 patients had received rituximab. Results: Costs. The 15 cost studies identified comprised 3 cost analyses using databases (2 US, 1 UK), 2 primary studies of costs (1 US, 1 Netherlands), and 1 primary study assessing work impact (Canada). There were also 8 economic models, including 6 cost-effectiveness analyses (1 with two publications), 1 budgetary impact model, and 1 model calculating total treatment costs. Most of these 15 economic studies focus on rituximab and fludarabine. Findings suggest that the high initial cost of rituximab is offset by its low incidence of adverse events, producing equivalent average annual direct costs to those of fludarabine. Maintenance with rituximab is cost-effective versus observation alone, and the addition of rituximab to systemic chemotherapy is cost-effective versus chemotherapy alone. The single study of indirect costs (work loss) indicates highest costs among patients receiving systemic therapy. Available economic data in FNHL do not include broader societal impact of the disease. Conclusions. Although the introduction of biological therapies such as rituximab has shifted the treatment paradigm for FNHL, few studies published in the last 10 years have evaluated treatment patterns and costs of this disease. As new treatments enter the market, primary cost data and other economic information about FNHL will be needed to evaluate their relative cost-effectiveness.