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Assessment and treatment of gesture in neurogenic communication disorders: an international survey of practice
Get PDFBackground: Gesture and speech collaborate in conveying meaning, and gesture is often leveraged by people with neurogenic communication disorders, such as aphasia, cognitive-communicative impairments and primary progressive aphasia, when words fail them. Because gesture is imagistic, transitory and holistic, there are inherent challenges when assessing and treating it. Aims: The survey had three primary research questions: (1) what gesture assessment practices, and (2) what gesture treatment practices, are employed by speech and language therapists (SLTs) internationally; and (3) what are the factors that influence these practices?. Methods and Procedures: An online survey of practice using Qualtrics was piloted and then disseminated to practising SLTs working with people with neurogenic communication disorders. In addition to descriptive statistics summarising across the three research questions, statistical comparisons were made for two independent groups: primary work setting (research versus clinical), and primary work setting considering years of experience specific to neurogenic communication disorders (research, high; research, low; clinical, high; and clinical, low). Outcomes and Results: A total of 130 international SLTs completed the first two parts of the survey. A total of 107 completed all four sections of the survey. Fifty percent of respondents reported assessing gesture sometimes/for some clients, with only 5% reporting that they never assessed gesture. Nearly 70% of respondents reported never using a published test to evaluate gesture, with qualitative results suggesting a lack of formal assessments. This was further highlighted by the most prominent barrier being a lack of published tests (50% of respondents said this). The primary reason for evaluating gesture was to assess nonverbal communication. There was no significant difference in gesture assessment practices across comparison groups. The research group, and those within the research group with most years of experience, tended to target gestures during treatment and write treatment goals containing gesture more than other respondents. The most common facilitator to assessing or treating gesture was that the family or individual prioritised gesture for enhancing communication (53.1% of respondents). No group differences were identified for barriers/facilitators. Conclusions and Implications: Findings indicate that whilst gesture is a critical nonverbal communicative behaviour, there is an unmet need for empirical and standardised methods for assessing gesture in speech and language clinical practice and there is a lack of gesture-specific treatment resources. SLTs working in research settings may feel more able, or have more resources, to include gesture during treatment. Essential next steps include creating empirical and standardised methods for assessing gesture in speech and language clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject Gesture is a complex and crucial aspect of communication. It is a key part of the role of speech and language therapists (SLTs), as described in clinical guidelines, to assess people with aphasia's use of gesture and consider whether it could be enhanced through treatment. What this study adds to existing knowledge This is the first international survey of practice focusing on gesture assessment and treatment. It highlights the variety of methods used by SLTs to assess and treat gesture, the importance they attach to this area and the need for standardised assessment tools and treatment resources. What are the clinical implications of this work? This study provides a comprehensive overview of practices for assessing and treating gesture in neurogenic communication disorders, as well as a list of gesture resources being actively used by clinicians and researchers. These may be useful for clinicians looking to expand their understanding of approaches and resources for assessment and treatment in this domain. The study also reports on the reasons clinicians assess gesture and the barriers and facilitators they encounter which may inform clinical practice in this area
High return to competition rate following on-field rehabilitation in competitive male soccer players after ACL reconstruction: GPS tracking in 100 consecutive cases
Get PDFBackground: Despite published guidelines describing on-field rehabilitation (OFR) frameworks for soccer, available evidence for practitioners who work with players with anterior cruciate ligament reconstruction (ACLR) is limited. Purpose: To document the activity and workloads completed by a large cohort of amateur and professional soccer players during OFR following ACLR after completing their indoor rehabilitation and to establish their return to competition (RTC) outcomes. Study Design: Case series; Level of evidence, 4. Methods: OFR measurements/activities, global positioning system (GPS), and heart rate data were collected from 100 male 11-a-side soccer players with ACLR undergoing a criteria-based rehabilitation process, concluding with a 5-stage OFR program. Consent was obtained directly from the players involved in this study before completing a follow-up questionnaire to document RTC outcomes. Differences between the level of play (professional and amateur) and 5 OFR stages were investigated using separate linear mixed models. Results: A minimum 9-month follow-up was possible for 97 players (97%), with a median time of 2.3 years after ACLR and 84% RTC, with higher rates in professionals (100%) than amateurs (80%). Ten (10%) players sustained an ACL reinjury. Professionals completed more OFR sessions (20.6 ± 7.7 vs 13.2 ± 7.7; P <.001) over a shorter period (44.7 ± 30.3 vs 59.3 ± 28.5 days; P =.044) and achieved higher workloads mostly in the high-intensity GPS metrics in each OFR stage. Typical external workload outputs in the final OFR stage aligned with team training demands for the total distance (TD) (106%), high-intensity distance (HID) (104%), peak speed (PS) (88%), acceleration distance (ACC) (110%), and deceleration distance (DEC) (48%), but they were lower compared with match play demands (TD: 44%; HID: 51%; PS: 82%; ACC: 63%; and DEC: 26%). Conclusion: High RTC rates were reported in those players who participated in OFR after indoor rehabilitation. Completion of all five OFR stages almost prepared them for team training demands; however, workloads remain low compared to match play
Enhancing Digital Innovation in Developing Country: Organizational Improvisation and Resource Constraints in Digital Entrepreneurial Firms.
Get PDFBy integrating theories of organizational dynamic capabilities and knowledge worker productivity, we explore the linkages between organizational improvisation and digital innovation performance via knowledge worker productivity, with boundary conditions of a firm’s resource constraints in the context of a developing country. We collected data from 308 managers of digital entrepreneurial information technology (IT) firms in Pakistan, a developing country. We found that organizational improvisation positively influences digital innovation performance. This relationship is weaker in firms with high resource constraints. Furthermore, knowledge worker productivity mediates the relationship between organizational improvisation and digital innovation performance. The distinctive characteristics of knowledge workers in the IT sector enable them to maintain productivity by relying on improvisation despite any resource constraints, thereby, enhancing digital innovation performance. This research contributes to the intersection of dynamic capabilities and Drucker’s knowledge worker productivity theories. It explores how organizational improvisation can facilitate improved digital innovation performance despite resource constraints and can build on the productivity level of knowledge workers in developing countries. Our research suggests that investing in knowledge workers facilitates the translation of organizational improvisation to improved digital innovation and mitigates resource constraints’ impact on digital innovation performance in the context of developing economies
Optimizing the application order under precedent-based decision-making.
Get PDFWe study the decision problem of a Proposer who has a set of applications to submit for approval to an Authority and can choose an order of submission. The Proposer's utility depends on the Authority's rulings. The Authority has to be consistent with its past decisions, which we model using the nearest-neighbor criterion. If the Proposer's utility increases with the set of approved applications, then any greedy strategy is optimal for her: She should submit any application that, given the current history, would be approved. However, if her utility increases with some approvals but decreases with others, the Proposer's problem becomes significantly more complex. In the single-dimensional case, an optimal strategy can be computed in polynomial time. In the general case, however, finding an optimal strategy is NP-hard. Thus, even in the absence of uncertainty or strategic behavior on the part of the Authority, evaluating the impact of current submissions on future outcomes can be computationally intractable
Empowering Adolescents to Transform Schools: Lessons from a Behavioral Targeting
Get PDFWe test the effectiveness of a behavioral program grounded in the idea that status
granting and self-persuasion might yield a robust behavioral change in disadvantaged
adolescents. We enlist socially connected senior middle school students with high emotional
intelligence as “student-teachers” and entrust them with delivering a curriculum
to their junior peers. The program empowers student-teachers, leading them to improve
their social environment. It reduces disciplinary incidents and anti-social behavior
among student-teachers and their friendship networks. The intervention significantly
enhances the likelihood of admission to selective high schools for student-teachers,
offering a cost-effective way to help disadvantaged adolescents escape neighborhood
disadvantages
Corporate ownership types and internationalization strategies: The moderating role of home country capitalism
No full textDespite widespread academic consensus that firm ownership impacts internationalization, there is disagreement on which ownership type increases internationalization. Also, the risk differentials of internationalization strategies need to be considered: sales internationalization (a low-risk strategy) and asset internationalization (a high-risk strategy). Furthermore, home-country capitalism can moderate these relationships – a relationship unexamined in such research. Using a sample of US, Western European, and emerging-market firms, this paper addresses these research gaps. It examines how five different firm-ownership types (government, family, institutional, managerial, and corporate) and home-country capitalism influence internationalization strategies. We find that government ownership reduces sales internationalization. Family and institutional ownership increases sales internationalization, whereas institutional, managerial, and corporate ownership increases asset internationalization. Higher home-country capitalism reduces the impact of institutional and corporate owners on sales internationalization while increasing the impact of all five ownership types on asset internationalization. Our findings have implications for corporate governance and internationalization literature and practice
‘Human, all too human’: the anthropocentricisation of ecocide
Get PDFUsing the theoretical framework of co-optation, this article argues that the ecocide movement can be accommodated under the institutional framework of the International Criminal Court in a mutually beneficial manner. However, how ecocide is formulated before the Court is pivotal. There are risks of, on the one hand, anthropocentricising ecocide, and on the other of undermining the Court’s core tenets as a judicial body required to uphold fundamental human rights. A typology of the major approaches to ecocide shows there is significant conceptual divergence regarding the purpose of this crime. Some commentators have inserted overarching anthropocentric interests into the definition, whereas others insist on its ecocentric formulation. The analysis herein argues that excessive incorporation of anthropocentric interests risks causing assimilative co-optation of the ecocentric strand of the ecocide movement. That would nullify the independent value of ecocide as a protection for nature. Conversely, the ecocentric roots of ecocide can be accentuated by ensuring its applicability independent of showing harm to humans. In this way, the relationship between the Court and the ecocide movement can shift away from assimilation and towards a mutually advantageous relationship adhering to the framework of strategic co-optation
Understanding suicidality in adults with learning disabilities: a qualitative exploration of the experiences and perceptions of professionals in NHS Community Learning Disability Services
Get PDFBackground: Experiences of suicidality within the learning disability population remain largely unknown. Despite suicide prevention strategies being a standard part of clinical practice in all healthcare settings in the United Kingdom (UK), no research has been conducted exploring professionals' understanding of suicidality as it presents in clinical practice. Difficulties with communication and comprehending death make navigating suicidality in this population more complicated. Little is known about clinicians' experience of engaging with individuals with learning disability who presents with suicidality. Aim: The current research aimed to explore professionals' experiences and perceptions of suicidality as it presents for individuals with a learning disability in clinical practice. Method: A qualitative methodological approach was applied using Reflexive Thematic Analysis. Semi-structured interviews were conducted with 14 professionals working in an NHS Community Learning Disability Service. Findings: Two overarching themes, five main themes, and four sub-themes were generated. The findings highlight that although suicidality was not seen as the most frequent presentation, it was consistently described as one of the most complex and challenging to navigate. Professionals understood suicidality to be grounded in the multitude of adversities, particularly trauma, social exclusion and unmet relational needs. It was predominantly viewed as a form of communication and learned relational strategy, which professionals interpreted as a desire for connection rather than a direct intention to die by suicide. Professionals highlighted the challenges of determining risk and needing to navigate uncertainty around the comprehension of death and suicide within this population. Emotional and professional burdens were evident, with professionals describing the weight of caring, concerns about responsibility, and the strain of working within current system limitations. Conclusion: The findings are considered in the context of existing research and psychological theory, with an overview of the study's strengths and limitations provided. Clinical implications and future research are also considered
Using climatic and imaging data to predict apple phenology
Get PDFThis thesis investigates the biological and environmental factors influencing apple maturity, with the aim of developing a non-destructive framework for accurate harvest prediction. It begins by reviewing phenology models commonly used to estimate flowering and harvest timing and introduces imaging as a promising alternative to directly assess apple maturity. Chapter 3 focuses on the parameterisation of multiple cultivars to determine the level of specificity during model fitting. This has not previously been done before, mainly due to the lack of training data. In this chapter, the PhenoFlex model is applied to a unique 85-year dataset of 26 apple cultivars grown at East Malling. The study demonstrates that generic (species-level) or grouped (based on flowering time similarity) parameterisation approaches can effectively predict flowering time, reducing the need for cultivar-specific calibration, especially with limited data. Chapter 4 explores the impact of flowering time variation on fruit maturity. The temperature experienced by individual flower clusters was tracked until their corresponding fruit was harvested. The Growing Degree Hours model was applied to each flowering to harvest period to determine the influence of temperature on growth. The variation in maturity was assessed considering flowering time, season, tree and canopy region, and it was found that flowering time accounts for up to 20% of maturity variation, depending on the cultivar. Smaller effects were observed from seasonal and tree-level effects. These findings highlight the limitations of using average flowering dates in harvest models and support the need for more precise, fruit-level assessments starting from the earliest possible harvest date. Chapter 5 evaluates hyperspectral imaging as a non-destructive method for assessing apple maturity. A large and diverse dataset of 5,756 apples was collected from different cultivars, seasons and countries. This dataset is approximately 1800% larger than the datasets used in previous studies studying apple traits. The Vision Transformer architecture achieved the highest accuracy in predicting Brix and firmness. Key spectral and spatial features were identified, and cultivar-specific information improved model performance. Imaging a single side of the fruit was insufficient; the model that was trained on images from all four sides yielded better results. The thesis concludes by discussing the results found in each chapter and proposes a way to integrate phenology and imaging into a framework for harvest window predictions
Understanding intertidal seagrass meadow dynamics and the role of Zostera noltii as a blue carbon habitat
Get PDFDistinct knowledge gaps concerning the intertidal seagrass Zostera noltii persist on pivotal environmental drivers contributing to variation in seagrass meadow size, location, structure and sedimentary carbon fluxes. This thesis addresses these gaps by characterising Z. noltii meadows in the southeast of England using key meadow descriptors. While sediment type and seagrass tissue nutrient enrichment were key environmental parameters, they did not fully account for the variation in seagrass meadow descriptors. Seasonal greenhouse gas (GHG) flux estimates and values from northern temperate regions were recently identified as priorities in blue carbon (BC) science. Carbon dioxide (CO2) and methane (CH4) flux of Z. noltii meadows were assessed across four seasons, capturing a full annual cycle. Net CO2 uptake of Z. noltii ranged from 0.77 - 2.33 mmolCO2 m-2 hr-1, of which 1-3% was offset by CO2-equivalent CH4 emissions. Z. noltii CO2 uptake was significantly higher than adjacent bare sediments, though in the lowest range of the seagrass global average (1.73 – 10.27 mmol CO2 m-2 hr-1). Z. noltii remained a net CO2 sink annually, however inclusion in carbon credit schemes should focus on multiple ecosystem benefits, beyond BC. Despite their pivotal role in coastal carbon biogeochemical cycling, microbial communities driving GHG fluxes are frequently overlooked, remaining understudied in seagrass ecosystems and seldom included in GHG research. Methanogen and methanotroph communities of Z. noltii and bare sediments were characterised alongside GHG flux measurements. The dominant methanogen in all sediments, Methanomassiliicoccus, had higher relative abundance during summer when CH4 flux was enhanced. Methanogen and methanotroph communities were comparable between seagrass and bare sediments, congruent to similar CH4 fluxes between habitats. Geographical location is thus critical in BC estimates, as regional characteristics may determine GHG-influencing microbial communities. Additionally, seasonal GHG measurements and interspecific differences in seagrass GHG fluxes are fundamental considerations for BC science