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TEleRehabilitation foR Aphasia (TERRA) Phase II Trial Design
Get PDFBackground and purpose Despite comprehensive evidence that supports the utility of aphasia therapy in persons with chronic (≥6 months) stroke-induced aphasia, the amount of therapy provided to patients in the United States is typically far less than what is likely necessary to maximize recovery. Two potential contributors to this discrepancy are limited access to rehabilitation services due to the availability of providers and logistical difficulties with transportation. One way to increase access to aphasia therapy is to rely on telerehabilitation. Methods The TEleRehabilitation foR Aphasia (TERRA) trial is a prospective, randomized, rater-blinded, multicenter phase II non-inferiority trial to evaluate telerehabilitation for aphasia therapy in persons with chronic post-stroke aphasia. Participants are randomized (1:1) to receive either aphasia remote therapy or in-clinic therapy for 30 total days of treatment (15 days of a semantically focused approach and 15 days of a phonologically focused approach) for 45 min per day. A total of 100 adults (ages 21–80) with a history of left hemisphere ischemic or hemorrhagic stroke incurred at least 12 months prior to study enrollment will be randomized. The trial will be conducted at the clinical research facilities at two sites: the Medical University of South Carolina and the University of South Carolina. Conclusions This paper details the design of the TERRA trial, which aims to test whether aphasia therapy delivered by a remote speech-language pathologist through videoconferencing (i.e., via telerehabilitation) is not clinically worse than in-clinic therapy for individuals with chronic post-stroke aphasia to provide an opportunity to move to a definitive phase III trial
A Rose by Any Other Name: Mapping Taxonomic and Thematic Naming Errors Poststroke
No full textUnderstanding the neurobiology of semantic knowledge is a major goal of cognitive neuroscience. Taxonomic and thematic semantic knowledge are represented differently within the brain\u27s conceptual networks, but the specific neural mechanisms remain unclear. Some neurobiological models propose that the anterior temporal lobe is an important hub for taxonomic knowledge, whereas the TPJ is especially involved in the representation of thematic knowledge. However, recent studies have provided divergent evidence. In this context, we investigated the neural correlates of taxonomic and thematic confrontation naming errors in 79 people with aphasia. We used three complementary lesion-symptom mapping (LSM) methods to investigate how structure and function in both spared and impaired brain regions relate to taxonomic and thematic naming errors. Voxel-based LSM mapped brain damage, activation-based LSM mapped BOLD signal in surviving tissue, and network-based LSM mapped white matter subnetwork integrity to error type. Voxel- and network-based lesion symptom mapping provided converging evidence that damage/disruption of the left mid-to-anterior temporal lobe was associated with a greater proportion of thematic naming errors. Activation-based lesion symptom mapping revealed that higher BOLD signal in the left anterior temporal lobe during an in-house naming task was associated with a greater proportion of taxonomic errors on the Philadelphia Naming Test administered outside of the scanner. A lower BOLD signal in the bilateral angular gyrus, precuneus, and right inferior frontal cortex was associated with a greater proportion of taxonomic errors. These findings provide novel evidence that damage to the anterior temporal lobe is especially related to thematic naming errors
Do Participation Rates Vary with Participation Payments in Laboratory Experiments?
Get PDFThis paper reports a series of experiments designed to evaluate how the advertised participation payment impacts participation rates in laboratory experiments. Our initial goal was to generate variation in the participation rate as a means to control for selection bias when evaluating treatment effects in common laboratory experiments. Initially, we varied the advertised participation payment to 1734 people from 15 using standard email recruitment procedures, but found no statistical evidence this impacted the participation rate. A second study increased the advertised payment up to 5 to 7 to $15. The combined results from our four experiments suggest moderate variation in the advertised participation payment from standard levels has little impact on participation rates in typical laboratory experiments. Rather, generating useful variation in participation rates likely requires much larger participation payments and/or larger potential subject pools than are common in laboratory experiments
Digital Assessments for Children and Adolescents with ADHD: A Scoping Review
Get PDFIntroduction: In spite of rapid advances in evidence-based treatments for attention deficit hyperactivity disorder (ADHD), community access to rigorous gold-standard diagnostic assessments has lagged far behind due to barriers such as the costs and limited availability of comprehensive diagnostic evaluations. Digital assessment of attention and behavior has the potential to lead to scalable approaches that could be used to screen large numbers of children and/or increase access to high-quality, scalable diagnostic evaluations, especially if designed using user-centered participatory and ability-based frameworks. Current research on assessment has begun to take a user-centered approach by actively involving participants to ensure the development of assessments that meet the needs of users (e.g., clinicians, teachers, patients).
Methods: The objective of this mapping review was to identify and categorize digital mental health assessments designed to aid in the initial diagnosis of ADHD as well as ongoing monitoring of symptoms following diagnosis.
Results: Results suggested that the assessment tools currently described in the literature target both cognition and motor behaviors. These assessments were conducted using a variety of technological platforms, including telemedicine, wearables/sensors, the web, virtual reality, serious games, robots, and computer applications/software.
Discussion: Although it is evident that there is growing interest in the design of digital assessment tools, research involving tools with the potential for widespread deployment is still in the early stages of development. As these and other tools are developed and evaluated, it is critical that researchers engage patients and key stakeholders early in the design process
Exposure and Connectedness to Natural Environments: An Examination of the Measurement Invariance of the Nature Exposure Scale (NES) and Connectedness to Nature Scale (CNS) Across 65 Nations, 40 Languages, Gender Identities, and Age Groups
Get PDFDetachment from nature is contributing to the environmental crisis and reversing this trend requires detailed monitoring and targeted interventions to reconnect people to nature. Most tools measuring nature exposure and attachment were developed in high-income countries and little is known about their robustness across national and linguistic groups. Therefore, we used data from the Body Image in Nature Survey to assess measurement invariance of the Nature Exposure Scale (NES) and the Connectedness to Nature Scale (CNS) across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). While multi-group confirmatory factor analysis (MG-CFA) of the NES supported full scalar invariance across gender identities and age groups, only partial scalar invariance was supported across national and linguistic groups. MG-CFA of the CNS also supported full scalar invariance across gender identities and age groups, but only partial scalar invariance of a 7-item version of the CNS across national and linguistic groups. Nation-level associations between NES and CNS scores were negligible, likely reflecting a lack of conceptual clarity over what the NES is measuring. Individual-level associations between both measures and sociodemographic variables were weak. Findings suggest that the CNS-7 may be a useful tool to measure nature connectedness globally, but measures other than the NES may be needed to capture nature exposure cross-culturally
On the Structure of Balanced Residuated Partially Ordered Monoids
No full textA residuated poset is a structure ⟨A,⩽, ·, \, /, 1⟩ where ⟨A,⩽⟩ is a poset and ⟨A, ·, 1⟩ is a monoid such that the residuation law x · y ⩽ z ⇐⇒ x ⩽ z/y ⇐⇒ y ⩽ x\z holds. A residuated poset is balanced if it satisfies the identity x\x ≈ x/x. By generalizing the well-known construction of Płonka sums, we show that a specific class of balanced residuated posets can be decomposed into such a sum indexed by the set of positive idempotent elements. Conversely, given a semilattice directed system of residuated posets equipped with two families of maps (instead of one, as in the usual case), we construct a residuated poset based on the disjoint union of their domains. We apply this approach to provide a structural description of some varieties of residuated lattices and relation algebras
Predisposing, Enabling, and Need Factors Influencing Health-related Quality of Life Among People with Metabolic Syndrome
Get PDFBackground Metabolic syndrome (MetS) continues to impact the health-related quality of life (HRQoL) of patients despite various available therapeutic interventions. There is a dearth of information on how patient-centered factors holistically predict HRQoL to provide more insights on addressing MetS. Objective To predict the HRQoL of patients with MetS in the Southern states, using the predisposing, enabling, and need factors. Methods The study adopted a cross-sectional approach in collecting 706 complete surveys on HRQoL assessment using the EQ-5D-5L survey and demographic characteristics based on the predisposing, enabling, and need factors of Andersen’s Behavioral model. The study focused on people with MetS in the southern states of the United States. Multinomial logistic regression was conducted to investigate the relationship between the number of comorbidities and each HRQoL dimension. Ordinal regression was used to explore factors predicting HRQoL. Sensitivity analysis was conducted using bootstrapping analysis to evaluate the regression’s robustness. Results Over 70% were females and 30% had at least a bachelor\u27s degree, while 47% were married. Most respondents (71.1%) had no problem with self-care. However, 20.0% had severe problems with pain, while the highest proportion (8.6%) was observed for extreme problems with anxiety or depression. A unit increase in comorbidities resulted in higher odds of having extreme problems with mobility (odds ratio [OR] = 1.95), usual activities (OR = 1.73), and pain (OR = 1.70). Only 40.8% of the respondents had good HRQoL, compared to 26.2% with poor HRQoL. Age, race, geographical area, marital status, household income, number of prescription drugs, comorbidities, and body mass index were predictors of HRQoL. Conclusion An increase in comorbidities significantly increased the odds of having challenges with the HRQoL dimensions. Demographic, socioeconomic, and health-related factors significantly predicted HRQoL. Therefore, health care providers must consider these factors as a component of patient-centered care to address health disparities and promote optimal health outcomes among people with MetS
Literacies of the Heart and Antiracist Pedagogy
Get PDFChallenging structural violence is a major project of our time. The massive Black Lives Matter (BLM) uprisings of Summer 2020 brought greater awareness of the systemic racism of universities and a commitment to challenge it. A Marxist-humanist lens recognizes racism as foundational to the racial-colonial capitalist patriarchy and the university as deeply implicated in the development and maintenance of these structures. While all these interlocking oppressions must be eradicated, in the US, racism has historically galvanized more people to action. For this we need a populace with critical literacy to connect their daily oppressions to structural forces. Critical literacy also encourages us to listen to the Oppressed whose “Reason and force” may prove useful toward our liberation. A critical literacy of the heart, drawing of Paulo Freire, is one that challenges us to transform structures of oppression through humanizing antiracist pedagogy. The bulk of the paper is drawn from a duoethnography of two Latina instructors. The stories shared offer insights into the deep-seeded racist policies and practices in education and the complexity of challenging these. We argue that such complexity calls for an intentional antiracist pedagogy of “other doing” that goes against the “commonsense” of our society
2024 1st Place Winner: Lauren A. Fillet, “Modification of Trauma Focused Cognitive Behavioral Therapy for Adolescents with Language Disorder”
No full textPictured is 2024 first-place winner Lauren A. Fillet (second from right, holding the certificate), with (left to right) Taylor Greene (Chair of Research and Instructional Services), Dr. Leah Beekman (Assistant Professor in Crean College of Health and Behavioral Sciences) and Mr. Eric Scandrett (contest co-sponsor).https://digitalcommons.chapman.edu/graduate_research_prize_photos/1000/thumbnail.jp
Toward Facilitating the Collection and Utilization of Patient-reported Outcomes in the Military Health System: Lessons Learned from a Pragmatic Clinical Trial on Physical Therapy Management for Low Back Pain
Get PDFIn pursuit of delivering \u27the right care to the right patient at the right time,\u27 the Military Health System (MHS) advocates for collecting and using patient-reported outcomes (PROs) to help demonstrate value-based care.1 PROs identify patients’ perceptions of their health, function, and well-being, which can enhance patient-centered communication and guide data-driven healthcare. 2 The MHS recognizes the value of incorporating PRO data into clinical decision-making and has established a number of platforms for PRO collection across health conditions (eg, behavioral health, traumatic brain injury, musculoskeletal injuries). The Military Orthopedics Tracking Injuries and Outcomes Network (MOTION)3 was started as a research endeavor specific to collecting PROs relevant to postsurgical conditions, which later expanded to cover rehabilitation settings and all musculoskeletal injuries. In MHS physical therapy clinics, the Defense Health Agency’s Clinical Assessment Management Portal (CAMP), a digital PRO collection platform, enables point-of-care capture of MOTION-recommended PROs