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1.
Stroke ; 54(6): e272-e291, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37125534

RESUMO

PURPOSE: Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. METHODS: We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. RESULTS: PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management.


Assuntos
Disfunção Cognitiva , Acidente Vascular Cerebral Hemorrágico , Acidente Vascular Cerebral , Humanos , Acidente Vascular Cerebral Hemorrágico/complicações , Estudos Prospectivos , American Heart Association , Qualidade de Vida , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia
2.
Int J Lang Commun Disord ; 58(2): 651-666, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36448626

RESUMO

BACKGROUND: Right hemisphere communication disorders are neither consistently labelled nor adequately defined. Labels associated with right hemisphere brain damage (RHD) are broad and fail to capture the essence of communication challenges needed for stroke-related service provisions. Determination of rehabilitation needs and best-practice guidelines for the education, management and functional improvement of communication disorders after RHD are all predicated on an apt diagnostic label and disorder characteristics. AIMS: In this paper apragmatism is proposed as a potential communication-specific diagnostic label for the impairments in communication that occur after RHD. In particular, the researchers aimed: (1) to establish an operational definition of apragmatism; and (2) to describe the linguistic, paralinguistic and extralinguistic communication deficits under the umbrella term apragmatism. METHODS & PROCEDURES: An international collaborative of researchers with expertise in RHD followed a multilevel approach to consider the utility of apragmatism as a diagnostic label. Adopting the relational approach to concept mapping, the researchers engaged in a series of group meetings to complete four levels of mapping: (1) identify and review, (2) define, (3) expert discussion and (4) label determination. MAIN CONTRIBUTION: Apragmatism was established as a suitable diagnostic label for the impairments in communication associated with RHD. The paper offers an operational definition and description of the linguistic, paralinguistic and extralinguistic features of apragmatism through evidence summaries and examples from people with RHD retrieved from the RHDBank. CONCLUSIONS & IMPLICATIONS: The adoption of the term apragmatism offers an opportunity to capture the hallmark of RHD communication deficits. The use of the term is recommended when referencing the pragmatic language impairments in this population. Apragmatism, which may co-occur with or be exacerbated by cognitive impairments, can interfere with the ability to interpret and convey intended meaning and impact the lives of right hemisphere stroke survivors and their families. WHAT THIS PAPER ADDS: What is already known on the subject RHD results in a heterogeneous group of deficits that range in cognitive-communicative complexity. Many of the deficits are subsumed under pragmatics. For example, adults with RHD may demonstrate tangential or verbose communication, insensitivity to others' needs and feelings, prosodic changes, minimal gesture use and facial expression, and more. While descriptions of pragmatic impairments pervade the literature, there is no consistently used diagnostic label. The clinical consequences of this absence include difficulty with inter- and intra-disciplinary communication about these patients, difficulty consolidating findings across research studies, and challenges in communicating about these pragmatic changes with patients, families and other stakeholders. What this paper adds to existing knowledge The term apragmatism is proposed as a diagnostic label to consistently describe pragmatic communication changes after RHD. Apragmatism is characterized using three components of pragmatics: linguistic, paralinguistic and extralinguistic. Descriptions and examples of these three components are provided with supplemental transcripts retrieved from the RHDBank. What are the potential or actual clinical implications of this work? Adoption of the term apragmatism by speech and language therapists and other medical and rehabilitation professionals has the potential to provide consistency in describing the abilities and challenges experienced by people following a right hemisphere stroke. Such improvements may help drive the development of evidence-based assessments and treatments for this population.


Assuntos
Transtornos da Comunicação , Transtornos da Linguagem , Acidente Vascular Cerebral , Adulto , Humanos , Transtornos da Comunicação/diagnóstico , Transtornos da Comunicação/etiologia , Transtornos da Comunicação/reabilitação , Comunicação , Acidente Vascular Cerebral/complicações , Gestos , Encéfalo
3.
J Int Neuropsychol Soc ; 28(10): 1075-1090, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-34989666

RESUMO

OBJECTIVES: The aim of this systematic review was to identify the presence and nature of relationships between specific forms of aprosodia (i.e., expressive and receptive emotional and linguistic prosodic deficits) and other cognitive-communication deficits and disorders in individuals with right hemisphere damage (RHD) due to stroke. METHODS: One hundred and ninety articles from 1970 to February 2020 investigating receptive and expressive prosody in patients with relatively focal right hemisphere brain damage were identified via database searches. RESULTS: Fourteen articles were identified that met inclusion criteria, passed quality reviews, and included sufficient information about prosody and potential co-occurring deficits. Twelve articles investigated receptive emotional aprosodia, and two articles investigated receptive linguistic aprosodia. Across the included studies, receptive emotional prosody was not systematically associated with hemispatial neglect, but did co-occur with deficits in emotional facial recognition, interpersonal interactions, or emotional semantics. Receptive linguistic processing was reported to co-occur with amusia and hemispatial neglect. No studies were found that investigated the co-occurrence of expressive emotional or linguistic prosodic deficits with other cognitive-communication impairments. CONCLUSIONS: This systematic review revealed significant gaps in the research literature regarding the co-occurrence of common right hemisphere disorders with prosodic deficits. More rigorous empirical inquiry is required to identify specific patient profiles based on clusters of deficits associated with right hemisphere stroke. Future research may determine whether the co-occurrences identified are due to shared cognitive-linguistic processes, and may inform the development of evidence-based assessment and treatment recommendations for individuals with cognitive-communication deficits subsequent to RHD.


Assuntos
Transtornos da Percepção , Acidente Vascular Cerebral , Humanos , Distúrbios da Fala , Emoções , Linguística , Acidente Vascular Cerebral/complicações , Transtornos da Percepção/etiologia
4.
J Int Neuropsychol Soc ; 28(7): 709-735, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34607619

RESUMO

OBJECTIVE: To identify which aspects of prosody are negatively affected subsequent to right hemisphere brain damage (RHD) and to evaluate the methodological quality of the constituent studies. METHOD: Twenty-one electronic databases were searched to identify articles from 1970 to February 2020 by entering keywords. Eligibility criteria for articles included a focus on adults with acquired RHD, prosody as the primary research topic, and publication in a peer-reviewed journal. A quality appraisal was conducted using a rubric adapted from Downs and Black (1998). RESULTS: Of the 113 articles appraised as eligible and appropriate for inclusion, 71 articles were selected to undergo data extraction for both meta-analyses of population effect size estimates and qualitative synthesis. Across all domains of prosody, the effect estimate was g = 2.51 [95% CI (1.94, 3.09), t = 8.66, p < 0.0001], based on 129 contrasts between RHD and non-brain-damaged healthy controls (NBD), indicating a significant random effects model. This effect size was driven by findings in emotional prosody, g = 2.48 [95% CI (1.76, 3.20), t = 6.88, p < 0.0001]. Overall, studies of higher quality (rpb = 0.18, p < 0.001) and higher sample size/contrast ratio (rpb = 0.25, p < 0.001) were more likely to report significant differences between RHD and NBD participants. CONCLUSIONS: The results confirm consistent evidence for emotional prosody deficits in the RHD population. Inconsistent evidence was observed across linguistic prosody domains and pervasive methodological issues were identified across studies, regardless of their prosody focus. These findings highlight the need for more rigorous and sufficiently high-powered designs to examine prosody subsequent to RHD, particularly within the linguistic prosody domain.


Assuntos
Linguística , Distúrbios da Fala , Adulto , Córtex Cerebral , Emoções , Humanos
5.
Brain Behav Immun ; 94: 41-50, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33713824

RESUMO

Vaccine hesitancy could undermine efforts to control COVID-19. We investigated the prevalence of COVID-19 vaccine hesitancy in the UK and identified vaccine hesitant subgroups. The 'Understanding Society' COVID-19 survey asked participants (n = 12,035) their likelihood of vaccine uptake and reason for hesitancy. Cross-sectional analysis assessed vaccine hesitancy prevalence and logistic regression calculated odds ratios. Overall vaccine hesitancy was low (18% unlikely/very unlikely). Vaccine hesitancy was higher in women (21.0% vs 14.7%), younger age groups (26.5% in 16-24 year olds vs 4.5% in 75 + ) and those with lower education levels (18.6% no qualifications vs 13.2% degree qualified). Vaccine hesitancy was high in Black (71.8%) and Pakistani/Bangladeshi (42.3%) ethnic groups. Odds ratios for vaccine hesitancy were 13.42 (95% CI:6.86, 26.24) in Black and 2.54 (95% CI:1.19, 5.44) in Pakistani/Bangladeshi groups (compared to White British/Irish) and 3.54 (95% CI:2.06, 6.09) for people with no qualifications versus degree. Urgent action to address hesitancy is needed for some but not all ethnic minority groups.


Assuntos
COVID-19 , Vacinas , Vacinas contra COVID-19 , Estudos Transversais , Etnicidade , Feminino , Humanos , Estudos Longitudinais , Grupos Minoritários , SARS-CoV-2 , Reino Unido
6.
Brain Cogn ; 152: 105759, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34118500

RESUMO

Affective prosody, or the changes in rate, rhythm, pitch, and loudness that convey emotion, has long been implicated as a function of the right hemisphere (RH), yet there is a dearth of literature identifying the specific neural regions associated with its processing. The current systematic review aimed to evaluate the evidence on affective prosody localization in the RH. One hundred and ninety articles from 1970 to February 2020 investigating affective prosody comprehension and production in patients with focal brain damage were identified via database searches. Eleven articles met inclusion criteria, passed quality reviews, and were analyzed for affective prosody localization. Acute, subacute, and chronic lesions demonstrated similar profile characteristics. Localized right antero-superior (i.e., dorsal stream) regions contributed to affective prosody production impairments, whereas damage to more postero-lateral (i.e., ventral stream) regions resulted in affective prosody comprehension deficits. This review provides support that distinct RH regions are vital for affective prosody comprehension and production, aligning with literature reporting RH activation for affective prosody processing in healthy adults as well. The impact of study design on resulting interpretations is discussed.


Assuntos
Percepção da Fala , Acidente Vascular Cerebral , Adulto , Compreensão , Emoções , Humanos
8.
Arch Sex Behav ; 45(1): 133-44, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25624001

RESUMO

We describe levels of sexual activity, problems with sexual functioning, and concerns about sexual health among older adults in the English Longitudinal Study of Ageing (ELSA), and associations with age, health, and partnership factors. Specifically, a total of 6,201 core ELSA participants (56 % women) aged 50 to >90 completed a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q) included in ELSA Wave 6 (2012/13). The prevalence of reporting any sexual activity in the last year declined with age, with women less likely than men at all ages to report being sexually active. Poorer health was associated with lower levels of sexual activity and a higher prevalence of problems with sexual functioning, particularly among men. Difficulties most frequently reported by sexually active women related to becoming sexually aroused (32 %) and achieving orgasm (27 %), while for men it was erectile function (39 %). Sexual health concerns most commonly reported by women related to their level of sexual desire (11 %) and frequency of sexual activities (8 %). Among men it was level of sexual desire (15 %) and erectile difficulties (14 %). While the likelihood of reporting sexual health concerns tended to decrease with age in women, the opposite was seen in men. Poor sexual functioning and disagreements with a partner about initiating and/or feeling obligated to have sex were associated with greater concerns about and dissatisfaction with overall sex life. Levels of sexual activity decline with increasing age, although a sizable minority of men and women remain sexually active until the eighth and ninth decades of life. Problems with sexual functioning were relatively common, but overall levels of sexual health concerns were much lower. Sexually active men reported higher levels of concern with their sexual health and sexual dissatisfaction than women at all ages. Older peoples' sexual health should be managed, not just in the context of their age, gender, and general health, but also within their existing sexual relationship.


Assuntos
Envelhecimento , Saúde Reprodutiva , Comportamento Sexual/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Envelhecimento/psicologia , Coito , Inglaterra/epidemiologia , Feminino , Humanos , Libido , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Vigilância da População , Prevalência , Parceiros Sexuais , Sexualidade/estatística & dados numéricos , Inquéritos e Questionários
9.
Neuropsychol Rehabil ; 25(1): 15-52, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-24983133

RESUMO

Coarse coding is the activation of broad semantic fields that can include multiple word meanings and a variety of features, including those peripheral to a word's core meaning. It is a partially domain-general process related to general discourse comprehension and contributes to both literal and non-literal language processing. Adults with damage to the right cerebral hemisphere (RHD) and a coarse coding deficit are particularly slow to activate features of words that are relatively distant or peripheral. This manuscript reports a pre-efficacy study of Contextual Constraint Treatment (CCT), a novel, implicit treatment designed to increase the efficiency of coarse coding with the goal of improving narrative comprehension and other language performance that relies on coarse coding. Participants were four adults with RHD. The study used a single-subject controlled experimental design across subjects and behaviours. The treatment involved pre-stimulation, using a hierarchy of strong and moderately biased contexts, to prime the intended distantly related features of critical stimulus words. Three of the four participants exhibited gains in auditory narrative discourse comprehension, the primary outcome measure. All participants exhibited generalisation to untreated items. No strong generalisation to processing non-literal language was evident. The results indicate that CCT yields both improved efficiency of the coarse coding process and generalisation to narrative comprehension.


Assuntos
Cérebro/lesões , Transtornos da Linguagem/reabilitação , Semântica , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Compreensão , Feminino , Lateralidade Funcional , Generalização Psicológica , Humanos , Masculino , Resultado do Tratamento
10.
Am J Speech Lang Pathol ; 31(5S): 2313-2328, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-35868292

RESUMO

PURPOSE: Hemispheric specialization for the comprehension and expression of linguistic and emotional prosody is typically attributed to the right hemisphere. This study used techniques adapted from meta-analysis to critically examine the strength of existing evidence for hemispheric lateralization of prosody following brain damage. METHOD: Twenty-one databases were searched for articles published from 1970 to 2020 addressing differences in prosody performance between groups defined by right hemisphere damage and left hemisphere damage. Hedges's g effect sizes were calculated for all possible prosody comparisons. Primary analyses summarize effects for four types: linguistic production, linguistic comprehension, emotion comprehension, and emotion production. Within each primary analysis, Hedges's g values were averaged across comparisons (usually from a single article) based on the same sample of individuals. Secondary analyses explore more specific classifications of comparisons. RESULTS: Out of the 113 articles investigating comprehension and production of emotional and linguistic prosody, 62 were deemed appropriate for data extraction, but only 21 met inclusion criteria, passed quality reviews, and provided sufficient information for analysis. Evidence from this review illustrates the heterogeneity of research methods and results from studies that have investigated aprosodia. This review provides inconsistent support for selective contribution of the two cerebral hemispheres to prosody comprehension and production; however, the strongest finding suggests that right hemisphere lesions disrupt emotional prosody comprehension more than left hemisphere lesions. CONCLUSION: This review highlights the impoverished nature of the existing literature; offers suggestions for future research; and highlights relevant clinical implications for the prognostication, evaluation, and treatment of aprosodia. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20334987.


Assuntos
Lesões Encefálicas , Cérebro , Humanos , Distúrbios da Fala , Linguística , Emoções , Compreensão , Lateralidade Funcional
11.
Wellcome Open Res ; 7: 166, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-37794900

RESUMO

Background: The National Surveys of Sexual Attitudes and Lifestyles COVID study (Natsal-COVID) was designed to understand the impact of COVID-19 on Britain's sexual and reproductive health (SRH). Natsal-COVID Wave 1 survey and qualitative follow-up interviews were conducted in 2020. The Wave 2 survey was designed to capture one-year prevalence estimates for key SRH outcomes and measure changes over the first year of the pandemic. We describe the Wave 2 survey methodology and assess the sample representativeness. Methods: Natsal-COVID Wave 2 was conducted March-April 2021; approximately one year after the start of Britain's first national lockdown. Data were collected using an online web-panel survey administered by Ipsos. The sample comprised a longitudinal sample of Wave 1 participants who had agreed to re-contact plus a sample of participants residing in Britain, aged 18-59, including a boost sample comprising people aged 18-29. Questions covered reproductive health, relationships, sexual behaviour and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British population. Comparisons were made with recent national probability surveys, Natsal-3 (2010-12) and Natsal-COVID Wave 1 to understand bias. Results: A total of 6,658 individuals completed the survey. In terms of gender, age, ethnicity, and rurality, the weighted Natsal-COVID Wave 2 sample was like the general population. Participants were less likely to be married or to report being in good health than the general population. The longitudinal sample (n=2,098) were broadly like participants who only took part in Wave 1 but were older. Among the sexually active, longitudinal participants were less likely to report multiple sexual partners or a new sexual partner in the past year compared to those who only took part in Wave 1. Conclusions: Natsal-COVID collected longitudinal, quasi-representative population data to enable evaluation of the population-level impact of COVID-19 on SRH and to inform policy.

12.
Top Lang Disord ; 41(1): 99-122, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34584326

RESUMO

PURPOSE: Right hemisphere brain damage (RHD) commonly causes pragmatic language disorders that are apparent in discourse production. Specific characteristics and approaches to assessment, diagnosis, and treatment of these disorders are not well-defined. RHDBank, a shared database of multimedia interactions for the study of communication using discourse, was created to address these gaps. The database, materials, and related analysis programs are free resources to clinicians, researchers, educators, and students. METHOD: A standard discourse protocol was developed to elicit multiple types of discourse: free speech, conversation, picture description, storytelling, procedural discourse, and question-asking. Testing included measures of cognition, unilateral neglect, and communicative participation. Language samples were video-recorded and transcribed in CHAT format. Currently, the database includes 24 adults with RHD and 24 controls. RESULTS: Illustrative analyses show how RHDBank can facilitate research using micro- and macrolinguistic discourse analysis techniques both within this population and across populations. Educational resources, such as the Grand Rounds tutorial, were developed using case studies from the database. CONCLUSIONS: RHDBank is a shared database of resources that can facilitate educational and research efforts to address the gaps in knowledge about RHD communication and improve the clinical management of individuals with RHD.

13.
Wellcome Open Res ; 6: 209, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35495088

RESUMO

Background: Britain's National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been undertaken decennially since 1990 and provide a key data source underpinning sexual and reproductive health (SRH) policy. The COVID-19 pandemic disrupted many aspects of sexual lifestyles, triggering an urgent need for population-level data on sexual behaviour, relationships, and service use at a time when gold-standard in-person, household-based surveys with probability sampling were not feasible. We designed the Natsal-COVID study to understand the impact of COVID-19 on the nation's SRH and assessed the sample representativeness. Methods: Natsal-COVID Wave 1 data collection was conducted four months (29/7-10/8/2020) after the announcement of Britain's first national lockdown (23/03/2020). This was an online web-panel survey administered by survey research company, Ipsos MORI. Eligible participants were resident in Britain, aged 18-59 years, and the sample included a boost of those aged 18-29. Questions covered participants' sexual behaviour, relationships, and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British general population. Participants meeting criteria of interest and agreeing to recontact were selected for qualitative follow-up interviews. Comparisons were made with contemporaneous national probability surveys and Natsal-3 (2010-12) to understand bias. Results: 6,654 participants completed the survey and 45 completed follow-up interviews. The weighted Natsal-COVID sample was similar to the general population in terms of gender, age, ethnicity, rurality, and, among sexually-active participants, numbers of sexual partners in the past year. However, the sample was more educated, contained more sexually-inexperienced people, and included more people in poorer health. Conclusions: Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy. Although sampling was less representative than the decennial Natsals, Natsal-COVID will complement national surveillance data and Natsal-4 (planned for 2022).

14.
J Clin Psychol ; 66(4): 339-54, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20127793

RESUMO

The present study looked to illustrate the convergent and divergent validity of the Relationship Profile Test (RPT), which is a 30-item self-report measuring destructive overdependence, dysfunctional detachment, and healthy dependence. The RPT items are written to draw upon Bornstein's (19921993) 4-component model as well as other essential components of the dimension in question (Bornstein et al., 2003). The results reveal that the subscales of the RPT are related in predictable ways to scores on measures of adult attachment, interpersonal distress, and psychological health and well-being. The clinical implications of the results and the assessment of dependency in the clinical setting are discussed.


Assuntos
Codependência Psicológica , Dependência Psicológica , Relações Interpessoais , Apego ao Objeto , Inventário de Personalidade/normas , Comportamento Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New England , Autoavaliação (Psicologia) , Estresse Psicológico/diagnóstico , Estudantes , Universidades , Adulto Jovem
15.
Clin Psychol Psychother ; 17(1): 44-50, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19701959

RESUMO

The Schwartz Outcome Scale-10 (SOS-10) is a 10-item questionnaire that measures the broad domain of psychological well-being and quality of life. The SOS-10 is easy to administer and score. Past research has shown its utility, reliability and validity in different clinical settings (i.e., inpatient, outpatient and non-psychiatry medical settings) and with diverse clinical populations in measuring treatment outcome. The present study looks to extend the construct validity of the SOS-10 to assessing quality of life and psychological health in non-clinical samples as well. The results reveal that the SOS-10 is associated in predicted ways with established measures of attachment, interpersonal distress, alexithymia and the big five model whose construct validity and psychometric soundness has been well documented. The SOS-10 was also associated in predicted ways with ratings of childhood memories and the length of the participants' longest romantic relationship.


Assuntos
Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Relações Interpessoais , Amor , Memória , Apego ao Objeto , Qualidade de Vida/psicologia , Inquéritos e Questionários , Criança , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
16.
Am J Speech Lang Pathol ; 29(2): 741-759, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32330389

RESUMO

Purpose Limited evidence exists to guide the assessment and treatment of cognitive-communication disorders associated with right hemisphere stroke. The purpose of this study was to obtain information about speech-language pathologists' (SLPs') clinical practices and decision making for this population to understand what practices are being used and identify gaps in clinical practice. Method A survey was distributed via online ASHA Communities for the Special Interest Groups and other social media platforms. Respondents included 143 SLPs from across the United States representing 3-50 years of experience and a wide range of practice settings. Survey questions probed assessment practices including how tests are selected, what tests are used to diagnose specific deficits, and how confident SLPs were in their diagnoses. Treatment decisions were queried for a small set of disorders. Results SLPs routinely assess cognitive disorders using standardized tests. Communication disorders are less likely to be formally assessed. Three core right cerebral hemisphere deficits-anosognosia, aprosodia, and pragmatic deficits-are either not assessed or assessed only through observation by 80% of SLPs. Evidence-based treatments are commonly used for disorders of attention, awareness, and aprosodia. Conclusion Communication disorders are less likely to be formally assessed than cognitive disorders, creating a critical gap in care that cannot be filled by other allied health professionals. Suggestions for free or low-cost resources for evaluating pragmatics, prosody, and awareness are provided to aid SLPs in filling this gap. Supplemental Material https://doi.org/10.23641/asha.12159597.


Assuntos
Transtornos da Comunicação , Patologia da Fala e Linguagem , Acidente Vascular Cerebral , Adulto , Transtornos da Comunicação/diagnóstico , Transtornos da Comunicação/etiologia , Transtornos da Comunicação/terapia , Humanos , Distúrbios da Fala , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Inquéritos e Questionários , Estados Unidos
17.
J Speech Lang Hear Res ; 52(2): 373-84, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19252126

RESUMO

PURPOSE: Comprehension deficits associated with right hemisphere brain damage (RHD) have been attributed to an inability to use context, but there is little direct evidence to support the claim. This study evaluated the effect of varying contextual bias on predictive inferencing by adults with RHD. METHOD: Fourteen adults with no brain damage (NBD) and 14 with RHD read stories constructed with either high predictability or low predictability of a specific outcome. Reading time for a sentence that disconfirmed the target outcome was measured and compared with a control story context. RESULTS: Adults with RHD evidenced activation of predictive inferences only for highly predictive conditions, whereas NBD adults generated inferences in both high- and low-predictability stories. Adults with RHD were more likely than those with NBD to require additional time to integrate inferences in high-predictability conditions. The latter finding was related to working memory for the RHD group. Results are interpreted in light of previous findings obtained using the same stimuli. CONCLUSIONS: RHD does not abolish the ability to use context. Evidence of predictive inferencing is influenced by task and strength of inference activation. Treatment considerations and cautions regarding interpreting results from one methodology are discussed.


Assuntos
Dano Encefálico Crônico/psicologia , Encéfalo/fisiopatologia , Cognição/fisiologia , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Dano Encefálico Crônico/fisiopatologia , Formação de Conceito , Feminino , Lateralidade Funcional , Humanos , Masculino , Memória de Curto Prazo , Pessoa de Meia-Idade , Probabilidade , Leitura
18.
J Speech Lang Hear Res ; 52(2): 359-72, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19252130

RESUMO

PURPOSE: This study was designed to replicate and extend a previous study of inferencing in which some adults with right hemisphere damage (RHD) generated but did not maintain predictive inferences over time (M. Lehman-Blake & C. Tompkins, 2001). Two hypotheses were tested: (a) inferences were deactivated, and (b) selection of previously generated inferences was slowed and not measurable with the original stimuli. Existing literature did not support one hypothesis over the other. METHOD: Fourteen adults with RHD and 14 with no brain damage (NBD) participated in this mixed-design study. Participants read short narratives that suggested a predictive inference. Reading times were obtained to assess inference generation, maintenance, and integration. RESULTS: The majority of participants evidenced generation and maintenance of inferences. For the few who did not maintain inferences, participants with NBD always deactivated the inferences, whereas those with RHD demonstrated either deactivation or slowed selection. Adults with RHD were more likely to exhibit slowing in inference generation and integration. CONCLUSIONS: The results for inference maintenance differ from the original study in that most participants with RHD maintained inferences. Deactivation appeared in both groups, whereas slowed selection appeared to be an aberrant process related to RHD. Future work is needed to tease out the relationships between comprehension, working memory, and inferencing processes.


Assuntos
Dano Encefálico Crônico/psicologia , Encéfalo/fisiopatologia , Cognição/fisiologia , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Dano Encefálico Crônico/fisiopatologia , Formação de Conceito , Feminino , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Leitura
19.
Artigo em Inglês | MEDLINE | ID: mdl-18722805

RESUMO

Infrared spectroscopic studies of 1:1 and 1:2 complexes of lead(II) bromide and lead(II) iodide with 1,10-phenanthroline were reported. Vibrational assignments are made by comparison to reported spectra of the uncomplexed 1,10-phenanthroline molecule. Small shifts of the ligand vibrational bands are characteristic of the complexes.


Assuntos
Chumbo/química , Fenantrolinas/química , Brometos/química , Brometos/efeitos da radiação , Halogênios/química , Halogênios/efeitos da radiação , Iodetos/química , Iodetos/efeitos da radiação , Chumbo/efeitos da radiação , Luz , Modelos Biológicos , Fenantrolinas/efeitos da radiação , Fotoquímica , Espectrofotometria Infravermelho , Difração de Raios X
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