The role of AT-SLP collaborations in return to academics following mTBI: A scoping review.

Return-to-academics (RTA) for student-athletes with mild traumatic brain injury (mTBI) is crucial, but relatively understudied compared to return-to-play (RTP). The transient and unpredictable nature of symptoms surrounding mTBI often results in underreporting of neurocognitive symptoms, leading to a greater susceptibility for repeated TBIs, as well as posing impediments to the process of RTA. Athletic Trainers (ATs) and Speech-Language Pathologists (SLPs) are in a unique position to help student-athletes achieve a safe, timely, and effective RTA following mTBI. They typically work in middle/high schools and collegiate-level academic settings and often serve as members of concussion management teams. Compared to other allied health professions, ATs and SLPs are relatively new professions with evolving scopes of practice. Despite established guidelines and recommendations for their scope of practice in treating student-athletes with mTBI, there is a lacuna in research regarding their individual and collaborative roles in achieving RTA. The current scoping review was conducted with the main goal of exploring published literature pertaining to the roles of ATs and SLPs in achieving RTA for student-athletes with mTBI. Current implications, recommendations for integrating pre-service interprofessional education (IPE) experiences, and future directions for AT-SLP collaborations are discussed.

The role and use of event-related potentials in aphasia: A scoping review.

Event-related potentials (ERPs) can provide important insights into underlying language processes in both unimpaired and neurologically impaired populations and may be particularly useful in aphasia. This scoping review was conducted to provide a comprehensive summary of how ERPs have been used with people with aphasia (PWA), with the goal of exploring the potential clinical application of ERPs in aphasia assessment and treatment. We identified 117 studies that met inclusionary criteria, reflecting six thematic domains of inquiry that relate to understanding both unimpaired and aphasic language processing and the use of ERPs with PWA. In these studies, a wide variety of ERP components were reported. Inconsistencies in reporting of participant characteristics and study protocols limit our ability to generalize beyond the individual studies and understand implications for clinical applicability. We discuss the potential roles of ERPs in aphasia management and make recommendations for further developing ERPs for clinical utility in PWA.

A Review of the Role of Auditory Evoked Potentials in Mild Traumatic Brain Injury Assessment.

Around 75% to 90% of people who experience a traumatic brain injury (TBI) are classified as having a mild TBI (mTBI). The term mTBI is synonymous with concussion or mild head injury (MHI) and is characterized by symptoms of headache, nausea, dizziness, and blurred vision. Problems in cognitive abilities such as deficits in memory, processing speed, executive functioning, and attention are also considered symptoms of mTBI. Since these symptoms are subtle in nature and may not appear immediately following the injury, mTBI is often undetected on conventional neuropsychological tests. Current neuroimaging techniques may not be sensitive enough in identifying the array of microscopic neuroanatomical and subtle neurophysiological changes following mTBI. To this end, electrophysiological tests, such as auditory evoked potentials (AEPs), can be used as sensitive tools in tracking physiological changes underlying physical and cognitive symptoms associated with mTBI. The purpose of this review article is to examine the body of literature describing the application of AEPs in the assessment of mTBI and to explore various parameters of AEPs which may hold diagnostic value in predicting positive rehabilitative outcomes for people with mTBI.

Validity of an eyetracking method for capturing auditory-visual cross-format semantic priming.

INTRODUCTION: Semantic priming paradigms are important for understanding lexical-semantic processing and the nature of linguistic deficits accompanying language performance in neurologically impaired individuals such as people with aphasia. Reaction-time-(RT)-based traditional semantic priming tasks entail potential confounds, especially problematic when applied to people with aphasia, who may have concomitant neurocognitive challenges that limit task performance. Some of these confounds include requirements of following complex instructions, making metalinguistic judgments, and using speech or limb-based motor actions to indicate overt responses. Eyetracking methods have great potential for avoiding some of these confounds. We tested the validity of an eyetracking method in capturing semantic priming in an auditory-visual cross-format priming paradigm (auditory word prime-visual image target). METHOD: A total of 72 neurologically unimpaired adults participated in two phases: a stimulus development phase using traditional priming (n = 32) and an experimental eyetracking phase (n = 40). Each phase included two conditions, representing distinct levels of prime-target semantic relatedness: unrelated and related. Mean RT data from the traditional priming (stimuli development) phase guided image selection for the eyetracking experiment. Eyetracking indices of fixation duration and latency of fixation were recorded to capture semantic priming in the eyetracking experiment. RESULTS: Eye fixation data indicated that images related to auditory primes were attended to earlier and attracted significantly greater visual attention than unrelated images. These results mirrored RT data from the traditional priming method, which showed faster RT latencies and more accurate naming performance for related images than for unrelated images. CONCLUSIONS: Results support the validity of eyetracking indices of semantic priming and offer a robust testing protocol for future studies in this line of research. Current clinical relevance for people with aphasia is highlighted. Further empirical testing of the psychometric properties of the eyetracking measures in various semantic priming contexts is recommended.

Retaining experienced hospital administrators: a neglected topic in healthcare.

The sharp increase in the present need for healthcare services has been attributed to the expanding population of older adults (those above the age of 65 years) and the increasing number of aging healthcare professionals seeking retirement without enough qualified replacements. In this regard, retaining experienced healthcare professionals, especially hospital administrators, may be the key to managing this growing demand for healthcare services at present and for the future. Veteran hospital administrators have many years of experience and can offer a wide array of skills and competencies to their organization. As such, organizations should make every effort to retain these individuals and implement efforts for their continued contribution to the healthcare industry. Given the nature of their work and the various changes accompanying aging, experienced hospital administrators may have specific personal and professional challenges that may be compelling them to consider retirement options. The authors' primary focus was to identify the unique issues associated with retaining experienced hospital administrators and to propose certain accommodations and recommendations to promote their continued and valued contributions to the healthcare industry.

Study of cardiac autonomic function in drug-naïve, newly diagnosed epilepsy patients.

BACKGROUND: Epilepsy is associated with ictal autonomic dysfunction which may extend into the inter-ictal period. Antiepileptic drugs have often been blamed for cardiac autonomic dysfunction in epilepsy patients. In this study we have investigated cardiac autonomic parameters in order to evaluate autonomic functions of drug-naïve epilepsy patients. METHOD: Twenty drug-naïve patients (15 males and 5 females) with epilepsy, and an equal number of age and gender matched controls, were evaluated for short-term resting heart rate variability and conventional cardiovascular autonomic measurements. RESULTS: The mean age of patients was 29.30 +/- 9.80 yrs (17-55 yrs), mean age at seizure onset was 19.70 +/- 9.15 yrs (3-40 yrs) and mean length of time since last seizure was 5.60 +/- 7.00 days (1-30 days). While there was no difference in the resting heart rate or conventional autonomic test parameters, time domain heart rate variability measurements showed a decreased percentage of R-R intervals of less than 50 ms and root mean square of R-R intervals in patients, when compared to controls. Frequency domain parameters showed a decreased total power (patients: 1,796.58 +/- 1,052.45 ms2; controls: 2,934.23 +/- 1,767.06 ms2, p = 0.008). Parameters indicative of decreased vagal tone, i.e. decreased high frequency power and increased low to high frequency ratio (patients: 1.69 +/- 0.94; controls: 1.14 +/- 0.64, p = 0.045), were observed among patients compared to controls. CONCLUSION: Subtle but definite cardiac autonomic dysfunction, especially in vagal tone, was identified in drug-naïve, new-onset epilepsy patients. Seizures can cause long-term and often progressive cardiac autonomic dysfunction which may be independent of concomitant antiepileptic drugs.