Using Think-Alouds to Uncover Expert-Novice Gaps in AAC Intervention Planning Skills

Because few studies have explored preservice speech-language pathologists’ (SLP’s) learning outcomes in augmentative and alternative communication (AAC) coursework and clinical practica, there is a need to investigate student learning in this area. This article represents a portion of a larger study that explored the expert-novice gap in planning for intervention with children who use AAC. The companion article reports clinical reasoning skills, whereas the present study revealed intervention planning skills. The methods are the consistent with those reported in the companion article. In summary, eight novice (i.e. preservice) SLPs and eight expert SLPs completed think-aloud tasks while they developed intervention plans. Verbal data were transcribed and analyzed qualitatively. Eight intervention planning skills emerged from the data: selecting treatment style, planning activities, selecting or developing materials, planning teaching strategies, selecting targets, goal setting, collecting data, and feature matching. Considerable overlap across expert and novice performance was observed in some areas, while minor differences were noted in other skills. Expert-novice gaps were identified in two areas, developing a treatment style and feature matching. Familiarity with expert-novice gaps in intervention planning has implications for preservice instruction in AAC

Clinical Reasoning Skills in AAC Intervention Planning: Investigating the Expert-Novice Gap

Clinical reasoning skills underlie the decisions speech-language pathologists (SLPs) make during practice. Although clinical reasoning is included in speech-language pathology accreditation standards in the United States, there is limited research on preservice SLPs’ development or use of clinical reasoning skills. Because clinical reasoning skills specific to augmentative and alternative communication (AAC) service provision have not been identified or reported in depth, this qualitative study focused on two cases of children with developmental disabilities who used AAC systems. Eight novice (i.e. preservice) SLPs and eight expert SLPs completed think-aloud tasks while they developed intervention plans, which made their clinical reasoning skills observable. Responses were transcribed for qualitative analysis. Six clinical reasoning skills were identified: summarizing, interpreting, hypothesizing, rationalizing, comparing and deferring. Expert and novices used four of these clinical reasoning skills similarly; however, there were differences among the remaining two skills. Novices deferred more frequently during the tasks and were limited in their ability to make comparisons to the fictional cases as compared to the experts. The expert-novice gap in clinical reasoning presents implications for teaching preservice SLPs in the classroom and the clinic

Three Approaches to Documenting Database Migrations

Database migration is a crucial aspect of digital collections management, yet there are few best practices to guide practitioners in this work. There is also limited research on the patterns of use and processes motivating database migrations. In the “Migrating Research Data Collections” project, we are developing these best practices through a multi-case study of database and digital collections migration. We find that a first and fundamental problem faced by collection staff is a sheer lack of documentation about past database migrations. We contribute a discussion of ways information professionals can reconstruct missing documentation, and some three approaches that others might take for documenting migrations going forward. [This paper is a conference pre-print presented at IDCC 2020 after lightweight peer review.

Three dimensional modeling via photographs for documentation of a village bath

24th International CIPA Symposium; Strasbourg; France; 2 September 2013 through 6 September 2013The aim of this study is supporting the conceptual discussions of architectural restoration with three dimensional modeling of monuments based on photogrammetric survey. In this study, a 16th century village bath in Ulamiş, Seferihisar, and Izmir is modeled for documentation. Ulamiş is one of the historical villages within which Turkish population first settled in the region of Seferihisar - Urla. The methodology was tested on an antique monument; a bath with a cubical form. Within the limits of this study, only the exterior of the bath was modeled. The presentation scale for the bath was determined as 1 / 50, considering the necessities of designing structural interventions and architectural ones within the scope of a restoration project. The three dimensional model produced is a realistic document presenting the present situation of the ruin. Traditional plan, elevation and perspective drawings may be produced from the model, in addition to the realistic textured renderings and wireframe representations. The model developed in this study provides opportunity for presenting photorealistic details of historical morphologies in scale. Compared to conventional drawings, the renders based on the 3d models provide an opportunity for conceiving architectural details such as color, material and texture. From these documents, relatively more detailed restitution hypothesis can be developed and intervention decisions can be taken. Finally, the principles derived from the case study can be used for 3d documentation of historical structures with irregular surfaces

Self-reported symptoms and managment by midwestern breast cancer survivors

Lymphedema (LE) is a life-long potential consequence of breast cancer treatment that may affect quality of life of breast cancer survivors in long-term survivorship. Previous studies reported that about 2 million women living with breast cancer are at a lifetime risk for LE development. Information from self-reported lymphedema symptoms and its management will provide potential early detection and intervention to manage LE. The purposes of this study were: To report the frequency of occurrence of commonly self- reported LE symptoms following breast cancer diagnosis and treatment. To find the most commonly reported self-management actions taken for the five LE symptoms.Research supported by NIH/NINR NR05342/NR010293, University of Missouri PRIME funds, and Ellis Fischel Cancer Center research funds

'You are at their mercy' : disclosure and trust in LGBTQI+ cancer care

Background Lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) populations represent an ‘ignored epidemic’ and a ‘growing, medically underserved population’ in cancer care, with preliminary evidence that these communities experience disproportionate cancer burdens and unique psychosocial challenges (e.g. lower satisfaction with care, greater cancer-related distress). Methods The Out with Cancer study is the first international study to explore the experiences of LGBTQI+ people diagnosed with cancer, using a mixed-methods approach (survey, semi-structured and photo-elicitation interviews). This presentation focuses on disclosure and trust in cancer care, from the perspective of LGBTQI+ people with cancer and healthcare professionals. Results LGBTQI+ participants (to date survey n=342; interviews n=105; data collection is ongoing) often reported careful control around disclosure of their sexual and gender identities or intersex variations in cancer care, in part, due to embarrassment, discomfort, and fear of negative reactions. Previous negative healthcare experiences contributed to distrust in cancer care, reluctance to disclose LGBTQI+ status and fears of inequitable treatment. Some participants reported explicit discriminations in cancer care, however, micro-aggressions (e.g. cis-heteronormative assumptions) and systemic absences of services and information tailored to the needs of LGBTQI+ people with cancer were more commonly reported. Healthcare professionals reported lacking confidence working with LGBTQI+ cancer patients, attributed to insufficient knowledge of the needs of these patients, uncertainty of correct terminology, and feeling embarrassed and uncomfortable discussing topics such as sexual needs. Furthermore, healthcare professionals reported lacking information and resources to guide the provision of quality clinical care and decision making with LGBTQI+ patients (e.g. such as the impact of hormone therapies on cancer treatment). Conclusions These findings highlight the need to develop resources for LGBTQI+ people with cancer and healthcare professionals, which facilitate access to information and care that is culturally informed and relevant to the needs of LGBTQI+ communities

Dual-Chamber Pacing for Hypertrophic Cardiomyopathy: A Randomized, Double-Blind, Crossover Trial

AbstractObjectives. In a double-blind, randomized, crossover trial we sought to evaluate the effect of dual-chamber pacing in patients with severe symptoms of hypertrophic obstructive cardiomyopathy.Background. Recently, several cohort trials showed that implantation of a dual-chamber pacemaker in patients with severely symptomatic hypertrophic obstructive cardiomyopathy can relieve symptoms and decrease the severity of the left ventricular outflow tract gradient. However, the outcome of dual-chamber pacing has not been compared with that of standard therapy in a randomized, double-blind trial.Methods. Twenty-one patients with severely symptomatic hypertrophic obstructive cardiomyopathy were entered into this trial after baseline studies consisting of Minnesota quality-of-life assessment, two-dimensional and Doppler echocardiography and cardiopulmonary exercise tests. Nineteen patients completed the protocol and underwent double-blind randomization to either DDD pacing for 3 months followed by backup AAI pacing for 3 months, or the same study arms in reverse order.Results. Left ventricular outflow tract gradient decreased significantly to 55 ± 38 mm Hg after DDD pacing compared with the baseline gradient of 76 ± 61 mm Hg (p < 0.05) and the gradient of 83 ± 59 mm Hg after AAI pacing (p < 0.05). Quality-of-life score and exercise duration were significantly improved from the baseline state after the DDD arm but were not significantly different between the DDD arm and the backup AAI arm. Peak oxygen consumption did not significantly differ among the three periods. Overall, 63% of patients had symptomatic improvement during the DDD arm, but 42% also had symptomatic improvement during the AAI backup arm. In addition, 31% had no change and 5% had deterioration of symptoms during the DDD pacing arm.Conclusions. Dual-chamber pacing may relieve symptoms and decrease gradient in patients with hypertrophic obstructive cardiomyopathy. In some patients, however, symptoms do not change or even become worse with dual-chamber pacing. Subjective symptomatic improvement can also occur from implantation of the pacemaker without its hemodynamic benefit, suggesting the role of a placebo effect. Long-term follow-up of a large number of patients in randomized trials is necessary before dual-chamber pacing can be recommended for all patients with severely symptomatic hypertrophic obstructive cardiomyopathy.(J Am Coll Cardiol 1997;29:435–41

The Collective Submitted Works from Honors 2030

Students in the Honors 2030, Inquiries in the Social and Behavioral Sciences course each participated in the URS 2020 as their final project for the course. Dr. Wilson worked with each student as a faculty mentor to create, draft, edit, approve and publish each of the final posters and papers submitted to the 2020 URS for the course

Intentional and unintentional nonadherence to hydroxyurea among people with sickle cell disease: A qualitative study

Hydroxyurea is an efficacious treatment for sickle cell disease (SCD), but adoption is low among individuals with SCD. The objective of this study was to examine barriers to patients' adherence to hydroxyurea use regimens by using the intentional and unintentional medication nonadherence framework. We interviewed individuals with SCD age 15 to 49.9 years who were participants in the Sickle Cell Disease Implementation Consortium (SCDIC) Needs Assessment. The intentional and unintentional medication nonadherence framework explains barriers to using hydroxyurea and adds granularity to the understanding of medication adherence barriers unique to the SCD population. In total, 90 semi-structured interviews were completed across 5 of the 8 SCDIC sites. Among interviewed participants, 57.8% (n = 52) were currently taking hydroxyurea, 28.9% (n = 26) were former hydroxyurea users at the time of the interview, and 13.3% (n = 12) had never used hydroxyurea but were familiar with the medication. Using a constructivist grounded theory approach, we discovered important themes that contributed to nonadherence to hydroxyurea, which were categorized under unintentional (eg, Forgetfulness, External Influencers) and intentional (Negative Perceptions of Hydroxyurea, Aversion to Taking Any Medications) nonadherence types. Participants more frequently endorsed adherence barriers that fell into the unintentional nonadherence type (70%) vs intentional nonadherence type (30%). Results from this study will help SCD health care providers understand patient choices and decisions as being either unintentional or intentional, guide tailored clinical discussions regarding hydroxyurea therapy, and develop specific, more nuanced interventions to address nonadherence factors

Publication of data collection forms from NHLBI funded sickle cell disease implementation consortium (SCDIC) registry

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline and first follow-up data collection forms available for other SCD research efforts. Results: Study data on 2400 enrolled patients across eight sites was stored and managed using Research Electronic Data Capture (REDCap). Standardized data collection instruments, recruitment and enrollment were refined through consensus of consortium sites. Data points included measures taken from a variety of validated sources (PHENX, PROMIS and others). Surveys were directly administered by research staff and longitudinal follow-up was coordinated through the DCC. Appended registry forms track medical records, event-related patient invalidation, pregnancy, lab reporting, cardiopulmonary and renal functions. Conclusions: The SCDIC Registry strives to provide an accurate, updated characterization of the adult and adolescent SCD population as well as standardized, validated data collecting tools to guide evidence-based research and practice