Mapping therapy for sentence production impairments in nonfluent aphasia

This study investigated a new treatment in which sentence production abilities were trained in a small group of individuals and nonfluent aphasia. It was based upon a mapping therapy approach which holds that sentence production and comprehension impairments are due to difficulties in mapping between the meaning form (thematic roles) and the syntactic form of sentences. We trained production of both canonical and noncanonical reversible sentences.Three patients received treatment and two served as control participants. Patients who received treatment demonstrated acquisition of all trained sentence structures. They also demonstrated across-task generalisation of treated and some untreated sentence structures on two tasks of constrained sentence production, and showed some improvements on a narrative task. One control participant improved on some of these measures and the other did not. There was no noted improvement in sentence comprehension abilities following treatment. Results are discussed with reference to the heterogeneity of underlying impairments in sentence production impairments in nonfluent patients, and the possible mechanisms by which improvement in sentence production might have been achieved in treatment

Profession-specific training on decision-making and capacity assessment in aphasia for speech-language therapy students

Background: Speech and Language Therapists (SLTs) play a vital role in supporting people with aphasia to communicate. Recent studies have shown that despite SLTs’ expertise, skills and knowledge to support people with aphasias’ communication needs; they are not regularly involved in the decision-making and capacity (DMC) assessments for people with aphasia. Literature suggests three key contributors to this under-involvement: 1) SLTs do not feel they understand their role in a DMC assessment, 2) they do not feel there is enough profession-specific training, and 3) they feel members of the multidisciplinary team do not fully understand their role and responsibilities to involve them in the process. Aims: This research reports the development of a profession-specific DMC training program for SLT trainees, and its implementation to document change in their confidence, knowledge and understanding of the DMC process in people with aphasia. Methodology: Thirty-nine SLT students attended a two-hour DMC training session conducted in three phases: pre-training questionnaire, the training program, and the post-training questionnaire. Topics in the training program included: the knowledge and tenets of the Mental Capacity Act (2005); DMC for people with aphasia, focusing specifically on the barriers faced by people with aphasia and professionals; the SLTs’ role within a multidisciplinary team regarding DMC assessments; and resources available for facilitating DMC assessments. The change in participants score from pre- to post-training questionnaire was taken as a measure of efficacy of the training program. Results: Following training there was a significant increase in the confidence levels of SLT students in terms of ability to complete capacity assessments and train others in their role within a capacity assessment. Participants also had a better understanding of the MCA (2005) and an increased knowledge of resources available to support people with aphasia in these assessments. These results demonstrate a crucial need for profession-specific training, which has implications for inter-professional education. Conclusions: The findings highlight the effectiveness of a short training session in increasing SLT trainees’ knowledge and confidence in DMC for aphasia, and improving their understanding of SLTs’ role and responsibilities. It is anticipated that this type of training will place SLTs in a better position for future clinical practice, reducing the risks currently present not only to patients, but also to staff themselves. We propose that similar training programs should become mandatory for SLT trainees as part of their clinical training

Name agreement in aphasia

Background: Images are essential materials for assessment and rehabilitation in aphasia. Psycholinguistic research has identified name agreement (the degree to which different people agree on a particular name for a particular image) to be a strong predictor of picture naming in healthy individuals in a wide variety of languages. Despite its significance in naming performance and its impact across linguistic families, studies investigating the effects of name agreement in neuropsychological populations are limited. Determining the impact of name agreement in neuropsychological populations can inform us about lexical processing, which in turn can aid in development of improved assessment and rehabilitation materials. Aims: To compare the naming accuracy and error profile in naming high versus low name agreement (HighNA and LowNA) images in people with aphasia (PWA) and in healthy Adults (HA). Methods & Procedures: Participants were 10 PWA and 21 age and gender-matched HA. Stimuli were black-and-white line drawings of 50 HighNA images (e.g., acorn, bell) and 50 LowNA images (e.g., jacket, mitten). The image sets were closely matched on a range of image and lexical variables. Participants were instructed to name the drawings using single words. Responses were coded into exclusive categories: correct, hesitations, Alternate names, visual errors, semantic errors and omissions. Outcomes and Results: HighNA images were named more accurately than LowNA images; the HA group had higher accuracy than the PWA group; there was a significant interaction in which the name agreement effect was stronger in HA than in PWA. In individual analyses, 7 of 10 PWA participants showed the group pattern of higher accuracies for HighNA, whilst 3 PWA did not. HighNA and LowNA images gave rise to more alternate names in HA than in PWA. There were also fewer visual errors, and more omissions, in PWA than in HA, but only for LowNA items. Conclusions: Name agreement produced measurable differences in naming accuracy for both HA and PWA. PWA shows a reduced effect of name agreement and exhibit a different pattern of errors, compared to healthy controls. We speculate that in picture naming tasks, lower name agreement increases competitive lexical selection, which is difficult for PWA to resolve. In preparation of clinical materials, we need to be mindful of image properties. Future research should replicate our findings in a larger population, and a broader range of pathologies, as well as determine the executive mechanisms underpinning name agreement effects

Decision-making capacity in aphasia: SLT’s contribution in England

Background: Individuals’ right to be involved with decisions regarding their health and social care is the cornerstone for modern patient-centred care. Decision-making is a complex process that involves multiple cognitive and linguistic abilities. These are often challenging for people with aphasia (PWA). The Mental Capacity Act (MCA) Code of Practice (2007) recommends that speech and language therapists (SLTs) support capacity assessments for individuals with communication problems, such as PWA. To date, little is known regarding SLTs’ involvement in the UK for supporting decision-making and capacity assessment for PWA. Aims: This research provides data to document when, how, and the extent to which SLTs are being used in capacity assessment for PWA in England. We also determined SLTs’ training and resource needs in capacity assessments, and their role in inter-professional training. Methods & Procedures: 56 SLTs working with PWA from a wide range of clinical settings in England were recruited; they completed a secure questionnaire using the online survey tool Survey Monkey. The questionnaire collected information in the following areas: knowledge and awareness of the MCA; current involvement of SLTs in capacity assessments and decision-making; inter-professional understanding of SLTs roles in capacity assessments; and training needs of SLTs. Outcomes & Results: The SLTs who participated in this survey indicated that they were not regularly involved to support capacity assessment for PWA. Moreover, they also reported that other professionals on the care team did not fully recognise or utilise their skills in supporting capacity assessment for PWA. Moreover, SLTs were not solicited to train professionals regarding communication difficulties in aphasia and its impact on capacity assessments. SLTs wanted profession-specific training to fulfil the role of supporting PWA in capacity assessments more effectively and reliably. Conclusions: Healthcare professionals have an ethical duty to ensure that judgements of capacity are unbiased and accurate. SLTs have an important contribution to make but their skills and knowledge are not fully recognised or utilised. These findings highlight an important need to raise the profile of SLTs’ skills and expertise amongst professionals through education and/or inter-professional communications. This would enable SLTs to be regularly and effectively utilised in capacity assessments and decision-making for PWA

Lexical and cognitive underpinnings of verbal fluency: evidence from Bengali-English bilingual aphasia

Research in bilingual healthy controls (BHC) has illustrated that detailed characterization of verbal fluency along with separate measures of executive control stand to inform our understanding of the lexical and cognitive underpinnings of the task. Such data are currently lacking in bilinguals with aphasia (BWA). We aimed to compare the characteristics of verbal fluency performance (semantic, letter) in Bengali–English BWA and BHC, in terms of cross-linguistic differences, variation on the parameters of bilingualism, and cognitive underpinnings. BWA showed significant differences on verbal fluency variables where executive control demands were higher (fluency difference score, number of switches, between-cluster pauses); whilst performed similarly on variables where executive control demands were lower (cluster size, within-cluster pauses). Despite clear cross-linguistic advantage in Bengali for BHC, no cross-linguistic differences were noted in BWA. BWA who were most affected in the independent executive control measures also showed greater impairment in letter fluency condition. Correlation analyses revealed a significant relationship for BWA between inhibitory control and number of correct responses, initial retrieval time, and number of switches. This research contributes to the debate of underlying mechanisms of word retrieval deficits in aphasia, and adds to the nascent literature of BWA in South Asian languages

From Geocycles to Genomes and Back

A holy grail for environmental microbiologists is being able to predict the effects of any given microbial community on a particular environment. In an era of increasingly dramatic changes in global climate, this goal is becoming evermore important. It is now well accepted that microorganisms have had and continue to have a profound influence on shaping the chemistry of the Earth. It would thus be both intellectually satisfying and practically useful if we could enumerate the microbial players in a specific locale, and, knowing their metabolic potential and how they regulate their various metabolisms, make predictions about how their presence would shape the geochemistry of that locale as it evolves in time

Anaerobic Oxidation of Ethane, Propane, and Butane by Marine Microbes: A Mini Review

The deep ocean and its sediments are a continuous source of non-methane short-chain alkanes (SCAs) including ethane, propane, and butane. Their high global warming potential, and contribution to local carbon and sulfur budgets has drawn significant scientific attention. Importantly, microbes can use gaseous alkanes and oxidize them to CO2, thus acting as effective biofilters. A relative decrease of these gases with a concomitant 13C enrichment of propane and n-butane in interstitial waters vs. the source suggests microbial anaerobic oxidation. The reported uncoupling of sulfate-reduction (SR) from anaerobic methane oxidation supports their microbial consumption. To date, strain BuS5 isolated from the sediments of Guaymas Basin, Gulf of California, is the only pure culture that can anaerobically degrade propane and n-butane. This organism belongs to a metabolically diverse cluster within the Deltaproteobacteria called Desulfosarcina/Desulfococcus. Other phylotypes involved in gaseous alkane degradation were identified based on stable-isotope labeling and fluorescence in-situ hybridization. A novel syntrophic association of the archaeal genus, Candidatus Syntrophoarchaeum, and a thermophilic SR bacterium, HotSeep-1 was recently discovered from the Guaymas basin, Gulf of California that can anaerobically oxidize n-butane. Strikingly, metagenomic data and the draft genomes of ca. Syntrophoarchaeum suggest that this organism uses a novel mechanism for n-butane oxidation, distinct from the well-established fumarate addition mechanism. These recent findings indicate that a lot remains to be understood about our understanding of anaerobic SCA degradation. This mini-review summarizes our current understanding of microbial anaerobic SCA degradation, and provides an outlook for future research

Therapy outcome in two individuals with jargon aphasia and neologisms

Two individuals with jargon aphasia with similar clinical profiles received identical phonological therapy but responded differently to the therapy-P9 did not show any positive gains but FF showed improved naming. Analysis showed that FF and P9 had comparable performance in the semantic domain but P9 had poorer phonological skills. FF also showed a decrease in the number of neologisms and an increase in similarity with the target following therapy. Discussion will focus on the importance of exploring underlying linguistic processes before initiating therapy and the importance of analyzing both quality and quantity of errors to measure the impact of therapy

An insoluble iron complex coated cathode enhances direct electron uptake by Rhodopseudomonas palustris TIE-1

Microbial electrosynthesis (MES) is a promising bioelectrochemical approach to produce biochemicals. A previous study showed that Rhodopseudomonas palustris TIE-1 can directly use poised electrodes as electron donors for photoautotrophic growth at cathodic potentials that avoid electrolytic H2 production (photoelectroautotrophy). To make TIE-1 an effective biocatalyst for MES, we need to improve its electron uptake ability and growth under photoelectroautotrophic conditions. Because TIE-1 interacts with various forms of iron while using it as a source of electrons for photoautotrophy (photoferroautotrophy), we tested the ability of iron-based redox mediators to enhance direct electron uptake. Our data show that soluble iron cannot act as a redox mediator for electron uptake by TIE-1 from a cathode poised at +100mV vs. Standard Hydrogen electrode. We then tested whether an immobilized iron-based redox mediator Prussian blue (PB) can enhance electron uptake by TIE-1. Chronoamperometry indicates that cathodic current uptake by TIE-1 increased from 1.47±0.04 to 5.6±0.09μA/cm2 (3.8 times). Overall, our data show that immobilized PB can enhance direct electron uptake by TIE-1

Bioelectrohydrogenesis and inhibition of methanogenic activity in microbial electrolysis cells - A review

Microbial electrolysis cells (MECs) are a promising technology for biological hydrogen production. Compared to abiotic water electrolysis, a much lower electrical voltage (~0.2V) is required for hydrogen production in MECs. It is also an attractive waste treatment technology as a variety of biodegradable substances can be used as the process feedstock. Underpinning this technology is a recently discovered bioelectrochemical pathway known as bioelectrohydrogenesis . However, little is known about the mechanism of this pathway, and numerous hurdles are yet to be addressed to maximize hydrogen yield and purity. Here, we review various aspects including reactor configurations, microorganisms, substrates, electrode materials, and inhibitors of methanogenesis in order to improve hydrogen generation in MECs