48 research outputs found

    Speech and language therapy for aphasia following stroke

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    Background  Aphasia is an acquired language impairment following brain damage that affects some or all language modalities: expression and understanding of speech, reading, and writing. Approximately one third of people who have a stroke experience aphasia.  Objectives  To assess the effects of speech and language therapy (SLT) for aphasia following stroke.  Search methods  We searched the Cochrane Stroke Group Trials Register (last searched 9 September 2015), CENTRAL (2015, Issue 5) and other Cochrane Library Databases (CDSR, DARE, HTA, to 22 September 2015), MEDLINE (1946 to September 2015), EMBASE (1980 to September 2015), CINAHL (1982 to September 2015), AMED (1985 to September 2015), LLBA (1973 to September 2015), and SpeechBITE (2008 to September 2015). We also searched major trials registers for ongoing trials including ClinicalTrials.gov (to 21 September 2015), the Stroke Trials Registry (to 21 September 2015), Current Controlled Trials (to 22 September 2015), and WHO ICTRP (to 22 September 2015). In an effort to identify further published, unpublished, and ongoing trials we also handsearched theInternational Journal of Language and Communication Disorders(1969 to 2005) and reference lists of relevant articles, and we contacted academic institutions and other researchers. There were no language restrictions.  Selection criteria  Randomised controlled trials (RCTs) comparing SLT (a formal intervention that aims to improve language and communication abilities, activity and participation) versus no SLT; social support or stimulation (an intervention that provides social support and communication stimulation but does not include targeted therapeutic interventions); or another SLT intervention (differing in duration, intensity, frequency, intervention methodology or theoretical approach).  Data collection and analysis  We independently extracted the data and assessed the quality of included trials. We sought missing data from investigators.  Main results  We included 57 RCTs (74 randomised comparisons) involving 3002 participants in this review (some appearing in more than one comparison). Twenty-seven randomised comparisons (1620 participants) assessed SLT versus no SLT; SLT resulted in clinically and statistically significant benefits to patients' functional communication (standardised mean difference (SMD) 0.28, 95% confidence interval (CI) 0.06 to 0.49, P = 0.01), reading, writing, and expressive language, but (based on smaller numbers) benefits were not evident at follow-up. Nine randomised comparisons (447 participants) assessed SLT with social support and stimulation; meta-analyses found no evidence of a difference in functional communication, but more participants withdrew from social support interventions than SLT. Thirty-eight randomised comparisons (1242 participants) assessed two approaches to SLT. Functional communication was significantly better in people with aphasia that received therapy at a high intensity, high dose, or over a long duration compared to those that received therapy at a lower intensity, lower dose, or over a shorter period of time. The benefits of a high intensity or a high dose of SLT were confounded by a significantly higher dropout rate in these intervention groups. Generally, trials randomised small numbers of participants across a range of characteristics (age, time since stroke, and severity profiles), interventions, and outcomes.  Authors' conclusions  Our review provides evidence of the effectiveness of SLT for people with aphasia following stroke in terms of improved functional communication, reading, writing, and expressive language compared with no therapy. There is some indication that therapy at high intensity, high dose or over a longer period may be beneficial. HIgh-intensity and high dose interventions may not be acceptable to all

    Hemingway: \u3cem\u3eFor Whom the Bell Tolls\u3c/em\u3e

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    Recounts Hemingway’s involvement in the Spanish Civil War, uncovering the historical analogues for some of the novel’s characters and events. Caute examines Robert Jordan’s ambivalent political allegiance along with Hemingway’s, arguing that despite their support of the Republic, both are reluctant to follow the party line

    The dancer defects : the struggle for cultural supremacy during the cold war /

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    Opinion

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    “Running with the hounds”: Academic McCarthyism and New York University, 1952-53

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    This paper is an anatomy of an inquisition. It examines the Cold War\ud persecution of Edwin Berry Burgum, a university professor and literary theorist.\ud Whilst his professional competence was consistently applauded, his academic\ud career was abruptly destroyed. His ‘fitness to teach’ was determined by his\ud political beliefs: he was a member of the American Communist Party. The paper\ud argues that New York University, an institution that embodied liberal values,\ud collaborated with McCarthyism. Using previously overlooked or unavailable\ud sources, it reveals cooperation between NYU’s executive officers and the FBI,\ud HUAC and the Senate Internal Security Subcommittee. Though its focus on one\ud individual, the paper illuminates larger themes of the vulnerability of academic\ud freedom and the bureaucratic processes of political repression

    Living the punk life in Green Bay, Wisconsin: exploring contradiction in the music of NOFX

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    This paper studies song lyrics from three mid-period songs written and performed by Californian punk band NOFX. I discuss NOFX’s skilful exploration of contradiction in the three selected songs, two of which are character studies of a single young male individual. The questions that the songs pose in true dialectical fashion (but do not definitively answer) include: Is it possible to maintain the carefree existential existence of the archetypal punk rocker in the face of the constraints imposed by suburban life and the voices of middle-class moderation? Can a Jewish gang in Fairfax, Los Angeles simultaneously affirm group self-identity, defend its turf, and practise its (marginalized) religion? Can a young man enjoy Christianity because it makes his life ‘seem less insane’ whilst simultaneously taking control of his life and not being a Christian sheep? NOFX poses these questions in admirable dialectical fashion, allows us to reflexively examine the issues involved, and form our own conclusions. The band rarely descends into moralism but moral values underpin NOFX’s worldview. Above all, NOFX tries to maintain a sophisticated but precarious ‘both/and’ rather than ‘either/or’ approach to each one of the questions posed in this abstract. Clever lyrics, which highlight the contradictions that a punk rocker must face whilst living in suburban America, have become one of the band’s most loved and most enduring themes
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