The use of the Communication Checklist - Adult (CC-A) for assessing the communication abilities of individuals post traumatic brain injury

Background and aims: Standardised and non-standardised assessments are used in speech pathology to evaluate an individual’s communication abilities post traumatic brain injury (TBI; e.g. Turkstra et al., 2005b). However, valid, reliable and norm-referenced standardised assessments that examine functional communication abilities of individuals post TBI outside of the clinical environment are limited. This study sought to investigate the validity of the Communication Checklist - Adults (CC-A; Whitehouse & Bishop, 2009), a caregiver questionnaire that assesses the communication abilities of individuals post TBI. Method: The project recruited 14 participants post TBI with varying communicative impairment severities. Each participant completed a routine communication assessment (RCA) which involved administration of a range of assessments. These were 1) the Communication Activities of Daily Living - Second Edition - (CADL-2; Holland, Frattali, & Fromm, 1999), a clinician-administered language assessment that generates percentile scores, with a higher percentile indicating better performance; 2) participation in a conversation which was analysed using Prutting and Kirchner’s pragmatic protocol (PKPP; Prutting & Kirchner, 1987); 3) collection of a monologic discourse sample through two single picture descriptions and description of two picture sequences. Discourse samples were transcribed and a composite of linguistic and pragmatic abilities were generated using measures derived from the Systematic Analysis of Language Transcription (SALT; Miller & Iglesias, 2008), where higher totals on test scoring indicated greater language difficulties. A caregiver or relative of the individual with TBI was also asked to complete the CC-A regarding the individual’s communication ability. The CC-A generated z scores that provided an overall measure of language abilities, as well as subscale measures of linguistic (Language Structure subscale) and pragmatic (Pragmatic Skills subscale and Social Engagement subscale) competence. Lower scores indicated greater difficulties. Results: Pearson’s correlation coefficients identified a strong positive correlation between the CC-A Overall z-scores and the CADL-2 percentile scores (r(14) = .70, p = .01). There were also statistically significant negative correlations between the CC-A Language Structure z-scores and the SALT Linguistic Composite totals, r(14) = -.65, p = .01, as well as between the CC-A Pragmatic Skills z-scores and SALT Pragmatic Composite totals, r(14) = -.53, p = .05. There were statistical trends for an association between CC-A Social Engagement z-scores and the PKPP ratings (r(14) = .48, p = .08) and between Social Engagement z-scores and the SALT Pragmatic Composite totals (r(14) = -.40, p = .15), but these correlations did not achieve statistical significance. Discussion: The results of this study provide preliminary evidence that the CC-A is a valid measure of the communication difficulties experienced by individuals with TBI. Future studies that assess a larger number of patients with a greater range of difficulties, will build on the findings presented here

Rotational and Vibrational Dynamics of Interstitial Molecular Hydrogen

The calculation of the hindered roton-phonon energy levels of a hydrogen molecule in a confining potential with different symmetries is systematized for the case when the rotational angular momentum $J$ is a good quantum number. One goal of this program is to interpret the energy-resolved neutron time of flight spectrum previously obtained for H$_{2}$C$_{60}$. This spectrum gives direct information on the energy level spectrum of H$_2$ molecules confined to the octahedral interstitial sites of solid C$_{60}$. We treat this problem of coupled translational and orientational degrees of freedom a) by construction of an effective Hamiltonian to describe the splitting of the manifold of states characterized by a given value of $J$ and having a fixed total number of phonon excitations, b) by numerical solutions of the coupled translation-rotation problem on a discrete mesh of points in position space, and c) by a group theoretical symmetry analysis. Results obtained from these three different approaches are mutually consistent. The results of our calculations explain several hitherto uninterpreted aspects of the experimental observations, but show that a truly satisfactory orientational potential for the interaction of an H$_2$ molecule with a surrounding array of C atoms has not yet been developed.Comment: 53 pages, 9 figures, to appear in Phys. Rev B (in press). Phys. Rev. B (in press

Bostonia

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs

Treatment recommendations for psoriatic arthritis

Objective: To develop comprehensive recommendations for the treatment of the various clinical manifestations of psoriatic arthritis (PsA) based on evidence obtained from a systematic review of the literature and from consensus opinion. Methods: Formal literature reviews of treatment for the most significant discrete clinical manifestations of PsA (skin and nails, peripheral arthritis, axial disease, dactylitis and enthesitis) were performed and published by members of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Treatment recommendations were drafted for each of the clinical manifestations by rheumatologists, dermatologists and PsA patients based on the literature reviews and consensus opinion. The level of agreement for the individual treatment recommendations among GRAPPA members was assessed with an online questionnaire. Results: Treatment recommendations were developed for peripheral arthritis, axial disease, psoriasis, nail disease, dactylitis and enthesitis in the setting of PsA. In rotal, 19 recommendations were drafted, and over 80% agreement was obtained on 16 of them. In addition, a grid that factors disease severity into each of the different disease manifestations was developed to help the clinician with treatment decisions for the individual patient from an evidenced-based perspective. Conclusions: Treatment recommendations for the cardinal physical manifestations of PsA were developed based on a literature review and consensus between rheumatologists and dermatologists. In addition, a grid was established to assist in therapeutic reasoning and decision making for individual patients. It is anticipated that periodic updates will take place using this framework as new data become available

Work-worlds colliding: Self-reflexivity, power and emotion in organizational ethnography

While organizational ethnographers have embraced the concept of self-reflexivity, problems remain. In this article we argue that the prevalent assumption that self-reflexivity is the sole responsibility of the individual researcher limits its scope for understanding organizations. To address this, we propose an innovative method of collective reflection that is inspired by ideas from cultural and feminist anthropology. The value of this method is illustrated through an analysis of two ethnographic case studies, involving a ‘pair interview’ method. This collective approach surfaced self-reflexive accounts, in which aspects of the research encounter that still tend to be downplayed within organizational ethnographies, including emotion, intersubjectivity and the operation of power dynamics, were allowed to emerge. The approach also facilitated a second contribution through the conceptualization of organizational ethnography as a unique endeavour that represents a collision between one ‘world of work’: the university, with a second: the researched organization. We find that this ‘collision’ exacerbates the emotionality of ethnographic research, highlighting the refusal of ‘researched’ organizations to be domesticated by the specific norms of academia. Our article concludes by drawing out implications for the practice of self-reflexivity within organizational ethnography

Predisposing Factors Associated With Development of Persistent Compared With Paroxysmal Atrial Fibrillation

Background: Once atrial fibrillation (AF) progresses to sustained forms, adverse outcomes increase and treatment success rates decrease. Therefore, identification of risk factors predisposing to persistence of AF may have a significant impact on AF morbidity. Methods and Results: We prospectively examined the differential associations between traditional, lifestyle, and biomarker AF risk factors and development of paroxysmal versus nonparoxysmal AF (persistent/permanent) among 34 720 women enrolled in the Women's Health Study who were free of cardiovascular disease and AF at baseline. AF patterns were defined based on current guidelines and classified according to the most sustained form of AF within 2 years of diagnosis. During a median follow‐up of 16.4 years, 690 women developed paroxysmal AF and 349 women developed nonparoxysmal AF. In multivariable time‐varying competing risk models, increasing age (hazard ratio [HR] 1.11, 95% CI 1.10 to 1.13, versus HR 1.08, 1.07 to 1.09, per year), body mass index (HR 1.07, 1.05 to 1.09, versus HR 1.03, 1.02 to 1.05, per kg/m2), and weight (HR 1.30, 1.22 to 1.39, versus HR 1.14, 1.08 to 1.20, per 10 kg) were more strongly associated with the development of nonparoxysmal AF compared with paroxysmal AF. Hemoglobin A1c levels at baseline were directly related to the development of nonparoxysmal AF but inversely associated with paroxysmal AF in multivariable competing risk models (P for nonequal association=0.01). Conclusions: In women without AF or CVD at baseline, increasing age, adiposity, and higher hemoglobin A1c levels were preferentially associated with the early development of nonparoxysmal AF. These data raise the hypothesis that efforts aimed at weight reduction or glycemic control may affect the proportion of the population with sustained AF

High-Level Human Herpesvirus-6 Viremia Associated With Onset of Stevens-Johnson Syndrome: Report of Two Cases:

The pathogenesis of Stevens Johnson Syndrome (SJS) remains obscure but it has been associated with various infectious agents, including members of the Herpes virus family. We present the first report of high level human herpesvirus-6 (HHV-6) viremia at the onset of SJS suggesting a possible new association. This finding supports the need for further investigation into the possible relationship between HHV-6 and SJS which may illuminate the pathogenesis of SJS and bring us closer to achieving enhanced prevention and treatment of this rare disease

Evaluating Disparities in Proton Radiation Therapy Use in AHOD1331, a Contemporary Children\u27s Oncology Group Trial for Advanced-Stage Hodgkin Lymphoma

The indications for proton radiation therapy carry the strongest evidence in pediatric cancers. In a recently published letter, Bitterman et al reviewed factors associated with receipt of proton radiation therapy in patients enrolled in Children\u27s Oncology Group (COG) solid tumor and CNS tumor trials. They demonstrated that Black children were less likely to receive this treatment than non-Hispanic white patients, a disparity that persisted when controlling for other demographic and clinical variables. We strongly commend them for their work, as addressing racism and infrastructural barriers to care requires its identification