Reviewing evidence for social approaches to aphasia intervention: An application of A-FROM

This presentation demonstrates an application of Living with Aphasia: Framework for Outcome Measurement (A-FROM) (Kagan, et al. in press) to the analysis of evidence for social approaches to aphasia. A-FROM is a conceptual framework adapted from the World Health Organization International Classification of Functioning, Disability and Health (ICF) (WHO, 2001). A-FROM provides a user-friendly graphic to guide research and outcome measurement and helps address the lack of an integrated approach across diverse aphasia interventions. Using examples from a literature review on social approaches, this method of organizing evidence will be described

Conversation as an Outcome of Aphasia Treatment: A Systematic Scoping Review

PURPOSE: Conversation-focused speech-language pathology services are a top priority for people living with aphasia, but little is known about how researchers measure conversation as an outcome of treatment. This scoping review was undertaken to systematically review the evidence regarding the measurement of conversation in aphasia studies and to identify current practices and existing gaps. METHOD: A systematic literature search was conducted for studies published between January 1995 and September 2019 in multiple electronic databases. Covidence software was used to manage search results, study selection, and data charting processes. Data were extracted from each study and then collated and organized to elucidate the breadth of approaches, tools, or procedures oriented to measuring conversation as an outcome and identify gaps in the existing literature. RESULTS: The systematic search of the literature resulted in 1,244 studies. A total of 64 studies met inclusion criteria and were included in the review. The review summarizes the various tools and procedures used to measure conversation as an outcome of aphasia intervention, including variations in data collection and analysis procedures. The review also evaluates the quality of conversation measures in terms of psychometric properties and informal measures of validity. There was a total of 211 measures used across the 64 studies. CONCLUSIONS: While there was no clear measure that was objectively superior, several measures show promise and warrant future exploration. Some of the orientations, conceptualizations, and procedures we have presented can be seen as options that might be included in a future conversation-focused core outcome set. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21514062

US bases in the Philippines: issues and implications

The United States maintains in the Philippines its most significant military presence - in terms of bases, facilities, forces and capabilities - in the Southeast Asian and Southwest Pacific region. The bases are designed to support US military operations not just in this region but also in Northeast Asia and throughout the Indian Ocean/Persian Gulf region. The Military Bases Agreement (MBA) between the United States and the Philippines expires in September 1991. There is a very real possibility that the Agreement will not be renewed and that the US will have to vacate the bases and dismantle the facilities. This monograph is intended to provide a basis for informed discussion of issues involved in the presence of the US bases and facilities in the Philippines and their possible closure and relocation elsewhere in the region. It includes discussion of the general political relationship between the United States and the Philippines; the current Philippine domestic political issues; the attitudes of the ASEAN countries; the various redeployment options available to the United States in the region; and the strategic and political implications of the bases issue for Australia

Patient-reported outcomes in the aging population of adults with congenital heart disease: results from APPROACH-IS.

The congenital heart disease (CHD) population now comprises an increasing number of older persons in their 6th decade of life and beyond. We cross-sectionally evaluated patient-reported outcomes (PROs) in persons with CHD aged 60 years or older, and contrasted these with PROs of younger patients aged 40-59 years and 18-39 years. Adjusted for demographic and medical characteristics, patients ≥60 years had a lower Physical Component Summary, higher Mental Component Summary, and lower anxiety (Hospital Anxiety and Depression Scale-Anxiety) scores than patients in the two younger categories. For satisfaction with life, older persons had a higher score than patients aged 40-59 years. Registration: ClinicalTrials.gov NCT02150603

A Note on the Contingent Necessity of a Morphogenic Society and Human Flourishing

The Centre for Social Ontology working group project has been exploring the concept of a Morphogenic Society since 2013. The project is now drawing to a close. One of the arising issues from the project has been whether such a society can be and is liable to be one of human flourishing. In this short paper, I explore one possible aspect of the concept of a Morphogenic Society.1 A Morphogenic Society may involve issues of ‘contingent necessity’. Contingent necessity may provide one way to think about human flourishing, and this in turn may highlight the potential significance of the concept of a Morphogenic Society as a resource in positional argument for human flourishing

Genome-wide meta-analysis identifies five new susceptibility loci for cutaneous malignant melanoma.

Thirteen common susceptibility loci have been reproducibly associated with cutaneous malignant melanoma (CMM). We report the results of an international 2-stage meta-analysis of CMM genome-wide association studies (GWAS). This meta-analysis combines 11 GWAS (5 previously unpublished) and a further three stage 2 data sets, totaling 15,990 CMM cases and 26,409 controls. Five loci not previously associated with CMM risk reached genome-wide significance (P < 5 × 10(-8)), as did 2 previously reported but unreplicated loci and all 13 established loci. Newly associated SNPs fall within putative melanocyte regulatory elements, and bioinformatic and expression quantitative trait locus (eQTL) data highlight candidate genes in the associated regions, including one involved in telomere biology.[Please see the Supplementary Note for acknowledgments.]This is the author accepted manuscript. The final version is available from NPG via http://dx.doi.org/10.1038/ng.337

Evaluating country-specific characteristics

Background: Measuring quality of life (QOL) is fundamental to understanding the impact of disease and treatment on patients’ lives. Objectives: This study aimed to explore QOL in an international sample of adults with congenital heart disease (CHD), the association between patient characteristics and QOL, and international variation in QOL and its relationship to country-specific characteristics.Objectives: This study aimed to explore QOL in an international sample of adults with congenital heart disease (CHD), the association between patient characteristics and QOL, and international variation in QOL and its relationship to country-specific characteristics.Methods: We enrolled 4,028 adults with CHD from 15 countries. QOL was assessed using a linear analog scale (LAS) (0 to 100) and the Satisfaction with Life Scale (SWLS) (5 to 35). Patient characteristics included sex, age, marital status, educational level, employment status, CHD complexity, and patient-reported New York Heart Association (NYHA) functional class. Country-specific characteristics included general happiness and 6 cultural dimensions. Linear mixed models were applied.Results: Median QOL was 80 on the LAS and 27 on the SWLS. Older age, lack of employment, no marriage history, and worse NYHA functional class were associated with lower QOL (p < 0.001). Patients from Australia had the highest QOL (LAS: 82) and patients from Japan the lowest (LAS: 72). Happiness scores and cultural dimensions were not associated with variation in QOL after adjustment for patient characteristics and explained only an additional 0.1% of the variance above and beyond patient characteristics (p = 0.56).Conclusions: This large-scale, international study found that overall QOL in adults with CHD was generally good. Variation in QOL was related to patient characteristics but not country-specific characteristics. Hence, patients at risk for poorer QOL can be identified using uniform criteria. General principles for designing interventions to improve QOL can be developed.peer-reviewe