Intensive Comprehensive Aphasia Programs: An International Survey of Practice

Background: In response to the need to simultaneously address multiple domains of the International Classification of Functioning, Disability and Health (ICF) in aphasia therapy and to incorporate intensive treatment doses consistent with principles of neuroplasticity, a potentially potent treatment option termed intensive comprehensive aphasia programs (ICAPs) has been developed. Objective: To conduct an international survey of ICAPs to determine the extent of their use and to explore current ICAP practices. Methods: A 32-item online survey was distributed internationally through Survey Monkey between May and August 2012. The survey addressed ICAP staffing, philosophy, values, funding, admission criteria, activities, family involvement, outcome measures, and factors considered important to success. Results: Twelve ICAPs responded: 8 from the United States, 2 from Canada, and 1 each from Australia and the United Kingdom. The majority of ICAPs are affiliated with university programs and are funded through participant self-pay. ICAPs emphasize individualized treatment goals and evidence-based practices, with a focus on applying the principles of neuroplasticity related to repetition and intensity of treatment. On average, 6 people with aphasia attend each ICAP, for 4 days per week for 4 weeks, receiving about 100 hours of individual, group, and computer-based treatment. Speech-language pathologists, students, and volunteers staff the majority of ICAPs. Conclusions: ICAPs are increasing in number but remain a rare service delivery option. They address the needs of individuals who want access to intensive treatment and are interested in making significant changes to their communication skills and psychosocial well-being in a short period of time. Their efficacy and cost-effectiveness require future investigation

Stress resistance in building a career in sports

In the modern world, a person is exposed to various stress-resistant situations that push a person to the emergence of various kinds of stress. The article focuses on the characteristics of the concepts of “stress tolerance”, “stress tolerance in sport”, “career”, “professional career”, “career in sport”: the main features and details. The purpose of the article is to study the psychoemotional state of an athlete; the development and testing of a program of psychological assistance to athletes who find themselves in a stressful situation when building a sports career. The article focuses on the features of psychological assistance to athletes who are in a stressful situation when building a sports career, by means of psychological counseling. The study of the emotional and personal sphere of athletes, the features of psychological assistance to athletes who are in a stressful situation when building a sports career, by means of psychological counseling. The framework, topics of counseling and support when dealing with stress in athletes in the study touched the framework of personal psychology. Let us analyze the results obtained by the method "Scale of rapid diagnosis of the level of neurotization." The presented fact allows us to judge the emerging trend among athletes who fall into the category of people who find themselves in a stressful situation, towards the development of instability of the emotional background. Also, this can often lead to mood recessions and an increased indicator of personal frustration in the event of a failure in competitions and in the usual training process, that is, in everyday life. This fact can tell us about the likelihood of a conflict within their personality. The achieved results can be used in programs of advisory work of a psychologist-consultant with athletes who have experienced stressful situations when building a sports career

How to Launch an Interdisciplinary Leadership Program

Building a doctoral program in leadership is never an easy task, and building an interdisciplinary doctoral program is even more difficult. Yet, it is the interdisciplinary approach that differentiates typical leadership programs from others and offers learners an integrated view of leadership theories and practices. This special report presents an example of designing and implementing an interdisciplinary doctoral program that promotes social justice leadership. Drawing from firsthand experiences of program faculty, staff, and administration, we share lessons learned and the logic behind adopting an interdisciplinary approach for those creating programs that seeks to promote social justice. We found that by allowing students and faculty to convene together, rather than disperse into separate, isolated academic disciplines, emerging scholar-practitioners are encouraged to engage in realistic, professional practice investigation and problem-solving techniques. Through this experience, we also found that conscious coursework design involves integrating multiple, often quite divergent, disciplines into a core set of courses. Additionally, we learned that unifying students through a common mission permits distinctive discussions, including personal reflection and ethical decision-making opportunities among the concepts, constructs, and knowledge that extend beyond disciplinary lines (Cherney et al., 2012). We also found that cultivating a diverse student body and faculty base requires everyone to work strategically within the program, recognizing the call for coherence and consistency across disciplinary lines. Finally, we discovered that developing a dissertation in practice allows students to implement an evidence-based solution within their professional practice setting as their pinnacle doctorate work (Herr & Anderson, 2014; Olson & Clark, 2009). We conclude this paper by reiterating our finding that leadership programs that promote social justice are enhanced by adopting an interdisciplinary approach as this allows for the creation of a program that challenges students to learn at a more complex level, faculty to integrate disciplines, and programs to promote socially just ideals. We discuss implications for other schools seeking to develop an interdisciplinary doctoral leadership program

Quantum theories of (p,q)-forms

We describe quantum theories for massless (p,q)-forms living on Kaehler spaces. In particular we consider four different types of quantum theories: two types involve gauge symmetries and two types are simpler theories without gauge invariances. The latter can be seen as building blocks of the former. Their equations of motion can be obtained in a natural way by first-quantizing a spinning particle with a U(2)-extended supersymmetry on the worldline. The particle system contains four supersymmetric charges, represented quantum mechanically by the Dolbeault operators and their hermitian conjugates. After studying how the (p,q)-form field theories emerge from the particle system, we investigate their one loop effective actions, identify corresponding heat kernel coefficients, and derive exact duality relations. The dualities are seen to include mismatches related to topological indices and analytic torsions, which are computed as Tr(-1)^F and Tr[(-1)^F F] in the first quantized supersymmetric nonlinear sigma model for a suitable fermion number operator F.Comment: 44 pages, 2 figures, a reference adde

Intensive Language Therapy for Nonfluent Aphasia With And Without Surgical Implantation of an Investigational Cortical Stimulation Device: Preliminary Language and Imaging Results

This randomized clinical trial evaluated the feasibility of targeted epidural cortical stimulation delivered concurrently with speech-language therapy (SLT) in four subjects with chronic Broca’s aphasia. Four matched controls received identical SLT without stimulation. Investigational subjects showed a mean WAB-AQ change of 8.0 points immediately post-therapy and at 6-week follow-up, and 12.3 points at 12-week follow-up. The control group’s mean WAB-AQ change was 4.6, 5.5, and 3.6 points, respectively. Similar patterns of change were noted on the Communicative Effectiveness Index. fMRI changes suggested differential reorganization. Cortical stimulation in combination with intensive SLT may enhance language rehabilitation for chronic Broca’s aphasia

STS-114 Engine Cut-off Sensor Anomaly Technical Consultation Report

The NESC consultation team participated in real-time troubleshooting of the Main Propulsion System (MPS) Engine Cutoff (ECO) sensor system failures during STS-114 launch countdown. The team assisted with External Tank (ET) thermal and ECO Point Sensor Box (PSB) circuit analyses, and made real-time inputs to the Space Shuttle Program (SSP) problem resolution teams. Several long-term recommendations resulted. One recommendation was to conduct cryogenic tests of the ECO sensors to validate, or disprove, the theory that variations in circuit impedance due to cryogenic effects on swaged connections within the sensor were the root cause of STS-114 failures

Zekerheid op Lading: Pandrecht en retentierecht op roerende zaken en cognossement in het handelsverkeer

Een zekerheidsrecht functioneert in het recht ongeveer op dezelfde manier als de grijper van een kraan in de haven. Zoals de machinist van een kraan de grijper kan openen of sluiten, zo heeft de zekerheidshouder de bevoegdheid om de zaken onder zich te houden totdat de verschuldigde vordering is betaald, dan wel om de zaken af te geven aan de schuldenaar of een derde. Door de uitoefening van zijn zekerheidsrecht houdt de schuldeiser dus grip op de lading. Dit aspect van het zekerheidsrecht is van groot belang voor logistieke dienstverleners en banken. De door hen verrichte handelingen, zoals kredietverlening, fysieke distributie, expeditie, vervoer, bewaarneming, laden, lossen, opdracht en lastgeving, brengen kosten met zich mee die in beginsel verhaalbaar zijn op de contractuele wederpartij, de schuldenaar. In veel gevallen wordt het verschuldigde loon echter pas betaald na het verrichten van de handeling ten behoeve van de zaken. Daardoor loopt de schuldeiser steeds het risico dat de schuldenaar, om wat voor reden dan ook, verzuimt zijn verbintenis uit de overeenkomst, namelijk de verplichting tot het betalen van het loon, na te komen. Hier komt het belang van het zekerheidsrecht naar voren: door middel van een zekerheidsrecht kan de schuldeiser het risico van wanbetaling door de schuldenaar beperken. De schuldeiser behoeft de zaken niet af te geven zolang het loon niet is betaald en hij kan zich zelfs onder bepaalde omstandigheden op de zaken verhalen. Uiteraard zal niet in alle gevallen waar sprake is van een betalingsverzuim een zekerheidsrecht worden ingeroepen. Vaak volstaat een commerciële oplossing, zoals het bieden van uitstel van betaling. Het zekerheidsrecht komt pas in beeld wanneer een commerciële oplossing geen resultaat (meer) geeft. Dat is het geval wanneer de schuldenaar failliet is gegaan of op andere wijze ervan blijk geeft niet aan zijn betalingsverplichtingen te kunnen voldoen. In deze gevallen waarin een commerciële oplossing niet meer baat, vervullen zekerheidsrechten een onmisbare rol. Dit boek handelt over twee zekerheidsrechten, het pandrecht en het retentierecht, en hun rol in het internationaal handelsverkeer

Evaluating the Benefits of Aphasia Intervention Delivered in Virtual Reality: Results of a Quasi-Randomised Study

Introduction This study evaluated an intervention for people with aphasia delivered in a novel virtual reality platform called EVA Park. EVA Park contains a number of functional and fantastic locations and allows for interactive communication between multiple users. Twenty people with aphasia had 5 weeks’ intervention, during which they received daily language stimulation sessions in EVA Park from a support worker. The study employed a quasi randomised design, which compared a group that received immediate intervention with a waitlist control group. Outcome measures explored the effects of intervention on communication and language skills, communicative confidence and feelings of social isolation. Compliance with the intervention was also explored through attrition and usage data. Results There was excellent compliance with the intervention, with no participants lost to follow up and most (18/20) receiving at least 88% of the intended treatment dose. Intervention brought about significant gains on a measure of functional communication. Gains were achieved by both groups of participants, once intervention was received, and were well maintained. Changes on the measures of communicative confidence and feelings of social isolation were not achieved. Results are discussed with reference to previous aphasia therapy findings

Kidney protection with canagliflozin: A combined analysis of the randomized CANVAS program and CREDENCE trials

AIM: In the CANVAS Program and CREDENCE trials, the sodium glucose co-transporter 2 inhibitor canagliflozin reduced the risk of cardiovascular and kidney events in patients with type 2 diabetes. The current study analysed a pooled population to ascertain the kidney protection provided by canagliflozin across the full spectrum of kidney parameters. METHODS: This post-hoc pooled analysis of the CANVAS Program (N = 10 142) and CREDENCE trial (N = 4401), assessed the risk of the primary kidney composite (doubling of serum creatinine, end-stage kidney disease, renal death), in all patients and subgroups defined by baseline estimated glomerular filtration rate (300 mg/g (33.9 mg/mmol)] and 2012 Kidney Disease: Improving Global Outcomes (KDIGO) classification of chronic kidney disease (low/moderate, high and very high risk). RESULTS: In the overall population, the risk for the primary kidney composite outcome was 37% lower in the canagliflozin group versus placebo (HR: 0.63; 95% CI: 0.53, 0.77; p  .05). A statistically significant risk reduction of the primary kidney composite outcome was sustained by approximately 18 months after randomization. CONCLUSIONS: These results emphasize a critical role of canagliflozin in kidney protection across a broad spectrum of participants with type 2 diabetes with varying levels of kidney function