Effects of a Telerehabilitation Group on Continuing Language Treatment after Participation in an Intensive Comprehensive Aphasia Program (ICAP)

Aphasia is an acquired neurogenic language disorder encompassing oral and/or written language expression and comprehension affecting an estimated two- to two to four million people in the United States, (Simmons-Mackie, 2018; National Aphasia Association, 2016). The primary aim of the current study was to investigate an option for targeted intervention as a follow-up to an Intensive Comprehensive Aphasia Program (ICAP). There is little research assessing maintenance of communication profile gains following conclusion of the ICAPs, and there are few options that exist as tailored ICAP follow-up programs or continued intervention guided by the ICAP principle features. To address this, a Tele-connect Aphasia Group (TAG) project was initiated to provide continuing intervention after ICAP via telerehabilitation group therapy. Following a formal language assessment via videoconference, six participants completed up to four one-hour aphasia group sessions via telerehabilitation, along with up to sixty minutes per week of individual sessions/coaching over telephone or videoconference, over the course of four weeks. Results demonstrate progress towards personalized communication goals by all six participants. Moreover, participants endorsed the benefit of continuing language therapy at home through participation in group telerehabilitation, especially when supplemented with individual meetings/sessions

Inflammation in Prediabetes and Type 2 Diabetes: A Potential Target to Improve Outcomes

Background: Inflammation is implicated in the development, progression and long-term complications of type 2 diabetes (T2DM). Hyperglycemia and visceral adipose tissue, which are common in people at risk or diagnosed with T2DM, promote inflammation. Hyperinsulinemia, a compensatory mechanism in response to insulin resistance and a result of some pharmacologic treatments for T2DM, may also be proinflammatory, which has important implications for treatment strategies. Purpose: To further understand the effect that diet and its associated relationship with insulin, has on inflammation and T2DM outcomes. Aim 1: Examines the association between fasting insulin and high sensitivity C-reactive protein (hs-CRP), a marker of inflammation, in adults without diabetes, assessing the potential mediating role of visceral adipose tissue, operationalized as waist circumference. Using a multinomial logistic regression, with hs-CRP divided into three levels of risk and average-risk as the base group, in the reduced adjusted model we found that fasting insulin was associated with high-risk (RRR = 1.07, p < .001) and low-risk (RRR = 0.91, p < .001) hs-CRP. In the full adjusted model also controlling for waist circumference, the low-risk RRR was 0.97 (p < .001) and high-risk RRR was 1.02 (p = .002), reflecting the attenuation of 69% and 68% for each group respectively, indicating this relationship may be partially mediated by visceral adipose tissue. Aim 2: Examines the association between diet (net carbohydrates and total sugar) and white blood cell count (WBC), a marker of inflammation, as well as glucose control (glycated hemoglobin [HbA1c]). We found a significant association between net carbohydrate intake and WBC (β = 0.001, p = .047) but not between total sugar intake and WBC (β = 0.000, p = .838), after adjusting for potential confounders. We did not find a significant association between HbA1c and either net carbohydrate (β = 0.001, p = .311) or total sugar (β = -0.000, p = .815), after adjusting for potential confounders. Aim 3: Examines the effect of a very low-carbohydrate diet (VLC) compared to a Dietary Approaches to Stop Hypertension diet (DASH) on fasting insulin, insulin resistance, and inflammation in overweight or obese adults with prediabetes or T2DM and hypertension over 4 months. Overall, the VLC group experienced greater reductions in fasting insulin compared to the DASH group (-3.86 µU/mL, p = .027) and Homeostatic Model Assessment 2-Insulin Resistance (HOMA2-IR; -0.51, p = .029). However, these effects were no longer significant after a Bonferroni adjustment for multiple comparisons. The VLC group experienced greater reductions in WBC (-0.72 K/uL, p = .004), which was maintained after a Bonferroni adjustment. Reductions in IL-6 approached significance in the DASH vs. VLC group (0.77 pg/mL, p = .070), although this was not significant after the Bonferroni adjustment. Statistically significant differences between diet groups were not observed for the other tested inflammatory markers. Conclusions: This dissertation adds to the evidence that prevention and treatment efforts for T2DM may be improved if inflammation is addressed. These results suggest that treatment approaches that simultaneously decrease insulin levels while achieving glycemic control may provide additional anti-inflammatory effects.PHDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162872/1/missaman_1.pd

We are preaching with you pastor : congregational input for the accurate and relevant application of the word of God

https://place.asburyseminary.edu/ecommonsatsdissertations/1292/thumbnail.jp

Hopping Conduction and Bacteria: Transport in Disordered Reaction-Diffusion Systems

We report some basic results regarding transport in disordered reaction-diffusion systems with birth (A->2A), death (A->0), and binary competition (2A->A) processes. We consider a model in which the growth process is only allowed to take place in certain areas--"oases"--while the rest of space--the "desert"--is hostile to growth. In the limit of low oasis density, transport is mediated through rare "hopping" events, necessitating the inclusion of discreteness effects in the model. By first considering transport between two oases, we are able to derive an approximate expression for the average time taken for a population to traverse a disordered medium.Comment: 4 pages, 2 figure

'Staying cool, calm and positive':A dialogical narrative analysis of emotional reactions in narratives about operable lung cancer

BACKGROUND: Patients with lung cancer suffer from physical, psychosocial and particularly emotional challenges. Twenty-five percent of patients with lung cancer are offered surgery as a potential cure. Nevertheless, 40% of surgically treated patients will experience recurrence. Paradoxically, research shows a dominant narrative of operable lung cancer patients 'being lucky', which silences other narratives about suffering, worries and emotional challenges.AIM: To explore narratives about operable lung cancer, particularly emotional reactions to illness and suffering in these narratives.METHODS: A qualitative design was applied. Six women and four men diagnosed with operable lung cancer were included from one university hospital in Denmark and interviewed 1 month after surgery using active interviews. The interviews were subject to dialogical narrative analysis. The theoretical foundation is social constructivism, with socio-narratological inspiration.FINDINGS: A typology of three emotional narratives emerged: 'staying cool', 'staying calm' and 'staying positive'. All three types of narrative are characterised by managing emotional reactions. Staying cool is characterised by not showing emotional reactions; staying calm narratives acknowledge emotional reactions, but that they need to be managed so that they do not burden relatives; and the last, staying positive, is characterised by managing emotional reactions in a positive direction. Together this typology of three emotional narratives revealed that operable lung cancer patients are under normative pressure from these socially preferred narratives of ideal emotional reactions to lung cancer.CONCLUSION: A typology of three emotional narratives were identified and can be called 'feeling rules' that guide patients after lung cancer surgery to manage their emotions. Consequently, if patients do not live up to these three emotional narratives of staying cool, calm and positive, they may be socially isolated and restricted from access to support.</p

Crystal oscillator for low-voltage applications

TCC(graduação) - Universidade Federal de Santa Catarina. Centro Tecnológico. Engenharia Eletrônica.Em virtude do recorrente aumento de aplicações para IoT (Internet das Coisas), que exige dispositivos autossuficientes, este trabalho de conclusão de curso propõe o projeto de um circuito integrado de baixa tensão que, combinado a um cristal de quartzo, forma um oscilador, o qual é um bloco importante em sistemas digitais e de comunicação. Esse circuito opera com 100mV de tensão de alimentação, compatível com o uso de dispositivos de colheita de energia, visto que esses dispositivos geram tensões de dezenas a centenas de milivolts. Por operar em baixa tensão, o consumo de potência do circuito diminui. Este trabalho apresenta a teoria, medições práticas usando componentes discretos e o projeto do circuito integrado, em conjunto com simulações de esquemático e layout, que permitem verificar o comportamento do circuito integrado e suas condições de operação.Given the increase of IoT applications, which requires autonomous devices, this final year project proposes the design of a low-voltage integrated circuit that, combined with a quartz-crystal, forms an oscillator, an important block in digital and communication systems. The circuit operates with 100 mV of supply voltage, which is compatible with the use of energy harvesting devices, since these devices provide from tens to hundreds of millivolts. By operating at low-voltages, the circuit’s power consumption is reduced. This work presents the theory, measurements using discrete components and the design of the integrated circuit of a Pierce oscillator along with schematic and layout simulations, which allows to verify and predict the behavior of the integrated circuit

DESAIN PERKERASAN KAKU PADA JALAN KANDANGAN–SEMEMI, SURABAYA DENGAN METODE MANUAL DESAIN PERKERASAN JALAN 2017

Pada Ruas Jalan Kandangan – Sememi memiliki status jalan Provinsi, dimana jalan tersebut berada di Kecamatan Benowo Kota Surabaya yang menyatukan antar Kota Surabaya dan Kabupaten Gresik. Dipilih lokasi tersebut sebagai objek penelitian karena seringnya dilalui kendaraan berat dan jalan existing mengalami kerusakan yang cukup parah hal itu pula menyebabkan seringnya kecelakaan pada lokasi ini. Maka dari itu dilakukan perencanaan ulang dengan menggunakan perkerasan kaku. Perencanaan ulang dilakukan dengan membandingkan dua metode dengan umur rencana 40 tahun dan jenis perkererasan ialah BBTT, metode yang digunakan yaitu Manual Desain Perkerasan Jalan 2017. Pada metode Manual Desain Perkerasan Jalan 2017 memperhatikan data nilai kelompok sumbu pada setiap jenis kendaraan niaga. Hasil perhitungan perencanaan tebal perkerasan kaku menggunakan metode Manual Desain Perkerasan Jalan 2017 diperoleh tebal perkerasan kaku setebal 285 mm, ruji (dowel) Ø 32 mm, panjang 450 mm, dan panjang 300 mm, batang pengikat (tie bars) D16 mm, panjang 700 mm dan jarak 750 m

A radialização do sutil – rádio na rua, ritornelos, ladaias e vastidão –

O dissertado aqui tem como acontecimento principal e dispositivo Rádio Na Rua: a rádio das pessoas em situação de rua criada em 2012 durante oficinas de artistagem no Centro Pop em Porto Alegre. Essa rádio hoje com 6 anos de performação conjuga músicas, poesia, dança, conversas, entrevistas, debates, piadas, assuntos polêmicos, apresentação de talentos, sorteios, inicialmente acontecendo apenas no Centro Pop, e posteriormente, migrando para performances no espaço público, entrevistando e sonorizando os trânsitos das pessoas pelas ruas da cidade, comunicando as complexidades das vidas das pessoas em situação de rua no urbano. Nessa pesquisa, procurou-se problematizar primeiro como transduzir essa experiência, vivência, performance, ao texto científico acadêmico de modo a problematizar tanto o campo de condições de possibilidade da RNR quanto a forma de registrar essa intervenção. A pesquisa poderia ser resumida no problema: como foi possível a criação de um dispositivo coletivo como a RNR e o que ela faz fazer? Outra questão é qual a implicação teórico-técnica da psicologia nesse dispositivo. Para tanto, conciliou-se o método cartográfico com o método do Looping para o desdobramento de agenciamentos convergentes à RNR e disparados por ela. Acontecem aqui radializações, encrencas, ritornelos, ladaias e vastidão.The dissertation here has as main event and device Radio On the Street: the radio of street people created in 2012 during artist workshops at the Pop Center in Porto Alegre. This radio, with 6 years of experience, combines music, poetry, dance, conversations, interviews, debates, jokes, controversial subjects, talent presentation, raffles, initially happening only in the Pop Center, and later, migrating to performances in public space, interviewing and sounding the transits of people through the streets of the city, communicating the complexities of the lives of street people in the urban. In this research, we tried to first problematize how to transduce this experience, experience, performance, to the academic scientific text in order to problematize both the field of conditions of possibility of RNR and how to register this problematic field. The research could be summarized in the problem: how was it possible to create a collective device like RNR and what does it do? Another question is what is the theoretical-technical implication of psychology in this device. For this, the cartographic method was reconciled with the Looping method for the unfolding of assemblages converging to the RNR and triggered by it. Radialization, trouble, ritornelos, ladaias, and vastness occur here