12 research outputs found

    A New Treatment for Aphasia? Borrowing from the Field of Foreign Language Learning

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    This is a report of a new type of aphasia treatment using a single subject design. The treatment was based on the principles of TPR (Total Physical Response), an innovative method for teaching language, whose main principle is that language is best learned when paired with movement and gesture. The underlying principle of TPR for aphasia treatment lies in the recruitment of the right hemisphere to help in language reorganization. We present a subject with severe fluent aphasia, 2 years post-stroke with no prior treatment, and report on his progress during TPR-based therapy

    A comparison of the mismatch negativity (MMN) event-related potential to tone and speech stimuli in normal and aphasic adults

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    We evaluated the mismatch negativity (MMN) event-related potential (ERP) in normal and aphasic adults to tone and speech stimuli to determine aphasic patients' auditory discrimination and the relationship between MMN measures and severity of aphasia. MMNs were present in 89 % of normal subjects and 79 % of aphasic subjects to tone stimuli. MMNs were present in 100% of normal subjects and 54 % of aphasic subjects to speech stimuli. The duration of the MMN ERP to speech stimuli was significantly related to severity of aphasia on the Western Aphasia Battery, Porch Index of Communicative Ability, and the Token Test. Thus, not all aphasic people show an early, preconscious orientation response to tone and speech stimuli. However, the duration of this response, when present, to speech stimuli appears to be related to the severity of aphasia

    Public health effects of travel-related policies on the COVID-19 pandemic: A mixed-methods systematic review

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    Objectives: To map travel policies implemented due to COVID-19 during 2020, and conduct a mixed methods systematic review of health effects of such policies, and related contextual factors. Design: Policy mapping and systematic review. Data sources and Eligibility Criteria: for the policy mapping, we searched websites of relevant government bodies and used data from the Oxford COVID-19 Government Response Tracker for a convenient sample of 31 countries across different regions. For the systematic review, we searched Medline (Ovid), PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and COVID-19 specific databases. We included randomized controlled trial, non-randomized studies, modeling studies, and qualitative studies. Two independent reviewers selected studies, abstracted data and assessed risk of bias. Results: Most countries adopted a total border closure at the start of the pandemic. For the remainder of the year, partial border closure banning arrivals from some countries or regions was the most widely adopted measure, followed by mandatory quarantine and screening of travelers. The systematic search identified 69 eligible studies, including 50 modeling studies. Both observational and modeling evidence suggest that border closure may reduce the number of COVID-19 cases, disease spread across countries and between regions, and slow the progression of the outbreak. These effects are likely to be enhanced when implemented early, and when combined with measures reducing transmission rates in the community. Quarantine of travelers may decrease the number of COVID-19 cases but its effectiveness depends on compliance and enforcement and is more effective if followed by testing, especially when less than 14 day-quarantine is considered. Screening at departure and/or arrival is unlikely to detect a large proportion of cases or to delay an outbreak. Effectiveness of screening may be improved with increased sensitivity of screening tests, awareness of travelers, asymptomatic screening, and exit screening at country source. While four studies on contextual evidence found that the majority of the public is supportive of travel restrictions, they uncovered concerns about the unintended harms of those policies.Peer Reviewe

    Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

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    OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

    Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

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    Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality
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