Working memory training in post-stroke aphasia: Near and far transfer effects

Purpose: Individuals with aphasia (IWA) show various impairments in speech, language, and cognitive functions. Working memory (WM), a cognitive system that functions to hold and manipulate information in support of complex, goal-directed behaviors, is one of the impaired cognitive domains in aphasia. The present study intended to examine the effects of a WM training program on both memory and language performance in IWA. Method: This quasi-experimental study with an active control group was performed on 25 people with mild or moderate Broca's aphasia aged 29�61 years resulting from left hemisphere damage following ischemic stroke. Participants were assigned into two groups, including a training group (n = 13) and a control group (n = 12). The treatment and control groups received WM training and routine speech therapy, respectively. Two separate lists of WM tests, including one list for both pre-training assessment and training program and a second list for the post-training assessment, were used in this study. Results: The treatment group showed significant improvements in both trained and non-trained WM tasks (near transfer effect) and language performance (far transfer effect) compared to the control group. Conclusion: Given the good generalizability of the WM training program on both WM and language performance, WM training is suggested as part of the rehabilitation program in aphasia. © 2020 Elsevier Inc

Research paper: Comparing the diadochokinetic rate in farsi-speaking young and older adults

Objectives: Speech Diadochokinesis (DDK) is defined as the ability to produce repetitive and fast speech movements. This study aimed at comparing the DDK rate between Farsi-speaking young and older adults. Methods: In this study, 244 normal adults (122 males and 122 females) were divided into two groups of young people (20-49 years) and elderly (50-69 years). DDK tasks was performed based on two ways: the participant was asked to produce /pa/,/ta/,/ka/,/pata/,/paka/,/taka/, and /pataka/ sounds in 5 s; and to repeat single syllable sounds (/pa/,/ta/,/ka/) 20 times, two syllables sounds (/pata/,/paka/,/taka/) 15 times, and a three syllables sound (/pataka/) ten times, separately and quickly. The independent T-test, one-way ANOVA, and Pearson correlation were used for data analysis. Results: The results indicated a significant negative and weak correlation between age and all syllables in the specified time (range:-0.139 to-0.254), and a positive and weak correlation between age and time with respect to the repetition of all syllables (range: 0.121 to 0.245). There was no significant difference between genders in both ways (P>0.05). Discussion: The results indicated different DDK rate between the young and elderly subjects that can be used as a benchmark for the diagnosis of disabled individuals in producing repetitive and fast oral movements and also as a basis for clinical assessments. © 2020 University of Social Welfare and Rehabilitation Sciences

Research paper: Wh-questions' expression in persianspeaking children: A comparison between spontaneous and elicited probes

Objectives: Studies have shown that most children before the age of 5 are capable to comprehend and express wh-questions in daily conversations. This study aimed at comparing the ability of wh-questions' production in 4-6-year-old children in spontaneous and elicited conditions. Methods: In this descriptive-analytic study, 72 (n=72) 4-6-year-old Persian-speaking children were selected randomly from kindergartens of Hamadan, Iran. Three different probes were used to evaluate the spontaneous and elicited conditions in the expression of questions with "what, where, who, why, and when". In the first probe, children were encouraged to ask questions spontaneously about experimental pictures. While in the second probe, the verbal prompt was presented about wh-questions, and wh-words were provided as key-words in the third probe. Repeated measures analysis of variance test with between-subjects' factors of sex (male, female) and age group (4-5 years, 5-6 years) and within-subjects' factor of the method (I, II, III) was performed in the study. Results: There was a main effect of probes in "where, who, and when" questions and the mean scores of the II and III probes were significantly higher than those of probe I. Children in probe I received higher scores for why questions than the other probes. "What" questions were expressed more by children in probe II. "Why, when, and where" scores were significantly higher for 5-6 years group than for 4-5 years group. There was no significant effect on all wh-questions. Discussion: The higher accuracy of wh-questions in probe II and III compared to probe I suggested that this competence is significantly developed by the use of elicited procedures (verbal prompt or providing wh-words as key-words) in comparison with no elicitation. © 2020 University of Social Welfare and Rehabilitation Sciences

Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae

Objective: Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched. Methods: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs. Results: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support. Conclusions: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Factors associated with quality of life among mothers of children with cerebral palsy

Aim: To identify the factors pertaining to the quality of life (QOL) among the mothers of patients with cerebral palsy. Methods: In this cross-sectional study, 203 mothers of children with cerebral palsy were selected using convenience sampling. The World Health Organization's Quality of Life Questionnaire (WHOQOL-BREF), the Beck Depression Inventory, the Caregiver Difficulties Scale, Fatigue Severity Scale, and a demographic information questionnaire were administered to these caregivers. Hierarchical multiple linear regression analysis was used to detect the factors associated with QOL. Results: Moderate to high significant negative correlations were observed between all WHOQOL-BREF domains and the other measures. The demographic/clinical variables were controlled, and hierarchical multiple linear regression analysis was run. The results indicated that depression, the burden of care, fatigue, and the type of cerebral palsy could significantly predict QOL in these mothers. Furthermore, QOL was lower in the mothers of children with tetraplegia than those of children with other types of disabilities (P <.05). Conclusion: QOL of mothers of children with cerebral palsy is negatively impacted by various factors such as burden of care, fatigue, and psychological symptoms. Thus, a holistic approach, including training (carrying, positioning, feeding, and how to manage the self-care of children) and psychological interventions, is required to improve QOL among this population. © 2020 John Wiley & Sons Australia, Lt

Caregiver Difficulties Scale (CDS): Translation and Psychometric Evaluation Among Iranian Mothers of Cerebral Palsy Children

The aim of this study was to investigate of psychometric properties of the Caregiver Difficulties Scale (CDS) for Iranian caregivers of children with cerebral palsy (CP). After a forward-backward translation, the Persian version of CDS (P-CDS) was administered to 151 Iranian mothers of CP children. The confirmatory factor analysis (CFA) was applied to measure the factor structure of P-CDS. The reliability was evaluated by examining internal consistency and test-retest method over a 2-week period using Cronbach's alpha and the intraclass correlation coefficient (ICC), respectively. The construct validity was assessed by measuring the association between the scores of the P-CDS and Caregiver Burden Scale (CBS), World Health Organization Quality of Life (WHOQOL-BREF), the Beck Depression Index (BDI II), and the Fatigue Severity Scale (FSS). The fit indices showed that the original model of CDS was relatively adequate (�2/df = 2.03, CFI = 0.90, TLI = 0.88 and RMSEA = 0.08). All domains of P-CDS met the minimum reliability standards (Cronbach'salpha and ICC &gt; 0.7). All subscales of P-CDS were positively correlated with the CBS, BDI-II and FSS and negatively correlated with the WHOQOL-BREF. The results showed that P-CDS is a valid and reliable measure for assessing the burden of care in Iranian mothers of CP children. © 2018 Taylor & Francis Group, LLC