Comparing linguistic complexity and efficiency in conversations from Stimulation Therapy and Conversation Therapy in Aphasia

The ultimate goal for speech language pathology interventions for people with aphasia (PWA) is to be able to converse as normally as possible (Armstrong & Mortensen, 2006). However, there are numerous approaches to aphasia therapy as well as various outcome measures. For instance, Stimulation therapy (ST) relies on structured repetition and drill to elicit language, while conversation therapy (CT) uses client-clinician conversation and conversation analysis to improve everyday language. Most speech language pathologists use standardized tests or rating forms to measure treatment progress rather than measuring conversations (Boles, 1998). We aimed to compare differences in linguistic complexity and efficiency in conversational outcomes in two treatment types, ST and CT. Researchers have examined the verbal abilities of PWA and aging adults by analyzing language samples (Capilouto et al., 2005; Kemper & Sumner, 2001); however few people have examined linguistic complexity in conversation as a treatment outcome measure. Conversational efficiency measured in Correct Information Units (CIUs)/minute is a valid and reliable way to measure improvement in connected speech (Nicholas and Brookshire, 1993). Efficiency can be measured by calculating CIUs/minute or % CIUs. Researchers have used %CIUs to measure efficiency in conversations (Doyle, Goda & Spencer, 1995) and CIUs/minute in story-telling (Jacobs, 2001). However, no one has reported using CIUs/minute to measure efficiency during conversational interactions. To address this we asked the following questions: 1. Does CT lead to a greater increase in linguistic complexity than ST based on the following measures of linguistic complexity: a) Mean length of utterance (in words) (MLU)? b) Type/token ratio (TTR)? c) Number of different words (NDW)? d) Percent of utterance responses? e) Percent of simple utterances? f) Percent of complex utterances? g) Propositional density? 2. Does ST lead to improved efficiency of conversation? 3. Does CT lead to improved efficiency of conversation? 4. Is conversational efficiency different when ST is compared to CT? 5. Is there a difference between clinician and participant total talk time during conversation probes taken during both treatments

Conversation Therapy for Aphasia: A Survey

There has been a growing interest in the engagement in and management of conversation in aphasia. The literature describes aspects of conversation in aphasia such as nonverbal communication and management of repair (e.g. Ferguson, 1994; Madden, Oelschlaeger & Damico, 2003). Research delineates strategies and resources employed to achieve conversation by people with aphasia and partners (e.g. Beeke, 2003; Beeke, Wilkinson & Maxim, 2001, 2009; Oelschlaeger & Damico, 1998; Wilkinson, Lock, Bryan & Sage, 2011). There is also growing interest in conversation as a target of aphasia treatment. Various approaches related to conversation have been reported such as multimodality training (Purdy & Van Dyke, 2011), discourse treatment for word retrieval (Boyle, 2011), group conversation therapy (Elman & Bernstein-Ellis, 1999; Simmons-Mackie, Elman, Holland & Damico, 2007), interaction-focused intervention (Wilkinson, Lock, Bryan & Sage, 2011), couples therapy (Boles, 2011) and partner training (Kagan et al, 2001). There has also been discussion of the impact of impairment-focused therapy on conversation (Carragher et al. 2012). Despite this growing knowledge base, there are no data regarding the translation of knowledge into clinical practice. Has conversation therapy become a routine aspect of clinical practice in aphasia? If so, what do clinicians do in conversation therapy for aphasia? In order to explore these questions, a web-based survey was initiated

Comparing the Treatment Effectiveness of Conversational and Traditional Aphasia Treatments Based on Conversational Outcome Measures

Background: Few studies have investigated conversation therapy between a person with aphasia and a clinician. Furthermore, little information exists on traditional stimulation treatment’s effect on conversational outcomes. Methods: Prospective single-subject (ABABA) study repeated across 4 participants, with quasi-randomized treatment order, investigated the treatment effects of conversation and traditional stimulation treatments on conversational outcomes. Primary outcomes included 6-minute conversations coded for pragmatic behaviors, percent CIUs; and auditory comprehension, lexical retrieval, and syntax probe performance. Results: Conversational abilities were highest during conversation therapy regardless which treatment was administered first. These results provide a template for conducting and measuring conversational therapy

Present‐day motion of the Sierra Nevada block and some tectonic implications for the Basin and Range province, North American Cordillera

Global Positioning System (GPS) data from five sites on the stable interior of the Sierra Nevada block are inverted to describe its angular velocity relative to stable North America. The velocity data for the five sites fit the rigid block model with rms misfits of 0.3 mm/yr (north) and 0.8 mm/yr (east), smaller than independently estimated data uncertainty, indicating that the rigid block model is appropriate. The new Euler vector, 17.0°N, 137.3°W, rotation rate 0.28 degrees per million years, predicts that the block is translating to the northwest, nearly parallel to the plate motion direction, at 13–14 mm/yr, faster than previous estimates. Using the predicted Sierra Nevada block velocity as a kinematic boundary condition and GPS, VLBI and other data from the interior and margins of the Basin and Range, we estimate the velocities of some major boundary zone faults. For a transect approximately perpendicular to plate motion through northern Owens Valley, the eastern California shear zone (western boundary of the Basin and Range province) accommodates 11±1 mm/yr of right‐lateral shear primarily on two faults, the Owens Valley‐White Mountain (3±2 mm/yr) and Fish Lake Valley (8±2 mm/yr) fault zones, based on a viscoelastic coupling model that accounts for the effects of the 1872 Owens Valley earthquake and the rheology of the lower crust. Together these two faults, separated by less than 50 km on this transect, define a region of high surface velocity gradient on the eastern boundary of the Sierra Nevada block. The Wasatch Fault zone accommodates less than 3±1 mm/yr of east‐west extension on the eastern boundary of the Basin and Range province. Remaining deformation within the Basin and Range interior is also probably less than 3 mm/yr

New kinematic models for Pacific‐North America Motion from 3 Ma to Present, II: Evidence for a “Baja California Shear Zone”

We use new models for present‐day Pacific‐North America motion to evaluate the tectonics of offshore regions west of the Californias. Vandenburg in coastal Alta California moves at the Pacific plate velocity within uncertainties (∼1 mm/yr) after correcting for strain accumulation on the San Andreas and San Gregorio‐Hosgri faults with a model that includes a viscoelastic lower crust. Modeled and measured velocities at coastal sites in Baja California south of the Agua Blanca fault, a region that most previous models consider Pacific plate, differ by 3–8 mm/yr, with coastal sites moving slower that the Pacific plate. We interpret these discrepancies in terms of strain accumulation on known on‐shore faults, combined with right lateral slip at a rate of 3–4 mm/yr on additional faults offshore peninsular Baja California in the Pacific. Offshore seismicity, offset Quaternary features along the west coast of Baja California, and a discrepancy between the magnetically determined spreading rate in the Gulf Rise and the total plate rate from a geological model provide independent evidence for a “Baja California shear zone.

An international effort towards developing standards for best practices in analysis, interpretation and reporting of clinical genome sequencing results in the CLARITY challenge

Background: There is tremendous potential for genome sequencing to improve clinical diagnosis and care once it becomes routinely accessible, but this will require formalizing research methods into clinical best practices in the areas of sequence data generation, analysis, interpretation and reporting. The CLARITY Challenge was designed to spur convergence in methods for diagnosing genetic disease starting from clinical case history and genome sequencing data. DNA samples were obtained from three families with heritable genetic disorders and genomic sequence data were donated by sequencing platform vendors. The challenge was to analyze and interpret these data with the goals of identifying disease-causing variants and reporting the findings in a clinically useful format. Participating contestant groups were solicited broadly, and an independent panel of judges evaluated their performance. Results: A total of 30 international groups were engaged. The entries reveal a general convergence of practices on most elements of the analysis and interpretation process. However, even given this commonality of approach, only two groups identified the consensus candidate variants in all disease cases, demonstrating a need for consistent fine-tuning of the generally accepted methods. There was greater diversity of the final clinical report content and in the patient consenting process, demonstrating that these areas require additional exploration and standardization. Conclusions: The CLARITY Challenge provides a comprehensive assessment of current practices for using genome sequencing to diagnose and report genetic diseases. There is remarkable convergence in bioinformatic techniques, but medical interpretation and reporting are areas that require further development by many groups

GPS-determination of along-strike variation in Cascadia margin kinematics: Implications for relative plate motion, Subduction zone coupling, and permanent deformation

High‐precision GPS geodesy in the Pacific Northwest provides the first synoptic view of the along‐strike variation in Cascadia margin kinematics. These results constrain interfering deformation fields in a region where typical earthquake recurrence intervals are one or more orders of magnitude longer than the decades‐long history of seismic monitoring and where geologic studies are sparse. Interseismic strain accumulation contributes greatly to GPS station velocities along the coast. After correction for a simple elastic dislocation model, important residual motions remain, especially south of the international border. The magnitude of northward forearc motion increases southward from western Washington (3–7 mm/yr) to northern and central Oregon (∼9 mm/yr), consistent with oblique convergence and geologic constraints on permanent deformation. The margin‐parallel strain gradient, concentrated in western Washington across the populated Puget Lowlands, compares in magnitude to shortening across the Los Angeles Basin. Thus crustal faulting also contributes to seismic hazard. Farther south in southern Oregon, north‐westward velocities reflect the influence of Pacific‐North America motion and impingement of the Sierra Nevada block on the Pacific Northwest. In contrast to previous notions, some deformation related to the Eastern California shear zone crosses northernmost California in the vicinity of the Klamath Mountains and feeds out to the Gorda plate margin

Global quieting of high-frequency seismic noise due to COVID-19 pandemic lockdown measures

Human activity causes vibrations that propagate into the ground as high-frequency seismic waves. Measures to mitigate the COVID-19 pandemic caused widespread changes in human activity, leading to a months-long reduction in seismic noise of up to 50%. The 2020 seismic noise quiet period is the longest and most prominent global anthropogenic seismic noise reduction on record. While the reduction is strongest at surface seismometers in populated areas, this seismic quiescence extends for many kilometers radially and hundreds of meters in depth. This provides an opportunity to detect subtle signals from subsurface seismic sources that would have been concealed in noisier times and to benchmark sources of anthropogenic noise. A strong correlation between seismic noise and independent measurements of human mobility suggests that seismology provides an absolute, real-time estimate of population dynamics