Expectation in Visual Symbolic Processing of Environmental Symbols in People with Fluent Aphasia

The purpose of this study was to examine aspects of visual symbolic processing in those individuals with fluent aphasia, and how it compares to that of their lexical ability. Two groups of participants were examined: a group with fluent aphasia, and a group of non-neurologically damaged controls. Participants were administered four computer based expectation tasks, two of which were symbolic, and two which were lexical. Each task contained a simple and a complex level. Participants were required to determine if the final stimulus, within a set of four, was congruent or incongruent. The measures taken included both reaction time and accuracy. Results suggest significant differences in reaction times for individuals with aphasia and non-neurologically damaged individuals. Individuals with aphasia also identified fewer incongruent stimuli correctly. Within the aphasia group, statistical significance was approached between the simple symbolic condition and simple lexical condition. If this study were completed with a larger sample size, results could indicate a relative preservation of the non-verbal symbolic system as compared to the lexical system for simple conditions. Strong correlations were also noted for several opposing non-verbal and lexical conditions

Time of day effects on language discourse in healthy aging and dementia

This study’s purpose was to investigate whether language discourse follows a diurnal pattern across one 10-hour day in normal healthy aging individuals (NHA) and individuals with mild to moderate Alzheimer’s disease. Ten healthy older adults; and ten older adults clinically labeled with probable Alzheimer’s disease were recruited for this study. Measurements of procedural language, narrative language, and cognition, the Benton Judgment of Line Orientation (BJLO), were collected across one day at 9:00am, 12:00pm, 3:00 pm, and 6:00pm. Language samples were evaluated for linguistic variables to evaluate the quantity and quality of the discourse samples. Results indicated that the two groups differed significantly on their cognitive performance across the day, but cognitive performance was not correlated with any of the linguistic measures. Measures of narrative quality were significantly different between the groups. Group differences in procedural quality and quantity were non-significant. Some linguistic variables were susceptible to changes in diurnal patterns, while others were not. Diurnal effects appeared most prevalent in those with a higher cognitive status, with individuals with Alzheimer’s disease showing less variation in linguistic measures across the day. Clinically, these results could impact the timing and administration of cognitive exams and therapies, as to account for changes in arousal patterns. Future studies should include examinations of other linguistic variables to evaluate their susceptibility to diurnal patterns. Physiological measures should be included to provide a more objective measure of circadian rhythms

Student Navigation Through Computer-Based Simulations: What Predicts Success?

Clinical simulations, in a variety of forms, is a viable educational tool, allowing CSD students to acquire professional competencies and skills. Simucase is a computer-based simulation program designed for this objective. The goal of this study was to determine what elements of simulation engagement predicted success on a student\u27s overall ability to make the correct recommendation for patient care, and what those predictors can tell us about how students navigate computer-based simulations. The data set used for this study comprised 149 graduate students in communication sciences and disorders (CSD) programs who completed a computer-based assessment simulation for a patient with aphasia. To determine which areas of the simulation predicted student success, a logistic regression was performed to determine which of the 12 types of decision points offered predictive data for making the correct final recommendation. The 12 types of decisions used comprised case history, collaborator, assessment, and diagnosis sections with reflective, acceptable, and rejected options in each. Results indicate that student patterns of case engagement can predict overall case success. The overall model was significant and individual predictors were significantly responsible for predicting which students would choose the correct outcome at the end of the case. This study revealed that students who engage in more careful navigation of preliminary assessment steps such as case history and collaborators were more likely to reach the correct recommendation at the end of the case. This finding has implications for the implementation of computer-based simulations for clinical education

Teaching End-of-Life Care in Speech-Language Pathology: A Tutorial

Speech-language pathologists often lack preparation for working with patients near the end of life (EoL). Few academic training programs offer dedicated or sufficient content in the area of end-of-life care (EoLC). Furthermore, traditional knowledge-focused outcomes are not the most effective pedagogical strategy in teaching EoL and palliative care to students. Instead, a focus on self-awareness and personal beliefs in relation to death and dying have been shown to have a positive effect on attitudes toward EoLC. The purposes of this paper are three-fold: First, to explore what is known about the teaching and training of EoL in the discipline of speech-language pathology; second, to explore successful pedagogical strategies being used to teach this content; and third, to provide evidence-based suggestions for the inclusion of this content into speech-language pathology curriculum

Use of a Standardized Tracheostomy Patient Simulation to Evaluate Student Clinical Communication Skills

Simulation is a valid pedagogical tool used to teach students, observe student clinical skills, and to assess clinical competencies. During the COVID-19 pandemic, a lack of medical speech-language pathology placements required graduate programs to re-examine clinical training. Simulation has proven useful in providing an alternative and safe learning modality. Standardized patients, which are one simulation modality, provide increased standardization and higher fidelity than medical manikins. This is particularly true in the context of both student learning and demonstration of clinical communication skills (CCS) within a simulated learning environment where the simulated patient can interact authentically with the student clinician. CCS are important because they can lead to better treatment outcomes and strengthen the therapeutic alliance. The purpose of this study was to evaluate the evidence for a CCS training in the context of a speaking valve trial with a standardized tracheostomy patient. Results showed that students are demonstrating emerging skills or have already developed CCS in this context. Student questionnaire ratings suggest that this simulation was helpful to their learning as it provided a safe environment for them to practice valuable clinical skills. Simulation appears to be a viable modality to use when training CSD students to improve their CCS

Clinical Simulations in Academic Courses: Four Case Studies Across the Medical SLP Graduate Curriculum

Simulation practices are growing in both popularity and necessity within speech pathology programs. Simulation use can serve to not only minimize client risk but to increase student confidence and competence prior to patient contact, particularly with low incidence or medically fragile patients. This paper describes and reflects on four individual simulation experiences within one graduate speech language pathology program and their outcomes. The use of both simulated patients and mannequin training resulted in an increase in students\u27 perception of knowledge and confidence in their clinical skills with medical patients

Boosting Confidence in Hearing Loss Services Through an Interprofessional Simulation led by Peer Instructors

Speech-language pathologists have an ethical responsibility to work with clients with hearing loss. Therefore, speech-language pathology (SLP) students must receive specific education and training in working with this population. SLP students may have low self-efficacy about their ability to work with clients with hearing loss if they haven’t participated in specific training. Interprofessional education utilizing peer teaching by doctor of audiology (AuD) students is one method for helping SLP students learn specific skills to address hearing loss in a clinical setting. The purpose of this study was to investigate SLP graduate students\u27 self-efficacy with working with individuals with hearing loss; SLP student perception of an interprofessional, peer-taught, experiential learning day (ELD) focused on skills related to serving individuals with hearing loss; and AuD peer teacher experiences. The ELD focused on developing skills and knowledge related to the insertion, troubleshooting, and maintenance of hearing aids. It also involved the exploration of hearing assistive technology, as well as information on hearing aids and hearing protection. The learning experience included multiple stations utilizing simulation, experiential learning, and AuD peer teaching. Results from this investigation suggest that an ELD benefits both SLP and AuD students. Specifically, SLP students reported increased self-efficacy for all tasks practiced, and AuD peer teachers reported increased confidence with teaching and a desire to teach again. Student questionnaire ratings suggested that SLP students enjoyed learning from AuD peer teachers, felt the ELD was beneficial to their learning, and thought they were gaining crucial skills for future practice. It appears that using an ELD with AuD peer teachers is a beneficial way to teach SLP students skills for working with clients with hearing loss

“It's like sludge green”: Young people's perceptions of standardised tobacco packaging in the UK

Background and Aims Standardised tobacco packaging was introduced in the United Kingdom (UK) in May 2016, together with larger graphic warnings. This study explored young Scottish people's awareness of and perceptions about standardised tobacco packaging in the UK Design Qualitative study using 16 focus groups conducted February‐March 2017. Setting Four schools in Scotland based in areas of differing socioeconomic status (high vs medium/low) and two levels of urbanity (large urban vs small town/other urban). Participants Eighty‐two S2 (13‐14 years) and S4 (15‐16 years) students who were smokers or at‐risk non‐smokers. Measurements Focus groups explored perceptions of standardised packaging and health warnings. The qualitative data underwent thematic analysis. Findings Views about standardised packaging were generally negative. Packs were described as being unattractive, drab and less appealing than non‐standardised versions. The new health warnings generated negative affective, often aversive, responses. These varied depending on the image's perceived ‘gruesomeness' and authenticity. Most participants thought that the impact would be greatest on young non/occasional smokers. There were divergent views about whether established smokers would be affected. Conclusions The introduction of standardised tobacco packaging and new larger graphic health warnings in the United Kingdom seems have reduced the perceived attractiveness of cigarette packs among young people in the UK who smoke or are at elevated risk of becoming smokers, disrupting positive brand imagery (the brand heuristic), increasing the salience of health warnings, and contributing to denormalising smoking

Are Retail Outlets Complying with National Legislation to Protect Children from Exposure to Tobacco Displays at Point of Sale? Results from the First Compliance Study in the UK

Background   From April 6th2015, all small shops in the UK were required to cover up tobacco products at point of sale (POS) to protect children from exposure. As part of a larger 5-year study to measure the impact of the legislation in Scotland, an audit was conducted to assess level and nature of compliance with the ban immediately following its introduction.  Materials and Methods   A discreet observational audit was conducted 7–14 days post implementation which took measures of physical changes made to cover products, server/assistant practices, tobacco signage and advertising, and communication of price information. The audit was conducted in all small retail outlets (n = 83) selling tobacco in four communities in Scotland selected to represent different levels of urbanisation and social deprivation. Data were analysed descriptively.  Results   Compliance with the legislation was high, with 98% of shops removing tobacco from permanent display and non-compliance was restricted almost entirely to minor contraventions. The refurbishment of shops with new or adapted tobacco storage units resulted in the removal of nearly all commercial brand messages and images from POS, dropping from 51% to 4%. The majority of shops stored their tobacco in public-facing storage units (81%). Most shops also displayed at least one generic tobacco message (88%).  Conclusions  Compliance with Scottish prohibitions on display of tobacco products in small retail outlets was high immediately after the legislation implementation date. However, although tobacco branding is no longer visible in retail outlets, tobacco storage units with generic tobacco messages are still prominent. This points towards a need to monitor how the space vacated by tobacco products is utilised and to better understand how the continuing presence of tobacco storage units influences people’s awareness and understanding of tobacco and smoking. Countries with existing POS bans and who are considering such bans should pay particular attention to regulations regarding the use of generic signage and where within the retail setting tobacco stocks can be stored

Assessing Change in Tobacco Visibility at Point-of-sale Following a Display Ban

Objectives:  In this paper, we describe a point-of-sale (POS) tobacco visibility tool and examine its utility for assessing changes in visibility following legislation banning tobacco displays.  Methods:  An observational tool was developed as part of DISPLAY, a multimodal, longitudinal study evaluating the impact of the tobacco POS display ban in Scotland. Measures were taken of product and storage unit visibility, over 5 years, pre- and post-implementation in all retail outlets selling tobacco in 4 contrasting study areas (N = 103).  Results:  Data generated by the visibility tool illustrated that whereas the display ban had reduced product visibility, it had little impact on reducing visibility of tobacco storage units. However, it did narrow the inequality gap in storage visibility. It also found some shop types reduced product visibility before legally required to do so.  Conclusions:  The DISPLAY visibility tool provides a reliable method for measuring visibility of tobacco displays before and after implementation of POS legislation. Tobacco product visibility reduced as expected following implementation of the legislation, but storage unit visibility persisted, providing residual cues of tobacco availability which may confound the effects of the legislation. The DISPLAY tool has the potential to be utilized in countries planning POS display bans