Cognitive control in bilingual aphasia

The ability to suppress irrelevant information requires cognitive control. This process plays a key role when bilinguals are required to speak one language and inhibit the non-target language. Previous research evaluating linguistic and non-linguistic inhibition in bilingual and monolingual healthy adults has revealed a bilingual advantage on non-linguistic tasks (Bialystok, 2001; Costa et al., 2008; Luk et al., 2010). However, a case study comparing healthy bilinguals, monolinguals, and bilingual aphasic patients contradicts the aforementioned studies (Green et al., 2010), suggesting that linguistic cognitive tasks may require different processing demands than non-linguistic cognitive tasks. No study has yet systematically examined cognitive control in bilingual aphasia to determine whether deficits in language inhibition are specific to the language domain or are a more general cognitive deficit. The current study investigates the degree to which language general cognitive control in bilingual aphasia is based in the cognitive domain or language domain. We predict that the language inhibition deficits noted in bilingual patients is language domain specific rather than cognitive domain general

Event Management: Defining Digital Marketing Trends

The purpose of this paper is to define and explore the trends of digital marketing in event management. As confirmed by Hensel and Deis (2010), digital and social media must be employed in a way that will ultimately improve that will improve marketing efficiency (as cited in Cole, DeNardin & Clow, 2017). Research by Cesaroni and Consoli (2015) further established that it is important how small businesses in particular social media -as many event management firms are utilizing digital and social media in such a way that they take full advantage of every feature and tool that are available and accessible to expand both productivity and profitability (As cited in Cole, DeNardin & Clow, 2017, p. 205). As the Internet continues to dominate other means of advertising so, too, does digital media represent one of the best ways for event management professionals and firms to reach the largest number of potential clients. In addition to the opportunity that digital media represents for event management professionals and firms, the “integration of people [with] the rapid development of social media” also presents a significant opportunity for the event management industry to efficiently market itself to a diverse audience” (Harb, Fowler, Chang, Blum, & Alakaleek, 2019, p. 29)

Inhibitory control mechanisms in linguistic and non-linguistic contexts in bilingual aphasia

In this project we examine mechanisms of linguistic and non-linguistic control in bilingual patients with aphasia for evidence of domain general cognitive control or domain specific cognitive control on tasks of low complexity and high complexity. Participants include 13 bilingual adults with aphasia and 20 neurologically healthy bilingual adults who are matched on age, years of education and measures of language experience. All participants completed two linguistic control tasks and two non-linguistic control tasks. Results from healthy controls and patients with less severe language impairment revealed that mechanisms of control do not overlap (i.e., indicative of domain specific cognitive control) on low complexity tasks, but do overlap (i.e., indicative of domain general cognitive control) on high complexity tasks, suggesting that as task demands increase, control mechanisms engage. In contrast, for patients with more severe language deficits, results revealed that control mechanism do not overlap on low or high complexity tasks, suggesting that (a) as task demands increase, linguistic and non-linguistic control mechanisms do not engage, thus they function differently compared to healthy participants and less severely impaired patients, and (b) there is a possibility that because patients with severe language deficits have difficulty with accessing lexical representations, this language impairment may supersede their ability to engage in linguistic control.2017-10-27T00:00:00

Rehabilitation In Bilingual Aphasia: Evidence For Within- And Between-Language Generalization

Purpose: The goal of this study was to examine if there was a principled way to understand the nature of rehabilitation in bilingual aphasia such that patterns of acquisition and generalization are predictable and logical. Method: Seventeen Spanish-English bilingual individuals with aphasia participated in the experiment. For each participant, three sets of stimuli were developed for each language: (a) English Set 1, (b) English Set 2 (semantically related to each item in English Set 1), (c) English Set 3 (unrelated control items), (d) Spanish Set 1 (translations of English Set 1), (e) Spanish Set 2 (translations of English Set 2; semantically related to each item in Spanish Set 1), and (f) Spanish Set 3 (translations of English Set 3; unrelated control items). A single-subject experimental multiple baseline design across participants was implemented. Treatment was conducted in 1 language, but generalization to within- and between-language untrained items was examined. Results: Treatment for naming on Set 1 items resulted in significant improvement (i.e., effect size >4.0) on the trained items in 14/17 participants. Of the 14 participants who showed improvement, within-language generalization to semantically related items was observed in 10 participants. Between-language generalization to the translations of trained items was observed in 5 participants, and between-language generalization to the translations of the untrained semantically related items was observed in 6 participants. Conclusion: The results of this study demonstrated within- and between-language patterns that were variable across participants. These differences are indicative of the interplay between facilitation (generalization) and inhibition.Communication Sciences and Disorder

Decrease In The Number Of People Taking The CPA Exam Not Due To The 150-Hour Requirement

This paper reports the results of a study that examined the association of the 120/150-hour education requirement with the number of CPA exam candidates during 1998 and 2008.  Data gathered from the NASBA Candidate Performance Reports 1999 and 2009 found no relationship between the number of CPA exam candidates and the education requirements in each of the US jurisdictions.  Approximately 48% of the total decline in candidates in 2008 as compared to 1998 occurred in jurisdictions that only required 120 hours of education to sit for the exam in 2008.  Approximately 20% of the total decline occurred in jurisdictions that required 150 hours of education in 2008. The 150-hour requirement is not the cause for the decrease in the number of people taking the CPA exam

Water Use and Abuse in the United States: Behavioural Patterns Behind Excess Water Consumption and an Argument for an Efficient Demand Side Remedy

The last decade saw severe drought in the southeastern United States, which presented questions about the ways in which Americans use water and the best ways for government entities to handle future drought. During and after the droughts, researchers examined existing literature on water overconsumption and conducted new studies to explore water use and related behavior. We review the predominant work on the factors that influence household water consumption, the different methods by which government agencies can combat overconsumption, and argue for the demand-side approach of structured rate increases to limit superfluous use of water

Assessment of emergency medicine residents: a systematic review

Background: Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment.Methods: We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 - June 2014. MeSH terms included “assessment,” “residency,” and “emergency medicine.” We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident. Two reviewers screened abstracts, reviewed full text studies, and abstracted data. Reporting of assessment-related costs was a secondary outcome.Results: The search returned 879 articles; 137 articles were full-text reviewed; 73 met inclusion criteria. Half of the studies (54.8%) were pilot projects and one-quarter (26.0%) described fully implemented assessment tools/programs. Assessment tools (n=111) comprised 12 categories, most commonly: simulation-based assessments (28.8%), written exams (28.8%), and direct observation (26.0%). Median assessment frequency (n=39 studies) was twice per month/rotation (range: daily to once in residency). No studies thoroughly reported costs.Conclusion: EM resident assessment commonly uses simulation or direct observation, done once-per-rotation. Implemented assessment systems and assessment-associated costs are poorly reported. Moving forward, routine publication will facilitate transitioning to competency-based medical education

Naming treatment and crosslinguistic generalization

Current research on bilingual aphasia has only begun to inform us about the optimal rehabilitation for bilingual aphasic patients and the literature is still sparse in terms of interpreting impairment and recovery in these individuals. Two recent reviews (Faroqi-Shah, Frymark, Mullen, & Wang, 2010; Lorenzen & Murray, 2008) highlight the beneficial effects of rehabilitation in bilingual aphasic patients, however, both reviews underscore the need for theoretically motivated and well controlled rehabilitation studies. There are still several unanswered questions about outcomes in bilingual aphasia rehabilitation, including (a) is it sufficient to rehabilitate only one language, (b) what are the nature of gains in the trained language, and (c) does rehabilitation in one language have beneficial effects in the untreated language? The present experiment attempts to address these questions with a relatively large set of Spanish-English bilinguals with aphasia, all of whom receive therapy in one language at a time. The extent of improvements in the trained language items, semantically related untrained items in the trained language, and between-language transfer to untrained items is examined. In addition to picture naming, changes in the evolution of naming errors and category fluency are also examined in this study

Telerehabilitation for word retrieval deficits in bilinguals with aphasia: Effectiveness and reliability as compared to in-person language therapy

Background: Bilinguals with post-stroke aphasia (BWA) require treatment options that are sensitive to their particular bilingual background and deficits across languages. However, they may experience limited access to bilingual clinical resources due to reduced availability of bilingual practitioners, geographical constraints, and other difficulties. Telerehabilitation can improve access to bilingual clinical services for BWA and facilitate the delivery of specific language treatments at distance, but more evidence on its effectiveness and reliability is needed. This study aimed to determine the equivalence of effectiveness and reliability of a semantic treatment for word retrieval deficits in BWA delivered via telerehabilitation relative to in-person therapy. Methods: We examined the retrospective data of 16 BWA who received 20 sessions of therapy based on semantic feature analysis for word retrieval deficits in person (n = 8) or via telerehabilitation (n = 8). The two groups were comparable on age, years of education, time of post-stroke onset, aphasia severity, and naming ability in both languages. Treatment effectiveness (i.e., effect sizes in the treated and the untreated language, and change on secondary outcome measures) and reliability (i.e., clinician adherence to treatment protocol) were computed for each delivery modality and compared across groups. Results: Significant improvements were observed in most patients, with no significant differences in treatment effect sizes or secondary outcomes in the treated and the untreated language between the teletherapy group and the in-person therapy group. Also, the average percentage of correctly delivered treatment steps by clinicians was high for both therapy delivery methods with no significant differences between the telerehabilitation vs. the in-person modality. Discussion: This study provides evidence of the equivalence of treatment gains between teletherapy and in-person therapy in BWA and the high reliability with which treatment for word retrieval deficits can be delivered via telerehabilitation, suggesting that the essential treatment components of the intervention can be conducted in a comparable manner in both delivery modalities. We further discuss the benefits and potential challenges of the implementation of telerehabilitation for BWA. In the future, telerehabilitation may increase access to therapy for BWA with varying linguistic and cultural backgrounds, thus, offering a more inclusive treatment approach to this population

Pemetrexed and Platinum Plus Pembrolizumab in Patients With Metastatic Nonsquamous NSCLC by Tumor Burden at Baseline: A Post Hoc Efficacy Analysis of KEYNOTE-189

INTRODUCTION: The aim of this study was to evaluate the efficacy of pemetrexed and platinum plus pembrolizumab by baseline tumor burden. METHODS: A total of 616 patients in the intention-to-treat population of the KEYNOTE-189 study were included in this analysis. Baseline tumor burden subgroups were identified on the basis of extent of distant metastasis (M1a versus M1b), median number (≤3 versus \u3e3) of organ systems with lesions, or symptom severity score of patient-reported lung cancer-associated symptoms (≤median versus \u3emedian). Overall survival (OS), progression-free survival (PFS), and PFS-2 were evaluated by Kaplan-Meier and univariate Cox methods. Objective response rate was analyzed using logistic regression models, and duration of response was analyzed descriptively. Efficacy outcomes were also analyzed according to the programmed death-ligand 1 expression levels. RESULTS: OS and PFS were significantly improved with pemetrexed and platinum plus pembrolizumab in all baseline tumor burden subgroups (M1a stage: OS hazard ratio [HR] = 0.54, p = 0.0037; PFS HR = 0.48, p = 0.0001; M1b stage: OS HR = 0.58, p ≤ 0.0001; PFS HR = 0.51, p ≤ 0.0001; number of organ systems with lesion ≤ 3: OS HR = 0.49, p ≤ 0.0001 PFS HR = 0.41, p ≤ 0.0001; \u3e3: OS HR = 0.67, p = 0.0068; PFS HR = 0.59, p = 0.0001; symptom severity score ≤ median: HR = 0.51, p ≤ 0.0001; PFS HR 0.49, p ≤ 0.0001; \u3e median: OS HR = 0.60, p = 0.0003; PFS HR = 0.48, p ≤ 0.0001). PFS2 and objective response rate were also improved with pemetrexed and platinum plus pembrolizumab in all baseline tumor burden subgroups. Efficacy outcomes were generally consistent regardless of programmed death-ligand 1 expression levels. CONCLUSIONS: Pemetrexed and platinum plus pembrolizumab were found to have relevant efficacy regardless of the extent of baseline tumor burden and the variables used to define it. These results further support pemetrexed and platinum plus pembrolizumab as the standard of care in the first-line treatment of metastatic nonsquamous NSCLC