Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol

Background: Spatial neglect is a frequent and debilitating consequence of acquired brain injury and currently has no widely accepted standard of care. While previous interventions for spatial neglect have targeted patients’ overt spatial deficits (e.g., reduced contralesional visual scanning), far fewer have directly targeted patients’ non-spatial deficits (e.g., sustained attention deficits). Considering that non-spatial deficits have shown to be highly predictive of long-term disability, we developed a novel computer based training program that targets both sustained (tonic) and moment-to-moment (phasic) aspects of non-spatial attention (Tonic and Phasic Alertness Training, TAPAT). Preliminary studies demonstrate that TAPAT is safe and effective in improving both spatial and non-spatial attention deficits in the post-acute recovery phase in neglect patients. The purpose of the current trial (referred to as the REmediation of SPatial Neglect or RESPONSE trial) is to compare TAPAT to an active control training condition, include a larger sample of patients, and assess both cognitive and functional outcomes. Methods/Design We will employ a multi-site, longitudinal, blinded randomized controlled trial (RCT) design with a target sample of 114 patients with spatial neglect. Patients will either perform, at their home, the experimental TAPAT training program or an active control computer games condition for thirty minutes/day, five days a week, over three months. Patients will be assessed on a battery of cognitive and functional outcomes on three occasions: a) immediately before training, b) within forty-eight hours post completion of total training, and c) after a three-month no-contact period post completion of total training, to assess the longevity of potential training effects. Discussion The strengths of this protocol are that it tests an innovative, in-home administered treatment that targets a fundamental deficit in neglect, employs highly sensitive computer-based assessments of cognition as well as functional outcomes, and incorporates a large sample size (relative to other neglect treatment studies) in an RCT design. Trial registration ClinicalTrials.gov identifier, NCT0196595

Mechanical Removal of Juniper and its Effects on Plant Diversity

The increase in density and distribution of juniper (Juniperus spp.) in sagebrush communities throughout the Western United States, primarily as a result of fire suppression and historic over-grazing, has raised concerns among land managers and ranchers due to the detrimental effects of juniper on livestock forage species, and wildlife habitat. Juniper may dominate sagebrush communities because it may decrease understory plant cover and is more proficient in accessing deep soil waters than common competitors in the area. The main objective of this study was to examine how removal of juniper by mechanical means may affect species richness and abundance of forbs in the immediate surrounding area. We estimated species richness and abundance of forbs in three treatments: live juniper, removed juniper (stump present with masticated juniper materials), and non-juniper (no live juniper tree or stump present). Removed juniper sites had 62% more species than live sites (

Edward Snowden and the Privacy vs. National Security Debate

The shockwaves emanating from Edward Snowden’s actions as a whistleblower beg the research question, how do whistleblowers, specifically Edward Snowden, influence media coverage (or lack thereof) regarding the national security vs. privacy debate? There are large swaths of literature surrounding Edward Snowden and other whistleblowers, surveillance as an exercise of power, and mass media theories. News articles from May 2013 to April 2014 were coded for frames and the sources. Agenda setting analysis, journalistic norms, and policy changes were also crucial to determining Snowden’s long term impact. The results showed an initial interest by the media, followed by a drop in coverage. The indexing study showed a reliance on elite political voices, even when the information was damaging to elite political sources’ credibility, and frames illustrated a balanced use of selection and salience in news coverage

Emergency Medical Services to Emergency Department Patient Handover: A Delphi Study of Interprofessional Content Expectations

Emergency Medical Service (EMS) patient handover impacts subsequent Emergency Department (ED) care. This study sought to determine the core and provider specific handover elements necessary for EMS to ED patient handover. In addition, the study examined the significance of patient acuity on handover content expectations. Prior to this research, there was no evidence-based guidance regarding information necessary for continuation of prehospital care. A 2 round modified Delphi method was used to collect interprofessional expert opinion. The panel of emergency medicine experts (emergency medicine physicians, emergency registered nurses, and paramedics) participated in 2 surveys where they determined the importance of given elements to 5 different acuity level patient scenarios. The findings show profession did not affect content expectation group means (Round I p=0.91, Round II p=0.44). Therefore the possibility exists for a prehospital handover element checklist to meet the needs of all emergency care providers involved in prehospital transfer of care. Ultimately 3 EMS handover content lists were generated: universal, interprofessional, and acuity. The universal list has 20 elements, interprofessional consensus has 17 elements, and the acuity list has 16. These results highlight the difference between interprofessional handover expectations and National EMS Education Standards

Phenotypic Variations of Erigeron strigosus Muhl. (Compositae) in Eastern Texas

In Texas, Erigeron strigosus Muhl. shows great variation, having: (1) spring forms which frequently resemble E. tenuis T.&G. and which have strigose, usually scanty pubescence; (2) taller summer forms with dense, predominantly spreading pubescence; and (3) autumn forms of tall plants having conspicuous basal rosettes

Direct, biomimetic synthesis of (+)-artemone via a stereoselective, organocatalytic cyclization

We present a four-step synthesis of (+)-artemone from (–)- linalool, featuring iminium organocatalysis of a doubly diastereoselective conjugate addition reaction. The strategy follows a proposed biosynthetic pathway, rapidly generates stereochemical complexity, uses no protecting groups, and minimizes redox manipulations

The Dialogics of Southern Quechua Narrative

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65196/1/aa.1998.100.2.326.pd