Exploring the relationship between hemi-inattention and functional recovery in the first six months after stroke: a longitudinal study with a multilevel modelling approach to data analysis

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonIn recent years, the functional outcomes of patients with right hemisphere stroke (RHS) received considerable attention due to their impact on disability, independent living, quality of life and economic burden. Hemi-inattention (HI) is a complex condition which often accompanies RHS. It is characterised by reduced alertness, attention and low spatial awareness levels. Past studies reported poor outcomes in patients with HI and inconsistent findings in regard to the relationship of HI with functional outcome. Literature review of 13 relevant studies highlighted poor research methodology which complicated interpretation of previous results. Aims: The aim of this study was to address the clinically important question “What is the relationship between early HI status (HI±) and functional change in the 1st six months after right hemisphere stroke?” by improving on research methodology from past studies. Methods: An all-inclusive stroke severity RHS sample (58 with and 35 without HI) were recruited from two stroke units and assessed on motor and cognitive factors with validated measurement tools on four occasions; baseline, hospital discharge, 6 weeks after discharge, and 6 months after stroke. A multi-level modelling approach was used to analyse change in functional progress over time with potential explanatory motor and cognitive factors. Results: HI status was only statistically significant when modelled alone. Its predictive importance greatly diminished when modelled with other factors e.g. stroke severity, time since stroke and age. Conclusion: On average, HI group membership at baseline is unrelated to functional recovery when other influential factors are also considered. The findings extend current knowledge in stroke recovery research and provide suggestions for optimal therapeutic and rehabilitation outcomes. In contrast with traditional methods of regression analysis, multi-level modelling techniques enabled important relationships to be studied in depth. This resulted in new insights into the data which can be used to inform patient management and future research in the field

Oral health literacy in adult dental patients - A clinical study

Paper II: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: “The association between oral health literacy and alexithymia: Implications for patient-clinician communication”. (Manuscript). Published version with title “Exploring the association between oral health literacy and alexithymia” available in Community Dental Health 2015, 32(3):143 - 147. Paper III: Stein, L., Bergdahl, M., Pettersen, K. S., Bergdahl, J.: Effects of communication sensitive to oral health literacy: A randomized controlled trial of adult patients. (Manuscript). Final version available in Munin at https://hdl.handle.net/10037/13475. Oral health literacy encompasses individuals’ capacity to obtain, process, and understand basic oral health information and services needed to make appropriate health decisions. Evidence suggests that limited oral health literacy inhibit patients from getting necessary oral health information, and that communication with dental professionals may be problematic. Various personality traits are also regarded as challenges to successful communication, and are together with oral health literacy considered as risk factors for poorer oral health outcomes. Health literacy models have proposed that knowing the health literacy level of the patients makes it possible to tailor communication, which in turn might lead to better comprehension and enhanced health outcomes. The aim of the thesis was to develop and validate the Adult Health Literacy Instrument for Dentistry (AHLID), an instrument to assess oral health literacy in Norwegian adult dental patients. Further, the aim was to investigate if oral health literacy was associated with the personality trait alexithymia, and test the effect of communication at the dental clinic sensitive to patients’ oral health literacy. The AHLID was found to be a reliable tool for measuring oral health literacy, and we discovered that limited oral health literacy was associated with Lactobacillus count in saliva and reduced knowledge of risk factors for oral health diseases. One out of three participants scored on an oral health literacy level considered less than minimum for understanding important oral health information. An association between oral health literacy and alexithymia was revealed, indicating that alexithymia may be an important factor for limited oral health literacy. The combination of limited oral health literacy and alexithymia may lead to communication challenges for dental professionals when providing information to patients and teaching them skills for self-management of oral diseases. In a RCT, the effect of communication sensitive to patients’ oral health literacy was tested. The result indicated that providing information regarding patients’ oral health using oral health literacy sensitive communication techniques may enhance patients’ oral hygiene and gingival status compared to a control group. When communicating with patients regarding their oral health, dental professionals need to take oral health literacy into account to reduce the barriers of limited oral health literacy and enhance patients’ ability to process and understand oral health information. Knowledge regarding oral health literacy and psychological factors is essential for dental professionals, and communication skills are also needed to treat different patients properly

Numerical relativity simulation of GW150914 beyond general relativity

We produce the first astrophysically-relevant numerical binary black hole gravitational waveform in a higher-curvature theory of gravity beyond general relativity. We simulate a system with parameters consistent with GW150914, the first LIGO detection, in order-reduced dynamical Chern-Simons gravity, a theory with motivations in string theory and loop quantum gravity. We present results for the leading-order corrections to the merger and ringdown waveforms, as well as the ringdown quasi-normal mode spectrum. We estimate that such corrections may be discriminated in detections with signal to noise ratio $\gtrsim 180-240$, with the precise value depending on the dimension of the GR waveform family used in data analysis.Comment: 7 pages + appendices, 8 figures, Updated to match Phys. D. Rev articl

A Rose by Any Other Verb: The Effect of Expectations and Word Category on Processing Effort in Situated Sentence Comprehension

Recent work has shown that linguistic and visual contexts jointly modulate linguistic expectancy and, thus, the processing effort for a (more or less) expected critical word. According to these findings, uncertainty about the upcoming referent in a visually-situated sentence can be reduced by exploiting the selectional restrictions of a preceding word (e.g., a verb or an adjective), which then reduces processing effort on the critical word (e.g., a referential noun). Interestingly, however, no such modulation was observed in these studies on the expectation-generating word itself. The goal of the current study is to investigate whether the reduction of uncertainty (i.e., the generation of expectations) simply does not modulate processing effort-or whether the particular subject-verb-object (SVO) sentence structure used in these studies (which emphasizes the referential nature of the noun as direct pointer to visually co-present objects) accounts for the observed pattern. To test these questions, the current design reverses the functional roles of nouns and verbs by using sentence constructions in which the noun reduces uncertainty about upcoming verbs, and the verb provides the disambiguating and reference-resolving piece of information. Experiment 1 (a Visual World Paradigm study) and Experiment 2 (a Grammaticality Maze study) both replicate the effect found in previous work (i.e., the effect of visually-situated context on the word which uniquely identifies the referent), albeit on the verb in the current study. Results on the noun, where uncertainty is reduced and expectations are generated in the current design, were mixed and were most likely influenced by design decisions specific to each experiment. These results show that processing of the reference-resolving word—whether it be a noun or a verb—reliably benefits from the prior linguistic and visual information that lead to the generation of concrete expectations

Occurrence of Anopheles (Anopheles) neomaculipalpus Curry in north-western Argentina

Agencia Nacional de Promocion Cientifica y Tecnologica (FONCyT)Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET)Consejo de Investigaciones de la Universidad Nacional de Tucuman (CIUNT)Coordinacion Nacional de Control de Vectores (Ministerio de Salud de la Nacion

Presence of ascogregarina culicis and ascogregarina sp. In natural sympatric populations of aedes aegypti and ae. albopictus (diptera: Culicidae) in argentina

Aedes aegypti is the main vector of the four arboviruses in America which have the greatest impact on human health. The introduction of Aedes albopictus in South America and Argentina acquires importance given the possibility that this species may be a new vector of arboviruses in this region. For this reason, the studies of the biology of their parasites, such as Ascogregarina spp., should be important for the knowledge of the invasive behavior of these vectors. We reported the finding of Ascogregarina culicis in Aedes aegypti and Ascogregarina sp. in Ae. albopictus populations in subtropical Argentina. The prevalence of parasitism by A. culicis in Ae. aegypti and Ascogregrarina sp. in Ae. albopictus was 34.81% (n = 464) and 37.23% (n = 70), respectively, differing between the seasons and habitats. The infection intensity caused by A. culicis and Ascogregarina sp. varied between 1 to 250 and 1 to 327 trophozoites respectively. Ascogregarina culicis was found throughout the all sampling period of Ae. aegypti (June 2016-April 2018). However the presence of Ascogregarina sp. in the midgut of Ae. albopictus was not recorded throughout the whole sampling period despite the presence of the host.Fil: Alonso, Ana Carolina. Universidad Nacional del Nordeste. Instituto de Medicina Regional. Área de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Stein, Marina. Universidad Nacional del Nordeste. Instituto de Medicina Regional. Área de Entomología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste; ArgentinaFil: Micieli, Maria Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Estudios Parasitológicos y de Vectores. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Centro de Estudios Parasitológicos y de Vectores; Argentin