Perinatal Depression: Breaking Barriers to Treatment

Depression in the perinatal period is a common medical issue in Vermont, affecting about 10% of women. Multiple and severe consequences of depression during this time are seen for both mothers and babies, including lower breastfeeding rates, fewer healthcare visits for the child, and psychopathology in the child later on. The goal of this project is to identify and address some of the barriers we currently face in identifying and treating women for depression. Major barriers women encounter in seeking help involve poor recognition of symptoms facing increasing stress of motherhood, stigma, as well as neglecting to attend to mental health preemptively. An educational pamphlet for mothers was developed to address these issues.https://scholarworks.uvm.edu/fmclerk/1439/thumbnail.jp

Culture Care of Puerto Rican Elderly in a Community Setting

The purpose of this ethnonursing study was to discover the culture care meanings, beliefs, expressions, and practices of urban elderly Puerto Ricans residing in a mid-sized community. The Culture Care Theory was used as the guiding framework in studying the domain of inquiry: the discovery of the meanings and practices of generic care and professional health care of elderly community dwelling Puerto Ricans. The qualitative research method used for this study was the ethnonursing research method. Twelve key informants and twenty-one general informants were interviewed. Four themes were extracted from analysis of the data, and patterns to support the themes were derived from emic care constructs. Discussion for culturally congruent nursing care within the nursing care actions of cultural care preservation or maintenance, culture care accommodation or negotiation, and culture care repatterning or restructuring are presented. Implications for nursing theory, education, and practice are suggested to facilitate the provision of culturally congruent nursing care. Recommendations for further research are presented

Improving the maintenance of word representations in short-term memory to improve language function: Acquisition and generalization effects

The hallmark of a successful rehabilitation program for aphasia is generalization. We report a treatment program for word processing impairment in aphasia that incorporates methods to promote acquisition and response generalization, as well as generalization of treatment effects to language tasks other than those used in treatment (Kalinyak-Fliszar, Kohen, & Martin, 2011). The program also includes a second feature to promote generalization based on the complexity account of treatment efficacy (CATE; Thompson, Shapiro, Kiran, & Sobecks, 2003; Kiran, 2008)

Cross-structural priming in sentences with verb particles and verb prepositions: A replication

Structural (syntactic) priming (Bock, 1986) is an experimental paradigm used to study sentence processing in non-brain damaged individuals. Repetition of a sentence structure in one or more “prime” trials leads to a tendency to use the same structure in a picture description task. Structural priming treatment for aphasia aims to improve sentence processing in aphasia by increasing accessibility of a syntactic structure, and making it temporarily easier to retrieve. However, this technique’s usefulness in treatment depends on the endurance of its effects. Whether structural priming reflects short-term residual activation or short-term learning is a matter of debate (Bock & Griffin, 2000). In treatment studies, this question can be addressed by evaluation of performance at post-treatment assessment

Improving auditory access to low imageabilty words by embedding them in imageable semantic-syntactic contexts in a case of deep phonological dysphasia

Deep dysphasia is a relatively rare subcategory of aphasia, characterized by word repetition impairment and profound auditory-verbal short-term memory (AVSTM) limitation. Accuracy of word repetition is better for words than nonwords (lexicality effect) and better for high-image than low-image words (imageability effect). The cardinal feature of deep dysphasia is the occurrence of semantic errors in single word repetition (Howard & Franklin, 1988). Phonological dysphasia shares all of these features except that semantic errors in repetition appear in repetition of multiple words and sentences. Thus, it has been proposed that these two ‘syndromes’ are not distinct, but actually are based on an impairment of auditory-verbal STM that can vary by severity, leading to deep dysphasia when severe and phonological dysphasia when mild (Martin, Saffran & Dell, 1996; Ablinger, Ablel & Huber, 2008). First, we report a single case treatment study of a person whose pattern of word repetition performance was consistent with the continuum of phonological-deep dysphasia: poor repetition of nonwords, imageability effects in repetition of single and multiple words and semantic errors in repetition of multiple word utterances. Differences in processing abstract (i.e., low imageability) versus concrete (i.e., high image) have been considered recently in aphasic treatment protocols (Kiran, Sandberg & Abbott, 2009). Here we test the effects of a theoretically motivated treatment that manipulates the semantic cohesiveness of low imageability (i.e., abstract)-low frequency (LI-LF)words to improve access to and short-term retention of LI words in deep-phonological dysphasia. Following presentation of the treatment case study, we describe an experimental protocol to determine if this approach of increasing imageability of abstract words through syntactic and semantic contexts can be extended to other individuals who present along the deep--phonological dysphasia continuum

Radon, From the Ground into Our Schools: Parent/Guardian Awareness of Radon Levels in Vermont Schools

Introduction. Radon is the leading cause of lung cancer among non-smokers. Ex- posure to radon in schools may be harmful to schoolchildren, faculty, and staff, but there is currently no legislation mandating testing or mitigation of radon levels in Vermont schools. Objectives. The goal of our study was to assess Vermont parents’ awareness of radon’s harmful effects, as well as awareness of and support for testing and mitigation of radon levels in their children’s schools. Methods. We distributed paper and online surveys to Vermont parents of children grades K-12. 126 surveys were received and quantitatively analyzed. We held a focus group of two Vermont parents to gather qualitative data. Results. Most surveyed parents demonstrated general knowledge of radon, but only 51% believed that radon affects the lungs. 8% were confident that their children’s schools had informed them about radon levels. 91.2% believe their children’s schools should take action to address elevated radon levels and 87% would support mandated mitigation. There is some concern and lack of knowledge about the financial implications of radon mitigation. Conclusions. Most Vermont parents of children grades K-12 are unaware that radon is a lung carcinogen and do not know their children’s school’s radon levels or mitigation status. However, most are in favor of legislation that would require testing and dis- closure of schools’ high radon levels. Educating parents about school radon levels and their association with lung cancer could be a foundation for community support of legislation that mandates testing and mitigation of radon in Vermont schools.https://scholarworks.uvm.edu/comphp_gallery/1252/thumbnail.jp

Comprehension of sentences with reversible semantic roles is sensitive to phonological STM capacity.

Comprehension of sentences with reversible semantic roles (e.g., The boy is kissing the girl.)is difficult for many individuals with agrammatic aphasia (e.g., Schwartz, Saffran & Marin, 1980), especially in the context of non-canonical sentence structures (e.g., passive). Early accounts attributed this difficulty to a specific deficit in syntactic processing that affected both comprehension and production Caramazza & Zurif, 1976; Caramazza & Berndt, 1981). This account was challenged in subsequent studies reporting that impaired comprehension of ‘semantically reversible sentences was not present in all people with agrammatic aphasia (e.g., Miceli, Mazzucchi, Menn, & Goodglass 1983) and that it was present in some people with other aphasic syndromes (e.g., Caplan & Hildebrandt, 1988). Even in their seminal paper, Caramazza & Zurif (1976) reported the difficulty in comprehending semantically reversible sentences in conduction aphasia, but attributed this to an impairment of short-term memory (STM). In another seminal study, Linebarger, Saffran & Schwartz (1983) who demonstrated that impairment in comprehending sentences with reversible roles did not preclude the ability to judge grammaticality of sentences. From this, they proposed the “Mapping Hypothesis”: Difficulty with comprehending semantically reversible sentences lies in the mapping of grammatical roles specified in the syntactic representation onto the underlying thematic roles in the semantic representation of that utterance. These and other similar findings (see R. Martin, 2006 for review) led to an increased interest in the role of verbal STM (semantic and phonological) in sentence comprehension. In the context of the mapping hypothesis, that role would be related to a reduction in processing capacity needed to assign grammatical roles of a sentence’s surface structure onto the underlying thematic roles. In this study, we provide evidence that is consistent with this hypothesis. We examined the comprehension of five sentence structures with and without reversible semantic roles by people with aphasia under two response conditions. We compared performance on the two semantic role conditions (reversible vs. not reversible) and examined the contributions of aphasia severity and verbal STM deficits (WAB-R score, semantic STM and phonological STM) to detriments in performance on the reversible semantic role condition

Verbal Perseveration in Aphasia during Word-String Repetition: Effects of a Filled versus Silent Interstimulus Interval

Verbal perseveration is experienced to varying degrees by many individuals with aphasia. Perseveration is defined as an inappropriate recurrence or repetition of a previously produced response in place of the target item. Despite numerous studies of factors influencing the occurrence of perseverations and several prominent accounts of their occurrence in aphasia (Cohen & Dehaene, 1998; Martin & Dell, 2004; 2007) there are only a few studies that address the treatment of perseveration in aphasia. The theoretical framework of the present study is Dell, Burger & Švec‟s (1997) account of perseverations: Perseverations are more likely to occur when activation of the target word is weak (reduced connection strength) and residual activation of a retrieved lexical representation is strong enough to be selected in error

Using Virtual Clinicians to Promote Functional Communication Skills in Aphasia

Persons with aphasia (PWA) re-enter their community after their rehabilitation program is ended. Thus it is incumbent on rehabilitation specialists to incorporate training in using residual language skills for functional communication [1]. Evidence indicates that language abilities improve with continued treatment, even during chronic stages of aphasia (refs) For optimal generalization, PWA need to practice language in everyday living situations. Virtual reality technology is a method of providing home-based therapeutic interventions. A valuable potential of virtual reality technology is that it supports the successful generalization of residual language skills to functional communication situations. Traditionally, role-playing [2] and script training [3] have been used to improve functional communication in PWA. A more recent approach has been the adaptation of scripts through the implementation of virtual technology. [4]. We report progress on a project that aims to develop a virtual clinician that is capable of recognizing a variety of potential responses in the context of functional communication scenarios. Our goal is to develop a virtual clinician-human interaction system that can be used independently by PWA to practice and improve communication skills. This involves development of software that will support a spoken dialog system (SDS) that can interact autonomously with an individual and can be configured to personalize treatment [5]. As use of virtual technology in aphasia rehabilitation increases, questions about the physical and psychosocial factors that influence successful use of residual communication skills need to be resolved. Thus, a second aim of this project, the topic of this paper, is to determine whether interactive dialogues between a client and virtual clinician differ in the quantity and quality of the client’s language output compared to dialogues between client and human clinician. Although the potential of using virtual clinicians is promising, it must be determined if individuals with aphasia (or other language disorder) will be responsive to the virtual clinician and produce as much language in this context as they would during dialogues with human clinicians. We addressed two hypotheses in this study: 1. For PWA, practice with dialogues that focus on everyday activities will improve quality and quantity of verbal output in those dialogues. 2. For PWA, verbal output practiced in dialogues with a virtual clinician and a human clinician will yield similar amounts of verbal output as measured by information units in the dialogues

Tracking of Normal and Malignant Progenitor Cell Cycle Transit in a Defined Niche.

While implicated in therapeutic resistance, malignant progenitor cell cycle kinetics have been difficult to quantify in real-time. We developed an efficient lentiviral bicistronic fluorescent, ubiquitination-based cell cycle indicator reporter (Fucci2BL) to image live single progenitors on a defined niche coupled with cell cycle gene expression analysis. We have identified key differences in cell cycle regulatory gene expression and transit times between normal and chronic myeloid leukemia progenitors that may inform cancer stem cell eradication strategies