Background: Communication allows people to gain understanding of themselves and their surroundings, which is a prerequisite for good health. The nurse may in her communication help patients develop a feeling that they are not alone in their situation. If the patients cannot express themselves and make themselves understood, it can lead the patients to feel left out which emphasizes the suffering at having aphasia. Aim: The aim of this study was to identify the components which affect nurse’s communication with patients with aphasia. Analysis method: A literature review was made based on eleven scientific articles in which similarities were pointed out. Results: The result of this study is presented in three main categories: Time, Environment and Strategies. Eighth subcategory emerged: Knowledge and patient under Time; Physical and psychosocial under Environment; and Verbal, Nonverbal, Augmentative and Alternative Communication (AAC) and Individual Care under Strategies. Conclusion: This study reveals how nurses can provide the opportunity for patients to increase self-confidence. The result suggests that a person-centered communication care plan as a basic instrument to facilitate patient and caregiver interaction is needed.

The iPad with the Proloquo2Go application has taken the world of autism by storm, and given individuals that do not have a voice, a voice. This study looks at the effectiveness of the iPad with the Proloquo2Go application to enhance the manding repertoire for children with autism. Participants included three children (2 girls and 1 boy) diagnosed with an autism spectrum disorder, or exhibiting characteristics of an autism spectrum disorder, between the ages of 3 and 5. A multiple probe design across participants was used to assess the effectiveness of the iPad. Methods included completing The Reinforcer Assessment for Individuals with Severe Disabilities (RAISD) with the parents and/or teachers of each participant and running a six stimuli preference assessment before implementing each Phase. Pretest probes were conducted before implementing Phases 1 through 4. These phases were comparable to Phases 1 through 4 of the Picture Exchange Communication System (PECS) (Bondy & Frost, 1994). Results of this study support that children with autism can acquire the skills needed to mand using the iPad with the Proloquo2Go application with training comparable to that of the Picture Exchange Communication System (Bondy & Frost, 1994). In addition, vocal requesting increased for the participants during the training phases in comparison to pretest probes.

Children with developmental disabilities often have complex communication needs that require professional intervention. For children with limited or no functional speech, the first step in treatment programming is choosing an augmentative and alternative communication (AAC) modality that best represents the needs of the child. The availability and diversity of AAC systems are only increasing (Loncke, 2014). Parents and practitioners are faced with a difficult decision and existing literature has yet to come to a consensus on the potential benefits or disadvantages of incorporating specific AAC strategies. The field of applied behavior analysis has empirically demonstrated the utility of AAC modalities as viable manding topographies to reduce problem behavior (Harding et al., 2009; Ringdahl et al., 2009). Despite reliable reductions in problem behavior, there is paucity in research directly comparing mand modalities and the subsequent effects on communication repertoires. Existing studies contain methodological features that make it difficult to draw firm conclusions (Chambers & Rehfeldt, 2003; Gregory, DeLeon, & Richman, 2009; Tincani, 2004). Therefore, the purpose of the current investigation is to expand on existing literature evaluating aided and unaided AAC modalities and contribute to literature on mand training as it relates to topography-based versus selection-based system outcomes. This study compares three popular mand modalities frequently utilized in interventions implemented by speech-language pathologists and behavior analysts: (1) speech only (2) picture card + speech (3) sign + speech. Conditions were compared in an alternating treatments design for two participants to determine differential modality acquisition, problem behavior reduction, communicative gesturing, and speech emergence. Methodological considerations were given to control for the influence of transfer of stimulus control procedures by adopting a graduated time delay prompt fading procedure and, to the greatest degree possible, minimize the influence of response effort variability by employing the lowest response effort possible across all conditions. Results support the “multimodal” conceptual framework and the practice of “total communication” and provide evidence against the opposing “incompatibility hypothesis.” Keywords: augmentative alternative communication (AAC), mand, verbal behavior, multimodal, total communication, incompatibility hypothesis, aided, unaided, topography-based, selection-based

I denna uppsats studeras hur en 15-årig pojke med dyskinetisk Cerebral Pares och dysartri använder ett kommunikationshjälpmedel med förformulerade fraser i samband med tre besök i butik. Bakgrunden till studien utgörs av ett interventionsprojekt vars syfte var att låta pojken öva på användandet av sitt hjälpmedel samt använda det i olika servicesituationer, dvs. att handla, gå på café eller motsvarande. Pojkens kommunikationshjälpmedel är en pratapparat i form av en bärbar dator med mjukvaran The Grid installerad vilken bland annat innehåller en ordprediktionsfunktion, en funktion att formulera fraser i förväg, samt en talsyntes. Uppsatsens material består av interventionsprojektets inledande och avslutande inspelningar i butik. I uppsatsen analyseras vilka typer av kommunikativa uppgifter deltagarna visar att de behärskar respektive behärskar mindre bra i dessa situationer, samt hur pratapparaten används och vilken konsekvens det får för interaktionen. Conversation Analysis (CA) används som analysmetod och analysen sker på basis av videofilmer och transkriberade utdrag ur dessa. Förslag ges på vilka konsekvenser studien kan få för klinisk implementering av en pratapparat som alternativ och kompletterande kommunikation (AKK).

Master of Science / Department of Architectural Engineering and Construction Science / Sutton F. Stephens / Autoclaved Aerated Concrete (AAC) is a lightweight concrete building material cut into masonry blocks or formed larger planks and panels. Currently it has not seen widespread use in the United States. However, in other parts of the world it use has been used successfully as a building material for over fifty years. AAC is a relatively new (at least to the United States) concrete masonry material that is lightweight, easy to construct, and economical to transport. Its light weight is accomplished through the use of evenly distributed microscopic air bubbles throughout the material; these bubbles result in a lightweight concrete that is composed of a latticework around spherical voids. This report details the history, physical properties, manufacturing process, and structural design of AAC. This report includes an explanation of the 2005 Masonry Standards Joint Committee (MSJC) Code for the design of AAC members subjected to axial compressive loads, bending, combined axial and bending, and shear. An example building design using AAC structural components is provided. This report concludes that AAC has important advantages as a structural building material that deserves further consideration for use in the United States.

The aim of this study is to examine the work carried out at Swedish upper-secondary special schools for pupils with learning disabilities in the subject area of language and communication, with particular focus on augmentative and alternative communication and multilingualism. The learning process is approached from a sociocultural perspective in this study, which entails that learning is taken to occur in social contexts in which interaction, communication, and co-operation play key roles. The method takes the form of semi-structured qualitative interviews inspired by a phenomenographical approach in the hope of highlighting five areas communication, possibilities, obstacles, AAC and competence development, that special education teachers and special educators are faced with in their work with students with language and communication impairments. The results show that special education teachers and special educators demonstrate a high capacity to see both possibilities and obstacles in the teaching process, together with an understanding for the students’ differing functional impairments and needs. The challenges facing special education teachers and special educators when dealing with multilingual student groups give an indication of the difficulties attached to determining remedies capable of leading to students’ increased participation and comprehension of the subject area. The two alternatives offered by Swedish special schools are individual native language instruction (in which the student is separated from the class) and support within the classroom in the form of a personal assistant with knowledge of the native language. The study demonstrates that the latter is preferable as means for a student to progress in their learning. The result also indicates that special education teachers and special educators have great understanding for the importance of using AAC in instructing materials but at the same time there are many things to be done about translating AAC material in order to increase educational participation for multilingual students. Results also indicates that peer learning within the profession is desirable. / Denna studie har till sitt syfte att belysa arbetet på gymnasiesärskolans individuella program inom ämnesområdet språk och kommunikation, och med fokus på AKK och flerspråkighet. Studien lyfter fram lärandet ur ett sociokulturellt perspektiv där lärande ses som handlingar i ett socialt sammanhang, och där interaktion, kommunikation och samarbete är viktiga för att nå ett lärande. Studien är en semistrukturerad kvalitativ intervjustudie och har inspirerats av en fenomenografisk ansats där jag försökt få kunskap och information kring hur verksamma speciallärare och specialpedagoger upplever arbetet med elever i kommunikativa svårigheter med behov av AKK- stöd och som har en flerspråkighet. Jag valde att redovisa resultatet utifrån fem olika teman kommunikation, möjligheter, hinder, AKK och kompetensutveckling. Resultatet visar att det finns en hög kompetens i att se både möjligheter och hinder i undervisningen, samt en förståelse för elevers olika funktionsvariationer och behov samt att öka delaktigheten för flerspråkiga elever. Möjligheterna och hindren i att möta och bemöta flerspråkigheten hos elevgruppen visar på svårigheterna i att bedöma vilka insatser som leder till både ökad delaktighet men också ökad förståelse och kunskap inom ämnesområden. Modersmålsundervisning och studiehandledning är de två alternativen som erbjuds inom den specifika gymnasiesärskolan. Studiens resultat visar att studiehandledning är att föredra för att öka flerspråkiga elevers delaktighet. Studien visar även på speciallärares och specialpedagogers kunskap kring att använda olika AKK-metoder för att skapa en större delaktighet hos elever med kommunikativa svårigheter och flerspråkighet men även på bristande översatta material att använda i undervisningssyfte för att öka delaktigheten för flerspråkiga elever. I resultatet kring kompetensutveckling ses kollegialt lärande som en möjlig kompetenshöjande funktion men respondenterna anser att det rent organisationsmässigt inte skapas utrymme för det kollegiala lärandet.

No description available.

Hospitals worldwide are becoming increasingly plagued by antibiotic-resistant pathogens; concomitantly, the number of patients who die from antibiotic-resistant pathogens is increasing. The rise of multi-drug resistant (MDR) pathogens has rendered many antibiotics obsolete. The streptogramin and aminoglycoside antibiotics are drugs of last resort against life-threatening, MDR Gram-positive (e.g., methicillin resistant Staphylococcus aureus (MRSA)) and -negative (e.g., Pseudomonas aeruginosa) pathogens, respectively; however, as microbial drug resistance continues to emerge, the efficacy of these two important drug classes is decreasing. One of the most common mechanisms by which pathogens become resistant to streptogramin and aminoglycoside antibiotics is enzymatic inactivation: the Vat and AAC(3) acetyltransferases are employed by pathogens to inactivate streptogramin and aminoglycoside antibiotics, respectively. There currently is a dire need to not only develop new antibiotics, but to find new, creative strategies to outwit microbial resistance mechanisms. One of these strategies is to rescue the activity of antibiotics through the discovery of antibiotic adjuvants. In the current study, adjuvants which rescue the activity of streptogramin and aminoglycoside antibiotics through inhibition of the resistance acetyltransferases, VatD and AAC(3)-Ia, have been discovered—through the development of a cell-based screening method, we have found the first inhibitors of VatD, as well as of AAC(3)-Ia and its homologues, AAC(3)-Ib, AAC(3)-Ic, and AAC(3)-Id. We have demonstrated that streptogramin and aminoglycoside resistance can be reversed both in vitro and in vivo by the protein kinase inhibitors, GW5074 and rottlerin. Steady state kinetics revealed these compounds to inhibit VatD and AAC(3) enzymes mainly through noncompetitive or mixed mechanisms. This study has also demonstrated that eukaryotic kinase inhibitor libraries may be repurposed for the discovery of not only new antibiotic adjuvants, but also new antimicrobial targets. The inhibitors described herein may someday serve as effective adjuvants of streptogramin and aminoglycoside antibiotics. / Thesis / Doctor of Philosophy (PhD)

Augmentative and alternative communication (AAC) is defined as “all forms of communication (other than oral speech)…used to express thoughts, needs, wants and ideas” (“Augmentative and Alternative Communication (AAC),” 2012). Working memory is a temporary cognitive process, which briefly maintains and manipulates information while it is being encoded as a part of long-term memory (Engle, Nations, & Cantor, 1990; “Introduction to Working Memory”, 2007). It has been suggested that based upon the unique skill set and needs of users of AAC systems, the design of these systems should reflect knowledge gleaned from the cognitive sciences (Light & Lindsay, 1991) with training and implementation of AAC incorporating an understanding of the cognitive processes impacting memory, learning, and visual processing (Light & Lindsay, 1991; Wilkinson & Jagaroo, 2004). This study sought to examine how users of AAC managed and perceived the cognitive load associated with working memory demands while communicating and what specific strategies and/or design features users of AAC perceived they used during conversation when using AAC. Results revealed an overall large amount of variability in participants’ responses. Length of symbol/word sequences, word prediction, seeing the message as it is being created, attention to the conversational topic, and attempting to remember what their conversational partner said appeared to be judged as having the highest degree of importance for the use of a speech generating device and success and message completion in conversation. Errors in conversational while using a speech generating device and stressors during the conversational process appeared to be most closely related to reported lack of time to create messages and the time it takes to create messages. Users of AAC did not report high frequency of actives attention to the working memory processes and design features. / Educational Psychology

In this dissertation, the seismic behavior and design of AAC-infilled steel moment frames are investigated systematically. The fundamental vehicle for this investigation is the ATC-63 methodology, which is intended for the establishment of seismic design factors for structural systems. The ATC-63 methodology is briefly reviewed, including the concepts of archetypical structures, design rules and mathematical models simulating the behavior of those archetypes. A limited experimental investigation on the hysteretic behavior of an AAC-infilled steel moment frame is developed, conducted, and discussed. Using the experimental results of that investigation, the draft infill design provisions of the Masonry Standards Joint Committee (MSJC) are extended to AAC infills, and a mathematical model is developed and calibrated to simulate the behavior of AAC infills under reversed cyclic loads. Prior to application of ATC-63 methodology to AAC-infilled steel moment frames, the methodology is applied to an example steel moment frame to demonstrate the methodology and verify understanding of it. Then, archetypical infilled frames to be evaluated by the ATC-63 methodology are developed using a series of pushover analyses. Infill configurations whose total lateral strength in a particular story exceeds about 35% of the lateral strength of the bare frame in that story are observed to provoke story mechanisms in the frame. Based on this observation, archetypical infilled frames are selected conforming to two infill configurations: uniformly infilled frames, and open ground story frames. Each infill configuration includes archetypes whose ratio of infill strength to bare-frame strength at each story is less than 35%, and archetypes whose ratio is greater than 35%. The former archetype is typical of steel moment frames infilled with AAC; the latter archetype is typical of steel moment frames infilled with conventional (clay or concrete) masonry. The ATC-63 methodology, specialized for application to infilled frames, is applied to the archetypical infilled frames developed above. The performance of those archetypical infilled frames is evaluated, and seismic design factors are proposed for AAC-infilled steel moment frames. The extension of this work to other types of infilled frames is discussed. / text