No description available.

No description available.

No description available.

The purpose of this study was to determine whether correlations existed between a measure of linguistic complexity in spontaneous speech and performance on the four verbal subtests of the PICA.

Background: The presence of AD pathology can result in diverse behavioral phenotypes, including the typical amnestic variant characterized by memory deficits, and an atypical aphasic variant characterized by language deficits. Previous research has identified unique cortical atrophy patterns in each phenotype, though less focus has been drawn to subcortical involvement. The current study sought to dissociate these behavioral phenotypes by characterizing their thalamic volume and shape features using high-dimensional brain mapping procedures. Relationships between brain metrics and specific language and memory deficits were also investigated in aphasic AD and amnestic AD, respectively. Method: Thalamic integrity was examined in aphasic AD (n = 25), amnestic AD (n = 21), and healthy control participants (n = 44). Age and supratentorial volume (STV) were used as covariates in all analyses. MR scans were acquired using high-resolution T1-weighted MPRAGE volumes following the ADNI protocol. Thalamic shape features were estimated using Large Deformation Diffeomorphic Metric Mapping. General linear models compared differences in thalamic shape between groups. Pearson correlation coefficients characterized relationships between thalamic nuclei (pulvinar, anterior, and mediodorsal) and language and memory performance in aphasic AD and amnestic AD, respectively. Results: After controlling for age and STV, thalamic volume did not differ between groups [F (2,85) = 2.55, p = 08]. However, AD phenotypes exhibited bilateral inward shape deformation in dorsal and ventral regions extending in an anterior to posterior fashion [left: F(20, 154) = 2.61, p < .001; right: F(20,154)= 2.26, p < .01]. Amnestic AD demonstrated right ventrolateral localized volume loss relative to aphasic AD. Pearson models revealed lower confrontation naming was correlated with localized volume loss of bilateral pulvinar (left: r = .59, p < .01; right: r = .55, p < .01), and bilateral anterior (left: r = .50, p = .01; right: r = .49, p = .01) thalamic nuclei for aphasic AD; lower delayed recall was significantly correlated with localized volume loss in left anterior (r = .46, p = .04) thalamic nuclei in amnestic AD. Conclusions: In the absence of volumetric differences, shape measures captured distinct patterns of localized volume loss in aphasic AD and amnestic AD behavioral phenotypes relative to control participants. Comparisons of AD variants demonstrated inward deformation in amnestic AD, particularly in right ventrolateral regions. Thalamic changes appear to be implicated in AD pathology, with relationships to the expected cognitive impairments, although thalamic atrophy patterns are unable to fully dissociate behavioral phenotypes.

Music-based interventions (MBI) may facilitate communication outcomes for people with aphasia (PWA; Cheever et al., 2018; Magee et al., 2017). There are few theory-based, protocolized MBIs for PWA. This study developed a transdisciplinary, theory-based, highly structured improvised singing protocol, the Music enhanced Verb Network Strengthening Treatment (MeVNeST), that is designed to enhance the Verb Network Strengthening Treatment (VNeST) (Edmond, 2016). The feasibility and the preliminary outcomes of MeVNeST were evaluated. The study involved three stages: 1) protocol development; 2) protocol testing; 3) microanalysis. In Stage 1 Standard VNeST procedures were adapted to incorporate music components based on the theoretical premises for music and language in the brain, theories of musical expectation (Lerdahl & Krumhansl, 2007), and two frameworks for music-based intervention protocol development (Robb et al., 2011; Hanson-Abromeit, 2015). The outcome was a preliminary MeVNeST protocol. In Stage 2, two phases were implemented to evaluate the effects of MeVNeST compared with VNeST, and the effect of MeVNeST alone on word retrieval and sentence production. Effect sizes were calculated for probe scores. One participant who received seven weeks of MeVNeST showed improvements in the sentence production score for the VNeST probes of the trained verbs (d=3.22). No changes were observed on the Boston Naming Test, the Verb Naming Test, and the Western Aphasia Battery and the adjective control task. Other participants did not achieve significant changes in word retrieval and sentence production. This indicates the increased duration of MeVNeST in Phase 2 was necessary to produce the desired outcomes. In stage 3, the microanalysis results revealed that patterns of music interaction, called Patterns of Musical Influence (PMI), underpinned how the key musical components in the therapists’ improvised music influenced participants’ improvised singing. Musical strategies named Structuring Strategies and Cueing Strategies clarified the therapists’ musical strategies to facilitate participants’ performance of language tasks that were difficult. The MeVNeST protocol was revised based on the findings. This study suggests that MeVNeST is a feasible treatment approach that warrants further research. Future research is needed to test the MeVNeST protocol with a larger sample, and to optimize the capacity of improvised music to support the structured language task and escalate the generative process in the training of the semantic network. / Music Therapy

Background: Aphasia related stroke affects an individual's ability to formulate and comprehend language, making communication difficult. This communicative impairment is caused by a stroke, affecting around 15 million people worldwide.  Aim: The aim is to investigate and describe the experiences of communication for individuals with aphasia after a stroke in healthcare interactions. Method: This study follows a general literature review approach. The databases CINAHL and PubMed were used, where scientific articles with a qualitative approach were selected for analysis. A thematic analysis by Braun and Clarke was applied in the study. Results: The literature review identified two themes: 1) communication in healthcare meetings, with two sub-themes: the inability to make oneself understood to healthcare providers and the inability to understand healthcare providers; 2) The individual in focus, with two sub-themes: trust and confidence, and the partnership in healthcare interactions.  Conclusion: The study found a lack of person-centered care in connection with aphasia-related communication difficulties, resulting in unmet basic care needs, such as inadequate pain management and fall accidents. Future research should examine implementing different standardized methods to aid healthcare workers in communication strategies, pain assessments, patient perspective training and involving relatives in communication. / Bakgrund: Personer med afasi efter genomgången stroke lever med en påverkad förmåga att formulera sig och/eller uppfatta kommunikation. Denna kommunikativa nedsättning påverkar ungefär 15 miljoner personer världen över. Kommunikationsnedsättningen som beskrivits är ett symptom på en cerebrovaskulär olycka som kan resultera i en påverkad tvåvägskommunikation. Syfte: Syftet var att undersöka och beskriva erfarenheter av kommunikation för personer med afasi efter stroke i vårdmöten. Metod: Denna studiedesign är en allmän litteraturstudie. Databaserna CINAHL samt PubMed användes där vetenskapliga artiklar av kvalitativ ansats utnämnts för analysering. En applicering av Braun och Clarkes tematiska analys har tillämpats i arbetet. Resultat: Litteraturstudien resulterade i att två teman identifierades; 1) Kommunikation i vårdmötet med två underteman, oförmågan att göra sig förstådd för vårdgivare samt oförmågan att förstå vårdgivare; 2) Individen i fokus som skildrades med två underteman, förtroende och tillit samt partnerskapet i vårdmötet. Slutsats: En brist på personcentrerad vård kunde identifieras i samband med afasirelaterade kommunikationssvårigheter som medförde att basala omvårdnadsbehov inte blev tillfredsställda. Denna avsaknad presenterade sig i form av vårdskador som fallolyckor och icke-adekvat smärtlindring. Framtida forskning bör undersöka hur vårdpersonal kan tillämpa standardiserade metoder för smärtskattning, anhörigstöd samt utbildning i kommunikationsverktyg och patientperspektivet.

Introduktion: Stroke är en av de vanligaste sjukdomarna som kan påverka livet både fysiskt, psykiskt och socialt hos drabbade personer. Ungefär mer än hälften av de som drabbas av stroke får afasi, vilket innebär att personen får svårigheter att kommunicera, läsa och skriva. I vården är effektiv kommunikation mellan vårdpersonal och patienter en förutsättning för att skapa patientsäkerhet och minska lidande. En god kommunikation har även inverkan på bemötandet mellan patienten och vårdpersonal.  Syfte: Syftet var att belysa patienters upplevelser av kommunikation med vårdpersonal vid afasi efter en stroke.  Metod: Litteraturstudie med beskrivande design där tio kvalitativa originalartiklar från PubMed och CINAHL kvalitetsgranskats med SBU:s granskningsmall för kvalitativa artiklar. Artiklarna analyserades med en innehållsanalys av författarna.  Resultat: Kommunikationen mellan patient och vårdpersonal beskrivs med hjälp av två teman och sex kategorier. Resultatet visade att personer med afasi upplever kommunikationen besvärlig och problematisk särskilt i situationer där de blir missförstådda, vilket visade sig i form av ilska, förtvivlan, sorg, uppgivenhet samt känsla av ensamhet. Resultatet beskriver de hinder som personer med afasi stötte på, vilket var svårigheter att initiera och bedriva djupa samtal, skamkänslor på grund av svårigheter gällande läs- och skrivförmåga samt känsla av social isolering. Slutsats: Förutom att afasi upplevs som ett hinder vid kommunikation, visar resultatet att bemötande från omgivningen spelar en stor roll vid kommunikation med den drabbade och att kommunikation underlättas när anhöriga och vårdpersonal visar empati och respekt för personen. / Introduction: Stroke is one of the most common diseases that can affect the lives of people both physically, psychologically and socially. Approximately more than half of those who suffer a stroke develop aphasia, which means that the person has difficulty communicating, reading and writing. In healthcare, effective communication between healthcare staff and patients is a prerequisite for creating patient safety and reducing suffering. Good communication also has an impact on the treatment between the patient and healthcare staff.  Purpose: The aim was to shed light on patients' experiences with aphasia on communication with healthcare professionals after a stroke.  Method: Literature study with descriptive design where ten qualitative original articles from PubMed and CINAHL were quality reviewed using SBU's review template for qualitative articles. The articles were analyzed using a content analysis by the authors.  Results: The communication between patient and healthcare staff is described using two themes and six categories. The results showed that people with aphasia find communication difficult and problematic, especially in situations where they are misunderstood, which manifested itself in the form of anger, despair, sadness, resignation and feelings of loneliness. The results describe the obstacles that people with aphasia encountered, which were difficulties in initiating and conducting deep conversations, feelings of shame due to difficulties regarding reading and writing skills and feelings of social isolation.  Conclusion: In addition to the fact that aphasia is experienced as an obstacle to communication, the results show that the response from the environment plays a large role in communication with the diseased and that communication is facilitated when relatives and healthcare professionals show empathy and respect for the person.

<p dir="ltr">It is well known that persons with aphasia (PWA) demonstrate deficits in sentence processing. Specifically, many show difficulties with syntactic re-analysis, or the ability to revise one’s interpretation of a sentence due to a temporary ambiguity. Emerging evidence suggests that structural priming, individuals’ tendency to unconsciously re-use a previously encountered structure, can facilitate production and comprehension of different sentence structures in PWA. However, there are inconsistencies within the literature regarding the robustness of priming across different sentence structures and tasks, and the existing findings are limited to off-line measures which do not capture real-time sentence processing. Furthermore, a range of individual variability has been shown in magnitudes of priming effects.</p><p dir="ltr">This current project addressed these critical gaps by investigating the effects of structural priming on comprehension of sentences with reduced relative (RR) clauses. Study 1 examined whether PWA show immediate structural priming and longer-term cumulative priming in a computerized self-paced reading paradigm. In this study, participants read RR target sentences that were preceded by prime sentences with either an RR or a main clause (MC) interpretation. Study 2 examined if and how individuals’ cognitive (memory) skills account for individual variability shown in structural priming. Participants completed a Serial Reaction Time task as a measure of implicit memory, and the Verbal Paired Associates I task as a measure of explicit memory. Eighteen healthy adults (HA) and 18 PWA participated in both studies.</p><p dir="ltr">In Study 1, PWA demonstrated robust and timely immediate structural priming effect, providing novel evidence that structural priming can be captured in real-time using self-paced reading, and that priming can help ameliorate syntactic re-analysis deficits in PWA. However, these online changes were not reflected in the behavioral measures, highlighting the sensitivity of self-paced reading in detecting the dissociation between automatic, real-time processing and overt behavioral responses. Cumulative priming as traditionally defined was also not significant for either group, although participants became faster at reading RR target sentences as the session progressed. Study 2’s findings suggest that implicit memory may be an important cognitive skill to promote sentence processing, whereas having strong explicit memory may not be facilitative of the learning process.</p>

Bakgrund: Stroke drabbar årligen 15 miljoner människor i världen varav 30% drabbas av den språkliga funktionsnedsättningen afasi. Afasi innebär varierande grad av nedsättning av den språkliga funktionen. Kommunikation mellan sjuksköterska och patient är en förutsättning för god omvårdnad, vilket ställer krav på sjuksköterskans kommunikativa förmåga. Syfte: Syftet var att belysa sjuksköterskans perspektiv på faktorer som påverkar kommunikationen i omvårdnadsmötet med patienter som drabbats av afasi till följd av stroke. Metod: Studien genomfördes som en allmän litteraturstudie baserat på nio resultatartiklar av kvantitativ, kvalitativ och mixad metod. Resultatartiklarna granskades och bearbetades, vilket resulterade i fyra kategorier. Resultat: Faktorer som påverkade sjuksköterskans kommunikation i omvårdnadsmötet var: (1) Upplevd tidsbrist hos sjuksköterskan, (2) Sjuksköterskans kunskap, (3) Användandet av strategiska kommunikationsåtgärder och (4) Användandet av icke-verbal kommunikation. Konklusion: Flera faktorer belystes påverka sjuksköterskans kommunikation i omvårdnadsmötet med patienter som drabbats afasi efter stroke. Kvaliteten på omvårdnaden blev lägre på grund av kommunikativa utmaningar i omvårdnadsmötet. Sjuksköterskan efterfrågade en anpassad och effektiv strategisk kommunikationsåtgärd för att effektivisera och förbättra omvårdnaden. / Background: Stroke affects 15 million people in the world annually, where30% suffer from the language impairment aphasia. Aphasia involvesvarying degrees of impairment of language function. Communicationbetween nurse and patient is a prerequisite for good nursing, which placesdemands on the nurse's communicative ability. Purpose: The purpose wasto shed light on the nurse's perspective on factors that affect communicationin the nursing meeting with patients affected by aphasia as a result of stroke.Method: The study was conducted as a general literature study based onnine results articles of quantitative, qualitative and mixed methods. Theresulting articles were reviewed and processed, resulting in four categories.Results: Factors that affected the nurse's communication in the nursingmeeting was: (1) Perceived lack of time by the nurse, (2) The nurse'sknowledge, (3) The use of strategic communication measures and (4) Theuse of non-verbal communication. Conclusion: Several factors werehighlighted to influence the nurse communication in the nursing meetingwith patients affected by aphasia after stroke. The quality of nursing waslower due to communicative challenges in the nursing meeting. The nurserequested an adapted and effective strategic communication measure tostreamline and improve nursing care.