Introduction: Dementia is a syndrome due to disease of the brain, usually of a chronic nature, in which there is disturbance of multiple higher cortical functions including Memory, Comprehension, Thinking, Judgment, Orientation, language and communication skills and abstract thinking. It is one of the most challenging disorders both in terms of prevalence and economic burden. There are currently approximately 800,000 people with dementia in UK and national cost is 17 billion per year. It is estimated that in next thirty years, number of people with dementia will increase to 1.4 million and the national cost will be over 50 billion. The exceptional advances in modern medicine in terms of prolonging life expectancy do not necessarily improve the care delivered to people with dementia. Dementia is a progressive condition where clinical recovery is not possible despite the discovery of cognition enhancing drugs. This belief leads to low expectations that tend to erode hope and foster indignity. Advances in treatment of Alzheimer’s disease have, however, stimulated new thinking and methods of service delivery. At certain stage of their illness, if not from the very beginning, personal, and social recovery becomes more meaningful for service users than their clinical recovery. Objective: To investigate whether recovery-orientated psychiatric assessment and therapeutic intervention enhances the wellbeing of people with memory problems and their family carers. Method: This study was a preliminary randomised control study. Patients were randomly allocated to recovery focus group or treatment as usual group acting as the control. Participants in the recovery focus group received a recovery-focused pre-diagnostic wellbeing assessment and counselling, diagnostic consultation with written feedback and post-diagnostic support over a period of six months. Participants in both groups were assessed using the WHO Wellbeing Index (WHO-5) as the primary outcome measure. The Mini Mental State Examination, Cornell Scale for Depression in Dementia, EuroQol-5D and Zarit Burden Interview were used as secondary outcome measures. Written records of the narrative accounts of participants in the recovery focus group were also obtained. Results: 48 patients with early dementia were recruited and agreed to take part in the study. Out of these, 34 patients completed the study, of which 17 patients were in the recovery focus group and 17 patients were in the treatment as usual group (control).There was a significant difference between the groups in terms of greater improvement in wellbeing as rated by the WHO – 5 Wellbeing Index in the recovery focus group compared to the control group. The secondary outcome measures in the areas of cognition, quality of life and caregiver burden showed no differences between the groups. However, case histories from the recovery focus group identified the main areas of improvement in improved mood, increased social interaction, reduction in carer strain and/or burden and improved self-worth and/or confidence. Conclusions: This study shows that recovery focused care can enhance the wellbeing of people with mild to moderate dementia. The additional benefits perceived by the patients and their relatives /carers include improvement in mood symptoms, social interaction and confidence as well as reduction in carer burden and strain.

Enligt “Teorin om planerat beteende” så finns det tre orsaker till beteendet. Denna teori handlar om vad som påverkar en persons förväntningar och beteende innan de ska utföra en uppgift på en webbplats. Tidigare forskning har visat att tillgängligheten på webbplatser fortfarande är bristfälliga för personer med synnedsättning, eftersom de har olika behov och det spelar en viktig roll hur webbplatserna är uppbyggda och anpassade för personer med synnedsättning. Det ska vara lätt för användaren att hitta, förstå och kunna ta del av informationen på webbplatsen. För att kunna anpassa en webbplats på bästa sätt för personer med synnedsättning, bör en designer ta hjälp av olika riktlinjer för att kunna designa webbplatsen mer tillgänglig med bra och användbar information för personer med synnedsättningar. Men dessa riklinjer hjälper inte alltid användare med svår synnedsättning, eftersom de är i behov av olika hjälpmedel. Forskningsområdet berör områdena universell design, tillgänglighet, användarupplevelse, tillgänglighet och förväntningar på webben. Syftet med denna studie var att undersöka tillgängligheten för personer med synnedsättning på Linnéuniversitets webbplats och studera om webbplatsen är tillgänglig för dem, och studera om webbplatsen uppfyller deras förväntningar och upplevelse till att använda webbplatsen. Studien har studerat hur tillgängligheten påverkar användarupplevelsen för människor med synnedsättning på en webbplats och vilka förväntningar som användaren har på webbplatser. En empirisk studie genomfördes utifrån användartest med uppgifter och intervjuer på den befintliga webbplatsen med hjälp av personer med synnedsättning. I detta arbete har fullständig blindhet uteslutits, eftersom det är helt annan inriktning. Resultatet av intervjuerna sammanställdes och kategoriserades inom tillgänglighet, upplevelse och förväntningar av webbplatsen utifrån de mönster där testpersonerna hade angett liknande svar. Resultatet av sammanställningen av användartestet och intervjuerna på Linnéuniversitetets webbplats visade att testpersonerna anser att webbplatsen är tillgänglig för personer med synnedsättning och att deras förväntningar på webbplatsen uppfylldes. Resultatet visade att det som påverkar tillgängligheten på en webbplats är dåligt utformade med dåliga kontraster som till exempel ljus blått på vit bakgrund. På grund av dålig utformade webbplatser så kan inte personer med synnedsättning använda sina eventuella hjälpmedel, till exempel talsyntes, för att läsa upp innehållet på webbplatsen åt dem. Rörliga bilder, placering av objekt, otydliga menyer och rubriker, dåliga typsnitt eller att texten är för liten så att den blir svår att läsa. Det som personer med synnedsättning förväntar sig ska finnas på en tillgänglig webbplats: bra kontraster, bra typsnitt och tydliga rubriker. Bra placering av element så att det blir lätt att navigera sig, inga rörliga bilder, kunna lyssna på innehållet och att kunna använda sina eventuella hjälpmedel på webbplatsen. Genom detta får användaren en positiv upplevelse av webbplatsen. / According to “Theory of planned behavior", there are three reasons for the behavior. This theory is about what affect a person ́s expectations and behavior before they need to perform a task on a website. Previous research has shown that the availability of websites is still inadequate for people with visual impairment, because they have different needs and it plays an important role in how sites are built and adapted for people with visual impairment. It should be easy for users to find, understand and be able to take note of the information provided on the site. To be able to customize a site in the best way for people with visual impairment, a designer should take the help of various guidelines to design a website more accessible with useful information for people with visual impairment. But these guidelines don't always help users with severe visual impairment, because they are in need of different means. The research area relevant to the fields of universal design, accessibility, user experience, availability and expectations on the websites. The purpose of this study is to investigate the availability of people with visual impairment on Linnaeus University website and learn about how the site is available to them, and to study their expectations and experience of using the website. This study has studied how accessibility affects the user experience for people with visual impairment on a website and the expectations that the user has on websites. To be able to examine, I conducted an empirical study based on user tests with data and interviews on the existing site with the help of people with visual impairment. In this work I have excluded complete blindness, because it is quite a different focus. The results of the interviews were compiled and were categorised in availability, experience and expectations of the website based on the pattern in which subjects had stated similar answers. The result of the compilation of user test and interviews at Linnaeus University website showed that subjects think that the website is accessible to people with visual impairment, and that their expectations of the website were satisfied. The results showed that what affects the accessibility of a website is poorly designed interfaces with poor contrasts such as light blue on a white background. Because of badly designed websites, persons with visual impairment cannot use any assistive devices such as speech synthesizers to read out the contents of the site for them, pictures that moves, position of objects, obscure menus and headlines, bad fonts or that the text is to small, making it difficult to read. What person with visual impairment expects to find on an accessible website: good contrast, good fonts and clear titles. Good placement of the elements so that it will be easy to navigate, no pictures that moves, ability to listen to the content and to use any means at the site. Through this, the user receives a positive experience of the website.

Syftet med denna studie är att med fokus på språkstörning och läs- och skrivlärande undersöka hur pedagoger ser på begreppet språkstörning, samt vilka erfarenheter de har vid undervisning av elever med språkstörning. Studien handlar om elevens utveckling när de hamnar i den situationen där en eventuell språkstörning kan bli ett hinder i språk-, läs- och skrivlärandet. Studien har genomförts med hjälp av semistrukturerade gruppintervjuer på fyra olika skolor inom samma kommun. Informanterna har ingått i ett arbetslag som har erfarenhet av elever med språkstörning. De områden som valts att fokusera på är läs- och skrivlärande processen, metoder och arbetssätt och lärmiljön. Som teoretisk utgångspunkt används det sociokulturella perspektivet där kommunikation och språkanvändning är centrala begrepp, dessa begrepp utgör länken mellan barnet och omgivningen. Resultaten är uppdelade under områdena: begreppet språkstörning, metoder och arbetssätt, pedagogers erfarenheter, lärmiljön, pedagogiska utmaningar och framgångsfaktorer. Dessa områden har sedan sammankopplats i diskussionen med den forsknings- och litteraturgenomgång som genomförts. Resultatet visar att begreppet språkstörning innefattar många olika områden och används inte alltid i rätt syfte. Arbetslagen utgår alltid från flera metoder och arbetssätt, de provar sig fram och utgår från elevens behov. Viktiga aspekter i lärmiljön är att använda tydlighet, struktur, ett gemensamt förhållningssätt, fasta rutiner och att alltid ha ett mål att vara flera vuxna i klassrummet. Pedagogiska utmaningar innebär att kartlägga elevens behov för att sätta in rätta åtgärder. En språkstörning hos en elev kan yttra sig på olika vis vilket innebär behov av stöd inom flera områden.

The purpose of the study was to evaluate the use of a constant time delay procedure to teach core content words in braille to a student with a visual impairment. A multiple probe (conditions) across behaviors design was used to evaluate the effectiveness of the training and follow-up sessions. The results showed the procedure was effective in teaching core content braille words within a resource setting and the student was able to generalize the information to an inclusive setting.

Introduction: This study investigated hearing aid (HA) satisfaction among adult with hearing impairment (HI) in New Zealand. This study aimed to answer three questions: 1) What are the current HA satisfaction levels amongst adult HA users in New Zealand? 2) How do the satisfaction findings of this study compare with other HA satisfaction data? 3) What client factors are related to HA satisfaction? Method: Participants were recruited prospectively. They completed a questionnaire prior to HA fitting and a questionnaire three months post-fitting. Information was collected on: age, gender, HA experience, HI severity, hearing ability, change in hearing ability, hearing handicap, communication self-efficacy, change in communication self-efficacy, HA self-efficacy, HA usage, and number of appointments. HA satisfaction was measured via the Satisfaction with Amplification in Daily Life questionnaire (SADL; Cox & Alexander, 1999). Results: Data were collected for 47 participants. Of these, 91.5% fell within or above the normative range for global satisfaction established by Cox & Alexander (1999). The mean SADL scores were predominantly high compared to previous research. Satisfaction with negative features of HAs was especially high in this study. However satisfaction with the service and cost of HAs was low compared to other research. SADL scores were found to significantly relate to age, gender, change in hearing ability, hearing handicap, communication self-efficacy, change in communication self-efficacy, and HA self-efficacy. Conclusions: Results differed from previous research indicating that HA satisfaction may differ over time and across countries. Assessing HA satisfaction in a comprehensive standardised way, as opposed to with a single-item measure, can help identify important related factors. Targeting identified variables such as communication and HA self-efficacy may lead to improved treatment efficacy.

The development of category knowledge is in part a function of one's experiences with the world. The types of errors produced during category generation tasks may reveal the boundaries of these experiences and the ways in which they are organized into lexical networks. Examining the errors made by bilingual children with and without language impairment (LI) and bilingual adults may help to distinguish the effects of ability versus experience on the development and organization of lexical-semantic categories. The purpose of this study was to examine the types of errors made by bilingual (Spanish-English) children with (n=37) and without (n=35) LI and bilingual adults (n=26) on category generation tasks in both their languages and at two category levels: taxonomic and slot-filler. Results revealed a main effect for level (taxonomic vs. slot-filler) and error type (semantic vs. other) and suggest that bilingual seven to nine-year-old children's and adults' proportions and types of errors produced on category generation tasks differ significantly based on ability (i.e., TD or LI) but not on experience (i.e., TD or Adults). / text

Alzheimer's disease (AD) is a progressive, irreversible, neurodegenerative disease. The key to understanding AD is to elucidate the pathogenesis of neuron degeneration in specific brain regions.We hypothesize that there is increased DNA oxidation in AD brain compared to age-matched control subjects, especially in mitochondrial DNA (mtDNA), and that the changes in DNA bases will affect protein expression in mitochondria and contribute to neurodegeneration in AD. To test this hypothesis:1) We quantified multiple oxidized bases in nuclear DNA (nDNA) and mtDNA of frontal, parietal, and temporal lobes and cerebellum from late-stage AD (LAD), mild cognitive impairment (MCI), and age-matched control subjects using gas chromatography/mass spectrometry with selective ion monitoring (GC/MS-SIM). Also, we quantified oxidized DNA bases in cortex of APP/PS1 transgenic mice. (a) nDNA and mtDNA were extracted from eight LAD and eight control subjects. We found levels of multiple oxidized bases were significantly higher in frontal, parietal, and temporal lobes and that mtDNA had approximately 10-fold higher levels of oxidized bases than nDNA. Eight-hydroxyguanine was approximately 10-fold higher than other oxidized base adducts in both LAD and control subjects. These results suggest that oxidative damage to mtDNA may contribute to the neurodegeneration of AD. (b) Mild Cognitive Impairment (MCI), the phase between normal aging and early dementia, is a common problem in the elderly with many subjects going on to develop AD. Results from eight amnestic MCI and six control subjects suggest oxidative damage to DNA occurs in the earliest detectable phase of AD. (c) Analysis of nDNA from the cortex of four groups (3m, 6m, 9m, 12m) of APP/PS1 and wild type mice showed elevations of 8-hydroxyguanine in 12 month old APP/PS1 mice.2) To analyze mitochondrial protein changes in LAD, 2D gels were run to separate proteins and MALDI-TOF mass spectrometry was used to identify proteins.Five mitochondrial proteins were significantly decreased in LAD. This proteomic study provides a proteome map of mitochondria in LAD brain and an insight into the pathogenesis of neuron degeneration in Alzheimer's disease.

Research has suggested that the Five Factor Model (FFM) is useful in describing personality pathology as well as personality traits. However, there appears to be disproportionate implications of the five domains for problems in living. Previous empirical research concerning the differential direction and magnitude of the relationship of the FFM domains to problems in living and personality disorder symptomatology has perhaps been limited in part by the use of a measure of the FFM that itself includes a disproportionate representation of maladaptive personality functioning across the domains. The current study also tests the hypothesis that the relationship of the FFM domains to problems in living parallels the definition of personality disorder as provided in the American Psychiatric Association’s (2000) diagnostic manual, concerning social impairment, occupational impairment, and distress. These hypotheses were tested in a sample of 79 persons who were within psychiatric treatment. The current study indicated that problems in living relate to the FFM domains in a meaningful manner and that these relationships correspond to the definition of personality disorder. Implications of the findings for future research are discussed.

Dementia is increasingly recognized as a major and growing threat to public health worldwide, and there is a critical need for prevention and treatment strategies. However, it is necessary that appropriate methodologies are used in the identification of risk factors. The purpose of this dissertation research was to develop further the body of literature featuring Markov chains as an analytic tool for data derived from longitudinal studies of aging and dementia. Data drawn from 649 participants in the University of Kentucky’s Alzheimer’s Disease Center’s (UK ADC) Biologically Resilient Adults in Neurological Studies (BRAiNS) cohort, which was established in 1989 and follows adults age 60 years and older who are cognitively normal at baseline to death, were used to conduct three studies. The first study, “Mild cognitive impairment: Statistical models of transition using longitudinal clinical data,” shows that mild cognitive impairment is a stable clinical entity when a rigorous definition is applied. The second study, “Self-reported head injury and risk of cognitive impairment and Alzheimer’s-type pathology in a longitudinal study of aging and dementia,” shows that when the competing risk of death is properly accounted for, self-reported head injury is a clear risk factor for late-life dementia and is associated with increased beta-amyloid deposition in the brain. The third study, “Incorporating prior-state dependence among random effects and beta coefficients improves multistate Markov chain model fit,” shows that the effect of risk factors, like age, may not be constant over time and may be altered based on the subject’s cognitive state and that model fit is significantly improved when this is taken into account.

Individuals with brain injury are in need of speech and language therapy to improve impaired cognitive-communicative skills. Including significant communication partners (e.g., caregivers, spouses or parents) in intervention encourages carryover of skills practiced in therapy to natural communication contexts. Additionally, unimpaired partners benefit from training on how to communicate more effectively and and support the partner’s use of compensatory strategies for impaired cognitive skills. The objective of this multiple single case study was to evaluate the outcomes of a training program delivered to two dyads (Dyad B. and Dyad W.) composed of an adult with brain injury and an everyday communication partner. Participant dyads were recruited from a local brain injury support group. Training consisted of a four-week program during which participants received brain injury education, developed and monitored progress on goals, received instruction on communication strategies, and engaged in self-evaluation and role-play activities. Dependent variables were progress on individual goals, analysis of discourse variables, and the LaTrobe Communication Questionnaire. Treatment effects included a decrease in the amount of overlapping speech and an increase in the proportion of obliges and responses relative to comments for Dyad B., and increased deficit awareness and decreased conversation dominance on the part of the participant with brain injury for Dyad W. Results of the study showed that communication dyads affected by brain injury benefit from short-term training provided to both partners. / text