| 1. |
- Blom Johansson, Monica, 1965-
(författare)
-
Aphasia and Communication in Everyday Life : Experiences of persons with aphasia, significant others, and speech-language pathologists
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this thesis were to describe the experiences of persons with aphasia and their significant others of their conversations and use of communication strategies, examine current practice of family-oriented speech-language pathology (SLP) services, and test a family-oriented intervention in the early phase of rehabilitation.The persons with aphasia valued having conversations despite perceiving their aphasia as a serious social disability. They acknowledged the importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies. Their own use of communication strategies varied considerably. The persons with aphasia longed to regain language ability and to be active participants in society.A majority of the significant others perceived their conversations with the person with aphasia as being less stimulating and enjoyable than conversations before stroke onset. Aphasia was considered a serious problem. The significant others took on increased communicative responsibility, where two thirds had changed their communicative behaviour to facilitate conversations. Type and severity of aphasia were especially related to the communicative experiences of the significant others and their motivation to be involved in SLP services.Thirty percent of the speech-language pathologists worked with people with aphasia and typically met with their families. They considered the involvement of significant others in SLP services as very important, especially in providing information about aphasia and communication partner training (CPT). However, involvement of significant others was restricted because of a time shortage and perceived limited skills and knowledge. In addition, there were national differences regarding aphasia rehabilitation services.The intervention consisted of three sessions directed to significant others (primarily emotional support and information) and three directed to the dyads (a person with aphasia and a significant other) (primarily CPT). All six participants (three dyads) felt that their knowledge and understanding of aphasia had increased and that their conversations had improved. These improvements were also evident to some extent with formal assessments.These results suggest the following: CPT should be an integral part of SLP services, national clinical guidelines are needed, and further education of speech-language pathologists and implementation of new knowledge into clinical practice requires consideration.
|
|
| 2. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
-
A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
- 2013
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 27:2, s. 201-226
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).Aims:To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.Methods & Procedures:An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.Outcomes & Results:The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.Conclusions:The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.
|
|
| 3. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
-
Communication changes and SLP-services according to significant others of persons with aphasia
- 2012
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 26:8, s. 1005-1028
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.
|
|
| 4. |
- Elmroth, Erik, 1964-, et al.
(författare)
-
A composable service-oriented architecture for middleware-independent and interoperable grid job management
- 2010
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- We propose a composable, loosely coupled Service-Oriented Architecture for middleware-independent Grid job management. The architecture is designed for use in federated Grid environments and aims to decouple Grid appli- cations from Grid middlewares and other infrastructure components. The notion of an ecosystem of Grid infrastructure components is extended, and Grid job management software design is discussed in this context. Non- intrusive integration models and abstraction of Grid middleware function- ality through hierarchical aggregation of autonomous Grid job management services are emphasized, and service composition techniques facilitating this process are explored. Earlier efforts in Service-Oriented Architecture design are extended upon, and implications of these are discussed throughout the paper. A proof-of-concept implementation of the proposed architecture is presented along with a technical evaluation of the performance of the proto- type, and a details of architecture implementation are discussed along with trade-offs introduced by the service composition techniques used.
|
|
| 5. |
- Espling, Daniel, et al.
(författare)
-
Integration and evaluation of decentralized fairshare prioritization (Aequus)
- 2014
-
Ingår i: Proceedings of the IEEE 28th International Parallel & Distributed Processing Symposium Workshops IPDPSW 2014. - : IEEE Computer Society. - 9781479941162 ; , s. 1198-1207
-
Konferensbidrag (refereegranskat)abstract
- Fairshare is commonly one of the factors used by cluster resource management systems to prioritize jobs during scheduling. Despite the grid vision of a transparent and unified infrastructure, fairshare is normally calculated and enforced at the local cluster level rather than at a grid-wide scale. Aequus is a self-contained decentralized system for grid-wide fairshare job prioritization. Using Aequus, detailed global share policies can be combined with local cluster policies to offer a unified grid fairshare prioritization system where local administrations retain control over their clusters. This work shows how Aequus can be integrated with local resource management systems such as SLURM and Maui with minimal intrusion. Early results from production help assess the maturity of the system, and the system is further tested and evaluated for use at a nation-wide scale using workload modeling techniques. Statistical models are created based on historical national grid usage data, and synthetic traces based on these models are used to create a diverse input set used to exemplify system behavior. The system is shown to behave consistently despite great variations in job arrival patterns and partial participation of some of the collaborating installations.
|
|
| 6. |
- Fernaeus, Sven-Erik, et al.
(författare)
-
Memory factors in Rey AVLT : implications for early staging of cognitive decline
- 2014
-
Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 55:6, s. 546-553
-
Tidskriftsartikel (refereegranskat)abstract
- Supraspan verbal list learning is widely used to assess dementia and related cognitive disorders where declarative memory deficits are a major clinical sign. While the overall learning rate is important for diagnosis, serial position patterns may give insight into more specific memory processes in patients with cognitive impairment. This study explored these patterns in a memory clinic clientele. One hundred eighty three participants took the Rey Auditory-Verbal Learning Test (RAVLT). The major groups were patients with Alzheimer's disease (AD), Vascular Dementia (VD), Mild Cognitive Impairment (MCI), and Subjective Cognitive Impairment (SCI) as well as healthy controls (HC). Raw scores for the five trials and five serial partitions were factor analysed. Three memory factors were found and interpreted as Primacy, Recency, and Resistance to Interference. AD and MCI patients had impaired scores in all factors. SCI patients were significantly impaired in the Resistance to Interference factor, and in the Recency factor at the first trial. The main conclusion is that serial position data from word list testing reflect specific memory capacities which vary with levels of cognitive impairment.
|
|
| 7. |
- Fägerstam, Patrik, et al.
(författare)
-
Similar inhibition of platelet adhesion, P-selectin expression and plasma coagulation by ioversol, iodixanol and ioxaglate
- 2010
-
Ingår i: The British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 83:989, s. 401-410
-
Tidskriftsartikel (refereegranskat)abstract
- Contrast media (CM) are reported to possess both pro-thrombotic and anticoagulant properties. The mechanisms are not clearly understood and early reports are contradictory. To study the effects of CM on haemostasis, we analysed the ex vivo effects of ioversol and iodixanol on platelet adhesion and P-selectin expression, and the in vitro effects of ioversol, iodixanol and ioxaglate on platelet adhesion, P-selectin expression and plasma coagulation. A novel enzymatic assay was used to measure platelet adhesion to protein surfaces and an enzyme-linked immunosorbent assay was used to measure platelet P-selectin surface expression. Pro-thrombin time (PT) and activated partial thromboplastin time (APTT) were used to measure plasma coagulation. The ex vivo study consisted of blood from 27 outpatients administered ioversol and 9 patients administered iodixanol intravenously. Samples were collected before and 5 min after CM administration. Healthy donors were used for the in vitro studies on the effects of CM. The ex vivo study showed significantly (p<0.05) decreased platelet adhesion and P-selectin expression after administration of ioversol and iodixanol. Adhesion was more affected than P-selectin expression. The in vitro study showed that ioversol, iodixanol and ioaxaglate significantly (p<0.05) and dose dependently (beginning at 3 mg ml(-1)) decreased platelet adhesion and P-selectin expression. APTT and PT were significantly (p<0.01) prolonged at concentrations of 10 mg ml(-1) and 30 mg ml(-1), respectively. In conclusion, ioversol, iodixanol and ioxaglate inhibit platelet adhesion and P-selectin expression, as well as plasma coagulation. Platelets are more sensitive in relation to the inhibiting effect on plasma coagulation.
|
|
| 8. |
|
|
| 9. |
- Lindberg, Olof, et al.
(författare)
-
Hippocampal Shape Analysis in Alzheimer's Disease and Frontotemporal Lobar Degeneration Subtypes
- 2012
-
Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 30:2, s. 355-365
-
Tidskriftsartikel (refereegranskat)abstract
- Hippocampal pathology is central to Alzheimer's disease (AD) and other forms of dementia such as frontotemporal lobar degeneration (FTLD). Autopsy studies have shown that certain hippocampal subfields are more vulnerable than others to AD and FTLD pathology, in particular the subiculum and cornu ammonis 1 (CA1). We conducted shape analysis of hippocampi segmented from structural T1 MRI images on clinically diagnosed dementia patients and controls. The subjects included 19 AD and 35 FTLD patients [13 frontotemporal dementia (FTD), 13 semantic dementia (SD), and 9 progressive nonfluent aphasia (PNFA)] and 21 controls. Compared to controls, SD displayed severe atrophy of the whole left hippocampus. PNFA and FTD also displayed atrophy on the left side, restricted to the hippocampal head in FTD. Finally, AD displayed most atrophy in left hippocampal body with relative sparing of the hippocampal head. Consistent with neuropathological studies, most atrophic deformation was found in CA1 and subiculum areas in FTLD and AD.
|
|
| 10. |
- Looi, Jefferey Chee Leong, et al.
(författare)
-
Shape analysis of the neostriatum in frontotemporal lobar degeneration, Alzheimer's disease, and controls
- 2010
-
Ingår i: NeuroImage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 51:3, s. 970-986
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Frontostriatal circuit mediated cognitive dysfunction has been implicated in frontotemporal lobar degeneration (FTLD), but not Alzheimer's disease, or healthy aging. We measured the neostriatum (caudate nucleus and putamen) volume in FTLD (n=34), in comparison with controls (n=27) and Alzheimer's disease (AD, n=19) subjects. Methods: Diagnoses were based on international consensus criteria. Manual bilateral segmentation of the caudate nucleus and putamen was conducted blind to diagnosis by a single analyst, on MRI scans using a standardized protocol. Intra-cranial volume was calculated via a stereological point counting technique and was used for scaling the shape analysis. The manual segmentation binaries were analyzed using UNC Shape Analysis tools (University of North Carolina) to perform comparisons among FTLD, AD, and controls for global shape, local p-value significance maps, and mean magnitude of shape displacement. Results: Shape analysis revealed that there was significant shape difference between FTLD, AD, and controls, consistent with the predicted frontostriatal dysfunction and of significant magnitude, as measured by displacement maps. There was a lateralized difference in shape for the left caudate for FTLD compared to AD; non-specific global atrophy in AD compared to controls; while FTLD showed a more specific pattern in regions relaying fronto- and corticostriatal circuits. Conclusions: Shape analysis shows regional specificity of atrophy, manifest as shape deflation, with implications for frontostriatal and corticostriatal motoric circuits, in FTLD, AD, and controls.
|
|
