[Activities and methods of phonopsychomotrich rehabilitation].
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Adolescent↗
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Treatment of anomia using errorless versus errorful learning: are frontal executive skills and feedback important?
BACKGROUND: Studies from the amnesia literature suggest that errorless learning can produce superior results to errorful learning. However, it was found in a previous investigation by the present authors that errorless and errorful therapy produced equivalent results for patients with aphasic word-finding difficulties. A study in the academic literature of phoneme discrimination learning found that errorful learning produced equivalent results to errorless learning when feedback was given. In the authors' previous study, feedback was available to the participants in the errorful therapy. It is possible, therefore, that this feedback may have improved the results from errorless learning -- thereby reducing an underlying difference between the two techniques. Generally, feedback is thought to aid learning, however, there is little information in the speech therapy literature about this factor. AIMS: The present investigation was conducted as a follow-up to authors' original study to compare errorless and errorful therapy for the amelioration of aphasic word-finding difficulties. The second aim was to replicate key findings from the original study: namely, that recognition memory, executive/problem-solving skills and monitoring ability predict immediate and long-term naming improvements but not the participants' remaining language ability. METHODS & PROCEDURES: Seven of the original 11 participants took part in a multiple baseline, crossover, case series design. OUTCOMES & RESULTS: The previous results were replicated: errorless and errorful therapy produced equivalent results immediately post-therapy and at follow-up. There was no effect of omitting feedback - the participants learnt equally well without therapist's feedback about whether or not their response was correct. In addition, executive/problem-solving skills and monitoring ability again predicted immediate naming improvements not language ability. CONCLUSIONS: The findings support the view that cognitive abilities and in particular executive function are important contributors to rehabilitation.
Adult↗
Position statement and guidelines for oral and oropharyngeal prostheses. Ad Hoc Committee on Use of Specialized Medical Speech Devices. American Speech-Language-Hearing Association.
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American Speech-Language-Hearing Association↗
Effect of treatment on contagiousness of patients with active pulmonary tuberculosis.
In view of the important consequences with regard to policies for respiratory isolation of hospitalized patients with active tuberculosis, the duration of contagiousness after initiation of effective therapy was reviewed. All relevant English-language literature was reviewed to identify in vitro, animal experimental, and epidemiological evidence regarding contagiousness of patients with active tuberculosis after initiation of therapy. Based on in vitro evidence of numbers of tubercle bacilli initially present and rapidity of reduction-with therapy, it can be predicted that patients whose respiratory secretions are initially smear-negative but culture-positive should no longer have viable bacilli detectable by culture within 2 weeks. Based on the same evidence, it can be predicted that, after 2 weeks of therapy, almost all smear-positive patients will remain culture-positive, and more than one half will remain smear-positive. There are few epidemiological studies of this issue, most of which have had major methodological weaknesses. None of the results from these studies can be considered relevant to the hospital environment, where the majority of workers are uninfected and patients are potentially immunocompromised. Animal and in vitro evidence suggest that patients with active tuberculosis remain contagious at least 2 weeks after the initiation of therapy. Patients with smear-positive disease are likely to be contagious much longer. There is no relevant and valid epidemiological evidence regarding this issue.
Animals↗
Gonococcal abscess of the obturator internal muscle: use of new diagnostic tools may eliminate the need for surgical intervention.
Obturator internal muscle (OIM) abscess or pyomyositis, a poorly recognized intrapelvic infection, is characterized by limping, pain in the hip with limited movement, and the sciatic type of radiating leg pain. With the use of advanced diagnostic tools such as computed tomography (CT), magnetic resonance imaging, and radionuclide scans, several cases of OIM abscess have been diagnosed; these cases have recently been reported in the English-language literature. Staphylococcus aureus is the predominant organism isolated from OIM abscesses. Gonococcal abscess involving the OIM has not been reported. We describe a case of gonococcal OIM abscess in an adolescent female whose condition was successfully diagnosed and managed with the use of CT-guided needle aspiration and antibiotic therapy. We review the English-language literature regarding the use of newly developed tools in the diagnosis of OIM abscess.
Abscess↗
Speech, language, and swallowing disorders in the older adult.
The geriatric population has become a major component in the practice of medical speech-language pathology. This article discusses normal and abnormal functions of speech, voicing, language, cognition, and swallowing. Particular attention is given to disorders affecting the geriatric population. Evaluation, treatment, and ethical issues are explored in addition to the role of the speech-language pathologist on the interdisciplinary team.
Aged↗
[Speech therapy for Aphasia following cerebrovascular accident].
Cerebrovascular accidents of the dominant hemisphere often result in aphasia. In this article the different types of aphasia are briefly explained and the pattern of spontaneous recovery, as well as the determining factors for the evolution, are discussed. Some therapeutic approaches are outlined and the main studies investigating the efficacy and specificity of speech therapy are presented. Finally, criteria for the selection of patients for intensive speech therapy are suggested.
Aphasia↗
Current dermatologic therapy.
This article reviews therapeutic advances reported in the English-language literature during 1991. Readers should review the original article in full before attempting any experimental or controversial therapy.
Humans↗
The efficacy and safety of combination warfarin and ASA therapy: a systematic review of the literature and update of guidelines.
The English-language literature was systematically reviewed to clarify the role of combination antithrombotic therapy with warfarin and acetylsalicylic acid (ASA) versus monotherapy with either agent, including data from several recently published trials. Sixteen published studies with evaluable efficacy and/or safety data were identified. For patients with prosthetic heart valves at high risk of thromboembolism, combined warfarin and ASA therapy may be beneficial compared with warfarin alone. Combination therapy may also be used for primary prevention in patients at high risk for ischemic heart disease, although the expected benefits are small. Evidence does not support the use of combined antithrombotic therapy in patients with established ischemic heart disease, ischemic stroke, coronary artery bypass grafts or atrial fibrillation. Combination therapy is associated with an increased risk of minor and major bleeding. The highest dose of ASA that can be recommended in combination with warfarin is 100 mg daily.
Anticoagulants↗
Teaching research: an introduction to statistical concepts and research terminology.
Concerns for establishing priorities in occupational therapy research and positive responses to these concerns are reviewed. Growth in occupational therapy research can be expected, but it is important that the research process not be limited to educators and graduate students alone. Involvement of occupational therapists in scientific inquiry is often deterred by misconceptions of the research process. Realistic acceptance of research is needed to replace these misconceptions. One major problem is understanding the language of research. It is suggested that the acquisition of research language can begin in regular occupational therapy classes. To introduce students to research concepts, frequently used statistical symbols and research terms are discussed. Limitations in applying "ideal" research methodology to clinical research are noted.
Occupational Therapy↗
Language-based cognitive abilities in adult aphasia: rationale for intervention.
The purpose of this investigation is to explore operational definitions of cognition, intelligence, information processing, language-based cognitive abilities, cognitive processes and products, problem solving, decision making, and the complex events that happen in the brain when one stimulates a patient. These definitions are explored in order to develop a coherent and generative rationale for therapy. It is hypothesized that a specification of the underlying targets of our stimulation therapy may increase the effectiveness of our intervention efforts.
Aphasia↗
Testosterone as a social inhibitor: two case studies of the effect of testosterone treatment on language.
This study aimed to correlate testosterone levels with natural written language in 2 people undergoing testosterone therapy. Two participants, a man receiving treatment for loss of upper-body strength and a female-to-male transgendered individual, supplied records of injections over 1-2 years along with e-mails or journal entries as writing samples. Results showed that higher testosterone levels correlated with reduced use of words related to social connections. Language relating to anger, sexuality, and achievement was unrelated to testosterone levels. It appears that testosterone steers attention away from social connections but not necessarily toward concerns with aggression or sexual activity.
Adult↗
Developmental language and speech disability.
Speech disabilities (articulation deficits) and language disorders--expressive (vocabulary) receptive (language comprehension) are not uncommon in children. An overview of these along with a global description of the impairment of communication as well as clinical characteristics of language developmental disorders are presented in this article. The diagnostic tables, which are applied in the European and Anglo-American speech areas, ICD-10 and DSM-IV, have been explained and compared. Because of their strengths and weaknesses an alternative classification of language and speech developmental disorders is proposed, which allows a differentiation between expressive and receptive language capabilities with regard to the semantic and the morphological/syntax domains. Prevalence and comorbidity rates, psychosocial influences, biological factors and the biological social interaction have been discussed. The necessity of the use of standardized examinations is emphasised. General logopaedic treatment paradigms, specific therapy concepts and an overview of prognosis have been described.
Child Language↗
[Parenting Stress Index and specific language impairment].
The aim of the present study was to get a differentiated view of stress experience of mothers of children with a specific language impairment with a standardised questionnaire. Our sample consisted of 63 mothers of language impaired children between 3.0 and 6.5 years consecutively recruited at the University-ENT clinic of Vienna. Parenting stress was assessed by the "Parenting Stress Index" of Abidin (1995) and the results were compared to mothers of a control group matched by sex and age of the children. The results showed significant mean differences between mothers of the clinical and the control group. In nearly all subscales mothers of language impaired children have higher stress scores than mothers of the control group. 68% of mothers of the clinical group are exposed to above-average stress levels whereas only 1.5% of mothers of children with normal language development show above-average parenting stress. For a successful intervention on children with a specific language impairment it seems to be very important to identify parental stressors and to treat and support parents too.
Adult↗
Single subject research strategies in occupational therapy: part 2.
This second of a 2-part paper on single subject research is devoted to practical implementation issues. Using clinical examples, the challenge of transferring single subject research strategies to occupational therapy intervention approaches is explored. The therapeutic approaches of behavioral, motoric, and processing are employed to discuss the use of single subject methodology in occupational therapy. Initial research activities for those interested in documenting treatment results are described. Finally, directions for the future use of single subject research are discussed.
Behavior Therapy↗
The polycystic ovary syndrome: pathogenesis and treatment.
PURPOSE: To propose a theory for the pathogenesis of the polycystic ovary syndrome that explains the endocrinologic abnormalities of the syndrome and provides a rational approach to therapy. DATA IDENTIFICATION: An English-language literature search using MEDLINE (1975 to 1988) and extensive bibliographic reviews of identified articles. STUDY SELECTION: We reviewed the literature and selected 169 articles considered most relevant for the definition of the endocrinologic abnormalities, elucidation of pathogenic mechanisms, or delineation of therapeutic interventions. DATA EXTRACTION: The authors independently assessed study quality and data concerning endocrinologic abnormalities, pathogenic mechanisms, and therapy of the polycystic ovary syndrome. RESULTS OF DATA SYNTHESIS: The polycystic ovary syndrome may be best defined as functional, gonadotropin-dependent ovarian hyperandrogenism. The polycystic ovary syndrome results when a primary defect increases one of three variables: the ratio of the serum concentrations of luteinizing hormone to follicle stimulating hormone, the ratio of the intraovarian concentrations of androgen to estrogen, or follicular atresia. An increase in one of these variables can then induce successive abnormalities in one or more of the remaining two variables in a to-and-fro manner. CONCLUSIONS: Evidence suggests that several causes exist, each of which can produce the clinical syndrome by a to-and-fro interaction among pathogenic mechanisms. Treatment objectives for the syndrome include amelioration of hirsutism, induction of ovulation, and weight reduction.
Androgens↗
[Cognitive deterioration in Parkinson's disease].
INTRODUCTION: Whether there are mental changes in Parkinson s disease (EP) or not, has been a confused and contradictory subject since the earliest studies and semiological definition of the disorder. James Parkinson himself, in his study An essay on the shaking palsy (1817), stated that in the condition he described, the sense and intellect were not damaged. DEVELOPMENT: Thanks to the development of cognitive neuropsychology, at the present time there are rather more precise concepts regarding this fascinating area of neurology. We give a summary, as schematic as possible, of theory relating to the known data. 1. The presence or absence of cognitive deterioration in EP 2. The neuropsychological characteristics of cognitive involvement in EP, cognitive defects in incipient EP and in established EP. 3. The risk factor involved in the occurrence of cognitive deterioration. CONCLUSIONS: This knowledge should be used for better understanding of the patient s mental state at every stage of the disease, during follow up studies and for the neuro conductual therapeutic and socio familial approach in each case.
Adaptation, Psychological↗
[Some reflections a propos of an experiment in family therapy].
A social assistant in conjonction with a multidimensional team in child psychiatry followed the progress of family therapy over a few years. The reason for this family therapy was based on the difficulty the parents had in expressing their conflicts through oral communication. It is chiefly by actual encounterances and a sub-verbal dialog that this experiment was carried out. This project was able to be investigated by having great freedom of openness by elaboration of each structure and with transferential attitudes. This experiment was carried out on 40 cases; however only 4 are described to illustrate the method.
Adult↗