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This study reports on current aphasia rehabilitation practices of speech-language pathologists in Australia. A 30-item web-based survey targeted approaches to aphasia rehabilitation, education, discharge, follow-up practices, counselling, interventions to improve communication access, community aphasia support services, and challenges to practice. One hundred and eighty-eight surveys were completed representing ~33% of the potential target population, with 58.5% urban and 41.5% rural participants across all states and territories. Respondents reported embracing a wide variety of approaches to aphasia rehabilitation; however, significant challenges in providing aphasia management in acute and residential care were identified. Low levels of knowledge and confidence were reported for both culturally and linguistically diverse clients and discourse approaches. Group and intensive services were under-utilized and clinicians reported inflexible funding models as major barriers to implementation. Few clinicians work directly in the community to improve communicative access for people with aphasia. Despite the chronic nature of aphasia, follow-up practices are limited and client re-entry to services is restricted. Counselling is a high frequency practice in aphasia rehabilitation, but clinicians report being under-prepared for the role. Respondents repeatedly cited lack of resources (time, space, materials) as a major challenge to effective service provision. Collective advocacy is required to achieve system level changes.

This review examined previous research applications of linguistic discourse analysis to assess the language of adults with aphasia. A comprehensive literature search of seven databases identified 165 studies that applied linguistic measures to samples of discourse collected from people with aphasia. Analysis of methodological applications revealed an increase in published research using linguistic discourse analysis over the past 40 years, particularly to measure the generalisation of therapy outcomes to language in use. Narrative language samples were most frequently subject to analysis though all language genres were observed across included studies. A total of 536 different linguistic measures were applied to examine language behaviours. Growth in the research use of linguistic discourse analysis and suggestions that this growth may be reflected in clinical practice requires further investigation. Future research directions are discussed to investigate clinical use of discourse analysis and examine the differences that exist between research and clinical practice.

This study highlights that family members of individuals with aphasia have a number of aphasia-related rehabilitation goals for themselves. In order to provide a family-centred approach to rehabilitation, health professionals, including speech-language pathologists, need systematically to identify and address family members' goals in light of the categories revealed in this investigation.

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Regulators of differentiated cell fate can offer targets for managing cancer development and progression. Here, we identify Runx2 as a new regulator of epithelial cell fate in mammary gland development and breast cancer. Runx2 is expressed in the epithelium of pregnant mice in a strict temporally and hormonally regulated manner. During pregnancy, Runx2 genetic deletion impaired alveolar differentiation in a manner that disrupted alveolar progenitor cell populations. Conversely, exogenous transgenic expression of Runx2 in mammary epithelial cells blocked milk production, suggesting that the decrease in endogenous Runx2 observed late in pregnancy is necessary for full differentiation. In addition, overexpression of Runx2 drove epithelial-to-mesenchymal transition-like changes in normal mammary epithelial cells, whereas Runx2 deletion in basal breast cancer cells inhibited cellular phenotypes associated with tumorigenesis. Notably, loss of Runx2 expression increased tumor latency and enhanced overall survival in a mouse model of breast cancer, with Runx2-deficient tumors exhibiting reduced cell proliferation. Together, our results establish a previously unreported function for Runx2 in breast cancer that may offer a novel generalized route for therapeutic interventions. Cancer Res; 74(18); 5277-86. Ó2014 AACR.

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