Language samples collected yearly for up to 11 years post-onset of symptoms from four subjects presenting with non-fluent primary progressive aphasia (PPA) were analyzed and compared with samples collected from both nonbrain-damaged subjects and those with agrammatic Broca's aphasia resulting from a single left-hemisphere stroke. Extensive analysis of lexical and morphosyntactic variables in these samples revealed two patterns of expressive language decline in the PPA subjects-one resembling that seen in our agrammatic aphasic subjects-i.e. impaired production of closed-class elements and loss of sentential structures governed by these elementsand the other characterized by advancing word-retrieval difficulties. These data are relevant for patient-management purposes and, in addition, they provide information relevant to language representation and organization.
The present research examines production of "complex" sentences, which involve movement of noun phrases (NPs), in 2 agrammatic aphasic subjects. According to linguistic theory (Chomsky, 1991, 1993), such sentences are derived using one of two movement operations, either wh- or NP-movement, subsumed under the general rule "move alpha." In this experiment recovery of both wh- and NP-movement derived sentences was investigated using a treatment research paradigm. Subjects were sequentially trained to produce either wh-movement (i.e., who questions, object clefts) or NP-movement (i.e., passives, subject-raising structures) derived sentences. Throughout training, generalization to untrained sentences relying on both types of movement was tested. The influence of training on aspects of narrative discourse also was examined. Results showed generalization patterns constrained to type of movement. Training wh-movement structures resulted in generalized production of untrained wh-movement structures without influencing production of NP-movement structures. Similarly, training of NP-movement structures resulted in generalization only to other sentence types also relying on NP-movement. Aspects of sentence production in narrative contexts also was improved with treatment. These data indicate that movement to an argument (A) position as in NP-movement is distinct from movement to a non-argument (A-bar) position, required in wh-movement. The site where movement terminates in the s-structure of noncanonical sentences appears to influence sentence production. These findings show that linguistic properties of sentences influence sentence production breakdown and recovery in aphasia.
Phenylalanine ammonia lyase (PAL, E.C.4.3.1.24), was entrapped in ultra-large-pore mesoporous silica (ULPS, 23 nm pore diameter) generating a recyclable, separable biocatalyst. The entrapped ULPS-PAL materials showed excellent stabilization, even after significant exposure to prolonged heating. Additionally, the entrapped ULPS-PAL materials showed extremely high catalytic activity in the deamination of L-phenylalanine to trans-cinnamic acid in aqueous solution and were recovered and recycled up to five times without any observable loss in activity. This approach is simple and capitalizes on the facile synthesis and easy recoverability of mesoporous silicas to generate a stable, reusable PAL-based biocatalyst.
BACKGROUND
The COVID-19 pandemic and consequent lockdowns disrupted mental health service delivery worldwide, accelerating the adoption of telehealth services to provide care continuity. Telehealth-based research largely highlights the value of this service delivery method for a range of mental health conditions. However, only limited research exists exploring client perspectives of mental health services delivered via telehealth during the pandemic.
OBJECTIVE
This study aimed to increase understanding of the perspectives of mental health clients around services provided via telehealth over the 2020 COVID-19 lockdown in Aotearoa New Zealand.
METHODS
Interpretive description methodology underpinned this qualitative inquiry. Semistructured interviews were conducted with 21 individuals (15 clients and 7 support people; 1 person was both a client and support person) to explore their experiences of outpatient mental health care delivered via telehealth during the COVID-19 pandemic in Aotearoa New Zealand. A thematic analysis approach supported by field notes was used to analyze interview transcripts.
RESULTS
The findings reveal that mental health services delivered via telehealth differed from those provided in person and led some participants to feel they need to manage their own care more actively. Participants highlighted several factors affecting their telehealth journey. These included the importance of maintaining and building relationships with clinicians, the creation of safe spaces within client and clinician home environments, and clinician readiness in facilitating care for clients and their support people. Participants noted weaknesses in the ability of clients and clinicians to discern nonverbal cues during telehealth conversations. Participants also emphasized that telehealth was a viable option for service delivery but that the reason for telehealth consultations and the technicalities of service delivery needed to be addressed.
CONCLUSIONS
Successful implementation requires ensuring solid relationship foundations between clients and clinicians. To safeguard minimum standards in delivering telehealth-based care, health professionals must ensure that the intent behind telehealth appointments is clearly articulated and documented for each person. In turn, health systems must ensure that health professionals have access to training and professional guidance to deliver effective telehealth consultations. Future research should aim to identify how therapeutic engagement with mental health services has changed, following a return to usual service delivery processes.
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