Shoplifting is one of the most frequent crimes in the United States, yet there is no agreement about effective prevention procedures. Since most prevention strategies are aimed at either increasing public awareness of the severity of the consequences or increasing the threat of detection, procedures that contain these elements were evaluated. Posting signs around a department of a department store pointing out that shoplifting is a crime, etc., partially reduced shoplifting rates. When merchandise that was frequently taken was identified by signs and stars, shoplifting decreased to near zero. Publicity campaigns to inform the public of consequences for shoplifting may produce desirable results, but identifying likely shoplifting targets, which may increase the likelihood of detection, effectively reduces shoplifting rates.
Background-Working memory (WM) limitations have been suggested as a significant source of the linguistic processing deficits observed in individuals with aphasia (IWA). Digits forward (DF) and digits backward (DB) span tasks are frequently used to study WM in both healthy and clinical populations. Unfortunately, only a handful of studies have explored digit span in IWA.
Background and Purpose: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia. Methods: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. Outcome measurement scores were standardized. A statistical inferencing, one-stage, random effects, network meta-analysis approach filtered individual participant data into an optimal model examining SLT regimen for overall language, auditory comprehension, naming, and functional communication pre-post intervention gains, adjusting for a priori–defined covariates (age, sex, time poststroke, and baseline aphasia severity), reporting estimates of mean change scores (95% CI). Results: Data from 959 individual participant data (25 trials) were included. Greatest gains in overall language and comprehension were associated with >20 to 50 hours SLT dosage (18.37 [10.58–26.16] Western Aphasia Battery–Aphasia Quotient; 5.23 [1.51–8.95] Aachen Aphasia Test–Token Test). Greatest clinical overall language, functional communication, and comprehension gains were associated with 2 to 4 and 9+ SLT hours/week. Greatest clinical gains were associated with frequent SLT for overall language, functional communication (3–5+ days/week), and comprehension (4–5 days/week). Evidence of comprehension gains was absent for SLT ≤20 hours, <3 hours/week, and ≤3 days/week. Mixed receptive-expressive therapy, functionally tailored, with prescribed home practice was associated with the greatest overall gains. Relative variance was <30%. Risk of trial bias was low to moderate; low for meta-biases. Conclusions: Greatest language recovery was associated with frequent, functionally tailored, receptive-expressive SLT, with prescribed home practice at a greater intensity and duration than reports of usual clinical services internationally. These exploratory findings suggest critical therapeutic ranges, informing hypothesis-testing trials and tailoring of clinical services. Registration: URL: https://www.crd.york.ac.uk/PROSPERO/ ; Unique identifier: CRD42018110947.
Background: Stroke is currently the leading cause of long-term disability in adults in the United States. There is a need for accessible, low-cost treatments of stroke-related disabilities such as aphasia. Aims: To explore an intervention for aphasia utilizing mindfulness meditation (MM). This preliminary study examines the feasibility of teaching MM to individuals with aphasia. Since physiological measures have not been collected for those with aphasia, the study was also an exploration of the potential attention, language and physiological changes after MM in adults with aphasia during a brief, daily group training. Methods & Procedures:A 5-day MM group training was provided to adults with aphasia (n = 5) with a waitlist control group (n = (3) who engaged in 'mind wandering'. Participants were assigned to groups in a pseudo-random manner. A double baseline (2 days apart) was administered prior to the training and/or control group beginning. Both the training and the control groups met in a group setting. Salivary cortisol, heart rate and heart rate variability were measured during each day for both groups. Measures of attention, auditory comprehension and fluency were collected immediately after the study period and 1 week post-completion. Outcome & Results:This study reinforces findings from previous work indicating that adults with aphasia can learn MM. Although not statistically significant, the training group demonstrated improved fluency immediately after MM; however, changes were not maintained at follow-up. Physiological measures showed little effect associated with MM training. No changes in attention were observed for either group. Conclusion & Implications: This is an emerging area of interest due to the potential low cost of MM training. Furthermore, MM is easily taught to patients, suggesting the possibility for widespread use in clinical practice as a supplement to existing language-focused interventions.
Given the psychophysiological and behavioral changes observed in this individual, further exploration of the influence of MM in the treatment of post-stroke aphasia is warranted.
Background: There is evidence to suggest that people with aphasia (PWA) may have deficits in attention stemming from the inefficient allocation of resources. The inaccurate perception of task demand, or sense of effort, may underlie the misallocation of the available attention resources. Given the lack of treatment options for improving attention in aphasia, Mindfulness Meditation, shown to improve attention in neurologically intact individuals, may prove effective in increasing attention in PWA. Aims: The purpose of the present study was to determine if Mindfulness Meditation improves divided attention or language in PWA and if it affects the overall sense of effort. Methods & Procedures: A multiple baseline single‐subject design was used to determine the effects of Mindfulness Meditation on divided attention for three PWA. Divided attention was measured using a non‐linguistic divided attention task. Visual inspection of the data was used to determine changes in performance (sense of effort, reaction time and accuracy, language) over time. Outcomes & Results: High performance observed on the attention measures suggests that PWA have varying degrees of attentional impairment that may surface when certain demands are presented. There were no observable changes in the performance on the sense of effort or language measures; however, measures of reaction time may indicate Mindfulness Meditation improved efficiency of task completion. Conclusions & Implications: All three participants reported that Mindfulness Meditation was easy to learn and carry out on a daily basis, and reported feeling more ‘relaxed’ and ‘peaceful’ after Mindfulness Meditation training than before. With the knowledge that PWA can learn meditative practices, and with such successful findings in neurologically intact individuals, it is important to continue evaluating the benefits of Mindfulness Meditation in PWA.
Background and Purpose: The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset. Methods: Individual participant data meta-analysis of systematically sourced aphasia datasets described overall-language ability using the Western Aphasia Battery Aphasia-Quotient; auditory comprehension by Aachen Aphasia Test (AAT) Token Test; naming by Boston Naming Test and functional-communication by AAT Spontaneous-Speech Communication subscale. Multivariable analyses regressed absolute score-changes from baseline across language domains onto covariates identified a priori in randomized controlled trials and all study types. Change-from-baseline scores were presented as estimates of means and 95% CIs. Heterogeneity was described using relative variance. Risk of bias was considered at dataset and meta-analysis level. Results: Assessments at baseline (median=43.6 weeks poststroke; interquartile range [4–165.1]) and first-follow-up (median=10 weeks from baseline; interquartile range [3–26]) were available for n=943 on overall-language ability, n=1056 on auditory comprehension, n=791 on naming and n=974 on functional-communication. Younger age (<55 years, +15.4 Western Aphasia Battery Aphasia-Quotient points [CI, 10.0–20.9], +6.1 correct on AAT Token Test [CI, 3.2–8.9]; +9.3 Boston Naming Test points [CI, 4.7–13.9]; +0.8 AAT Spontaneous-Speech Communication subscale points [CI, 0.5–1.0]) and enrollment <1 month post-onset (+19.1 Western Aphasia Battery Aphasia-Quotient points [CI, 13.9–24.4]; +5.3 correct on AAT Token Test [CI, 1.7–8.8]; +11.1 Boston Naming Test points [CI, 5.7–16.5]; and +1.1 AAT Spontaneous-Speech Communication subscale point [CI, 0.7–1.4]) conferred the greatest absolute change-from-baseline across each language domain. Improvements in language scores from baseline diminished with increasing age and aphasia chronicity. Data exhibited no significant statistical heterogeneity. Risk-of-bias was low to moderate-low. Conclusions: Earlier intervention for poststroke aphasia as crucial to maximize language recovery across a range of language domains, although recovery continued to be observed to a lesser extent beyond 6 months poststroke.
Background: Collation of aphasia research data across settings, countries and study designs using big data principles will support analyses across different language modalities, levels of impairment, and therapy interventions in this heterogeneous population. Big data approaches in aphasia research may support vital analyses, which are unachievable within individual trial datasets. However, we lack insight into the requirements for a systematically created database, the feasibility and challenges and potential utility of the type of data collated. Aim: To report the development, preparation and establishment of an internationally agreed aphasia after stroke research database of individual participant data (IPD) to facilitate planned aphasia research analyses.
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