The Application of Relaxation Training Approaches to Patients With Neurogenic Disorders and Their Caregivers

Author(s):  
Laura L. Murray

Abstract Purpose: Because relaxation therapy remains a popular complementary and alternative medicine approach, this review paper was written to (a) introduce speech-language clinicians to relaxation therapy procedures, (b) summarize research regarding outcomes associated with relaxation therapy in healthy and patient populations, including those with neurogenic cognitive and communicative disorders, and (c) identify future research needs and clinical applications regarding the use of relaxation therapy within speech-language management protocols. Method: A review of the literature pertaining to relaxation therapy among healthy adults, individuals with non-neurogenic disorders, and individuals with neurogenic cognitive-communicative disorders was conducted and critically summarized. Results and Conclusions: Preliminary data suggest that relaxation therapy, when applied alone or in concert with conventional speech-language therapy protocols, may be used to address a variety of neurogenic cognitive and communicative problems ranging from dysarthria in Parkinson's disease to high-level cognitive deficits in traumatic brain injury. Further research is needed, however, given the paucity of studies involving individuals with neurogenic cognitive or communicative disorders and that much of the extant literature regarding relaxation therapy has lacked the methodological rigor necessary to evoke confidence in the reported findings. Suggestions regarding how to broaden the scope of research regarding relaxation training are provided.

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Orla Boyle ◽  
Louise Kelly ◽  
Maeve Ryan ◽  
Deirdre Brady ◽  
Ruth Wade ◽  
...  

Abstract Background Dysphagia, frailty and negative patient outcomes are interlinked1. Changes in communication may result from the ageing process, chronic conditions, and/or neurologic conditions presenting in later years2. However, unlike other cohorts, including stroke, frail older patients are not routinely screened for swallowing/communication difficulties in acute settings. We investigated the proportion of Speech and Language Therapy (SLT) referrals generated for older patients attending our Emergency Department (ED) following use of a swallowing/communication screening tool and their association with Clinical Frailty Scale (CFS) scores. Methods A retrospective analysis of data collected over a four week period was completed. Older patients presenting to ED were screened by the interdisciplinary gerontological ED team using a screening tool, including a locally developed swallow/communication screen. Statistical analyses were performed using STATA Version 12. Results Of 176 patients screened (mean age 81.8 years, SD 5.9 years), median CFS score was 5 (IQR 3-6). Thirty-seven percent (66/176) of patients were referred for SLT assessment following initial screen. SLT referrals were more commonly required in patients with a CFS score of ≥4 (46.2% vs. 19.3%, P=0.001) and likelihood of requiring SLT referral increased with greater CFS score (P<0.0001). Conclusion Results suggest that screening for swallowing and communication difficulties in older patients yields a high level of SLT referrals, with a higher frequency of SLT referrals observed with increasing frailty scores. Further research is required to determine the optimum swallowing/communication screening tool in the acute setting. Future research will focus on evaluating outcomes of SLT assessments completed and determining the prevalence of swallowing and/or communication difficulties in this cohort.


Methodology ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Pablo Livacic-Rojas ◽  
Guillermo Vallejo ◽  
Paula Fernández ◽  
Ellián Tuero-Herrero

Abstract. Low precision of the inferences of data analyzed with univariate or multivariate models of the Analysis of Variance (ANOVA) in repeated-measures design is associated to the absence of normality distribution of data, nonspherical covariance structures and free variation of the variance and covariance, the lack of knowledge of the error structure underlying the data, and the wrong choice of covariance structure from different selectors. In this study, levels of statistical power presented the Modified Brown Forsythe (MBF) and two procedures with the Mixed-Model Approaches (the Akaike’s Criterion, the Correctly Identified Model [CIM]) are compared. The data were analyzed using Monte Carlo simulation method with the statistical package SAS 9.2, a split-plot design, and considering six manipulated variables. The results show that the procedures exhibit high statistical power levels for within and interactional effects, and moderate and low levels for the between-groups effects under the different conditions analyzed. For the latter, only the Modified Brown Forsythe shows high level of power mainly for groups with 30 cases and Unstructured (UN) and Autoregressive Heterogeneity (ARH) matrices. For this reason, we recommend using this procedure since it exhibits higher levels of power for all effects and does not require a matrix type that underlies the structure of the data. Future research needs to be done in order to compare the power with corrected selectors using single-level and multilevel designs for fixed and random effects.


2020 ◽  
Author(s):  
Sina Faizollahzadeh Ardabili ◽  
Amir Mosavi ◽  
Pedram Ghamisi ◽  
Filip Ferdinand ◽  
Annamaria R. Varkonyi-Koczy ◽  
...  

Several outbreak prediction models for COVID-19 are being used by officials around the world to make informed-decisions and enforce relevant control measures. Among the standard models for COVID-19 global pandemic prediction, simple epidemiological and statistical models have received more attention by authorities, and they are popular in the media. Due to a high level of uncertainty and lack of essential data, standard models have shown low accuracy for long-term prediction. Although the literature includes several attempts to address this issue, the essential generalization and robustness abilities of existing models needs to be improved. This paper presents a comparative analysis of machine learning and soft computing models to predict the COVID-19 outbreak as an alternative to SIR and SEIR models. Among a wide range of machine learning models investigated, two models showed promising results (i.e., multi-layered perceptron, MLP, and adaptive network-based fuzzy inference system, ANFIS). Based on the results reported here, and due to the highly complex nature of the COVID-19 outbreak and variation in its behavior from nation-to-nation, this study suggests machine learning as an effective tool to model the outbreak. This paper provides an initial benchmarking to demonstrate the potential of machine learning for future research. Paper further suggests that real novelty in outbreak prediction can be realized through integrating machine learning and SEIR models.


2020 ◽  
Vol 12 (11) ◽  
pp. 4460 ◽  
Author(s):  
Mohammadsoroush Tafazzoli ◽  
Ehsan Mousavi ◽  
Sharareh Kermanshachi

Although the two concepts of lean and sustainable construction have been developed due to different incentives, and they do not pursue the same exact goals, there exists considerable commonality between them. This paper discusses the potentials for integrating the two approaches and their practices and how the resulting synergy from combining the two methods can potentially lead to higher levels of fulfilling the individual goals of each of them. Some limitations and challenges to implementing the integrated approach are also discussed. Based on a comprehensive review of existing papers related to sustainable and lean construction topics, the commonality between the two approaches is discussed and grouped in five categories of (1) cost savings, (2) waste minimization, (3) Jobsite safety improvement, (4) reduced energy consumption, and (5) customers’ satisfaction improvement. The challenges of this integration are similarly identified and discussed in the four main categories of (1) additional initial costs to the project, (2) difficulty of providing specialized expertise, (3) contractors’ unwillingness to adopt the additional requirements, and (4) challenges to establish a high level of teamwork. Industry professionals were then interviewed to rank the elements in each of the two categories of opportunities and challenges. The results of the study highlight how future research can pursue the development of a new Green-Lean approach by investing in the communalities and meeting the challenges of this integration.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 920.1-921
Author(s):  
N. Stepanenko ◽  
E. Fedorov ◽  
S. Salugina ◽  
S. Feoktistova

Background:Monogenic auto-inflammatory diseases (mAID) are a group of severe chronic multisystemic diseases with recurring episodes of fever and other manifestations that significantly affect the patients’ life quality. Moreover, the hyper expression of pro-inflammatory cytokines (IL1β, etc.) observed in these patients may have a negative effect on the central nervous system.Objectives:to study the state of the cognitive and emotional spheres in children suffering from monogenic auto-inflammatory diseases.Methods:there were examined 22 children at the age of 7 to 17 years old diagnosed with CAPS-9, TRAPS-8, FMF-5. Among them there were 12 boys and 10 girls. The diagnosis in all the patients was confirmed through detection of pathogenic mutations in the NLRP3, TNFRSF1A and MEFV genes. The following methods were used: a clinical conversation; memory diagnostics (learning by heart of 10 words, a pictogram using cues taking into account the patients’ age); attention diagnostics (Schulte tables); thinking diagnostics (establishing a sequence of events, “four is a crwod”, simple analogies, interpretation of proverbs); emotional and communicative fields (the Eight-Color Luscher Test; CMAS (adaptation by A. Prikhozhan); STAI test, a drawing called “an animal that does not exist” and “a house-a tree-a man”).Results:The memory study revealed in all patients with TRAPS and FMF high and medium values of short-term and long-term memory, in patients with CAPS - a low level of short-term auditory-speech memory, information storage and indirect memorization in 1/3 of patients. In 100% of the examined patients with TRAPS, a significant decrease in all processes of attention and distribution of attention. In 1/3 of patients with CAPS, an increased exhaustion of attention was registered and in 11% - a decrease in its stability. In patients with FMF, attention disorders were not detected. In 44% of patients with CAPS, a decrease in the level of generalization and difficulties in establishing causal relationships were registered. In 25% of patients with TRAPS a decrease in the level of generalization, in 12.5%- difficulties in establishing cause-effect relationships, inertia of thinking in 37.5%. In 60% of patients with FMF: a decrease in the level of generalization, in 80%: difficulties in establishing cause-effect relationships, inertia of thinking in 20%. In the emotional sphere, patients with CAPS, TRAPS, and FMF demonstrated signs of aggression (11.1%, 20% and 20% of patients, respectively), communicative disorders (77.8% -80% - 80%), and reduced social adaptation (55.5% - 80% - 80%), a tendency to form neurotic fears (22% - 40% - 40%). A high level of personal anxiety was noted in 1/3 of patients with CAPS and 40% of patients with FMF.Conclusion:various psychological disorders in the cognitive and emotional fields were noted in the majority of the examined patients with monogenic auto-inflammatory diseases. In patients with TRAPS, attention processes are most significantly affected; in patients with CAPS, memory is more often affected. In patients with FMF, disorders in thinking processes are revealed more often. In the emotional sphere, most patients with all the three forms of AID note communicative disorders and social adaptation.Disclosure of Interests:None declared


Author(s):  
Mateusz Iwo Dubaniowski ◽  
Hans Rudolf Heinimann

A system-of-systems (SoS) approach is often used for simulating disruptions to business and infrastructure system networks allowing for integration of several models into one simulation. However, the integration is frequently challenging as each system is designed individually with different characteristics, such as time granularity. Understanding the impact of time granularity on propagation of disruptions between businesses and infrastructure systems and finding the appropriate granularity for the SoS simulation remain as major challenges. To tackle these, we explore how time granularity, recovery time, and disruption size affect the propagation of disruptions between constituent systems of an SoS simulation. To address this issue, we developed a high level architecture (HLA) simulation of three networks and performed a series of simulation experiments. Our results revealed that time granularity and especially recovery time have huge impact on propagation of disruptions. Consequently, we developed a model for selecting an appropriate time granularity for an SoS simulation based on expected recovery time. Our simulation experiments show that time granularity should be less than 1.13 of expected recovery time. We identified some areas for future research centered around extending the experimental factors space.


2021 ◽  
Vol 54 (4) ◽  
pp. 1-16
Author(s):  
Abdus Salam ◽  
Rolf Schwitter ◽  
Mehmet A. Orgun

This survey provides an overview of rule learning systems that can learn the structure of probabilistic rules for uncertain domains. These systems are very useful in such domains because they can be trained with a small amount of positive and negative examples, use declarative representations of background knowledge, and combine efficient high-level reasoning with the probability theory. The output of these systems are probabilistic rules that are easy to understand by humans, since the conditions for consequences lead to predictions that become transparent and interpretable. This survey focuses on representational approaches and system architectures, and suggests future research directions.


2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.


2016 ◽  
Vol 33 (S1) ◽  
pp. S623-S623
Author(s):  
D. Ivanova ◽  
V. Giannouli

IntroductionCo-dependent relationships are characterized as a type of dysfunctional helping relationship in which there is an excessive reliance on other people for approval and identity. This is very common for female relatives who support/enable another person's addiction, poor mental health, immaturity, and/or irresponsibility.ObjectiveThe aim of the present study is to reveal the co-dependence profile of mothers of addicted persons in Bulgaria.MethodFour hundred Bulgarian women coming from Blagoevgrad, Sofia and Stara Zagora (Mage = 53.55, SDage = 5.58; level of education: 71% with high school degree, 29%with university degree; all mothers of addicted persons) were examined at the Municipal Council on Drug Addiction Blagoevgrad with the STAI-state questionnaire, the ZUNG Self Rating Depression Scale and the Questionnaire of Establishment of Codependency.ResultsResults indicated that in a scale of scores ranging from 2 = minimum to 4 = maximum of co-dependence, this group of women had high self-reported levels of co-dependence (M = 3.6375, SD = .52610), a high depressive profile (M = 49.07, SD = 3.23, and high state anxiety (M = 66.60, SD = 5.58).ConclusionsThe present research suggests that mothers of dependent individuals in Bulgaria show a high level of co-dependency, anxiety and depression. Future research should clarify the reasons of this overall negative emotional profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2009 ◽  
Vol 27 (24) ◽  
pp. 4014-4020 ◽  
Author(s):  
Elizabeth Goss ◽  
Michael P. Link ◽  
Suanna S. Bruinooge ◽  
Theodore S. Lawrence ◽  
Joel E. Tepper ◽  
...  

Purpose The American Society of Clinical Oncology (ASCO) Cancer Research Committee designed a qualitative research project to assess the attitudes of cancer researchers and compliance officials regarding compliance with the US Privacy Rule and to identify potential strategies for eliminating perceived or real barriers to achieving compliance. Methods A team of three interviewers asked 27 individuals (13 investigators and 14 compliance officials) from 13 institutions to describe the anticipated approach of their institutions to Privacy Rule compliance in three hypothetical research studies. Results The interviews revealed that although researchers and compliance officials share the view that patients' cancer diagnoses should enjoy a high level of privacy protection, there are significant tensions between the two groups related to the proper standards for compliance necessary to protect patients. The disagreements are seen most clearly with regard to the appropriate definition of a “future research use” of protected health information in biospecimen and data repositories and the standards for a waiver of authorization for disclosure and use of such data. Conclusion ASCO believes that disagreements related to compliance and the resulting delays in certain projects and abandonment of others might be eased by additional institutional training programs and consultation on Privacy Rule issues during study design. ASCO also proposes the development of best practices documents to guide 1) creation of data repositories, 2) disclosure and use of data from such repositories, and 3) the design of survivorship and genetics studies.


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