Quantifying Experiences with Telepractice for Aphasia Therapy: A Text Mining Analysis of Client Response Data

2020 ◽  
Vol 41 (05) ◽  
pp. 414-432
Author(s):  
Molly Jacobs ◽  
Patrick Briley ◽  
Charles Ellis
Keyword(s):  
Treatment Satisfaction ◽  
Healthcare Delivery ◽  
Response Patterns ◽  
Verbal Abilities ◽  
Response Data ◽  
Novel Approach ◽  
Aphasia Therapy ◽  
Limited Output ◽  
Aphasia Treatment ◽  
Client Responses

AbstractMeasures of satisfaction following treatment for aphasia have been limited. The challenge associated with reduced verbal output among many persons with aphasia (PWA) has reportedly been a key reason measures of treatment satisfaction have been limited. A novel approach to measure treatment satisfaction is the use of content analysis (CA), which uses the presence of certain words, themes, or concepts to explore outcomes such as treatment satisfaction particularly among individuals who generate limited output. CA utilizes responses and response patterns to assign meaning to client responses. The aim of this study was to use CA to measure posttreatment satisfaction with a telepractice approach for aphasia treatment. Seventeen PWA received 12 treatment sessions over a 6-week period. At the conclusion of the treatment, CA was utilized to explore patient satisfaction with this treatment approach. The participants reported an overall positive sentiment for the telepractice approach. Two primary topics emerged which were healthcare provider and healthcare delivery, where text analysis revealed discussion of these topics to be centered around being “helpful” and “being effective.” This study demonstrated that CA can be an effective approach for determining satisfaction with aphasia treatment particularly among PWA with limited verbal abilities.

Unobtrusive Smart Environments for Independent Living and the Role of Mixed Methods in Elderly Healthcare Delivery

2017 ◽  
pp. 1307-1324
Author(s):  
Alexander Astaras ◽  
Hadas Lewy ◽  
Christopher James ◽  
Artem Katasonov ◽  
Detlef Ruschin ◽  
...  
Keyword(s):  
Independent Living ◽  
Healthcare Delivery ◽  
The Elderly ◽  
Sensor Data ◽  
Novel Approach ◽  
Intelligent Decision ◽  
Significant Difference ◽  
Research Findings ◽  
Smart Tv ◽  
Intelligent Decision Support

In this chapter the authors describe a novel approach to healthcare delivery for the elderly as adopted by USEFIL, a research project which uses unobtrusive, multi-parametric sensor data collection to support seniors. The system is based on everyday devices such as an in-mirror camera, smart TV, wrist-mountable personal communicator and a tablet computer strategically distributed around the house. It exploits sensor data fusion, intelligent decision support for carers, remote alerting, secure data communications and storage. A combined quantitative and qualitative knowledgebase was established and analysed, target groups were established among elderly prospective users and scenarios were built around each group. Use cases have been prioritised according to quantitative functional and non-functional criteria. Our research findings suggest that an unobtrusive system such as USEFIL could potentially make a significant difference in the quality of life of elderly people, improve the focus of provided healthcare and support their daily independent living activities.

Intensive Care Unit Operational Modeling and Analysis

2011 ◽  
pp. 132-147
Author(s):  
Yue Dong ◽  
Huitian Lu ◽  
Ognjen Gajic ◽  
Brian Pickering
Keyword(s):  
Health Care ◽  
Critical Care ◽  
Health Care Providers ◽  
Systems Engineering ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Organizational Factors ◽  
Modeling And Analysis ◽  
Novel Approach ◽  
Life Threatening

The outcome of critical illness depends not only on life threatening pathophysiologic disturbances, but also on several complex “system” dimensions: health care providers’ performance, organizational factors, environmental factors, family preferences and the interactions between each component. Systems engineering tools offer a novel approach which can facilitate a “systems understanding” of patient-environment interactions enabling advances in the science of healthcare delivery. Due to the complexity of operations in critical care medicine, certain assumptions are needed in order to understand system behavior. Patient variation and uncertainties underlying these assumptions present a challenge to investigators wishing to model and improve health care delivery processes. In this chapter we present a systems engineering approach to modeling critical care delivery using sepsis resuscitation as an example condition.

scholarly journals Description of an Intensive Residential Aphasia Treatment Program: Rationale, Clinical Processes, and Outcomes

2014 ◽  
Vol 23 (2) ◽  
Author(s):  
Ronda L. Winans-Mitrik ◽  
William D. Hula ◽  
Michael W. Dickey ◽  
James G. Schumacher ◽  
Brooke Swoyer ◽  
...  
Keyword(s):  
Day Treatment ◽  
Complex Interventions ◽  
Community Dwelling ◽  
Parameter Estimates ◽  
Latent Growth ◽  
Standardized Measures ◽  
Group Activities ◽  
Aphasia Therapy ◽  
Aphasia Treatment

Purpose The purpose of this article is to describe the rationale, clinical processes, and outcomes of an intensive comprehensive aphasia program (ICAP). Method Seventy-three community-dwelling adults with aphasia completed a residentially based ICAP. Participants received 5 hr of daily 1:1 evidence-based cognitive-linguistically oriented aphasia therapy, supplemented with weekly socially oriented and therapeutic group activities over a 23-day treatment course. Standardized measures of aphasia severity and communicative functioning were obtained at baseline, program entry, program exit, and follow-up. Results were analyzed using a Bayesian latent growth curve model with 2 factors representing (a) the initial level and (b) change over time, respectively, for each outcome measure. Results Model parameter estimates showed reliable improvement on all outcome measures between the initial and final assessments. Improvement during the treatment interval was greater than change observed across the baseline interval, and gains were maintained at follow-up on all measures. Conclusions The rationale, clinical processes, and outcomes of a residentially based ICAP have been described. ICAPs differ with respect to treatments delivered, dosing parameters, and outcomes measured. Specifying the defining components of complex interventions, establishing their feasibility, and describing their outcomes are necessary to guide the development of controlled clinical trials.

scholarly journals Ramp Tests: A Novel Approach to VIV Model Testing of Flexible Cylinders Using Continuously Varying Towing Speeds

2015 ◽  
Author(s):  
Themistocles L. Resvanis ◽  
J. Kim Vandiver ◽  
Shixiao Fu
Keyword(s):  
Dimensionless Parameter ◽  
Reynolds Numbers ◽  
Constant Speed ◽  
Flow Conditions ◽  
Response Data ◽  
Ramp Test ◽  
Response Information ◽  
Novel Approach ◽  
Uniform Current ◽  
Towing Speed

In this paper we present a small portion of the results from the 2011 SHELL tests at the MARINTEK basin. The tests involved towing densely instrumented flexible cylinders at Reynolds numbers up to 150,000 in order to study the Vortex-Induced Vibration (VIV) response in uniform current profiles. This paper presents the experimental results collected from a series of tests where the towing speed was continuously varied while the cylinder and carriage traversed the basin. As the cylinder is accelerated (or decelerated) the incident current speed is continuously changing which means that multiple modes can be excited consecutively in a single tow through the basin. These varying towing speed tests are collectively referred to as ‘ramp tests’. The response data collected in these ‘ramp tests’ are presented in terms of CF response amplitudes and strains and are carefully compared with the response data collected during conventional steady towing speed tests. The data shows that when the acceleration of the carriage is kept below a critical value the ‘ramp tests’ are then able to provide VIV response information which is equivalent to that obtained from many constant speed tests. One ramp test provides the equivalent response data of (up to) 10 constant speed tests in a single run. This paper also introduces a dimensionless parameter γ, which determines if the proposed acceleration for a ramp test is within acceptable limits and may be used as a substitute for many constant speed tests. The parameter can be used to determine the appropriate acceleration or deceleration rate in order to ensure that a ramp test will yield suitable VIV response data. The parameter also allows one to know quickly whether or not fully developed VIV is possible in a given set of unsteady flow conditions.

scholarly journals The Changing “Face” of Aphasia Therapy

2008 ◽  
Vol 18 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Jaime B. Lee ◽  
Leora R. Cherney
Keyword(s):  
New Technology ◽  
Computer Software ◽  
Cost Effective ◽  
Clinical Expertise ◽  
Speech Language Pathologist ◽  
Aphasia Therapy ◽  
Software Program ◽  
Aphasia Treatment ◽  
Interactive Computer Software

Abstract Purpose: Clinicians and researchers are searching for cost effective ways to deliver intensive aphasia treatment. The purpose of this article is to describe one method of providing less costly but intensive treatment via a computer software program called AphasiaScripts TM . Method: First, we describe the unique, interactive computer software program developed for individuals with aphasia to practice conversations that have been individually scripted for them. In AphasiaScripts TM , an avatar serves as the virtual therapist or conversational partner. The simplicity of the user interface allows the person with aphasia to quickly learn how to use the program and to manage the level of supportive cueing needed. Second, we clarify the role of the speech-language pathologist in the light of new technology that allows the person with aphasia to practice these conversations intensively and independently. Conclusions: AphasiaScripts TM serves as an example of a software program that makes use of advanced computer technology, yet still requires the clinical expertise of the speech-language pathologist.

scholarly journals Novel Advances to Post-Stroke Aphasia Pharmacology and Rehabilitation

2021 ◽  
Vol 10 (17) ◽  
pp. 3778
Author(s):  
Natalia Cichon ◽  
Lidia Wlodarczyk ◽  
Joanna Saluk-Bijak ◽  
Michal Bijak ◽  
Justyna Redlicka ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Cortical Excitability ◽  
Treatment Strategies ◽  
Current Evidence ◽  
Post Stroke ◽  
Melodic Intonation Therapy ◽  
Rehabilitation Outcomes ◽  
Aphasia Therapy ◽  
Computer Based ◽  
Aphasia Treatment

Aphasia is one of the most common clinical features of functional impairment after a stroke. Approximately 21–40% of stroke patients sustain permanent aphasia, which progressively worsens one’s quality of life and rehabilitation outcomes. Post-stroke aphasia treatment strategies include speech language therapies, cognitive neurorehabilitation, telerehabilitation, computer-based management, experimental pharmacotherapy, and physical medicine. This review focuses on current evidence of the effectiveness of impairment-based aphasia therapies and communication-based therapies (as well as the timing and optimal treatment intensities for these interventions). Moreover, we present specific interventions, such as constraint-induced aphasia therapy (CIAT) and melodic intonation therapy (MIT). Accumulated data suggest that using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) is safe and can be used to modulate cortical excitability. Therefore, we review clinical studies that present TMS and tDCS as (possible) promising therapies in speech and language recovery, stimulating neuroplasticity. Several drugs have been used in aphasia pharmacotherapy, but evidence from clinical studies suggest that only nootropic agents, donepezil and memantine, may improve the prognosis of aphasia. This article is an overview on the current state of knowledge related to post-stroke aphasia pharmacology, rehabilitation, and future trends.

scholarly journals Further perceptions of probability: in defence of trial-by-trial updating models

2020 ◽  
Author(s):  
Mattias Forsgren ◽  
Peter Juslin ◽  
Ronald van den Berg
Keyword(s):  
Cognitive Processes ◽  
Model Comparison ◽  
Quantitative Model ◽  
Response Patterns ◽  
Delta Rule ◽  
Response Data ◽  
Rule Model ◽  
Stochastic Events ◽  
Stationary Probabilities ◽  
Behavioural Sciences

ABSTRACTExtensive research in the behavioural sciences has addressed people’s ability to learn probabilities of stochastic events, typically assuming them to be stationary (i.e., constant over time). Only recently have there been attempts to model the cognitive processes whereby people learn – and track – non-stationary probabilities, reviving the old debate on whether learning occurs trial-by-trial or by occasional shifts between discrete hypotheses. Trial-by-trial updating models – such as the delta-rule model – have been popular in describing human learning in various contexts, but it has been argued that they are inadequate for explaining how humans update beliefs about non-stationary probabilities. Specifically, it has been claimed that these models cannot account for the discrete, stepwise updating that characterises response patterns in experiments where participants tracked a non-stationary probability based on observed outcomes. Here, we demonstrate that the rejection of trial-by-trial models was premature for two reasons. First, our experimental data suggest that the stepwise behaviour depends on details of the experimental paradigm. Hence, discreteness in response data does not necessarily imply discreteness in internal belief updating. Second, previous studies have dismissed trial-by-trial models mainly based on qualitative arguments rather than quantitative model comparison. To evaluate the models more rigorously, we performed a likelihood-based model comparison between stepwise and trial-by-trial updating models. Across eight datasets collected in three different labs, human behaviour is consistently best described by trial-by-trial updating models. Our results suggest that trial-by-trial updating plays a prominent role in the cognitive processes underlying learning of non-stationary probabilities.

Unobtrusive Smart Environments for Independent Living and the role of Mixed Methods in Elderly Healthcare Delivery

2015 ◽  
pp. 290-305 ◽  
Author(s):  
Alexander Astaras ◽  
Hadas Lewy ◽  
Christopher James ◽  
Artem Katasonov ◽  
Detlef Ruschin ◽  
...  
Keyword(s):  
Independent Living ◽  
Healthcare Delivery ◽  
The Elderly ◽  
Sensor Data ◽  
Novel Approach ◽  
Intelligent Decision ◽  
Significant Difference ◽  
Research Findings ◽  
Smart Tv ◽  
Intelligent Decision Support

In this chapter the authors describe a novel approach to healthcare delivery for the elderly as adopted by USEFIL, a research project which uses unobtrusive, multi-parametric sensor data collection to support seniors. The system is based on everyday devices such as an in-mirror camera, smart TV, wrist-mountable personal communicator and a tablet computer strategically distributed around the house. It exploits sensor data fusion, intelligent decision support for carers, remote alerting, secure data communications and storage. A combined quantitative and qualitative knowledgebase was established and analysed, target groups were established among elderly prospective users and scenarios were built around each group. Use cases have been prioritised according to quantitative functional and non-functional criteria. Our research findings suggest that an unobtrusive system such as USEFIL could potentially make a significant difference in the quality of life of elderly people, improve the focus of provided healthcare and support their daily independent living activities.

scholarly journals Constraint-induced or multi-modal personalized aphasia rehabilitation (COMPARE): A randomized controlled trial for stroke-related chronic aphasia

2019 ◽  
Vol 14 (9) ◽  
pp. 972-976 ◽  
Author(s):  
Miranda L Rose ◽  
David Copland ◽  
Lyndsey Nickels ◽  
Leanne Togher ◽  
Marcus Meinzer ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Controlled Trial ◽  
Cost Effective ◽  
Open Label ◽  
Post Intervention ◽  
Aphasia Therapy ◽  
Quality Of Life Scale ◽  
Chronic Aphasia ◽  
Aphasia Treatment ◽  
Effectiveness Index

Rationale The comparative efficacy and cost-effectiveness of constraint-induced and multi-modality aphasia therapy in chronic stroke are unknown. Aims and hypotheses In the COMPARE trial, we aim to determine whether Multi-Modal Aphasia Treatment (M-MAT) and Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) are superior to usual care (UC) for chronic post-stroke aphasia. Primary hypothesis: CIAT-Plus and M-MAT will reduce aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ)) compared with UC: CIAT-Plus superior for moderate aphasia; M-MAT superior for mild and severe aphasia. Sample size estimates A total of 216 participants (72 per arm) will provide 90% power to detect a 5-point difference on the WAB-R-AQ between CIAT-Plus or M-MAT and UC at α = 0.05. Methods and design Prospective, randomized, parallel group, open-label, assessor blinded trial. Participants: Stroke >6 months; aphasia severity categorized using WAB-R-AQ. Computer-generated blocked and stratified randomization by aphasia severity (mild, moderate, and severe), to 3 arms: CIAT-Plus, M-MAT (both 30 h therapy over two weeks); UC (self-reported usual community care). Study outcomes WAB-R-AQ immediately post-intervention. Secondary outcomes: WAB-R-AQ at 12-week follow-up; naming scores, discourse measures, Communicative Effectiveness Index, Scenario Test, and Stroke and Aphasia Quality of Life Scale-39 g immediately and at 12 weeks post-intervention; incremental cost-effectiveness ratios compared with UC at 12 weeks. Discussion This trial will determine whether CIAT-Plus and M-MAT are superior and more cost-effective than UC in chronic aphasia. Participant subgroups with the greatest response to CIAT-Plus and M-MAT will be described.

scholarly journals Filling the Gaps in Adolescent Care and School Health Policy-Tackling Health Disparities through Sports Medicine Integration

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 132 ◽  
Author(s):  
Kemba Noel-London ◽  
Anthony Breitbach ◽  
Rhonda Belue
Keyword(s):  
Health Disparities ◽  
Athletic Training ◽  
Sports Medicine ◽  
School Health ◽  
Health Centre ◽  
Healthcare Delivery ◽  
Health Issues ◽  
Youth Athletes ◽  
Novel Approach ◽  
School Health Policy

The School-Based Health Centre (SBHC) model of healthcare delivery in community health is designed to address the unique needs of adolescents. Through a collaborative interprofessional approach, they aim to provide comprehensive care with the goal of reducing health disparities in underserved, at-risk adolescents. Integration of sports medicine health professionals is a novel approach to increasing available services, as well as patient utilization, while addressing multiple public health issues, including lack of athletic training services for youth athletes.

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