scholarly journals Where are aphasia theory and management “headed”?

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1038 ◽  
Author(s):  
Donna C. Tippett ◽  
Argye E. Hillis
Keyword(s):  
Cognitive Processes ◽  
Behavioral Therapy ◽  
Standard Of Care ◽  
Cortical Stimulation ◽  
Evidence Based ◽  
Functional Neuroanatomy ◽  
Optimal Care ◽  
Post Stroke

The sequelae of post-stroke aphasia are considerable, necessitating an understanding of the functional neuroanatomy of language, cognitive processes underlying various language tasks, and the mechanisms of recovery after stroke. This knowledge is vital in providing optimal care of individuals with aphasia and counseling to their families and caregivers. The standard of care in the rehabilitation of aphasia dictates that treatment be evidence-based and person-centered. Promising techniques, such as cortical stimulation as an adjunct to behavioral therapy, are just beginning to be explored. These topics are discussed in this review.

日本における抑うつ症状に対する心理学的介入を目的とした スマートフォン用アプリケーション・プログラムのレビュー

2020 ◽  
Author(s):  
Hikari Takashina ◽  
Kengo Yokomitsu
Keyword(s):  
Depressive Symptoms ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Mobile Apps ◽  
Evaluation Model ◽  
Ease Of Use ◽  
Background Information ◽  
Evidence Based ◽  
Privacy And Security ◽  
Current State

There are thousands of mobile apps delivering information and offering support and intervention in situations of daily life. The aim of this study was to identify the current state of apps for depressive symptoms or prevention of depression within the official Android and iOS app stores in Japan. The 47 apps for depression available for download from the app stores were evaluated by the App Evaluation Model regarding background information, risk/ privacy and security, evidence, ease of use, and interoperability. Also, we evaluated their primary purpose, technology components, and cognitive-behavioral therapy components. The results suggest that in general few apps have been developed that are evidence-based, secure, and provide the services that users expect. In the future, it will be necessary to develop a framework for developing and disseminating more effective apps. This study is the first review of apps for depression available in Japan and seeks to help create a framework for such apps.

Championing Change to Save Lives: A Call to Action to Implement Reforms to Increase Use of Medications to Treat Opioid Use Disorder in Correctional Settings

2020 ◽  
pp. 073401682098162
Author(s):  
Sonia L. Canzater ◽  
Regina M. LaBelle
Keyword(s):  
Standard Of Care ◽  
Opioid Use Disorder ◽  
Correctional Facilities ◽  
Evidence Based ◽  
Opioid Use ◽  
Call To Action ◽  
Evidence Based Treatment ◽  
High Prevalence ◽  
Correctional Settings ◽  
Overdose Deaths

The disproportional rates of opioid use disorder (OUD) in U.S. correctional facilities make them prime intervention points to treat OUD utilizing medication to treat opioid use disorder (MOUD), the evidence-based clinical standard of care. MOUD has been shown to be effective to support recovery and reduce recurrence of OUD, overdose deaths, and recidivism for justice-involved persons both while incarcerated and once they reenter their communities. Despite the high prevalence, most jails and prisons do not offer MOUD. Litigation has spurred expanded access in more facilities, but widespread MOUD access can only become a reality through a comprehensive effort of corrections officials, medical experts, advocates, legislators, and other champions to raise awareness and affect ideological and policy change. It is a legal and ethical imperative that the lives of justice-involved persons not be jeopardized by the lack of evidence-based treatment for OUD in correctional settings.

scholarly journals COVD-25. THE PARADOXICAL EFFECTS OF COVID-19 ON CANCER CARE IN THE NEURO-ONCOLOGY SETTING

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Nicole Cort ◽  
Alex Broom ◽  
Katherine Kenny ◽  
Alexander Page ◽  
Jennifer Durling ◽  
...  
Keyword(s):  
Cancer Care ◽  
Standard Of Care ◽  
Adult Brain ◽  
Evidence Based ◽  
Negative Consequences ◽  
Traditional Practice ◽  
Delivery Of Care ◽  
Paradoxical Effects ◽  
Oncology Care ◽  
The Impact

Abstract COVID-19 has caused ongoing interruptions to healthcare systems worldwide, shifting care to virtual platforms, and placing significant economic and logistical burdens on clinical practice. The pandemic has created uncertainty in delivering the standard of care, both in areas of cancer diagnosis and treatment, especially within neuro-oncology. Due to the pandemic, care and operational planning goals have shifted to infection prevention, modifying recommendations to decrease viral transmission and increasing telemedicine use, potentially creating a burden on implementing evidence-based medicine. These dynamics have since begun to redefine traditional practice and research regimens, impacting the comprehensive care that cancer patients can and should receive; and the enduring consequences for the delivery of healthcare. The impact of COVID-19 on oncology practice and trials might endure well beyond the short- to mid-term of the active pandemic. Therefore, these shifts must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care. To address these paradoxical effects, we will conduct iterative, qualitative (face-to-face/video conference) interviews with neuro-oncology clinical and research professionals and adult brain tumor patients receiving care during the pandemic. We will capture unique aspects of oncology care: the lived, subjective, situated, and contingent accounts of patients and medical professionals, especially during a pandemic. We will also specifically compare the impact of telehealth during the pandemic on delivery of care to complex neuro-oncology patients. A summary of this in-depth, qualitative approach will result in a sophisticated understanding of neuro-oncology care on the frontline at a time of crisis, as experienced during a pandemic, to articulate best practices for future implementation.

scholarly journals Brief Psychotherapy for Depression: A Systematic Review and Meta-Analysis

2012 ◽  
Vol 43 (2) ◽  
pp. 129-151 ◽  
Author(s):  
Jason A. Nieuwsma ◽  
Ranak B. Trivedi ◽  
Jennifer McDuffie ◽  
Ian Kronish ◽  
Dinesh Benjamin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Problem Solving ◽  
Cognitive Behavioral Therapy ◽  
Systematic Reviews ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Behavioral ◽  
Evidence Based ◽  
Brief Psychotherapy ◽  
Problem Solving Therapy

Objective: Because evidence-based psychotherapies of 12 to 20 sessions can be perceived as too lengthy and time intensive for the treatment of depression in primary care, a number of studies have examined abbreviated psychotherapy protocols. The purpose of this study was to conduct a systematic review and meta-analysis to determine the efficacy of brief psychotherapy (i.e., < 8 sessions) for depression. Methods: We used combined literature searches in PubMed, EMBASE, PsycINFO, and an Internet-accessible database of clinical trials of psychotherapy to conduct two systematic searches: one for existing systematic reviews and another for randomized controlled trials (RCTs). Included studies examined evidence-based psychotherapy(s) of eight or fewer sessions, focused on adults with depression, contained an acceptable control condition, were published in English, and used validated measures of depressive symptoms. Results: We retained 2 systematic reviews and 15 RCTs evaluating cognitive behavioral therapy, problem-solving therapy, and mindfulness-based cognitive therapy. The systematic reviews found brief psychotherapies to be more efficacious than control, with effect sizes ranging from −0.33 to −0.25. Our meta-analysis found six to eight sessions of cognitive behavioral therapy to be more efficacious than control (ES −0.42, 95% CI −0.74 to −0.10, I2 = 56%). A sensitivity analysis controlled for statistical heterogeneity but showed smaller treatment effects (ES −0.24, 95% CI −0.42 to −0.06, I2 = 0%). Conclusions: Depression can be efficaciously treated with six to eight sessions of psychotherapy, particularly cognitive behavioral therapy and problem-solving therapy. Access to non-pharmacologic treatments for depression could be improved by training healthcare providers to deliver brief psychotherapies.

Kidney Disease among People Who Are Incarcerated

2021 ◽  
pp. CJN.01910221
Author(s):  
Matthew Murphy ◽  
Ann Ding ◽  
Justin Berk ◽  
Josiah Rich ◽  
George Bayliss
Keyword(s):  
Criminal Justice ◽  
Kidney Disease ◽  
Criminal Justice System ◽  
Justice System ◽  
Standard Of Care ◽  
Health Impact ◽  
Legal Obligation ◽  
Evidence Based ◽  
Racial And Ethnic Minorities ◽  
Community Standard

Chronic kidney disease (CKD) affects 15% of US adults and is associated with increased morbidity and mortality. CKD disproportionately impacts certain populations, including racial and ethnic minorities and individuals from disadvantaged socioeconomic backgrounds. These groups are also disproportionately impacted by incarceration and barriers to accessing health services. Incarceration represents an opportunity to link marginalized individuals to CKD care. Despite a legal obligation to provide a community standard of care including the screening and treatment of individuals with CKD, there is little evidence to suggest systematic efforts are in place to address this prevalent, costly, and ultimately fatal condition. This review highlights unrealized opportunities to connect individuals with CKD to care within the criminal justice system and as they transition to the community, while underscoring the need for more evidence-based strategies to address the health impact of CKD on over-represented communities in the criminal justice system.

Koro Syndrome in an Obsessive-Compulsive Disorder Patient

2016 ◽  
Vol 33 (S1) ◽  
pp. S496-S496 ◽  
Author(s):  
L. Silva ◽  
C. Raposo-Lima ◽  
C. Soares ◽  
J.J. Cerqueira ◽  
P. Morgado
Keyword(s):  
Behavioral Therapy ◽  
Rare Condition ◽  
The Body ◽  
Obsessive Compulsive ◽  
Optimal Care ◽  
Related Disorder ◽  
Compulsive Disorder ◽  
Western Countries ◽  
Competing Interest ◽  
Psychiatric Department

IntroductionKoro syndrome is a culturally related disorder characterized by intense anxiety that the penis (vulva or nipples in females) is shrinking or retracting and will recede into the body. Usually it occurs in epidemics in Southeastern Asia, being extremely rare in western countries. The condition is more common in males and is classified within Obsessive Compulsive and Related Disorders.Case reportA 27-year-old single man was referred to the psychiatric department. By the age of 23, he began worrying that his penis was shrinking and retracting into the abdomen. He described these thoughts as intrusive, ridiculous and repetitive. During the first months the thoughts were not very disturbing but he progressively developed an urge to verify the length of his penis several times a day. To diminish the anxiety provoked by the obsessive doubts on penis length, he started to have repetitive thoughts and mental images about sexual acts, to consume pornography compulsively and to increase his masturbatory behaviors (from some times a week to several times a day). He described those thoughts and behaviors as unpleasant and uniquely driven to reduce anxiety provoked by obsessions.He was prescribed fluvoxamine 200 mg/day and initiated cognitive behavioral therapy with good response. Y-BOCS score decreased from 30 at initial evaluation to 18 after 3 months of treatment.ConclusionsKoro syndrome is a very rare condition in psychiatry in western countries, usually presenting secondarily to other psychiatric disorders. Awareness of this diagnosis and knowledge on its management are critical to provide optimal care to patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Model for Sustaining Evidence-Based Practices in a Statewide System

2017 ◽  
Vol 98 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Jason M. Lang ◽  
Kellie G. Randall ◽  
Michelle Delaney ◽  
Jeffrey J. Vanderploeg
Keyword(s):  
Public Health ◽  
Cognitive Behavioral Therapy ◽  
Quality Indicators ◽  
Behavioral Therapy ◽  
Health Impact ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
The Public ◽  
The Past ◽  
Large Systems

Over the past 20 years, efforts have been made to broadly disseminate evidence-based practices (EBPs). However, the public health impact of EBPs has yet to be realized and most EBPs are not sustained. Few structured models exist for disseminating and sustaining EBPs across large systems. This article describes the EBP Dissemination and Support Center (DSC) model and how it was used to sustain trauma-focused cognitive behavioral therapy (TF-CBT) across Connecticut. More than 600 clinicians at 35 agencies have been trained and nearly all agencies have sustained TF-CBT for up to 9 years. More than 6,200 children have received TF-CBT and have shown improvements in outcomes and quality indicators. Recommendations are made for using or adapting the DSC model.

scholarly journals Self-guided cognitive behavioral therapy apps: Can they help? Systematic assessment of features, functionality, and congruence with evidence (Preprint)

2021 ◽  
Author(s):  
Laura Martinengo ◽  
Anne-Claire Stona ◽  
Konstadina Griva ◽  
Paola Dazzan ◽  
Carmine Maria Pariante ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
Data Security ◽  
Suicide Risk ◽  
Behavioral Therapy ◽  
Cognitive Restructuring ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Systematic Assessment ◽  
Health Apps

BACKGROUND Mental health disorders affect one in ten people globally, of which around 300 million are affected by depression. At least half of affected people remain untreated. Cognitive behavioral therapy (CBT) is an effective treatment but access to specialized providers, habitually challenging, has worsened with COVID-19. Internet-based CBT (iCBT) is effective and a feasible strategy to increase access to treatment for people with depression. Mental health apps may further assist in facilitating self-management for people affected by depression but accessing the right app might be cumbersome given the large number and wide variety of apps offered by public app marketplaces. OBJECTIVE To systematically assess features, functionality, data security and congruence with evidence of self-guided CBT-based apps available in major app stores, suitable for users suffering from depression. METHODS A systematic assessment of self-guided CBT-based apps available in Google Play and Apple’s App Store was conducted. Apps launched or updated since August 2018 were identified through a systematic search in 42matters using CBT-related terms. Apps meeting inclusion criteria were downloaded and assessed using a Samsung Galaxy J7 Pro (Android 9) and iPhone 7 (iOS 13.3.1). Apps were appraised using a 182-question checklist developed by the research team, comprising apps’ general characteristics, CBT-related features, including six evidence-based CBT techniques as informed by a CBT manual, CBT competences framework and a literature review of iCBT clinical trial protocols (psychoeducation, behavioral activation, cognitive restructuring, problem solving, relaxation, and exposure for comorbid anxiety), and technical aspects and quality assurance. Results were reported as a narrative review, using descriptive statistics. RESULTS The initial search yielded 3006 apps, of which 98 apps met inclusion criteria and were systematically assessed. There were 20 wellbeing apps, 65 mental health apps and 13 depression apps. Twenty-eight apps offered at least four evidence-based CBT techniques, particularly depression apps. Cognitive restructuring was the most common technique, offered by 77/98 apps. Only a third of apps offered suicide- risk management resources while less than 20% of apps offered COVID-19-related information. Most apps included a privacy policy, but only a third of apps presented it before account creation. Eighty percent of privacy policies stated sharing data with third party service providers. Half of app development teams included academic institutions or healthcare providers. CONCLUSIONS Only few self-guided CBT-based apps offer comprehensive CBT programs or suicide risk management resources. Sharing of users’ data is widespread, highlighting shortcomings in the health app market governance. To fulfill their potential, self-guided CBT-based apps should follow evidence-based clinical guidelines, be patient-centered and enhance users’ data security. CLINICALTRIAL NA

Abstract 13: Corticospinal Tract Injury Estimated From Acute Stroke Imaging Predicts Upper Extremity Motor Recovery After Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
David J Lin ◽  
Alison M Cloutier ◽  
Kimberly S Erler ◽  
Jessica M Cassidy ◽  
Samuel B Snider ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Upper Extremity ◽  
Corticospinal Tract ◽  
Standard Of Care ◽  
Major Effect ◽  
Motor Recovery ◽  
Post Stroke ◽  
Stroke Imaging ◽  
Recovery Potential ◽  
Structural Injury

Introduction: Injury to the corticospinal tract (CST) has been shown to have a major effect on upper extremity motor recovery after stroke. This study aimed to examine how well CST injury, measured from neuroimaging acquired during the acute stroke workup, predicts upper extremity motor recovery. Methods: Patients (N = 48) with upper extremity weakness after ischemic stroke were assessed using the upper extremity Fugl-Meyer (FM) during the acute stroke hospitalization and again at 3-month follow-up. CST injury was quantified and compared, using four different methods, from images obtained as part of the stroke standard-of-care workup. Logistic and linear regression were performed using CST injury to predict delta FM. Injury to primary motor and premotor cortices were included as potential modifiers of the effect of CST injury on recovery. Results: 48 patients were enrolled 4.2 ± 2.7 days post-stroke and completed this study. CST injury distinguished patients who reached their recovery potential (as predicted from initial impairment) from those who did not, with AUC values ranging from 0.75 to 0.8. In addition, CST injury explained ~20% of the variance in the magnitude of upper extremity recovery, even after controlling for the severity of initial impairment. Results were consistent when comparing four different methods of measuring CST injury. Extent of injury to primary motor and premotor cortices did not significantly influence the predictive value that CST injury had for recovery. Conclusions: Structural injury to the CST, as estimated from standard-of-care imaging available during the acute stroke hospitalization, is a robust way to distinguish patients who achieve their predicted recovery potential and explains a significant amount of the variance in post-stroke upper extremity motor recovery.

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