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The energy consumption of Cloud–Edge systems is becoming a critical concern economically, environmentally, and societally; some studies suggest data centers and networks will collectively consume 18% of global electrical power by 2030. New methods are needed to mitigate this consumption, e.g. energy-aware workload scheduling, improved usage of renewable energy sources, etc. These schemes need to understand the interaction between energy considerations and Cloud–Edge components. Model-based approaches are an effective way to do this; however, current theoretical Cloud–Edge models are limited, and few consider energy factors. This paper analyses all relevant models proposed between 2016 and 2023, discovers key omissions, and identifies the major energy considerations that need to be addressed for Green Cloud–Edge systems (including interaction with energy providers). We investigate how these can be integrated into existing and aggregated models, and conclude with the high-level architecture of our proposed solution to integrate energy and Cloud–Edge models together. [ABSTRACT FROM AUTHOR]

To explore quantitative and qualitative features of anomia in participants with left-hemisphere stroke, Parkinson's disease, or multiple sclerosis. This descriptive cross-sectional study compares signs of anomia within and across participants (n = 87), divided into four groups; moderate to severe anomia after stroke (MSAS, n = 19), mild anomia after stroke (MAS, n = 22), PD (n = 19) and MS (n = 27). Aspects analysed include naming accuracy and speed, the nature of incorrect responses, semantic and phonemic verbal fluency, information content in re-telling, and the relationship between test results and self-reports on word-finding difficulties and communicative participation. All groups had impaired verbal fluency, prolonged response times and reduced information content in re-telling. The MSAS group had significantly more signs of anomia than the other groups. Results from the other groups overlapped on a MAS—PD—MS continuum. Both semantically and phonologically incorrect responses were common in the stroke groups, while semantically incorrect ones predominated in the PD and MS groups. All four groups reported a similar negative impact on self-perceived communicative participation. Correlations between self-reports and test results were inconsistent. Anomia features have quantitative and qualitative similarities and differences across neurological conditions. People with moderate or severe anomia after stroke not only exhibit more severe symptoms of word-finding difficulties but also manifest a wide variety of such symptoms, compared to people with Parkinson's disease or multiple sclerosis. The present findings underscore the need to ask patients about their self-perceived word-finding difficulties. Regardless of the degree of difficulties or the underlying condition, self-perceived word-finding difficulties can have a negative impact on communicative participation and should therefore be appropriately addressed. An assessment comprising aspects such as verbal fluency, connected-speech tasks and the measurement of response times in naming tasks may serve to affirm the self-reported word-finding difficulties. [ABSTRACT FROM AUTHOR]

Objective: The cerebral substrates of apraxia of speech (AOS) recovery remain unclear. Resting state fMRI post stroke can inform on altered functional connectivity (FC) within cortical language networks. Some initial studies report reduced FC between bilateral premotor cortices in patients with AOS, with lowest FC in patients with the most severe AOS. However, longitudinal FC studies in stroke are lacking. The aims of the present longitudinal study in early post stroke patients with AOS were (i) to compare connectivity strength in AOS patients to that in left hemisphere (LH) lesioned stroke patients without a speech-language impairment, (ii) to investigate the relation between FC and severity of AOS, aphasia and non-verbal oral apraxia (NVOA) and (iii) to investigate longitudinal changes in FC, from the subacute phase to the chronic phase to identify predictors of AOS recovery. Methods: Functional connectivity measures and comprehensive speech-language assessments were obtained at 4 weeks and 6 months after stroke in nine patients with AOS after a LH stroke and in six LH lesioned stroke patients without speech-language impairment. Functional connectivity was investigated in a network for speech production: inferior frontal gyrus (IFG), anterior insula (aINS), and ventral premotor cortex (vPMC), all bilaterally to investigate signs of adaptive or maladaptive changes in both hemispheres. Results: Interhemispheric vPMC connectivity was significantly reduced in patients with AOS compared to LH lesioned patients without speech-language impairment. At 6 months, the AOS severity was associated with interhemispheric aINS and vPMC connectivity. Longitudinal changes in FC were found in individuals, whereas no significant longitudinal change in FC was found at the group level. Degree of longitudinal AOS recovery was strongly associated with interhemispheric IFG connectivity strength at 4 weeks. Conclusion: Early interhemispheric IFG connectivity may be a strong predictor of AOS recovery. The results support the importance of interhemispheric vPMC connection in speech motor planning and severity of AOS and suggest that also bilateral aINS connectivity may have an impact on AOS severity. These findings need to be validated in larger cohorts. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) commonly includes anomia and other communicative deficits that affect communicative participation and quality of life. Anomia treatment in MS is currently unexplored. Owing to the degenerative nature of MS, compensatory treatment might be preferable to restorative treatment. Semantic feature analysis (SFA) has been reported to have a treatment effect in aphasia and traumatic brain injury, and it can also be used as a compensatory word-finding strategy. SFA might therefore be effective on anomia in MS. The aim of this study was to evaluate the treatment effects of SFA on mild anomia in MS. Hypotheses were that, if used as a strategy, SFA may improve word-retrieval ability in connected speech, reduce self-perceived word-finding difficulties and increase communicative participation. Two participants (one with relapsing-remitting MS, one with progressive MS) experiencing anomia and reduced communicative participation took part in this early-phase study with a single-case experimental design (SCED). Outcome measures included accuracy and speed in confrontation naming of treated items, correct information units (CIUs) in a re-telling task, self-reported strategy use in everyday communication, self-reported occurrence of anomia and related nuisance, and self-reported communicative participation. Measurements were carried out before treatment, at the beginning of every third treatment session, once directly after treatment, repeatedly during a maintenance phase, and once at a follow-up session ten weeks after treatment. No treatment effects on confrontation-naming ability, re-telling ability or self-reported measures were evident in either participant after treatment with SFA. Effects of repeated measures appeared as reduced response time in confrontation naming. SFA as the sole element of treatment may not be sufficient to obtain treatment effects on mild anomia in MS. Further research is warranted. [ABSTRACT FROM AUTHOR]

Purpose: To study the occurrence of speech features commonly associated with Childhood Apraxia of Speech (CAS) in Swedish children with suspected CAS (sCAS) or Speech Sound Disorder (SSD) related to Cleft Palate and/or Lip (CP ± L). Method: Thirty-four children (4.10–5.11) with SSD related to sCAS (n = 15) or repaired CP ± L (n = 19) participated. Consensus judgement of presence/absence of CAS features in single words were based on a checklist with operationalised definitions. Speech sound production measures were based on semi-narrow phonetic transcription. Intra- and inter-transcriber agreement was determined. Result: Twelve participants (ten with sCAS (67%) and two with CP ± L (11%)) shared a CAS profile of phonemic speech inconsistency for consonants and vowels and a set of four features: vowel error, voicing error, difficulty achieving initial articulatory configurations or transitionary movement gestures and stress errors. The most frequent speech difficulties in children with non-CAS CP ± L (n = 17) were consonant distortion (88%) and hypernasal resonance (76%). Prosodic impairment was rare. Conclusion: A distinct CAS speech feature profile was found for children with CAS, differing in number and distribution compared to children with CP ± L and SSD. CAS was found more frequently in CP ± L and SSD compared to reported estimates of clinical prevalence. [ABSTRACT FROM AUTHOR]

Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO's working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs' perceptions of the PWA's stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation. [ABSTRACT FROM AUTHOR]

Background: Written language impairments are common in Alzheimer's disease and reduced syntactic complexity in written discourse has been observed decades before the onset of dementia. The validity of average dependency distance (ADD), a measure of syntactic complexity, in cognitive decline needs to be studied further to evaluate its clinical relevance. Aims: The aim of the study was to determine whether ADD is associated with levels of cognitive impairment in memory clinic patients. Methods & procedures: We analyzed written texts collected in clinical practice from 114 participants with subjective cognitive impairment, mild cognitive impairment, and Alzheimer's disease during routine assessment at a memory clinic. ADD was measured using automated analysis methods consisting of a syntactic parser and a part-of-speech tagger. Outcomes & results: Our results show a significant association between ADD and levels of cognitive impairment, using ordinal logistic regression models. Conclusion: These results suggest that ADD is clinically relevant with regard to levels of cognitive impairment and indicate a diagnostic potential for ADD in cognitive assessment. [ABSTRACT FROM AUTHOR]

Objective: Aphasia and apraxia of speech (AOS) after stroke frequently co-occur with a hand motor impairment but few studies have investigated stroke recovery across motor and speech-language domains. In this study, we set out to test the shared recovery hypothesis. We aimed to (1) describe the prevalence of AOS and aphasia in subacute stroke patients with a hand motor impairment and (2) to compare recovery across speech-language and hand motor domains. In addition, we also explored factors predicting recovery from AOS. Methods: Seventy participants with mild to severe paresis in the upper extremity were assessed; 50% of these (n = 35) had left hemisphere (LH) lesions. Aphasia, AOS and hand motor assessments and magnetic resonance imaging were conducted at 4 weeks (A1) and at 6 months (A2) after stroke onset. Recovery was characterized in 15 participants showing initial aphasia that also had complete follow-up data at 6 months. Results: All participants with AOS and/or aphasia had LH lesions. In LH lesioned, the prevalence of aphasia was 71% and of AOS 57%. All participants with AOS had aphasia; 80% of the participants with aphasia also had AOS. Recovery in aphasia (n = 15) and AOS (n = 12) followed a parallel pattern to that observed in hand motor impairment and recovery correlated positively across speech-language and motor domains. The majority of participants with severe initial aphasia and AOS showed a limited but similar amount of recovery across domains. Lesion volume did not correlate with results from behavioral assessments, nor with recovery. The initial aphasia score was the strongest predictor of AOS recovery. Conclusion: Our findings confirm the common occurrence of AOS and aphasia in left hemisphere stroke patients with a hand motor impairment. Recovery was similar across speech-language and motor domains, even in patients with severe impairment, supporting the shared recovery hypothesis and that similar brain recovery mechanisms are involved in speech-language and motor recovery post stroke. These observations contribute to the knowledge of AOS and its relation to motor and language functions and add information that may serve as a basis for future studies of post stroke recovery. Studies including neuroimaging and/or biological assays are required to gain further knowledge on shared brain recovery mechanisms. [ABSTRACT FROM AUTHOR]

We examine the relation between the shareholder base and payout policy. Consistent with the idea that the shareholder base is related to the cost of external financing, we find that firms with small shareholder bases have lower payout levels and maintain higher cash holdings. We show that undertaking an open market repurchase results in a significant reduction in the size of the shareholder base. Consequently, we find that firms with small shareholder bases are less likely to undertake a repurchase (reduce the shareholder base even further) and are more likely to pay special dividends. [ABSTRACT FROM PUBLISHER]

Large-scale software systems are currently designed as distributed entities and deployed in cloud data centers. To overcome the limitations inherent to this type of deployment, applications are increasingly being supplemented with components instantiated closer to the edges of networks--a paradigm known as edge computing. The problem of how to efficiently orchestrate combined edge-cloud applications is, however, incompletely understood, and a wide range of techniques for resource and application management are currently in use. This article investigates the problem of reliable resource provisioning in joint edge-cloud environments, and surveys technologies, mechanisms, and methods that can be used to improve the reliability of distributed applications in diverse and heterogeneous network environments. Due to the complexity of the problem, special emphasis is placed on solutions to the characterization, management, and control of complex distributed applications using machine learning approaches. The survey is structured around a decomposition of the reliable resource provisioning problem into three categories of techniques: workload characterization and prediction, component placement and system consolidation, and application elasticity and remediation. Survey results are presented along with a problem-oriented discussion of the state-of-the-art. A summary of identified challenges and an outline of future research directions are presented to conclude the article. [ABSTRACT FROM AUTHOR]

Background: The Eating Assessment Tool is a self-rating questionnaire developed to assess symptom severity and treatment efficacy in swallowing disorders. The aim of this study was to investigate the structural validity of the Eating Assessment Tool and whether individual item scores differed between dysphagia secondary to neurological and structural/esophageal disorders, respectively.Methods: This is a prospective cross-sectional questionnaire study. In total, 200 community-dwelling adults with suspected dysphagia referred for fiberoptic endoscopic examination of swallowing at Karolinska University Hospital, Stockholm, Sweden, completed the S-EAT-10. Patients' medical charts were reviewed in order to establish the type of dysphagia. Principal axis factoring was conducted to examine structural validity, and Mann-Whitney U tests were used to study differences in the S-EAT-10 score patterns between different types of dysphagia.Results: One single factor explained 54% of the total variance in EAT-10 item scores. All ten items loaded substantially or strongly on this factor, supporting the single-factor solution (Cronbach's alpha = 0.90). Structural/esophageal dysphagia was associated with higher scores on six items and with a higher total EAT-10 score.Conclusions: The EAT-10 yields a unidimensional index of symptom severity in patients with dysphagia. Individual item scores reflect typical symptoms in neurogenic and structural/esophageal dysphagia, supporting its clinical relevance. [ABSTRACT FROM AUTHOR]

Background/objective: It has been suggested that central auditory processing dysfunction might precede the development of cognitive decline and Alzheimer's disease (AD). The Dichotic Digits Test (DDT) has been proposed as a test of central auditory function. Our objective was to evaluate the predictive capacity of the DDT in conversion from mild cognitive impairment (MCI) to dementia.Methods: A total of 57 participants (26 females) with MCI were tested at baseline with pure tone audiometry, speech in quiet and in noise, and the DDT. The cognitive outcome was retrieved from medical files after 5 years. Groupwise comparisons of the baseline DDT scores were performed and the relative risk was calculated.Results: Altogether 22 subjects developed any kind of dementia. Of the original 57 individuals within the MCI group, 15 developed AD and 7 developed other types of dementia. There was no significant difference in baseline DDT scores between the participants who converted to AD and those who did not. However, the group who developed other types of dementia (especially frontotemporal dementia) had lower DDT scores in the left ear than those participants who did not develop dementia. With a baseline DDT score below 50% correct responses, the participants diagnosed with MCI had a 2.49-times-higher risk of developing dementia than those with scores of 50% or better.Conclusion: The DDT as a central auditory test may be suitable when evaluating cognitive decline. [ABSTRACT FROM AUTHOR]

Background: A traditional curricular structure may challenge integration between foundational and clinical sciences in speech and language pathology (SLP) education. This project aimed to increase curriculum integration at a Swedish SLP education programme. Methods: Learning outcomes in the existent curriculum were copied from their original courses and re-structured with reference to vertical tracks, in order to address them within and across years of study. A content analysis of interviews with teachers and students was conducted for the evaluation of curricular change. Results: Among the changes were earlier introduction to clinical science and revisiting of foundational sciences later in the education. Theme concepts were defined to scaffold horizontal integration, whereas revisited use of documented material was formalized to ensure vertical integration. In evaluation interviews, multiple examples were provided of how the new curriculum was perceived as being more integrated, with horizontal themes and vertical tracks providing structure. Concerns raised highlight the importance of appointing clear responsibilities. Conclusions: The concepts "gaps" and "overlaps" may guide remediation of areas where increased curricular integration is warranted. Serial child observations running through the curriculum may provide a platform for both horizontal and vertical integration. For maintenance of curricular integration, clear responsibilities are needed, stretching across course and semester boundaries. [ABSTRACT FROM AUTHOR]

Screening tests can be performed to identify stroke patients who require further assessment of swallowing function. The Repetitive Saliva Swallowing Test (RSST) is a screening test during which the patient is asked to swallow saliva as many times as possible for 30 s, while deglutition is counted through palpation of the larynx. This study aimed to establish normative values for three age groups of non-patients (total N = 120) on RSST. One patient group (N = 40) was also recruited from a geriatric stroke unit to assess whether RSST scores predicted outcomes on the Standardised Swallowing Assessment-Svenska (SSA-S), a clinical screening tool here used as a reference test. Since the RSST involves the swallowing of saliva, this study also measured the participants' saliva secretion in order to examine its effect on RSST performance. This study showed that RSST results vary with age (lower among older) and gender (higher for men than women), while the number of doctor-prescribed medications, objective saliva secretion and self-assessed dryness of mouth did not affect the performance significantly. In comparison to a more extensive clinical screening procedure (SSA-S), the RSST correctly predicted 93% of negative cases and 69% of positive cases. This suggests that patients who show signs of aspiration according to SSA-S have a lower probability of detection with RSST. [ABSTRACT FROM AUTHOR]

Verbal fluency tasks, in which participants generate words during a set time, have been used in research and assessments of neurobiological disorders and impairments. Research on verbal fluency in dyslexia has shown impaired performance in semantic and letter fluency. However, studies report inconsistent results, and action fluency has not been examined in dyslexia. Current research has mainly examined verbal fluency in relation to executive functions, vocabulary, and phonological processing. The present study examined performance on letter, semantic, and action fluency in relation to reading ability in 42 students in higher education, of which 16 had developmental dyslexia and 26 had typical reading development. It was examined if verbal fluency can predict variance in reading ability when group, phonological awareness, and rapid automatized naming are controlled for. Results showed impaired verbal fluency in the developmental dyslexia group. Action fluency and group were significant predictors of reading ability, together explaining 73% of the variance, in a backward elimination regression analysis. The results point to a possible, unique connection between action fluency and reading ability; this connection is discussed based on their neurocognitive underpinnings. [ABSTRACT FROM AUTHOR]

Few comprehensive spelling tests are available in Swedish, and none have been validated in adults with reading and writing disorders. The recently developed STAVUX test includes word and pseudoword spelling subtests with high internal consistency and adult norms stratified by education. This study evaluated the convergent and diagnostic validity of STAVUX in adults with dyslexia. Forty-six adults, 23 with dyslexia and 23 controls, took STAVUX together with a standard word-decoding test and a self-rated measure of spelling skills. STAVUX subtest scores showed moderate to strong correlations with word-decoding scores and predicted self-rated spelling skills. Word and pseudoword subtest scores both predicted dyslexia status. Receiver-operating characteristic (ROC) analysis showed excellent diagnostic discriminability. Sensitivity was 91% and specificity 96%. In conclusion, the results of this study support the convergent and diagnostic validity of STAVUX. [ABSTRACT FROM AUTHOR]

ConclusionThe Swedish Eating Assessment Tool (S-EAT-10) is a reliable and valid self-administered tool in assessment of dysphagia in adult Swedish patients with high internal consistency, reliability, and discriminative validity. The normative data show that a score of 3 or more is abnormal. S-EAT-10 is recommended to be used in preliminary diagnostics of dysphagia.ObjectiveTo translate and adapt the EAT-10 for use in the Swedish patient population, and to present norms and measures of discriminative validity and reliability of a Swedish version of the Eating Assessment Tool-10 (S-EAT-10).MethodsProspective consecutive clinical study. In total, 134 community-dwelling adult respondents/controls without dysphagia completed the S-EAT-10, as did 119 patients referred for fiberendoscopic evaluation of swallowing at Karolinska University Hospital, Stockholm, Sweden. Patient vs control status was used as the criterion for discriminative validity assessment by logistic regression analysis.ResultsThe mean S-EAT-10 score was 0.2 (range = 0–3) for controls and 18 (range = 0–38) for patients. Based on a cut-off score of ≥ 3 which was considered to be reflective of abnormalities, sensitivity was 98.5% and specificity 94.1%. Internal consistency reliability was high (Cronbach’s alpha = 0.88), as was test–re-test reliability (ICC = 0.90). [ABSTRACT FROM PUBLISHER]

Objectives Darier disease is an autosomal dominant skin disorder caused by mutations in the ATPase, Ca++ transporting, cardiac muscle, slow twitch 2 ( ATP2A2) gene and previously reported to cosegregate with bipolar disorder and schizophrenia in occasional pedigrees. It is, however, unknown whether these associations exist also in the general population, and the objective of this study was to examine this question. Methods We compared a national sample of individuals with Darier disease and their first-degree relatives with matched unexposed individuals from the general population and their first-degree relatives, respectively. To examine risks for bipolar disorder and schizophrenia, risk ratios and 95% confidence intervals ( CIs) were estimated using conditional logistic regressions. Results Individuals with Darier disease had a 4.3 times higher risk of being diagnosed with bipolar disorder (95% CI: 2.6-7.3) and a 2.3 times higher risk of being diagnosed with schizophrenia (95% CI: 1.1-5.2) than matched individuals from the general population. Relatives of individuals with Darier disease had a 1.6 times higher risk of having bipolar disorder (95% CI: 1.1-2.5) than relatives of matched individuals from the general population, but no increased risk of schizophrenia (risk ratio = 0.8, 95% CI: 0.4-1.8). Conclusions The association between Darier disease and bipolar disorder is manifest also in the population, and our data suggest that genetic variability within the ATP2A2 gene that causes Darier disease also confers susceptibility for bipolar disorder. The Darier-causing mutations merit additional attention in molecular genetic research on bipolar disorder. [ABSTRACT FROM AUTHOR]

Supraspan verbal list learning is widely used to assess dementia and related cognitive disorders where declarative memory deficits are a major clinical sign. While the overall learning rate is important for diagnosis, serial position patterns may give insight into more specific memory processes in patients with cognitive impairment. This study explored these patterns in a memory clinic clientele. One hundred eighty three participants took the Rey Auditory-Verbal Learning Test ( RAVLT). The major groups were patients with Alzheimer's disease ( AD), Vascular Dementia ( VD), Mild Cognitive Impairment ( MCI), and Subjective Cognitive Impairment ( SCI) as well as healthy controls ( HC). Raw scores for the five trials and five serial partitions were factor analysed. Three memory factors were found and interpreted as Primacy, Recency, and Resistance to Interference. AD and MCI patients had impaired scores in all factors. SCI patients were significantly impaired in the Resistance to Interference factor, and in the Recency factor at the first trial. The main conclusion is that serial position data from word list testing reflect specific memory capacities which vary with levels of cognitive impairment. [ABSTRACT FROM AUTHOR]

Morphology of the corpus callosum is a useful biomarker of neuronal loss, as different patterns of cortical atrophy help to distinguish between dementias such as Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD). We used a sophisticated morphometric analysis of the corpus callosum in FTLD subtypes including frontotemporal dementia (FTD), semantic dementia (SD), and progressive non-fluent aphasia (PNFA), and compared them to AD patients and 27 matched controls. FTLD patient subgroups diverged in their callosal morphology profiles, with FTD patients showing marked widespread differences, PNFA patients with differences largely in the anterior half of the callosum, and SD patients differences in a small segment of the genu. AD patients showed differences in predominantly posterior callosal regions. This study is consistent with our previous findings showing significant cortical and subcortical regional atrophy across FTLD subtypes, and suggests that callosal atrophy patterns differentiate AD from FTLD, and FTLD subtypes. [ABSTRACT FROM AUTHOR]

Background: Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs). Aims: To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services. Methods & Procedures: An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires. Outcomes & Results: The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues. Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention. Conclusions: The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved. [ABSTRACT FROM AUTHOR]

Hippocampal pathology is central to Alzheimer's disease (AD) and other forms of dementia such as frontotemporal lobar degeneration (FTLD). Autopsy studies have shown that certain hippocampal subfields are more vulnerable than others to AD and FTLD pathology, in particular the subiculum and cornu ammonis 1 (CA1). We conducted shape analysis of hippocampi segmented from structural T1 MRI images on clinically diagnosed dementia patients and controls. The subjects included 19 AD and 35 FTLD patients [13 frontotemporal dementia (FTD), 13 semantic dementia (SD), and 9 progressive nonfluent aphasia (PNFA)] and 21 controls. Compared to controls, SD displayed severe atrophy of the whole left hippocampus. PNFA and FTD also displayed atrophy on the left side, restricted to the hippocampal head in FTD. Finally, AD displayed most atrophy in left hippocampal body with relative sparing of the hippocampal head. Consistent with neuropathological studies, most atrophic deformation was found in CA1 and subiculum areas in FTLD and AD. [ABSTRACT FROM AUTHOR]

Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services. Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others' experiences of SLP services and their motivation to participate in these services. Finally, the significant others' experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia. Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia. Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services. Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training. [ABSTRACT FROM AUTHOR]

The aim of this study was to present adult norms and to estimate the test-retest reliability for durational and response accuracy measures on the word sequence production test, Months Backward. A total of 216 neurologically intact adults (aged 18-88) stratified by sex, age, and education took the test at maximum speed. Errors and speech duration were recorded. A retest was conducted with 40 participants after 3 weeks. Altogether 94% of the participants completed the test without error. Errors were associated with slow performance. Duration was predicted by years of education (beta == −0.39) and self-reported dyslexia (beta == 0.19). The test-retest reliability was 0.82 for duration and 0.97 for errors. A regression formula for adjustment of logarithmically transformed duration scores is provided. [ABSTRACT FROM AUTHOR]

We describe a case of frontotemporal lobar degeneration with semantic dementia and lower motor neuron disease. A 63-year-old man presented with the full clinical picture of semantic dementia, including semantic anomia, surface alexia, lexical agraphia, associative agnosia, prosopagnosia and phonagnosia. Flaccid dysarthria, bulbar dysphagia and fasciculations developed 7 years after onset, followed by death within a year. The neuropathological examination showed heavy neuronal loss in the anterior temporal lobe cortex, dorsal vagal and hypoglossal nuclei and anterior horns of the spinal cord. Ubiquitin- and TDP-43-positive cytoplasmic inclusions were abundant in layer II of affected cortices and in granular cells of the hippocampal dentate gyrus, whereas dystrophic neurites were sparse and intranuclear inclusions absent. It is concluded that FTLD-TDP type 3 can be associated with semantic dementia and lower motor neuron disease in combination. [ABSTRACT FROM AUTHOR]

The Absentmindedness and Memory Questionnaire (AMQ) is a new self-rating scale designed to evaluate everyday memory problems related to absentmindedness. It includes 24 items and is based on studies of different samples ( N= 623). Its test-retest reliability is high and it has consistently shown similar factor structure. The AMQ thus measures four weakly correlated factors: Absentmindedness, Persons, Locations and Codes/Addresses. Factor analysis further indicates that Absentmindedness may include two subfactors: momentary attention deficit and prospective forgetfulness or impaired agenda memory. Gender differences were found in Persons (Female+) and Locations (Male+) but not in Absentmindedness or Codes/Addresses. The current version of AMQ has seven interindividually comparable response alternatives for each item in the questionnaire. This makes it useful as a measure of subjective absentmindedness or forgetfulness as well as a complementary measure of subjective memory for persons, locations, and codes/addresses/stories, especially at follow-up examinations. [ABSTRACT FROM AUTHOR]

Backward recall of automatic word sequences involves declarative and working memory abilities known to be impaired in the early stages of cognitive decline. Yet its utility in the diagnosis of mild cognitive impairment and mild dementia has not been studied in detail. We analysed word sequence production in 234 participants drawn from three categories: subjective cognitive impairment, mild cognitive impairment, and mild dementia in Alzheimer's disease. The names of the months were used as a diagnostic target for investigating forward versus backward sequence production. Forward production remained normal across categories. In contrast, backward speed was significantly decreased in mild cognitive impairment. In dementia both speed and accuracy were impaired. Backward production had significant diagnostic classificatory power. We conclude that word sequence production yields data relevant to the diagnosis of dementia with a minimum of time and expense. [ABSTRACT FROM AUTHOR]

A group of 172 mild cognitive impairment ( MCI) patients and 79 healthy control participants ( HC) were tested on simple reaction time ( SRT). There was a significant difference between MCI and HC in mean SRT. The test could be partitioned into five segments of 16 trials each, but RT's were not always available for each partition. However, scores from each segment for 166 MCI and 41 of the HC's were available. These data showed that a significant interaction between RT-partition and diagnostic category was the main source of the difference between groups. The interaction indicated that MCI patients performed at about the same level as HC in the initial three of the five segments of the test, but were significantly impaired during the last two segments of the 80 trials. The results were interpreted as impaired sustained attention among a large part of the MCI group, and the study shows the importance of taking into account all avaliable data resulting from this type of test. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented about the reliability and validity of the Mini-Mental State Examination in clinical usage.

Presents a discussion on issues surrounding the diagnosis of frontotemporal dementia as of July 2002. Insights on the concept of Pick disease; Relation between the occurrence of ballooned cells and the course of dementia; Efforts to improve the criteria and procedures for the diagnosis of frontotemporal dementia.