Awareness Of Deficits Research Articles

Rasch validation of the revised body awareness rating questionnaire (BARQ-R) in adults with and without musculoskeletal pain

BackgroundThe Revised Body Awareness Rating Questionnaire (BARQ-R) is a self-report measure of body awareness. First aim: evaluate the structural validity of BARQ-R with Rasch analysis in community-dwelling Americans with and without musculoskeletal pain. Subaim: validate a Rasch analysis of BARQ-R done in Norwegian adults with musculoskeletal pain, through a secondary analysis in our sample of Americans with musculoskeletal pain.MethodsBARQ-R has 12 items with scores ranging from 0 (completely disagree) to 3 (completely agree), with higher total scores reflecting lower degrees of body awareness. Through Rasch analysis, we evaluated unidimensionality, item hierarchy, and structural validity with item and person fit, targeting, person separation reliability (PSR), local item dependence (LID), differential item functioning (DIF), and principal components analysis of residuals (PCAR).ResultsWe recruited 623 adults with and without musculoskeletal pain (average age = 50.27 ± 17.25 years). After rescoring 1 item and deleting 3 items, the 9-item Rasch-based BARQ-R had no misfitting items, the hierarchical ordering of the items followed clinical expectations, 3 (0.48%) misfitting persons, person mean location: -0.62 ± 1.03 logits (max -0.53, min 0.72 logits), minimal floor effect (1.93%) and ceiling effect (0.48%), no DIF, and PSR = 0.72. LID was found in 5 item pairs. The PCAR’s eigenvalue was 2.18. The secondary Rasch analysis in 152 adults with musculoskeletal pain (average age = 52.26 ± 16.13 years), demonstrated that, after rescoring 2 items, BARQ-R had no misfitting items and only 2 (1.32%) misfitting persons, good targeting (person mean location: -0.36 ± 0.88 logits), minimal floor effect (0.01%), no ceiling effect (0.00%), and PSR = 0.75. LID was found in 6 item pairs. The PCAR’s eigenvalue was 2.47.ConclusionsBARQ-R had good item and person fit. PSR with items covering a limited logit range suggests that differing levels of body awareness are measured with only modest precision. Adding and revising items to cover a wider range of body awareness and to better address concepts of internal body awareness and body movements would improve BARQ-R’s utility. Further analyses are needed before BARQ-R’s use for research or in the clinic. In addition, future BARQ-R Rasch validation is needed in other populations with body awareness deficits, such as stroke or spinal cord injury.

Constrains for attending District Early Intervention Centre (DEIC) of Purba Bardhaman district, West Bengal: Perspectives of both service providers and caregivers of the beneficiaries, a Mixed-Method Study.

This study was conducted to assess the clinicosocial profile characteristics of the beneficiaries attending DEIC and to explore the challenges faced by both the caregivers and service providers. A facility-based, mixed-method study with phenomenological approach was conducted in Burdwan Medical College of Purba Bardhaman district, West Bengal, from January 2023 to April 2023. For quantitative part, record analysis was conducted involving all children enrolled at DEIC from January 2022 to December 2022, and for qualitative part, caregivers and service providers were selected purposively and interviewed using the in-depth-interview (IDI) guide. Inductive thematic analysis was conducted simultaneously till data saturation was achieved. The principles of descriptive statistics were applied to organize and present the quantitative data in tables and diagrams. Qualitative data were transcribed into verbatim and analyzed thematically with inductive approach. Out of 3332 children enrolled, 58.4% were males, and 44.2% were aged between 0 and 1 month. 59.3% of them had developmental delays, 7.9% had defects, 42.9% had diseases, and 21.3% had some deficiencies. Major hindering factors in service provision among service providers were resource deficiency, inadequate capacity building, administrative bottlenecks, limited supportive supervision, inadequate advocacy, and awareness deficit. No major constraints were found from caregivers' perspective in accessing healthcare. DEIC is running with shortage of proper infrastructure and adequate supervision. Periodic training, appropriate awareness building, and continuous flow of logistics are needed to ensure a better quality of life among beneficiaries.

Reduced awareness of cognitive deficits in idiopathic normal pressure hydrocephalus and its change following lumbar puncture

ObjectiveAwareness of cognitive deficits is related to executive functions and may, therefore, be sensitive to the effects of lumbar puncture (LP) in idiopathic normal pressure hydrocephalus (iNPH). Although a reduction in awareness of cognitive deficits (RACD) has been previously described in iNPH, there is a lack of systematic, psychometrically validated reports. In this study, we investigated RACD and its LP-related changes in iNPH patients and compared them with those in clinical and healthy control groups. MethodsRACD was assessed before and after lumbar puncture (LP) in 24 patients (14 iNPH, 10 other age-associated cognitive syndromes; AACS) and compared with 23 healthy controls (HC), employing two RACD measures alongside cognitive examination. Local metacognition was measured using a visual percentile-based rating system and operationalized as the t-scaled distance between the participants' task-specific performance estimations and their objective test performance (ΔTSPE). Global metacognition, targeting broader estimates of cognitive functioning (ECF), was quantified by subtracting self- from informant-obtained sum scores on a questionnaire evaluating participants' dysexecutive problems (DEX-DS). Within-group and between-group differences in ΔTSPE and DEX-DS scores were compared non-parametrically, focusing on post-LP changes. ResultsAveraged ΔTSPE was higher in the patient groups and mirrored the groups' lower objective test performance, while averaged DEX-DS showed no group difference. Following LP, group comparisons revealed iNPH-specific decrease in both RACD measures. ConclusionOur study revealed LP-related RACD changes in iNPH patients compared to those in AACS and HC participants. The results suggest a mitigation of impaired metacognitive abilities in iNPH, possibly resulting from LP-induced improvements in (local) metacognitive performance, facilitating ECF adjustment alongside a metacognitively stimulating testing procedure.

White matter substrates underlying morphological awareness deficit in Chinese children with developmental dyslexia

BackgroundMorphological awareness (MA) deficit is strongly associated with Chinese developmental dyslexia (DD). However, little is known about the white matter substrates underlying the MA deficit in Chinese children with DD. MethodsIn the current study, 34 Chinese children with DD and 42 typical developmental (TD) children were recruited to complete a diffusion magnetic resonance imaging scan and cognitive tests for MA. We conducted linear regression to test the correlation between MA and DTI metrics, the structural abnormalities of the tracts related to MA, and the interaction effect of DTI metrics by group on MA. ResultsFirst, MA was significant related to the right inferior occipito-frontal fascicle (IFO) and inferior longitudinal fsciculus (ILF), the bilateral thalamo-occipital (T_OCC) and the left arcuate fasciculus (AF); second, compared to TD children, Chinese children with DD had lower axial diffusivity (AD) in the right IFO and T_OCC; third, there were significant interactions between metrics (fractional anisotropy (FA) and radial diffusivity (RD)) of the right IFO and MA in groups. The FA and RD of the right IFO were significantly associated with MA in children with DD but not in TD children. ConclusionIn conclusion, compared to TD children, Chinese children with DD had axonal degeneration not only in the ventral tract (the right IFO) but also the visuospatial tract (the right T_OCC) which were associated with their MA deficit. And Chinese MA involved not only the ventral tracts, but also the visuospatial pathway and dorsal tracts.

Providing Better Support for Entrepreneurial Activities in the Weather, Water, and Climate Community

Abstract There has been an increase in entrepreneurial activity within the weather, water, and climate (WWC) community over the past decade, with the potential for much more as artificial intelligence/machine learning techniques continue to develop and as new opportunities arise across the weather, climate, and ocean service enterprises. Despite indications of recent growth, this study reports on key challenges that are limiting the community’s ability to achieve the full potential of commercialization of new WWC products and services. Most of these challenges are related to the preparation of those in the WWC community for jobs in the private sector in general and entrepreneurial activities in particular. These results extend and build upon the work of others who have reported on shortcomings in the preparation of students for positions in the private sector, with this study showing that deficits in preparation and awareness of available resources affect potential entrepreneurs well into their career—most researchers are unaware of the resources available to them. Based on a synthesis of input from successful WWC entrepreneurs, many of the challenges could be greatly reduced by relatively minor adjustments to curriculums at universities and through new programs that could be offered by scientific and professional societies to help potential entrepreneurs better take advantage of existing resources as they spin up a new business.

Жалобы на когнитивные нарушения при унилатеральной компрессии височной доли

<p>Awareness of cognitive deficits, as a rule, occurs in the form of «memory complaints». Spontaneous narration of problems reveals their semantic hierarchy and can be a model for generating a spontaneous flow of thoughts and memories with the activity of the default brain network. The objective of the study was to study the nature of spontaneously expressed complaints about memory by patients with mild compression of the temporal regions of the resting network of the brain. The study was conducted in a homogeneous clinical group of 48 patients with extracerebral benign neoplasms located in close proximity to the medio-basal parts of the left (25 people) or right (28 people) temporal lobe. The tumor compresses these parts, but does not infiltrate the brain substance. With left-sided compression, complaints about verbal processes dominated, and their quantitative predominance over similar complaints was recorded in the group with right-sided compression and in the control group of healthy subjects (24 people). The severity of cognitive complaints with left-sided exposure to the brain revealed a negative correlation with experimental indicators of the success of spatial distribution of attention and simultaneous perception. With right-sided compression, spontaneously generated cognitive complaints revealed a dependence on the number of recognition errors in the AVP test, but this dependence was paradoxical: the worse this memory indicator was, the fewer cognitive complaints patients presented. The phenomenology of neural network compression makes it possible to register hemispheric specificity in spontaneously generated thoughts and memories.</p>

Barriers and benefits of mHealth for community health workers in integrated community case management of childhood diseases in Banda Parish, Kampala, Uganda: a cross-sectional study

BackgroundLow-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala.MethodsThis qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model.ResultsThree themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology.ConclusionDespite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs’ demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts.

Vitamin D: Analytical Advances, Clinical Impact, and Ongoing Debates on Health Perspectives.

Vitamin D, acknowledged since the 1930s for its role in preventing rickets, gained additional prominence in relation to fragility fracture prevention in the late 1980s. From the early 2000s, connections between vitamin D deficiency and extra-skeletal pathologies emerged, alongside increased awareness of widespread deficits. This prompted crucial debates on optimal serum concentrations, expected to conclude when the outcomes of high-dose supplementation randomized controlled trials were available. Skepticism arose with inconclusive results from these trials. This review begins with an exploration of vitamin D metabolism, followed by a detailed description of the measurement of vitamin D metabolites and the crucial role of standardization. Subsequent sections focus on the association of vitamin D with bone health and explore the extra-skeletal effects. The review concludes with a comprehensive discussion on the definition of vitamin D status and its implications for supplementation. Despite standardization efforts, assay variations and challenges still exist, especially in specific patient groups. Vitamin D supplementation has a significant impact on bone metabolism and optimal vitamin D status improves the efficacy of antiresorptive drugs such as bisphosphonates. The extra-skeletal effects of vitamin D remain debated, but may include potential benefits in conditions such as respiratory infections and cancer mortality, particularly in deficient individuals. The definition of vitamin D sufficiency is nuanced, especially when variations in population groups and analytical methods are taken into account. Despite ongoing debates and recent mega-trials tempering enthusiasm, vitamin D remains a complex and essential element in human health. Further research is needed to clarify its role in various health outcomes and guide supplementation strategies.

The importance of non-technical skills in robot-assisted surgery in gynaecology.

Robot-assisted surgery (RAS) in gynaecology has undergone exponential growth in recent decades, with utility in treating both benign and malignant gynaecological conditions. The technological complexities and amended theatre dynamics that RAS demands mean that effective non-technical skills (NTS) are vitally important to overcome these unique challenges. However, NTS have been neglected in RAS-training programmes with focus placed instead on the exclusive acquisition of technical skills (TS). NTS include teamwork, communication, leadership, situational awareness, decision-making and stress management. Communication is the most frequently cited NTS impacted during RAS, as the physical limitations imposed by the robotic hardware make communication exchange difficult. The full immersion that RAS enables can contribute to situational awareness deficits. However, RAS can complement communication and teamwork when multidisciplinary (MDT) surgeries (such as complex endometriosis excisions) are undertaken; dual-console capabilities facilitate the involvement of specialties such as general surgery and urology. The development of NTS in RAS cannot be achieved with in-situ experience alone, and current training is poorly standardised. RAS-training programmes and curricula for gynaecology do exist, however the integration of NTS remain limited. Simulation is a viable tool to facilitate enhanced-NTS integration, yet cost implications form a barrier to its wider implementation. However, given that RAS will continue to occupy a greater proportion of the gynaecological caseload, integration of NTS within gynaecological RAS training curricula is necessary. Patients undergoing gynaecological RAS would benefit from the improved safety standards and enhanced surgical outcomes that would result.

Awareness of enterprise finance support programmes: the role of networks, gender and ethnicity

PurposeThis paper investigates how gender, ethnicity, and network membership interact to influence how small and medium-sized enterprise (SME) owner-managers become aware of finance support programmes developed by government policy and/or support schemes advanced by the banking industry.Design/methodology/approachDrawing on expectation states theory (EST), we develop eight sets of hypotheses and employ the UK SME Finance Monitor data to test them using bivariate probit regression analysis.FindingsIn general, network membership increases awareness, but more so for government programmes. We also find no differences between female and male owner-managers when in networks. However, we identify in-network and out-network differences by ethnicity, with minority females seemingly better off than minority males.Practical implicationsBusiness networks are better for disseminating government programmes than industry-led programmes. For native White women, network membership can enhance policy awareness advantage further, whilst for minorities, networks significantly offset the big policy awareness deficits minorities inherently face. However, policy and practice need to address intersectional inequalities that remain in access to networks themselves, information access within networks, and the significant out-network deficits in awareness of support programmes afflicting minorities.Originality/valueThis study provides one of the first large-scale empirical examinations of intersectional mechanisms in awareness of government and industry-led enterprise programmes. Our novel and nuanced findings advance our understanding of the ways in which gender and ethnicity interact with network dynamics in entrepreneurship.

Teleneuropsychology intervention in phonological awareness for children with specific learning disorder with reading and mathematical difficulties

Specific learning disorder (SLD) is a neurodevelopmental disorder that affects 5–15% of school-aged children worldwide. Often, difficulties in reading (SLD-RD) and mathematics (SLD-MD) occur together. Deficits in phonological awareness (PA) have been identified as the common factor between the two difficulties. Intervention in PA has been shown to be effective in SLD-RD; however, it is not clear whether it is also effective in SLD-MD. Neuropsychological intervention is usually conducted face-to-face, but when the patient is in a remote location or during extraordinary situations such as the COVID-19 pandemic, tele neuropsychology (TeleNP) may be a suitable alternative. The objective of this study was to evaluate the efficacy of a telerehabilitation program for PA to improve math skills in children with SLD-RD/SLD-MD. The study had an N-of-1 SCED design, and included six children aged 10–12 years with SLD-RD/SLD-MD. After four baseline measurements with an arithmetic verification paradigm, they were treated with TeleNP-PA. The effect on each participant was evaluated using visual analysis and the reliable change index. After the intervention, all participants showed improvement in arithmetic tasks, suggesting that the PA intervention had a positive influence on these skills.

Building Cybersecurity Capacities in Zambia’s Business Sector: Guideline for SMEs

This research explores cybersecurity awareness and implementation within Zambia’s small and medium-sized enterprises (SMEs), a sector increasingly targeted by cyberattacks that lead to substantial financial losses. The study’s primary aim was to enhance cyber awareness and develop actionable guidelines for SMEs in Zambia. Utilising an interpretivist philosophy and inductive approach, the methodology encompassed semi-structured interviews, cross-sectional analysis, and a comprehensive review of CISA, ENISA guidelines, and Zambia’s Data Protection Act. Findings indicate a notable deficit in cybersecurity training and awareness among SMEs. Key concerns include inadequate data security measures, a lack of formal cybersecurity policies, and a reliance on basic tools like antivirus software. In response, the study formulated targeted guidelines, emphasising the integration of cyber awareness into SME governance and risk management. These guidelines have garnered significant interest from Zambian government entities, highlighting their potential influence on national cybersecurity policy. The study contributes theoretically by contextualising international cybersecurity standards within Zambia’s unique SME landscape. Methodologically, it pioneers a Cyber Awareness Framework tailored to Zambian SMEs, underscoring the critical role of human factors in cybersecurity. Practically, the research has sparked engagement among SMEs and government bodies, demonstrating its applicability and potential for shaping policy. However, limitations include reliance on outdated demographic data and a focus on digitally enabled SMEs, potentially overlooking broader IT governance aspects and less digitized businesses. Future research should aim for comprehensive, up-to-date analysis across all SME sectors, contributing to a more inclusive and resilient cybersecurity landscape in Zambia.

Measures of Awareness in Alzheimer's Disease and Clinical Differences Between Groups with Preserved, Impaired, and Absent Awareness.

Awareness is a heterogeneous construct that requires accurate assessment. There is no consensus on the best methodology for capturing the phenomenon, thus leading to inconsistent results in this area. We aim to evaluate the reliability of clinicians' ratings and a discrepancy assessment method, examining groups of people with Alzheimer's disease (PwAD) according to their degree of awareness and demographic and clinical aspects. We cross-sectionally assessed 134 PwAD and their caregivers. Individuals' level of awareness was assessed with two methods: clinicians' ratings identified three groups (preserved awareness, impaired awareness, and absent awareness), while discrepancy assessment identified four groups (preserved awareness, mildly impaired awareness, moderately impaired awareness, and absent awareness). Clinicians' ratings showed significant differences between PwAD with preserved, impaired, and absent awareness groups in cognition, functionality, and neuropsychiatric symptoms. There was a significant difference in caregivers' anxiety between the impaired and absent awareness groups. Discrepancy assessment showed no clinical differences between the preserved and mildly impaired awareness groups or between the absent and moderately impaired awareness groups. A significant difference in functionality was observed between the other groups. Clinical aspects of each measure tended to differ between the chosen methods. Impairments in awareness fluctuate despite disease progression. Cognition and severity of disease cannot explain deficits in awareness.

IDF23-0123 Awareness deficit: link between insulin resistance/hyperinsulinemia and non-communicable diseases among St Lucian adults

IDF23-0123 Awareness deficit: link between insulin resistance/hyperinsulinemia and non-communicable diseases among St Lucian adults

Factors Associated with Knowledge of Hypertension in Rural Guinea, 2023: Case of the Rural Commune of Maferinyah

Introduction: While numerous studies have explored hypertension knowledge across Africa, they have predominantly focused on urban hospital settings and diagnosed patients. This study aimed to evaluate the determinants of hypertension knowledge in rural Guinea, a less-explored demographic. Methods: This cross-sectional study was conducted from March 01 to April 2023 within the Maferinyah sub-district and employed multivariate logistic regression to analyze the relationship between hypertension knowledge and various demographic characteristics. Results: The study included 701 individuals aged 16–65 years (mean age 38 years), with a predominance of women (68.3%) and those without formal education (62.8%). Key findings revealed that high economic status (aOR= 2.97; 95% CI: 1.91 - 4.64), age brackets of 41-50 years (aOR= 6.30; 95% CI: 3.51 - 11.5), 30-40 years (aOR= 4.74; 95% CI: 2.89 - 7.90), over 50 years (aOR= 4.13; 95% CI: 2.51 - 6.87), and unemployment (aOR= 2.60; 95% CI: 1.75 - 3.89) were significantly associated with higher hypertension awareness. Conclusion: Analysis of the collected data highlights a notable deficit in awareness of hypertension and its associated risk factors among the rural population of Guinea, underscoring the urgent need for targeted educational and awareness initiatives, especially among younger populations, to improve the understanding and management of Hypertension and other non-communicable diseases.

Isolated insular stroke: topography is the answer with respect to outcome and cardiac involvement.

Isolated insular strokes (IIS) are a rare occurrence due to the frequent concomitant involvement of adjacent territories, supplied by the M2 segment of the middle cerebral artery (MCA), and clinical aspects are sometimes contradictory. We aimed to describe clinical and radiological characteristics of a pure IIS case series, focusing on its functional outcome and cardiac involvement. We identified 15 isolated insular ischemic strokes from a pool of 563 ischemic strokes occurred between January 2020 and December 2021. Data collection consisted of demographic and baseline clinical characteristics, comorbidities, electrocardiograms, echocardiograms, stroke topography and etiology, reperfusive treatments, and outcome measures. Descriptive statistical analysis was carried out. Newly detected cardiovascular alterations were the prevalent atypical presentation. Cardioembolism was the most frequent etiology. Most of patients had major neurological improvement at discharge and good outcome at 3-months follow-up. IIS are extremely rare, representing according to our study about 2.6% ischemic strokes cases per year, and patients have peculiar clinical manifestations, such as dysautonomia and awareness deficits. Our data suggest the possibility for these patients to completely recover after acute ischemic stroke notwithstanding the pivotal role of the insula in cerebral connections and the frequent association with MCA occlusion. Moreover, given the central role of the insula in regulating autonomic functions, newly detected cardiac arrhythmias must be taken into consideration, as well as a full diagnostic work-up for the research of cardioembolic sources. To our knowledge, this is the largest monocentric case series of IIS and it might be useful for future systematic reviews.

Undergraduate deficits in plastic surgery exposure and awareness of the specialty: a systematic review.

Plastic surgery is an important specialty that involves widespread medical knowledge, some of which is taught in undergraduate curricula. The General Medical Council provides a well-defined plastic surgery curriculum for postgraduate training. However, there is no consensus on the provision for undergraduates in this specialty, potentially giving rise to a deficit in undergraduate medical education and a suboptimal basis for plastic surgery postgraduate training. Our aim was to identify the gap in undergraduate plastic surgery teaching and to understand student perceptions of the specialty as well as any trialled interventions. A prospectively registered systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The MEDLINE®, Embase™, PubMed® and Google Scholar™ databases were searched for literature relating to undergraduate exposure to plastic surgery and relevant teaching interventions. Ten studies were included in this review, categorised into three main themes: exposure during medical school, determining factors and perceptions for pursuing a plastic surgery career, and teaching interventions. Surveys assessing medical student perceptions indicate a significant deficit in exposure to plastic surgery in the undergraduate curriculum. Medical students' interest in the specialty is affected by multiple factors, including the amount of surgical exposure in medical school. Interventions to address the deficit mostly involve one-day courses. Although the literature is currently limited, studies are needed to effectively assess the outcomes of plastic surgery teaching methods in undergraduate training. Moreover, there is a need for consensus around the provision of undergraduate teaching in plastic surgery. This should be reflected in the latest undergraduate curricula in medical education.

Emotion regulation and heart rate variability may identify the optimal posttraumatic stress disorder treatment: analyses from a randomized controlled trial.

High variability in response and retention rates for posttraumatic stress disorder (PTSD) treatment highlights the need to identify "personalized" or "precision" medicine factors that can inform optimal intervention selection before an individual commences treatment. In secondary analyses from a non-inferiority randomized controlled trial, behavioral and physiological emotion regulation were examined as non-specific predictors (that identify which individuals are more likely to respond to treatment, regardless of treatment type) and treatment moderators (that identify which treatment works best for whom) of PTSD outcome. There were 85 US Veterans with clinically significant PTSD symptoms randomized to 6 weeks of either cognitive processing therapy (CPT; n = 44) or a breathing-based yoga practice (Sudarshan kriya yoga; SKY; n = 41). Baseline self-reported emotion regulation (Difficulties in Emotion Regulation Scale) and heart rate variability (HRV) were assessed prior to treatment, and self-reported PTSD symptoms were assessed at baseline, end-of-treatment, 1-month follow-up, and 1-year follow-up. Greater baseline deficit in self-reported emotional awareness (similar to alexithymia) predicted better overall PTSD improvement in both the short- and long-term, following either CPT or SKY. High self-reported levels of emotional response non-acceptance were associated with better PTSD treatment response with CPT than with SKY. However, all significant HRV indices were stronger moderators than all self-reported emotion regulation scales, both in the short- and long-term. Veterans with lower baseline HRV had better PTSD treatment response with SKY, whereas Veterans with higher or average-to-high baseline HRV had better PTSD treatment response with CPT. To our knowledge, this is the first study to examine both self-reported emotion regulation and HRV, within the same study, as both non-specific predictors and moderators of PTSD treatment outcome. Veterans with poorer autonomic regulation prior to treatment had better PTSD outcome with a yoga-based intervention, whereas those with better autonomic regulation did better with a trauma-focused psychological therapy. Findings show potential for the use of HRV in clinical practice to personalize PTSD treatment. ClinicalTrials.gov identifier, NCT02366403.

Effect of Phonological Awareness-Focused Interventions on Phonological Errors and Phonemic Awareness in Young School-Age Children.

This study aimed to explore the effects of an integrated phonological awareness intervention on phonological errors and phonemic awareness among young school-age children. Three children with at least one phonological error pattern and below-average phonological awareness skills participated in a non-concurrent multiple baseline single-subject design across participants' investigation. The integrated phonological awareness intervention consisted of completing blending and segmenting activities using 20 trained words, with a dose of 70 to 100 productions of the targeted phonological error pattern for 10, 30-minute sessions. All participants showed improvement in the primary dependent variable of percent consonants correct for their targeted error pattern for trained words. Results for percent phonemes correct showed gains for both blending and segmenting for all participants. All the participants transferred targeted skills to untrained words with their error pattern and generalized blending and segmenting to consonant-vowel-consonant words that did not contain their target error pattern in a pretest/posttest. Integrated phonological awareness intervention was an effective method of simultaneously improving speech production and phonemic awareness skills for young school-age children across 5 hours of treatment. The intervention was designed to be replicable by school-based speech-language pathologists seeking to efficiently support students with phonological errors and phonological awareness deficits.

Dissociating the impact of alexithymia and impaired self-awareness on emotional distress and aggression after traumatic brain injury.

Alexithymia, a deficit in identifying and describing feelings, is prevalent in traumatic brain injury (TBI). Sometimes referred to as "emotional unawareness," we sought to investigate whether alexithymia after TBI was related to, or distinct from, impaired self-awareness (ISA) and whether the two predicted differentiable emotional and aggression profiles. Further, the mediating role of frontal system behaviors (disinhibition, dysexecutive function, apathy) was explored. Participants with TBI (N = 40) from diverse backgrounds completed self-report measures of alexithymia, emotional distress, aggression, and frontal system behaviors. For the assessment of ISA, significant other ratings were obtained to identify discrepancies from self-ratings. Data were analyzed quantitatively using independent samples t tests, correlations, partial correlations, and simple mediation. There was a negative correlation between alexithymia and ISA. Alexithymia, but not ISA, was associated with higher expressions of emotional distress and aggression even after controlling for the effects of ISA via partial correlations. Exploratory analyses found that frontal system behaviors mediated the relationships between alexithymia and aggression and alexithymia and emotional distress. Alexithymia is more accurately conceptualized as an emotional processing deficit than an awareness deficit. Indeed, self-awareness may be a prerequisite for the ability to identify alexithymic tendencies. Negative psychological effects of alexithymia are compounded by poorer executive function and disinhibition and call for the development of TBI-specific alexithymia screening tools and interventions. Alexithymia interventions are best delivered in conjunction with rehabilitation of emotion regulation and executive function. (PsycInfo Database Record (c) 2024 APA, all rights reserved).