Anxiety and depression among epilepsy patients in low-risk areas for COVID-19 in the northern part of Guizhou Province, China, during the COVID-19 pandemic

BackgroundThis study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time.MethodsThe survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated.ResultsThere were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people.ConclusionsDuring the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.

Therapeutic prospects of naturally occurring p38 MAPK inhibitors tanshinone IIA and pinocembrin for the treatment of SARS-CoV-2-induced CNS complications.

P38 mitogen-activated protein kinase (p38 MAPK) signaling pathway is closely related to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) replication and hyperinflammatory responses in coronavirus disease 2019 (COVID-19). Therefore, blood-brain barrier-penetrating p38 MAPK inhibitors have good potential for the treatment of central nervous system (CNS) complications of COVID-19. The aim of the present study is the characterization of the therapeutic potential of tanshinone IIA and pinocembrin for the treatment of CNS complications of COVID-19. Studies published in high-quality journals indexed in databases Scopus, Web of Science, PubMed, and so forth were used to review the therapeutic capabilities of selected compounds. In continuation of our previous efforts to identify agents with favorable activity/toxicity profiles for the treatment of COVID-19, tanshinone IIA and pinocembrin were identified with a high ability to penetrate the CNS. Considering the nature of the study, no specific time frame was determined for the selection of studies, but the focus was strongly on studies published after the emergence of COVID-19. By describing the association of COVID-19-induced CNS disorders with p38 MAPK pathway disruption, this study concludes that tanshinone IIA and pinocembrin have great potential for better treatment of these complications. The inclusion of these compounds in the drug regimen of COVID-19 patients requires confirmation of their effectiveness through the conduction of high-quality clinical trials.

[Psychological, psychiatric and neurological aspects of COVID-19]. / Psikhologicheskie, psikhiatricheskie i nevrologicheskie aspekty COVID-19.

OBJECTIVE: To analyze neurological, psychological and psychiatric aspects of COVID-19, as well as to study the current state of the problem. MATERIAL AND METHODS: The study included 103 patients with COVID-19. The main research method was clinical/psychopathological. To study the impact of activities related to the care of patients with COVID-19 in a hospital setting, the medical and psychological state of 197 hospital workers involved in the treatment of patients with COVID-19 was assessed. The level of anxiety distress was assessed with the Psychological Stress Scale (PSM-25), distress indicators corresponded to values of more than 100 points. The severity of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale (HADS). RESULTS: When considering psychopathological disorders in the context of COVID-19, it is necessary to distinguish between two main groups of disorders: mental disorders during the pandemic, and mental disorders directly caused by the causative agent SARS-CoV-2. The analysis of psychological and psychiatric aspects in various periods of the initial stage of COVID-19 showed that each of them was characterized by specific features depending on the nature of the influence of different pathogenic factors. In the structure of nosogenic mental disorders in patients with COVID-19 (103 patients), the following clinical forms were identified: acute reaction to stress (9.7%), anxiety-phobic disorders (41.7%), depressive symptoms (28.1%), hyponosognosic nosogenic reactions (20.5%). At the same time, the majority of the patients had manifestations of somatogenic asthenia (93.2%). A comparative analysis of neurological and psychological/psychiatric aspects of COVID-19 showed that the main mechanisms of the impact of highly contagious coronaviruses, including the SARS-CoV-2, on the central nervous system are: cerebral thrombosis and cerebral thromboembolism, damage to the neurovascular unit, neurodegeneration, including that induced by cytokines, and immune-mediated demyelinating nerve damage. CONCLUSION: Neurological and psychological/psychiatric aspects of COVID-19 should be taken into account both at the stage of disease treatment and in the post-infection period due to the pronounced neurotropism of SARS-CoV-2 and its effect on the neurovascular unit. Along with helping patients, an important aspect is the preservation of the mental health of medical personnel working in hospitals for infectious diseases, due to special working conditions and a high level of professional stress.

Delineating Health and Health System: Mechanistic Insights into Covid 19 Complications

This book discusses the organ-specific systemic manifestations of COVID-19. The initial chapters of the book review the origin and evolution of the coronaviruses, followed by pathogenesis and immune response during COVID-19 infection. The book also provides insight into the role of angiotensin-converting enzyme 2 in the onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesis. It summarizes the neurological aspects of SARS-CoV2, including transmission pathways, mechanisms of invasion into the nervous system, and mechanisms of neurological disease. It also delineates the association of severe disease with high blood plasma levels of inflammatory cytokines and inflammatory markers in SARS-CoV-2 infection. Lastly, it discusses the perturbation of gut microbiota by SARS-CoV-2 and uncovers the potential risk of virus infection on reproductive health. © The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.

Pharmaceutical prospects of Silymarin for the treatment of neurological patients: an updated insight.

Background: Silymarin is a polyphenolic flavonoid complex extricated from dried fruits and seeds of the plant Silybum marianum L. Chemically, it is a mixture of flavonolignan complexes consisting of silybin, isosilybin, silychristin, silydianin, a minor quantity of taxifolin, and other polyphenolic compounds, which possess different bio medicinal values. Purpose: This review critically looks into the current status, pharmaceutical prospects and limitations of the clinical application of Silymarin for treating neurological disorders. In particular, Silymarin's medicinal properties and molecular mechanisms are focused on providing a better-compiled understanding helpful in its neuro-pharmacological or therapeutic aspects. Methods: This review was compiled by the literature search done using three databases, i.e., PubMed (Medline), EMBASE and Science Direct, up to January 2023, using the keywords-Silymarin, neurological disorders, cognitive disorders, Type 2 Diabetes, pharmaceutical prospects and treatment. Then, potentially relevant publications and studies (matching the eligible criteria) were retrieved and selected to explain in this review using PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) study flow chart. Result: Since its discovery, it has been widely studied as a hepatoprotective drug for various liver disorders. However, in the last 10-15 years, several research studies have shown its putative neuroprotective nature against various brain disorders, including psychiatric, neurodegenerative, cognitive, metabolic and other neurological disorders. The main underlying neuroprotective mechanisms in preventing and curing such disorders are the antioxidant, anti-inflammatory, anti-apoptotic, pro-neurotrophic and pro-estrogenic nature of the bioactive molecules. Conclusion: This review provides a lucid summary of the well-studied neuroprotective effects of Silymarin, its underlying molecular mechanisms and current limitations for its usage during neurological disorders. Finally, we have suggested a future course of action for developing it as a novel herbal drug for the treatment of brain diseases.

Internet-based interventions for family carers of people with dementia

There is an urgent global need for accessible, usable, effective and scalable skills training and support programs for carers of people with dementia, particularly in LMICs. WHO's iSupport is filling this gap by providing such a program, accessible for translation and cultural adaptation worldwide. First steps have been undertaken to support the systematic and culturally fair translation and adaptation of the program in several countries. However, while web-based or online programs for dementia carers such as iSupport seem to be promising, the scaling of these programs remains challenging and is a common issue for digital health solutions. In fact, the findings of a first efficacy study from India highlight the need to understand carers' individual situation better and tailor support programs even more to their specific needs. Going forward, iSupport could be improved by adding a mobile phone application to offer more flexibility to users, including an interactive or moderated chat function or more audio-visual materials to the online program to increase its appeal. To assist carers who wish to use more traditional ways of learning, WHO has released the iSupport hardcopy manual, which presents the entire iSupport content in book format. Further robust cultural adaptations and high-quality research investigating the effectiveness of iSupport across different settings and for different groups of carers are required. Finally, in the context of the ongoing COVID-19 pandemic, digital support services such as iSupport are more important than ever and present a real opportunity to build back better, which will help to reach the global target set by WHO that 75% of countries will provide support and training programs for carers and families of people with dementia by 2025. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Cannabis: Global Histories ed. by Lucas Richert and James H. Mills (review)

Peter Hynd replicates verbatim the language of excise reports in British India to narrate the colonial state's apparently successful fiscal measures to lower cannabis sales and maximize revenue. Besides misnaming Hemchunder Kerr as Dutt and misidentifying the Garhjat in Orissa as Gujarat sixteen hundred kilometers west, Hynd concludes that the infrastructure of cannabis revenue extraction by an oppressive colonial force is that reasonable but rare occasion where "modern governments stand to learn a thing or two from the example set by the British Raj.” Behind the story of the GW Pharmaceuticals product Sativex, Suzanne Taylor uncovers years of lobbying by middle-class citizen groups like the Multiple Sclerosis Society in the 1990s that pushed for controlled medical research on cannabis and gave it a respectable face. [...]the editors' invitation to a renewed research agenda around this assessment, tediously termed "globalization without globalizers,” is constrained by their neglect of the teeming scholarly assessments and critiques of the category "global” and the framework "globalization.” More importantly, in 2022, even as emerging mass spectrometry research on cannabinoid non-psychoactive acids at the Linus Pauling Institute suggest their potential to successfully bind Covid-19 spike proteins against human epithelial cells, states in the Global South continue to face restrictions from global narcotics control institutions on scientific studies of cannabis.

Hearing Happiness: Deafness Cures in History by Jaipreet Virdi (review)

The book begins with bacterial meningitis, an infection the author contracted in early childhood that left her with "profound-to-severe" hearing loss (Virdi, 7). Not only do we see her as a scholar in the archive, requesting permission to try a Victorian ear trumpet, we also see her as a child with her d/Deaf classmates, being fitted for hearing aids "as we squirmed and giggled when the wet silicone mold was injected into our ears," and as an adult, experiencing difficulty switching from analog to digital hearing aids (258). When Virdi's first pair of behindthe-ear hearing aids make her six-year-old ears stick out, and her hair "tied in a long braid as per the Sikh tradition, did little to disguise them," it is the hearing aids, not the braid, that provoke "snickers, puzzled glances, and finger-pointing from younger children" (18).

A Bitter Experience That Enlightens the Future: COVID-19 Neurological Affection and Perspectives on the Orexigenic System.

The history of coronaviruses revealed that these viruses caused multiple outbreaks in the past, including a previous severe acute respiratory syndrome (SARS) outbreak in 2003. In 2019, a novel SARS virus, SARS-CoV-2, started a drastic pandemic that, up till now, keeps peaking in successive waves owing to the mutational ability of the virus versus the short-term immunity against it. Although the angiotensin-converting enzyme 2 (ACE2) is the gate through which the virus gets access to human cells, yet ACE2 is deemed protective in lung injury yielding vasodilator, anti-fibrotic, and anti-inflammatory peptides. The viral-provoked ACE2 downregulation aggravated a subsequent potentially lethal cytokine storm. Both the tumor necrosis factor-alpha (TNF-α) receptor (TNFR), activated by the proinflammatory cytokine, TNF-α, released during coronavirus disease 2019 (COVID-19), and ACE2 are cleaved by tumor necrosis convertase enzyme (TACE) to render respective soluble decoy mediators. Several risk factors were linked to COVID-19 morbidity and neurological affection, including obesity and diabetes mellitus (DM), attributed to ACE2 overexpression in obesity, a low-grade inflammatory state with both obesity and DM, and defective lung reparative machinery, added to low tissue-to-lung ACE2 expression in DM. The ACE2 shedding by SARS-CoV-2 upon its entry into the brain, together with the inflammatory cytokines invading the brain, predispose to such neurological affection. However, ACE2 was not sufficient to justify the occurrence of neurological disorders with COVID-19, owing to its lower brain expression, relative to other tissues. Other mediators should have contributed to such neurological disorders, of which, orexins (OXs) are discussed, owing to multiple functional similarities to ACE2. Eventually, this review highlights such similarities selected according to their possible relevance to COVID-19 symptomatology and pathology. Both ACE2 and OXs confer anti-inflammatory benefits, reduce cerebral endothelial dysfunction, promote neuronal survival and neurogenesis, and add to their therapeutic potentiality in sepsis. Both ACE2 and OXs assist in moderating the stress responses and the stress-activated hypothalamic-pituitary-adrenal axis. Both ACE2 and OXs are affected by obesity and DM. The loss of ACE2 and OXs signaling was suggested in neuro-inflammatory and neurodegenerative diseases. Of interest is the abundance of OXs in the dissemination routes to the brain, namely, the peripheral olfactory and the enteric systems. The presumptive role of OXs as analgesics and antipyretics might add to their favorable profile. Advantageously, the availability of OXs agonists and antagonists makes it applicable to corroborate or abrogate the future utility of targeting the orexigenic system in terms of COVID-19 neurological affection. Elaborative work, exploring in vitro and in vivo models, is recommended to identify or deny such perspective involvement.

Clinical presentation and rehabilitation outcomes in post-coronavirus disease-2019 vaccination longitudinal extensive transverse myelitis: Report of three cases with follow-up at 8 months

Longitudinally extensive transverse myelitis (LETM) is an infrequent subtype of acute transverse myelitis, which presents with sensory, motor and autonomic dysfunction after a focal or widespread inflammation of the spinal cord due to either direct infection or an autoimmune response. We present case reports of three females who developed LETM following COVID-19 vaccination. Their clinical presentation, deficits and rehabilitation outcome at discharge and at 8 months follow-up have been briefly described.

This work was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health under award number P50NS108676 and Moore Foundation

The increasingly remote workforce resulting from the global coronavirus pandemic has caused unprecedented cybersecurity concerns to organizations. Considerable evidence has shown that one-pass authentication fails to meet security needs when the workforce work from home. The recent advent of continuous authentication (CA) has shown the potential to solve this predicament. In this paper, we propose NF-Heart, a physiological-based CA system utilizing a ballistocardiogram (BCG). The key insight is that the BCG measures the body's micro-movements produced by the recoil force of the body in reaction to the cardiac ejection of blood, and we can infer cardiac biometrics from BCG signals. To measure BCG, we deploy a lightweight accelerometer on an office chair, turning the common chair into a smart continuous identity "scanner". We design multiple stages of signal processing to decompose and transform the distorted BCG signals so that the effects of motion artifacts and dynamic variations are eliminated. User-specific fiducial features are then extracted from the processed BCG signals for authentication. We conduct comprehensive experiments on 105 subjects in terms of verification accuracy, security, robustness, and long-term availability. The results demonstrate that NF-Heart achieves a mean balanced accuracy of 96.45% and a median equal error rate of 3.83% for CA. The proposed signal processing pipeline is effective in addressing various practical disturbances. © 2023 ACM.

[The neurology of COVID-19]. / La neurología de COVID-19.

The clinical manifestations of COVID-19 are reminiscent of those of acute respiratory distress syndrome induced by cytokine release syndrome and secondary hemophagocytic lymphohistiocytosis that is observed in patients with other coronaviruses such as SARS-CoV and MERS-CoV. Neurologists face the challenge of assessing patients with pre-existing neurological diseases who have contracted SARS-CoV-2, patients with COVID-19 who present neurological emergencies, and patients who are carriers of the virus and have developed secondary neurological complications, either during the course of the disease or after it. Some authors and recent literature reports suggest that the presence of neurological manifestations in patients who are carriers of SARS-CoV-2 may be associated with a greater severity of the disease.

Las manifestaciones clínicas de COVID-19 recuerdan las del síndrome de insuficiencia respiratoria aguda inducido por el síndrome de liberación de citocinas y la linfohistiocitosis hemofagocitica observada en pacientes con otros coronavirus como SARS-CoV y MERS-CoV. Los neurólogos tienen el reto de evaluar pacientes con enfermedades neurológicas preexistentes que contraen SARS-CoV-2, pacientes con COVID-19 que presentan emergencias neurológicas y pacientes portadores del virus que desarrollan complicaciones neurológicas secundarias, durante el curso de la enfermedad o posterior a la misma. Algunos autores y reportes en la literatura recientes sugieren que las manifestaciones neurológicas en pacientes portadores de SARS-CoV-2 pueden asociarse con mayor gravedad de la enfermedad.

Diagnostic challenges of functional neurological disorders after covid-19 disease or vaccination: case series and review of the literature.

BACKGROUND: Functional neurological disorders have rarely been described in patients recovering from Covid-19 or after vaccination but they are probably under diagnosed. MATERIAL AND METHODS: Six patients referred for rehabilitation of persistent symptoms and/or sequelae of Coronavirus disease 2019 (COVID-19) were diagnosed with functional neurological disorders. A literature review was conducted to identify reported cases of functional neurological disorders after Covid-19 infection or vaccination. RESULTS: In the current case series, patients diagnosed with functional neurological disorders presented high variability of clinical symptoms including hemiplegia, lower limb unilateral or bilateral paralysis, myoclonus, dystonia, tremor and sensory impairment. Four patients were young females with mild Covid-19 infection without hospital admission. Their neurological symptoms developed over the course of 4 weeks after the beginning of Covid-19 symptoms or vaccine administration with normal ancillary exams. One patient presented overlapping functional neurological symptoms and mild impairment of the left common peroneal nerve after prolonged ICU stay. In addition, all patients in our case series reported other non-motor symptoms such as fatigue, cognitive impairment and diffuse pain or dysesthesia, which are compatible with post Covid-19 condition. CONCLUSIONS: It is important that clinicians recognize functional neurological symptoms and consider it as a differential diagnosis in patients with neurological complications of Covid-19 infection and vaccination.

Living and dying well with dementia

Many people with intellectual disability, particularly those with Down syndrome, are at increased risk for Alzheimer's disease. Recent findings suggest that while onset may be at an earlier age and more rapid in early dementia stages, there is often a long late stage where decisions about end-of-life care and dying well must be supported. For the individual and caregivers, later stages of dementia can be complicated by lack of understanding and preparedness by both generic palliative care and intellectual disability services. The COVID-19 pandemic has posed significant challenges for staff and family, and many have struggled with moral distress as they feel forced to act in a manner contrary to their own care beliefs. Three case studies with reflective questions about caring for people with Down syndrome and dementia are offered, one from the COVID-19 period. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

2019-NCoV: What every neurologist should know?

The 2019 novel Corona Virus pandemic beginning from Wuhan, China primarily affects the respiratory tract but its has impacted clinical practice across a range of specialities including neurology. We review the bearing of the 2019 NCoV infection on neurological practice. Neurological manifestations are less common than respiratory manifestations, yet conspicuous, affecting nearly over a third of hospitalized individuals. These may be classified in to early – headache, dizziness, hyposmia and hypogeusia and late – encephalopathy. Rarely but surely, a very small proportion of infected individuals might present with stroke. Certain neurological conditions, including cerebrovascular disease in both China and Italy and dementia in Italy predispose to infection and more severe manifestations, requiring intensive care unit admission. There is no convincing evidence that the manifestations, course and outcome of various neurological disorders is impacted by 2019 nCoV infection. Concerns of an increased risk of febrile seizures offset by a reduced frequency of infection in the paediatric age group. Individuals with multiple sclerosis might potentially experience both true and pseudorelapses. Besides a direct effect, 2019 nCoV has tremendously affected neurological care by disrupting the continuity of care and the availability of neurological medicines worldwide. Neurologists should respond to this challenge by developing and sustaining innovative methods of providing care as well as alerting the society at large to adopt measures to contain the spread of 2019 nCoV.

Neurovirulence of SARS CoV2: From Clinical Data to Preclinical Neu-ropsychological Exploration

Introduction: COVID-19 pandemic represents a major health issue caused by SARS CoV2, a human coronavirus. Since the outbreak of this pandemic, the literature on SARS CoV-2 has grown differentially, with increased awareness of extra-respiratory symptoms, including neurological symptoms. Method(s): Review based on studies published from December 2019 to June 2020. Results and Discussion: This review discusses the neurological aspect of SARS CoV2, including the suggested mechanism involved. Neurological disorders are cited in addition to emerging experimental models with viral involvement. Conclusion(s): There is a need for further investigation to clarify how it can lead to the onset of acute and chronic neurological disorders, mentioning the importance of experimental studies in neuropsy-chopharmacology.Copyright © 2022 Bentham Science Publishers.

Lockdown life - experiences of partners of individuals with an acquired brain injury during the covid-19 pandemic: A qualitative study

Objectives: The present study sought to investigate the experience of individuals living with their partner with an acquired brain injury (ABI) during the first lock down period of the COVID-19 pandemic. Method: Semi-structured interviews were conducted with seven partners of individuals who had sustained a range of ABIs. Interviews were transcribed verbatim and thematic analysis was carried out by two of the researchers exploring the unique narratives. Results: ABI occurs within a relational framework, which means that it has repercussions not only for the individual but also the entire family system. COVID-19 prevented family systems (living separately) from coming together which negatively impacted them;however, it also slowed life down, with many people working from home with flexible arrangements in place which participants found to be beneficial. Three main themes emerged from the interview data: partner focus, slowing down and support networks. The narratives identified the struggles of having to continue their partner's rehabilitation when face to face services could not visit the home, the importance of establishing routine, the positives of a slower paced life (due to COVID-19) that enabled them to build stronger relationships with their partners, and the difficulties of being separated from family and loved ones. Conclusion: This research suggests that it is imperative to consider individual experiences and choices. Some families benefited from reduced treatment and a slowed pace of life, whilst others may find this overwhelming and burdensome. The study makes recommendations for supporting couples after an ABI during the ongoing pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Facing amyotrophic lateral sclerosis under lockdown: The experiences of minors

Purpose: The purpose of this study is to assess the effect of social isolation of minors with a parent or grandparent suffering from amyotrophic lateral sclerosis (ALS) and to determine whether the psychological support offered by an Italian no-profit association helped them to manage stress. Methodology: This study followed a qualitative research design. The participants responded to in-depth interviews that were processed with inductive thematic analysis. Findings: Five themes emerged: feedback on the psychological intervention;learning and changes after the intervention;discourses on illness and death in the family;experiences and difficulties during the lockdown and suggestions for other peers who might face the same situation. Social Implications: Psychological support is necessary for these minors, and it helped them to manage both the stress of living with ALS and the limitations of social relationships during the pandemic. It showed the importance of authentic and honest communication about illness and death that allowed minors to manage anxiety and fear. Positive reinterpretation of these experiences by transforming them into opportunities was also revealed. Originality: Studies on families with ALS patients are numerous, but studies on children of these patients are still rare, and no study has investigated the impact of the COVID-19 pandemic on these children. This research investigated a topic that has not been covered previously and it also provided the opportunity to know how these children, preadolescents and adolescents living in an already complex environment, have experienced lockdown and restrictions. The study also enriched the literature on this important issue. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Exploring the lived experience of patients with neurological disorders in pro bono physical therapy teaching & learning clinics: An interpretive phenomenological approach

The purpose of this dissertation was to investigate the lived experience of patients with neurological disorders in pro bono physical therapy teaching and learning clinics (PB-TLCs). It is important to understand the meaning of this experience since a growing number of physical therapy education programs utilize this type of clinic to meet their educational and accreditation needs. It would be unethical for physical therapy education programs to benefit from PB-TLCs should the patients not benefit from the care provided. Understanding the patients' lived experience will assist programs to better facilitate the benefits to the patients, as well as the benefits to the students, faculty, clinicians, and university. An interpretive phenomenological approach (IPA) was taken for this qualitative study. A total of 15 participants from 13 universities across the United States were included. The primary source of recruitment was the use of direct referrals from PB-TLCs. Interviews were transcribed by the primary investigator and analyzed using the 6-step process recommended by the IPA founders in Chapter 5 of Interpretive Phenomenological Analysis Theory, Method and Research. A total of seven superordinate themes were established: PB-TLCs 1) provide ongoing, quality physical therapy care;2) are a personal and emotional experience;3) provide physical and psychological benefits;4) are a teaching and learning environment;5) foster a symbiotic therapeutic relationship;6) were affected by COVID-19;and 7) are appreciated. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Using technology and telepractice to evaluate discourse after traumatic brain injury

Technology plays an increasing role in everyday communication. People regularly use technology in their daily lives for a range of spoken discourse tasks, including monologic discourse and conversational discourse. Written discourse is also commonly supported through technology as part of text messaging, email, and communication on social media. In addition to the increasing use of technology for communication in daily life, technology is also employed in the clinical assessment of discourse impairments after a traumatic brain injury (TBI). During the COVID-19 pandemic, clinicians embraced technology in serving people with TBI as traditional in-person clinical services presented hazards. Technology can also provide the means to collect data about discourse in different contexts, including phone conversations with different communication partners, video conferencing to capture conversations in the home environment, or virtual reality to evaluate discourse in a range of real-life situations, all without leaving the clinical setting. This chapter provides an overview of the use of telepractice in discourse assessment, implementation of technology to support the analysis of discourse, and future directions in evaluating discourse via the application of new and emerging technologies. (PsycInfo Database Record (c) 2023 APA, all rights reserved)