Self-efficacy and resilience in severe aphasia - an exploratory cross-sectional study of two psychosocial factors and their relation to functional communication.

PURPOSE: Self-efficacy and resilience are important for various aspects of rehabilitation outcome after stroke. However, little is known about how these factors are affected and related to communication outcome in stroke survivors with aphasia. The purpose was to investigate self-efficacy and resilience, and associations to language and functional communication, in people with severe post-stroke aphasia. MATERIALS AND METHODS: 37 participants with severe aphasia rated their self-efficacy and resilience, using adapted versions of the existing instruments DLSES and CD-RISC. In addition, linguistic ability, executive function and functional communication were assessed. RESULTS: Participants rated their self-efficacy and resilience as expected based on reports in the literature; somewhat lower than general populations and at similar levels as clinical populations. There were no association between self-efficacy, resilience and linguistic ability. In the sample as a whole, there were no associations between self-efficacy, resilience and functional communication. However, when results were stratified by executive function, associations emerged in the group with stronger executive function. CONCLUSIONS: People with severe aphasia have decreased self-efficacy and resilience compared to general populations, but not necessarily in proportion to their language impairment. Among participants with relatively spared executive functions there were indications of an association between self-efficacy, resilience and functional communication.

The constructs self-efficacy and resilience are related to several outcomes after stroke.Self-efficacy and resilience can be assessed in many people with severe aphasia, provided that materials and administration procedure are adequately adapted.There are indications of an association between functional communication and self-efficacy and resilience.Integrating activities to increase self-efficacy and resilience in aphasia rehabilitation may be beneficial to treatment outcomes regarding functional communication.

Understanding and overcoming obstacles in adaptive management.

Adaptive management (AM) is widely promoted to improve management of natural resources, yet its implementation is challenging. We show that obstacles to the implementation of AM are related not only to the AM process per se but also to external factors such as ecosystem properties and governance systems. To overcome obstacles, there is a need to build capacities within the AM process by ensuring adequate resources, management tools, collaboration, and learning. Additionally, building capacities in the legal and institutional frames can enable the necessary flexibility in the governance system. Furthermore, in systems experiencing profound changes in wildlife populations, building such capacities may be even more critical as more flexibility will be needed to cope with increased uncertainty and changed environmental conditions.

Evaluation of Nutritional Quality and Sensory Parameters of Meat from Mallard and Four Species of Wild Goose.

Future challenges concerning protein supply for food and feed include the management of all currently available resources. In Sweden, wildfowl are hunted for several reasons, one of which is to protect growing crops. In this study, meat from wild geese and mallard was evaluated with respect to its quality and sensory parameters. The most pronounced sensory differences were between meat from the barnacle goose and the Canada goose and between meat from mallards that were farmed and born wild. This study also provides measurements of values for the nutritional and heavy metal contents of the meat from these wildfowl species in order to elucidate their possible use as modern foods.

Leapfrog migration and residents: New migratory habits in Swedish Greylag geese.

Knowledge about intraspecific and individual variation in bird migration behavior is important to predict spatiotemporal distribution, patterns of phenology, breeding success, and interactions with the surrounding environment (e.g., human livelihoods). Such variation is key to adaptive, evolutionary responses, i.e., how individuals respond spatiotemporally to the environment to maximize fitness. In this study we used GPS location data from one to three full annual cycles from 76 Greylag geese (Anser anser) to test the hypothesis that geese originating at five latitudinally separated capture sites in Sweden have different migration strategies. We also assessed individual consistency in movement strategy over consecutive annual cycles. We used the scale-independent net squared displacement modeling framework to quantify variables of autumn and spring migration for geese from each capture site: distance, timing, and duration. Our results demonstrate a positive correlation between migration distance and latitudinal origin. Geese from the northernmost site on average migrated farther south and about 15 times as far as the short-moving or resident geese from the two southernmost sites. Movement strategies of individual geese varied considerably both within and among capture sites. Individual consistency in movement strategy from one annual cycle to the consecutive was high in geese from the northern sites moving the farthest, whereas the resident or short-moving geese from the southernmost sites generally showed lower or no individual consistency. These changes have come about during a time span so short (i.e., ca. 35 years or 8-10 generations) that it can unlikely be explained by classical Darwinian between-generation adaptation. Consequently, and given that young geese follow their parents during their first migration, we presume an important role of within-family, inter-generation change as a driver behind the large-scale changed migration habits in Swedish Greylag geese.

What do people respond to when rating executive function? - a cognitive interviewing investigation of BRIEF-A informant ratings in severe aphasia.

PURPOSE: Executive dysfunction is common in persons with severe aphasia. Assessing these functions in this population is challenging. Informant ratings, such as the BRIEF-A, might be a useful alternative to neuropsychological tests. However, research has shown weak relationships between tests and ratings. The aim of this study was to understand how significant others of people with severe aphasia interpret and respond to questions about executive function in the informant report version of BRIEF-A. METHODS: Eleven significant others were interviewed about a subset of the BRIEF-A items, using cognitive interviewing. Interviews were subjected to thematic analysis. RESULTS: There was variation in the interpretation of the items of BRIEF-A which frequently corrupted the items' relation to what it was intended to measure. Further, informants wavered between considering the person with aphasias' ability or actual performance and many had lowered their expectations. The language problems caused by the aphasia affected the validity of some items. CONCLUSIONS: The quantitative results of BRIEF-A informant ratings should be interpreted with caution, since it is unclear to what extent the responses represent executive function. The use of informant ratings does not solve the problem with aphasia being a confounding factor in assessment of executive function.IMPLICATIONS FOR REHABILITATIONAssessing executive function in people with severe aphasia is important but challenging.Quantitative results of informant ratings of executive function, such as BRIEF-A, in this population should be interpreted with caution, since it is unclear to what extent the ratings represent executive function.Using informant ratings does not solve the problem of the aphasia being a confounding factor, since the aphasia impacts on the validity of some of the items.

Measuring executive function in people with severe aphasia: Comparing neuropsychological tests and informant ratings.

BACKGROUND: Knowledge about patients' executive function is important in the rehabilitation of language and communication in stroke patients with aphasia. Due to linguistic demands, most neuropsychological tests are unsuitable for this population, and it might seem appealing to use informant report of executive function as a substitute. OBJECTIVE: To investigate the relationships between scores on a neuropsychological test and informant ratings of executive function, as well as between the informant ratings and the functional communication ability, in people with severe aphasia after stroke. METHODS: Thirty-eight people with severe aphasia and their significant others participated. Executive function was tested with parts of the neuropsychological screening instrument CLQT and rated by significant others (informants) using BRIEF-A. Functional communication was assessed with a standardised test and rated by significant others. RESULTS: Results revealed few correlations between CLQT and BRIEF-A. There was no correlation between informant ratings on BRIEF-A and scores on the measures of functional communication. CONCLUSIONS: Informant ratings of executive function do not measure the same construct as, and cannot be used as a substitute for, standardised neuropsychological tests. Informant ratings of executive function do not seem to provide information that is relevant to the understanding of functional communication in people with severe aphasia.

Safety climate and readiness for implementation of evidence and person centered practice - A national study of registered nurses in general surgical care at Swedish university hospitals.

BACKGROUND: The rationale behind this study is the increasing research on relationships between patient safety, evidence based practice and person centered care, and the growing interest in outcomes of surgical patients. The aim of this study was to explore the safety climate and readiness to implement evidence-based and person centered care as perceived by registered nurses in Swedish surgical care. METHODS: The design was an exploratory, cross-sectional survey carried out in a national Swedish context. Data were collected through the Safety Attitudes Questionnaire (SAQ - Short form) and the Context Assessment Index (CAI). RESULTS: In total, 1570 questionnaires were distributed, of which 727 were returned, giving a response rate of 46.3 %. The results revealed that in general, the safety climate in Swedish surgical care is positively related to readiness for evidence-based and person centered care, although specific management and cultural factors may be more sensitive and represent targets for improvement. CONCLUSION: This study presents new knowledge regarding the safety climate and readiness to implement evidence based practice and person centered care in general surgical wards in university hospitals and indicates important associations between these two areas. While RNs generally reported positive job satisfaction and a good team work culture in their units, there were indications that improvements in organizational management are needed.

Effects of amylopectin structure and molecular weight on microstructural and rheological properties of mixed beta-lactoglobulin gels.

Nongelling amylopectin fractions from potato and barley have been used to form mixed beta-lactoglobulin gels. The amylopectin fractions were produced by varying the time of alpha-amylase hydrolysis followed by sequential ethanol precipitation. The molecular weights, radius of gyration, chain length distribution, and viscosity of the fractions were established. The mixed gels were analyzed rheologically with dynamic mechanical analysis in shear and microstructurally with light microscopy, transmission electron microscopy, and nuclear magnetic resonance spectroscopy. The result of the gel studies clearly showed that small differences in the molecular weight of amylopectins have a significant influence on the kinetics of protein aggregation and thereby on the gel microstructure and the rheological behavior of the gel. Both an increase in the molecular weight and a higher concentration of amylopectins resulted in a more open protein network structure, with thicker strands of larger and more close-packed beta-lactoglobulin clusters, which showed a larger storage modulus. The transmission electron micrographs revealed that degraded amylopectins were enclosed inside the protein clusters in the mixed gels, whereas nondegraded amylopectin was only found outside the protein clusters. The volume-weighted mean value of the molecular weight of the amylopectins was found to vary between 3.2 x 10(4) and 5.0 x 10(7) Da and the ratio of gyration between 14 and 61 nm. The maximum in chain length distribution was generally somewhat distributed toward longer chain lengths for potato compared to barley, but the differences in chain length distribution were minor compared to those seen in the molecular weight and ratio of gyration between the fractions.