Morphologic agrammatism following a right hemisphere stroke in a dextral patient.

There is evidence of two major components of grammatic function in the brain: (1) morphologic, probably based in the postcentral perisylvian cortex, encompassing the selection of individual words and inflectional endings according to the rules of grammar; and (2) syntactic, probably based in the frontal lobes, encompassing construction of the overall structure of a sentence (syntax) to match the concept being considered. We present a stroke patient with impaired morphology but, unlike Broca's aphasics, relative sparing of syntax. He omitted 43% of articles, 40% of complementizers, 20% of pronouns, 27% of semantically marked prepositions, 43% of purely grammatic prepositions, and 22% of auxiliary verbs, but his average sentence length was 9.8 words and 64% of his sentences contained embedded clauses. He frequently intermingled two sentences to convey a given concept, juxtaposing words in grammatically unacceptable ways. This intermingling may represent either a grammatic "conduite d'approche," or a failure of the filtering function of a defective morphologic processor. His great difficulty in completing syntactic frames suggests that a more general form of the processes underlying grammatic morphology may play an important role in phrase structure generation.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Risk and Protective Factors for Comorbid Posttraumatic Stress Disorder among Homeless Individuals in Treatment for Substance-Related Problems

Homeless individuals undergoing treatment for substance use disorders (SUD) can pose clinical challenges. Posttraumatic stress disorder (PTSD) symptoms have been observed in the most difficult clients. The study sample consisted of 51 homeless individuals, 9 women and 42 men, undergoing consultation for SUD in Montreal. The mean age was 46 years (SD = 7.19). Of the sample, 49% had a potential PTSD diagnosis. Most participants had the following characteristics: an alcoholic parent, a history of an early trauma, and little social support. The participants with a potential PTSD diagnosis were significantly more likely to have had an alcoholic parent, to have experienced an early trauma, and to use more maladaptive coping strategies. The study results and limits are discussed.     

Psychometric Evaluation of the Rage Outbursts and Anger Rating Scale in an Outpatient Psychiatric Sample

The primary objective of this study was to examine the psychometric properties of a measure of anger/rage attacks—the Rage Outburst and Anger Rating Scale (ROARS)—in a sample of youth (n = 81, ages 7–17 years, 72.8 % male) receiving treatment at an outpatient pediatric psychiatric clinic. A trained rater completed the ROARS and Clinical Global Impression-Rage (CGI-Rage). Children completed the Spence Children’s Anxiety Scale for Children and Center for Epidemiological Studies Depression Scale. Parents completed the Spence Children’s Anxiety Scale for Parents. Internal consistency (α = .89), inter-rater reliability (κ = .94) and 1-week test–retest reliability (r = .72) were calculated for the ROARS. The ROARS was correlated with CGI-Rage (r = .68, ρ < .001), although not with parent- and child-rated anxiety symptoms or with child-rated depressive symptoms. Implications regarding clinical utility of the ROARS and directions for future research are discussed.     

Magnitude of force perception errors during static contractions of the knee extensors in healthy young and elderly individuals

The accuracy of force perception during muscular contraction has not been studied extensively, despite its importance in rehabilitation and training. The purpose of this study was to quantify the errors made by healthy young and elderly individuals in their perceptions of force produced at the knee. Four different tasks were used to evaluate the perception of force and the effect of a sensory-motor reference and simultaneous contraction on the accuracy of perception. The absolute errors were similar between groups, with values of 11.9% to 16.3%, depending on the task. The raw perception errors were greater for high levels of force (>50% of the maximal voluntary contraction, or MVC), indicating an overestimation of the forces produced for both groups. At 70% MVC, the sensory-motor reference reduced raw perception errors, and the simultaneous contraction improved the accuracy of force production. Healthy young and elderly individuals had about the same capacity to judge the muscular force of their knee extensors. Therapists involved in the training of active?elderly?individuals should be aware that the accuracy of force perception is not perfect and that these clients have the same ability as young individuals to perceive their knee extension strength.     

Quality of Life in Patients with Recurrent Vasovagal or Unexplained Syncope: Influence of Sex, Syncope Type and Illness Representations

Health-related quality of life (QoL) is reduced in patients with recurrent vasovagal (VVS) or unexplained (US) syncope. Little is known regarding these patients’ QoL as pertains to their capacity to attain their life goals. Factors influencing QoL, such as sex, syncope type and illness representations have not been studied. Our objective is to examine the relationship between illness representations and QoL, as well as possible sex and syncope type differences. One hundred and four patients undergoing tilt-table testing (TTT) for recurrent syncope were interviewed one month before TTT, using questionnaires. Data were analysed using ANCOVAs, a-priori Helmert contrasts for illness representations, and regressions. Patients with US had a poor QoL compared to those with VVS [F(1, 91) = 10.46; p < 0.01], particularly in men (p < 0.01). Patients with higher perceived syncope severity showed an impoverished QoL relative to those with less severe perceptions [F(1, 91) = 5.47; p < 0.05]. A hierarchical regression revealed that illness representations mediate the impact of lifetime number of syncope on QoL. In conclusion, QoL is reduced in these patients, and is influenced by illness representations. Helping patients change their perceptions about their syncope may be an efficient way to promote QoL.     

Visuo-haptic integration in object identification using novel objects

Although some studies have shown that haptic and visual identification seem to rely on similar processes, few studies have directly compared the two. We investigated haptic and visual object identification by asking participants to learn to recognize (Experiments 1, and 3), or to match (Experiment 2) novel objects that varied only in shape. Participants explored objects haptically, visually, or bimodally, and were then asked to identify objects haptically and/or visually. We demonstrated that patterns of identification errors were similar across identification modality, independently of learning and testing condition, suggesting that the haptic and visual representations in memory were similar. We also demonstrated that identification performance depended on both learning and testing conditions: visual identification surpassed haptic identification only when participants explored the objects visually or bimodally. When participants explored the objects haptically, haptic and visual identification were equivalent. Interestingly, when participants were simultaneously presented with two objects (one was presented haptically, and one was presented visually), object similarity only influenced performance when participants were asked to indicate whether the two objects were the same, or when participants had learned about the objects visually—without any haptic input. The results suggest that haptic and visual object representations rely on similar processes, that they may be shared, and that visual processing may not always lead to the best performance.     

Perception of weight-bearing distribution during sit-to-stand task in healthy young and elderly individuals

The first objective was to assess whether healthy individuals could accurately estimate their weight-bearing distribution in sit-to-stand transfers. The second was to evaluate the effect of age on weight-bearing perception. 16 young participants (11 women, 5 men; M age 29 yr., SD = 8.7) and 15 elderly participants (7 women, 8 men; M age 65 yr., SD = 3.8) were recruited. Verbal instructions and visual feedback referring to different percentages of weight-bearing distribution to execute were used to quantify weight-bearing perception in sit-to-stand tasks. For the feedback approach, the perception was assessed with a visual analog scale. For the verbal task, the weight-bearing distribution produced was assessed with force plates. Both young and elderly participants had good perception of weight-bearing distribution, with mean absolute errors of 6.4%. Moreover, their perceived and real weight-bearing distribution showed good agreement (ICC > or = .79).