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Guy Horton posted an update 6 months, 2 weeks ago
Traumatic brain injuries (TBIs) are relatively common in the pediatric population, yielding several potential challenges across a wide range of skills and abilities. Cognitive-communication disorders are particularly prevalent, with implications for long-term academic and social outcomes. While considerable evidence exists for identifying and characterizing the effects of cognitive-communication deficits, evidence informing effective interventions is still emerging. This review includes discussion of individual factors that affect treatment needs and outcomes as well as evidence that supports cognitive-communication intervention approaches at both a fundamental/discrete and integrated level. Also addressed is the need for modifying contextual factors that may be barriers as well as augmenting facilitators of successful communication and participation, including collaboration with everyday communication partners and identification and use of appropriate accommodations. Overall, research suggests a growing trend toward interventions that are individualized, dynamic, and combine multiple approaches for cognitive-communication treatment after pediatric TBI. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.The subtle cognitive-communication challenges experienced by students with traumatic brain injury (TBI) are often missed, leaving these students with unmet needs in the school environment and increasing the likelihood for negative social, academic, and vocational outcomes. For children and adolescents with TBI, nonstandardized assessment offers several advantages over standardized assessment procedures, and may improve speech-language pathologists’ ability to identify students who might benefit from intervention services. This article discusses curriculum-based assessment and discourse analysis specifically and uses case studies to demonstrate how these procedures can be used within the school environment. Nonstandardized assessment procedures are a valuable tool to measure a student’s cognitive-communication abilities and the effects of intervention in real-world contexts. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Attention to pediatric traumatic brain injury (TBI) has grown in recent years, likely due to the increased awareness of mild TBI (mTBI) in contact sports. With this increased attention, along with an increased diagnosis of injury, more students with TBI need services, especially as they return to the classroom environment and progress through school. Support of students with TBI of all severities requires an interdisciplinary team with the school-based speech-language pathologist playing a critical role. The purpose of this tutorial is to provide a clinically focused summary of the complexities that exist for students with TBI of all severities and practical steps that can be implemented in clinical practice to enhance service provision for students with TBI. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Social communication impairments are common following pediatric traumatic brain injury (TBI) and can lead to social isolation, and poor social outcomes. Social communication has been documented as a persistent area of need in terms of proper assessment and intervention; however, this is not consistently addressed in clinical practice. While there is a body of evidence regarding social communication impairments and pediatric TBI, this area is not yet fully understood and remains underrecognized. To meet this gap, we provide a conceptual framework of social communication from a neurodevelopmental perspective, which can be applied to better understand the social communication impairments associated with pediatric TBI. We propose a general model of social communication with component constructs and consideration of internal factors such as sex and gender. These can inform considerations, clinical applications, and future research in assessment and evidence-based interventions within the domain of social communication. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.To review the evidence available on early childhood (i.e., 0-5 years 11 months) traumatic brain injury (TBI) and identify clinical implications and future directions for speech-language pathology (SLP) practice and research, a scoping review of the literature was conducted following the 2018 Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRSIMA-ScR) guidelines. A total of 44 peer-reviewed articles were included for review. Included studies were assigned one or more of the following thematic labels related to early childhood TBI etiology, assessment, treatment, outcomes, contributing factors. Most of the studies were nonexperimental studies and addressed outcomes following early childhood TBI. We conclude, based on this scoping review, that children who experience a TBI before 6 years of age are at risk for persistent long-term difficulties in academic and social functioning. SLPs are among the group of clinicians most appropriate to assess and treat these children; yet, the evidence for assessment, treatment, and identification of factors contributing to the recovery of young children with TBI is particularly lacking. Rigorous research is needed to improve the evidence base for SLPs. Selleck A-83-01 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Intestinal cells control delivery of lipids to the body by adsorption, storage and secretion. Copper (Cu) is an important trace element and has been shown to modulate lipid metabolism. Mutation of the liver Cu exporter ATP7B is the cause of Wilson disease and is associated with Cu accumulation in different tissues. To determine the relationship of Cu and lipid homeostasis in intestinal cells, a CRISPR/Cas9 knockout of ATP7B (KO) was introduced in Caco-2 cells. KO cells showed increased sensitivity to Cu, elevated intracellular Cu storage, and induction of genes regulating oxidative stress. Chylomicron structural protein ApoB48 was significantly downregulated in KO cells by Cu. Apolipoproteins ApoA1, ApoC3 and ApoE were constitutively induced by loss of ATP7B. Formation of small sized lipid droplets (LDs) was enhanced by Cu, whereas large sized LDs were reduced. Cu reduced triglyceride (TG) storage and secretion. Exposure of KO cells to oleic acid (OA) resulted in enhanced TG storage. The findings suggest that Cu represses intestinal TG lipogenesis, while loss of ATP7B results in OA-induced TG storage.
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