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Background: Endovascular clot retrieval (ECR) is known to reduce global disability at 3 months post stroke however limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits between onset and 3 months. Aims: To assess language, swallowing, and cognitive performance following ECR and explore whether impairment severity is correlated with modified Thrombolysis in Cerebral Infarction score (mTICI), stroke severity or quality of life (QoL). Methods: Assessment was completed within 7 days (T1), 1 month (T2) and 3 months (T3) post‐stroke. Performance was measured with the Functional Oral Intake Scale (FOIS), Repeatable Battery for Assessment of Neuropsychological Status (RBANS), Trail Making Test (TMT A and B) and Brixton Spatial Awareness Test. The Western Aphasia Battery (WAB) was used for left hemisphere stroke. QoL was measured with the Stroke and Aphasia Quality of Life Scale. Results: Twenty‐five participants (median 72 years; 64% male) were prospectively recruited following ECR. High reperfusion success (68% mTICI 3) and low stroke severity post ECR (median 24 h NIHSS = 3, IQR 7–18) were noted. At T1, 10 participants presented with aphasia, eight required a modified diet and 20 had impaired cognition. At T3 all had recovered to a normal oral diet, 39% had persistent cognitive impairment and 45% of patients with left hemisphere stroke remained aphasic. Performance on the WAB, FOIS, RBANS and TMT changed significantly over time (all p < 0.05). The severity score at T1 for all measures, excluding TMT B and Brixton, was significantly correlated with 24 h NIHSS. WAB scores at T3 were correlated with QoL (r = 0.618; p = 0.043). Conclusion: This exploratory study found the longitudinal performance of language, swallowing and cognition significantly improved over time and severity in the first‐week post‐ECR was correlated with 24 h NIHSS rather than the degree of reperfusion. WHAT THIS PAPER ADDS: What is already known on the subject: Randomised control trials have demonstrated the benefit of ECR in patients with ischemic stroke using global measures of disability and function. Limited research exists regarding the trajectory of specific clinical impairments including language, swallowing and cognitive deficits. There is also a reliance on screening assessments and a lack of consideration of the influence of co‐occurring impairments. What this paper adds to existing knowledge: This prospective study is amongst the first to explore the longitudinal trajectory of language, swallowing and cognitive impairment using a standardised assessment battery. Twenty‐four‐hour NIHSS was significantly correlated with language, swallowing, global cognition and some measures of executive function. Language performance post ECR was correlated with domain‐specific cognitive assessment of attention, immediate memory and delayed memory, which differed from swallowing performance post ECR that correlated with measures of executive function. What are the potential or actual clinical implications of this work?: It is important for speech‐language pathologists and the wider medical team to monitor language, swallowing and cognitive performance post ECR regardless of treatment success. Stroke severity at 24 h post‐ECR influences the severity of language, swallowing and cognitive impairments. [ABSTRACT FROM AUTHOR]

As a leading cause of death and disability worldwide, how to effectively manage and prevent stroke is a key consideration for health care systems. Throughout the world stroke management recommendations include education; however, not all patients receive this intervention. Advances in technology have provided health professionals with a range of innovative, effective, and modern tools that may be useful in delivering stroke education. This study aimed to systematically review the current evidence for the use of interactive technology in stroke patient education, and whether this was effective for increasing patients' stroke knowledge and behaviours that lower stroke risk. The protocol was registered with PROSPERO (#225223) and a literature search undertaken in Embase (including MEDLINE and PubMed), PsycInfo and CINAHL from inception until August 2022. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the included articles. From an initial yield of 760 articles, 10 articles met the study inclusion criteria. The articles explored a range of interactive technologies, with none of them includes articles using the same technology. All of the articles reported at least one positive effect from the technology. Two articles reported on stroke incidence post-intervention. The methodological quality of the articles varied, but was largely medium to high. The paucity of evidence highlights a need for future studies to provide insights into the benefits of quality interactive technology-based stroke education and to identify options for optimal delivery modes in stroke education. The explosion and rapid growth of technology in all aspects of everyday life means that people with stroke are more connected to technology than ever before. There is limited research into the effects of interactive technology in stroke education, in particular whether the education reduces the risks of subsequent strokes or improves patient understanding of stroke. There is an urgent need for further research to explore whether one technology or combination of technologies is optimal in enhancing stroke education. [ABSTRACT FROM AUTHOR]

Most aphasia research is published in international, peer-reviewed journals in a format that is inaccessible for people with aphasia (PWA). Video presents an ideal format for disseminating information to PWA in an accessible digital format. No research has explored the preferred format for aphasia research videos from the perspectives of PWA. To explore the format preferences of PWA for aphasia-accessible research videos. The study involved three stages; all used a semi-structured focus group design. Stage 1 (n = 16 PWA) developed the topic guide. PWA shared opinions about which questions they considered important for Stage 2 interview questions. Stage 2 gathered the votes of PWA (n=40) using these questions. Stage 3 (n = 6 PWA) reviewed the voting results of Stage 2 and collected opinions from PWA about an example video that adhered to the identified preferences. Data analysis for all stages used descriptive statistics (e.g., counts) and qualitative content analysis. We identified 11 consumer-informed preferences for aphasia-accessible research videos: 1-Speak with normal rate; 2-Tailor video duration to content: 5-10 minutes was most acceptable; 3-Include researcher photos; 4-Use written keywords; 5-Use a mix of images; 6-Include a PWA; 7-No preference for deciding topic; 8-Avoid background music; 9-Provide a summary at the end; 10-Translate into other languages; and 11-Link to resources. These preferences should guide the development of aphasia-accessible research videos, assisting researchers to bridge the evidence-knowledge gap in the aphasia community. Further research is required, including with non-English participants and family members of PWA. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests that people with minor stroke experience persisting post‐stroke impairments across a range of domains. Our primary aim was to determine whether a new multicomponent intervention for people with minor stroke reduced unmet needs at 1 and 3 months post-hospital discharge compared with usual care. Secondary aims explored the efficacy of the intervention on functional outcomes, health-related quality of life, return to work and social group membership. Methods: A parallel, randomised controlled trial design with 1:1 allocation to the intervention and control groups (n = 34 per group) was used. The intervention group received a multicomponent intervention (comprising information about minor stroke, checklist and group education sessions). The control group received usual care. Participants completed assessments at baseline (T1), 1 month (T2) and 3 months (T3) post-hospital discharge. The primary outcome measure was unmet need according to the Survey of Unmet Needs and Service Usage. Results: The intervention did not significantly reduce unmet need (P = 0.839); however, the control group reported a significant need for existing support to continue (P = 0.032). Participation in the intervention led to significant improvements in emotional wellbeing compared to the control group (P = 0.041). There was no difference between the groups according to social participation, health-related quality of life, return to work or social group membership (all P > 0.05). Usage of the three intervention components was lower than anticipated. Conclusions: A suite of mixed format, evidence-based education and support tools did not fully meet the unmet needs of minor stroke survivors during their transition from hospital. Further research is required to refine the intervention. Clinical trial registration: Prospectively registered – Australian New Zealand Clinical Trials Registry (ACTRN12619000133134p). Despite the name, people with minor stroke can experience debilitating long‐term consequences post‐stroke that impact on multiple areas of everyday life. Our study found that a new multicomponent treatment can improve wellbeing in people with a minor stroke but did not fully meet all their unmet needs. Further research is required; however, the new treatment has the potential to provide a service pathway for people with minor stroke that could be used by other health services. [ABSTRACT FROM AUTHOR]

Background: Cognitive rehabilitation of people with traumatic brain injury is a complex and challenging area of practice. Practitioners working in cognitive rehabilitation require ongoing training to stay abreast of new research and best practice interventions. A needs analysis was conducted to inform the development of a capacity building program for cognitive rehabilitation providers. Methods: A cross-sectional online survey of providers of cognitive rehabilitation services in Queensland collected data on demographic information, perceptions of knowledge, skills and confidence in cognitive rehabilitation, previously completed training, desired training opportunities and delivery methods, and barriers and facilitators to engaging in training. Results: The 103 respondents included 67 occupational therapists, 17 speech pathologists, 12 psychologists and seven social workers with a broad range of practice experience. Participants perceived a need for further training, with executive function and functional cognition the most desired topics. The number of topics previously trained on was significantly correlated with levels of knowledge, skills and confidence (P < 0.01). Barriers to training were time and affordability, and facilitators included flexibility, workplace support, positive practitioner mindset and targeted content. Conclusion: Cognitive rehabilitation providers in Queensland reported a need for further training, delivered flexibly, with a focus on managing complex cognitive impairments. A needs analysis of 103 providers of cognitive rehabilitation services to people with brain injury in Queensland indicated a need for further training in this complex area of practice. Respondents perceived a need for further training on the management of complex impairments such as in executive function, self-awareness and functional cognition. There was a preference for flexible delivery of training with support from the workplace to overcome barriers associated with time constraints and affordability. [ABSTRACT FROM AUTHOR]

Dysphagia is a well-documented sequela of stroke. Recent advancements in medical treatments for stroke include reperfusion therapies (endovascular thrombectomy (EVT) and thrombolysis). As outcomes following reperfusion therapies are typically measured via general functional scales, the pattern and progression of acute dysphagia following reperfusion therapies is less known. To determine the progression of acute dysphagia (0–72 h) following reperfusion therapies and relationships between various stroke parameters and dysphagia, twenty-six patients were prospectively recruited across two EVT and thrombolysis centres in Brisbane, Australia. Dysphagia was screened via the Gugging Swallowing Screen (GUSS) at the bedside at three timepoints: 0–24 h, 24–48 h, and 48–72 h post-reperfusion therapies. Across three groups (EVT only, thrombolysis only, or both), the incidence of any dysphagia within the first 24 h of reperfusion therapy was 92.31% (n = 24/26), 91.30% (n = 21/23) by 48 h, and 90.91% (n = 20/22) by 72 h. Fifteen patients presented with severe dysphagia at 0–24 h, 10 at 24–48 h, and 10 at 48–72 h. Whilst dysphagia was not significantly correlated to infarct penumbra/core size, dysphagia severity was significantly related to the number of passes required during EVT (p = 0.009).Dysphagia continues to persist in the acute stroke population despite recent advancements in technology aimed to reduce morbidity and mortality post-stroke. Further research is required to establish protocols for management of dysphagia post-reperfusion therapies. [ABSTRACT FROM AUTHOR]

Individuals with non-traumatic subarachnoid haemorrhage (SAH) are often excluded from studies of stroke populations due to differing pathophysiology and treatment pathways. Thus, aphasia presentation in the non-traumatic SAH population is potentially under-represented within existing research evidence. Five databases were systematically searched with terms related to "aphasia" and "subarachnoid haemorrhage." Studies were included if aphasia was attributed to non-traumatic SAH or its associated complications, and where at least one language assessment measure used determined the presence or absence of aphasia. Study quality was evaluated using the Mixed Methods Appraisal Tool (MMAT). Following deduplication, 2726 articles were identified for title and abstract screening. Full text screening for 162 articles occurred, with 18 articles selected for inclusion. Aphasia incidence ranged from 5 to 24%, and was influenced by assessment measure, timing of assessment, subgroup studied, and classifications of aphasia. Many studies excluded participants with poorer clinical outcome, intracerebral complications, or severe aphasia. Few studies used comprehensive language assessment measures to examine across language domains. Aphasia presentation is highly heterogenous following non-traumatic SAH. Future research using comprehensive language assessments at multiple time points post onset is required to better understand aphasia presentation and management needs for this population. Aphasia screening and/or assessment should be routinely performed for all individuals following non-traumatic subarachnoid haemorrhage (SAH). Comprehensive assessment across all language domains is required to ascertain the nature and extent of aphasia. Co-occurring cognitive deficits are likely in the SAH population. [ABSTRACT FROM AUTHOR]

To investigate speech-language pathologists' (SLPs) perceptions and clinical experiences of dysphagia management following reperfusion therapies. A multi-staged mixed approach involving a two-phase cross-sectional design was used. Data generated during phase 1 (a purpose-built, online survey) guided the development of phase 2 (semi-structured interviews). Sixty-two SLPs participated in phase 1 and six SLPs participated in phase 2. SLPs in both phases reported perceived changes in dysphagia presentation according to the success of reperfusion therapy administered and had concerns regarding worsened dysphagia following unsuccessful procedures. Fluctuations in dysphagia were more frequently reported in the acute stage post-stroke. SLPs reported increased workload demands due to increased interhospital transfers between ECR/thrombolysis centres and referring facilities. The optimal timing for swallowing screening and assessment was not identified, with initial SLP involvement ranging from during the administration of thrombolysis to up to 24 hours post-reperfusion therapy. Preliminary evidence suggests that SLPs perceive that the presentation of post-stroke dysphagia is changing, with increasing fluctuations and complexities in the acute stage of post-stroke care, within the context of increasing use of reperfusion therapies. There is a critical need for research investigating the trajectory of dysphagia in the acute stage to inform dysphagia management within this patient population. [ABSTRACT FROM AUTHOR]

Outcome measurement is recommended in stroke clinical practice guidelines, however there is considerable variability in how this activity is performed in clinical practice. Factors driving clinician behaviour have been explored in English-speaking countries, but little is known about the factors influencing clinical practice in non-English-speaking populations. (1) To explore barriers and facilitators to aphasia outcome measurement from the perspective of international aphasia clinicians. (2) To determine whether barriers and facilitators to outcome measurement differ in English- and non-English- speaking countries. The primary hypothesis was that clinicians working with people with aphasia in non-English-speaking countries would experience more barriers to outcome measurement than those in English-speaking countries. An international sample of aphasia clinicians completed an online survey informed by the Theoretical Domains Framework. Quantitative data were analysed using descriptive statistics and a Mann-Whitney U Test to compare English- and non-English- speaking groups. TDF domains identified as influencing clinician behaviour were mapped to the Behaviour Change Wheel, producing theory-informed strategies to improve practice. A total of 208 clinicians from 25 countries completed the survey. Almost all (93.7%) reported measuring outcomes to some extent, most commonly to measure client progress. Facilitators to outcome measurement included "social/professional role and identity" (understanding that measuring outcomes is part of the clinicians' role), "optimism" (feeling positive about measuring outcomes), and "emotion" (enjoying, and feeling comfortable measuring outcomes). Barriers were "environmental context and resources" (time and resource limitations, and competing caseload priorities), "behavioural regulation" (a lack of personal and workplace systems to measure outcomes) and "skills" (having insufficient training and experience in outcome measurement). There was no significant difference between the barriers and facilitators experienced by clinicians in English- and non-English- speaking countries. Implementation strategies, informed by Behaviour Change Techniques, were created to improve clinical practice. Internationally, clinicians working with people with aphasia measure outcomes and believe that this is part of their role, and a positive aspect of their work. Common barriers to outcome measurement included insufficient time and access to resources, inadequate personal and workplace systems, and insufficient skills necessary for performing outcome measurement. Preliminary, theory-informed strategies (e.g., improving access to culturally and linguistically appropriate measurement instruments; developing protocols, templates or checklists guided by recommended practice; and providing training in outcome measurement) would assist with uptake of clinical practice guidelines in this area. [ABSTRACT FROM AUTHOR]

Mixed martial arts (MMA) is a sport growing in popularity around the world. However, many individuals participate in the sport with little understanding of the potential short- and long-term consequences of injuries sustained while participating. Specifically, individuals are placed at a high risk of minor traumatic brain injury (mTBI) and concussive episodes as a result of head injuries incurred during training and competition. The current review aimed to examine the literature surrounding the occurrence and outcomes of mTBI in MMA athletes to gain a better understanding of these consequences. Twenty-five studies were identified within the current review, of which 14 examined occurrence of mTBI within the sport setting, and elevenidentified outcomes of injury. Overall, studies found that MMA athletes experienced mTBI and concussion to a greater extent than athletes in other sports. Deficits in memory, reaction time and processing speed were identified following occurrence of mTBI; however, several gaps in outcome measurement were identified within the current literature, including a lack of focus on speech and language outcomes. Future research should examine a wider variety of outcomes to provide a clearer understanding of the consequences of participating in the sport. [ABSTRACT FROM AUTHOR]

Purpose: Esophageal screening is a valuable inclusion in videofluoroscopic swallowing studies (VFSSs). However, routine standardized esophageal screening does not always occur in clinical practice. This study introduced and evaluated an esophageal screening protocol at one Australian hospital. Method: Radiology, gastroenterology, and speech-language pathology endorsed an esophageal screening protocol, which followed a timed 20-ml International Dysphagia Diet Standardisation Initiative Level 0 bolus from mouth to stomach in an upright anterior-posterior position. Measures exploring clinical impacts and barriers were recorded. Participants were compared with 100 consecutive VFSS patients prior to the introduction of the esophageal screening protocol. Results: During the esophageal screening protocol trial, 163 VFSSs were conducted with recruited patients. Aspiration risk (29%, n = 47/163) and positioning limitation (3%, n = 5/163) were barriers to esophageal screening. Rates of esophageal screening significantly increased with the esophageal screening protocol (χ² = 63.462, p < .001). There was no difference in radiation dose for patients who had esophageal screening and those who did not in the esophageal screening protocol group (U = 1689.000, p = .237). The VFSS team breached the esophageal screening protocol for some patients, when evaluating esophageal transit time (n = 28) and recommending gastroenterology referral (n = 6). There was no difference between groups for rates of gastroenterology consults (χ² = 1.805, p = .188) or dysphagia procedures (χ² = 1.951, p = .209). Conclusions: This study confirms that routine esophageal screening provides additional clinical information to assist holistic dysphagia management without adverse operational impacts. Further research with the multidisciplinary dysphagia team has commenced to continue to optimize and refine esophageal screening practice. [ABSTRACT FROM AUTHOR]

Background: Stroke education is a key factor in minimising secondary stroke risk, yet worldwide stroke education rates are low. Technology has the potential to increase stroke education accessibility. One technology that could be beneficial is augmented reality (AR). We developed and trialled a stroke education lesson using an AR application with stroke patients and significant others. Methods: A feasibility study design was used. Following development of the AR stroke education lesson, 19 people with stroke and three significant others trialled the lesson then completed a customised mixed method questionnaire. The lesson involved narrated audio while participants interacted with a model brain via a tablet. Information about participant recruitment and retention, usage, and perceptions were collected. Results: Fifty-eight percent (n = 22) of eligible individuals consented to participate. Once recruited, 100% of participants (n = 22) were retained. Ninety percent of participants used the lesson once. Most participants used the application independently (81.82%, n = 18), had positive views about the lesson (over 80% across items including enjoyment, usefulness and perception of the application as a good learning tool) and reported improved confidence in stroke knowledge (72.73%, n = 16). Confidence in stroke knowledge post-lesson was associated with comfort using the application (p = 0.046, Fisher's exact test) and perception of the application as a good learning tool (p = 0.009, Fisher's exact test). Conclusions: Technology-enhanced instruction in the form of AR is feasible for educating patients and significant others about stroke. Further research following refinement of the lesson is required. [ABSTRACT FROM AUTHOR]

There is building evidence that oesophageal screening (OS) should be considered a critical component of videofluoroscopic swallow studies (VFSS). This study surveyed Australian speech-language pathologists (SLPs) regarding current practices and perceptions of OS in VFSS. A 16–24 item online survey was distributed to Australian SLPs via relevant email forums. One response per site was requested. Survey questions explored experience and training in VFSS, skill and confidence with OS, OS protocol use, and pathways following OS. One hundred and one SLPs across all Australian states and territories responded, with 70% (n = 69/99) from metropolitan hospitals and 74% (n = 75/101) having more than five years' VFSS experience. While 69% (n = 70/101) of SLPs conducted OS, only half (n = 35/70) conducted OS routinely, and only 4% (n = 3/70) always used published OS protocols. Barriers to OS, for some participants, were concerns about scope of practice and confidence. This study confirms higher levels of OS in Australia compared to similar international surveys and provides rich data on the Australian context. Prescriptive clinical guidelines for OS, consensus regarding a preferred OS protocol, and specific OS training may clarify SLP scope of practice and improve SLP confidence and standardisation in OS. [ABSTRACT FROM AUTHOR]

Background: A number of practice barriers (e.g., time constraints, patient comorbidities and competing demands) exist as regards the evidence‐based assessment of adult language within the acute hospital setting. There is need for an evidence‐based, diagnostically validated, adaptable, comprehensive and efficient aphasia assessment. The Brisbane Evidence Based Language Test (EBLT) was developed to meet this need for a clinically appropriate and diagnostically robust assessment measure. Since the release of the EBLT, there has been no detailed investigation into speech and language therapists' (SLT) use and perceptions of the assessment. To inform future research and improvements to the EBLT, a better understanding of current language assessment practices, use and thoughts on the EBLT are required. Aims: To investigate SLTs' current language assessment practices; and to explore the current usage and future directions of the Brisbane EBLT. Methods & Procedures: A convergent parallel mixed‐methods study design with an electronic survey was utilized. The survey consisted of 16 multiple‐choice, multiple‐answer and free‐text questions that explored respondents' perceptions of current language assessment measures, ideal language assessment features, Brisbane EBLT use, positives and negatives, and future directions for the EBLT. The survey was developed on Qualtrics and disseminated via email, social media and professional networks. Snowball sampling was used. Study inclusion criteria required participants to be qualified SLTs with clinical experience working with patients with aphasia. Quantitative data were analysed via descriptive and correlative statistics, and qualitative data were analysed via content analysis. Outcomes & Results: The survey was completed by 115 SLTs from Australia, New Zealand, the United States, the UK, Canada, France, Lebanon and Belgium. Many respondents identified that a range of assessments is required to meet SLT clinical needs in the assessment of aphasia. Key desirable assessment features reported were: comprehensive, efficient, evidence‐based, responsive and flexible. The EBLT was the most frequently used standardized measure reported by respondents (used by 78.63%). The EBLT reportedly has many positive features; however, respondents indicated dislike of the form layout, scoring and responsiveness. The majority of respondents indicated that the development of additional EBLT tests (94.29%) and additional cut‐off scores (95.15%) would benefit their clinical practice. Conclusions & Implications: The study findings indicate that SLT assessment of language is complex and multifaceted. While the EBLT is reportedly used widely by SLTs, respondents identified areas for further research which would optimize the test's usability within their practice, to ultimately improve patient outcomes. WHAT THIS PAPER ADDS: What is already known on the subject: Previous studies have explored existing SLT adult language assessment practices within acute settings; however, the most recent comprehensive study was completed in 2010. In 2020, the development, diagnostic validation, intra‐ and interrater reliability of the Brisbane EBLT were published. As of yet there has not been an investigation into clinician use and perspectives of the assessment since its release. What this paper adds to existing knowledge: This study provides contemporary data about international aphasia assessment practices, as well as descriptive and qualitative information on the current use of the Brisbane EBLT, and the positives, negatives, and future directions for the assessment measure. What are the potential or actual clinical implications of this work?: The study suggests that no one language assessment currently satisfies all SLTs' assessment needs. It additionally implies that a large proportion of SLTs believe that it is best practice to use multiple language assessment measures and select these based on the patient's presentation and context. Further research is required to aid the development of additional EBLT test versions and cut‐off scores to improve SLT adult language assessment practices. [ABSTRACT FROM AUTHOR]

Introduction: The focus on medical management and secondary prevention following Transient Ischemic Attack (TIA) and minor stroke is well-established. Evidence is emerging that people with TIA and minor stroke can experience lasting impairments as fatigue, depression, anxiety, cognitive impairment, and communication difficulties. These impairments are often underrecognized and inconsistently treated. Research in this area is developing rapidly and an updated systematic review is required to evaluate new evidence as it emerges. This living systematic review aims to describe the prevalence of lasting impairments and how they affect the lives of people with TIA and minor stroke. Furthermore, we will explore whether there are differences in impairments experienced by people with TIA compared to minor stroke. Methods: Systematic searches of PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Libraries will be undertaken. The protocol will follow the Cochrane living systematic review guideline with an update annually. A team of interdisciplinary reviewers will independently screen search results, identify relevant studies based on the defined criteria, conduct quality assessments, and extract data. This systematic review will include quantitative studies on people with TIA and/or minor stroke that report on outcomes in relation to fatigue, cognitive and communication impairments, depression, anxiety, quality of life, return to work/education, or social participation. Where possible, findings will be grouped for TIA and minor stroke and collated according to the time that follow-up occurred (short-term < 3 months, medium-term 3-12 months, and long-term > 12 months). Sub-group analysis on TIA and minor stroke will be performed based on results from the included studies. Data from individual studies will be pooled to perform meta-analysis where possible. Reporting will follow the Preferred Reporting Items for Systematic review and Meta-Analysis Protocol (PRISMA-P) guideline. Perspectives: This living systematic review will collate the latest knowledge on lasting impairments and how these affect the lives of people with TIA and minor stroke. It will seek to guide and support future research on impairments emphasizing distinctions between TIA and minor stroke. Finally, this evidence will allow healthcare professionals to improve follow-up care for people with TIA and minor stroke by supporting them to identify and address lasting impairments. [ABSTRACT FROM AUTHOR]

The Rio do Peixe Basin is part of a series of aborted Cretaceous rifts formed within the Proterozoic Borborema Province, onshore NE Brazil in response to rifting between Africa and South America. The basin is remarkably well‐imaged and comprises fault‐bounded depocentres, the main ones being the NE‐oriented Brejo das Freiras and the E–W‐oriented Sousa half‐grabens. These grabens and their bounding faults are influenced by Neoproterozoic basement shear zones and present a complex framework of secondary normal faults and folds. Recent workers also interpret large reverse faults and regional post‐rift shortening driven by far‐field stresses from the Andes. For those reasons, the basin represents an ideal setting to investigate the multiphase history of rift basins. We thus combine borehole‐calibrated 2D and 3D seismic and magnetic data with section restoration and numerical modelling to investigate the architecture and evolution of this basin. We aim to understand: (i) the controls of the basement fabric in 3D fault architecture and kinematics and (ii) how syn‐rift faults controlled the geometry and development of fault‐related folds. By doing this, we also investigate the timing, kinematics, and magnitude of inversion in the basin to explore its multiphase history. We demonstrate that (i) the basement fabric controlled not only the strike of faults but also their geometry and polarity at depth, (ii) folds in the syn‐rift sequence are attributed simply to syn‐rift extension along stepped and/or curved faults, and (iii) inverted and/or reverse faults occur within the basin, but these are minor and appear to have formed during rifting. We explain this minor inversion by a change in plate kinematics related to the onset of the nearby transform margin to the north. These results have implications for understanding the 3D evolution of oblique grabens, the role of structural inheritance, and the recognition of inversion‐ versus extension‐related folds in rift basins worldwide. [ABSTRACT FROM AUTHOR]

Oropharyngeal dysphagia is common post-stroke and can have serious consequences for patients. Understanding dysphagia recovery is critically important to inform prognostication and support patients and professionals with care planning. This systematic review was undertaken to identify clinical predictors of dysphagia recovery post-stroke. Online databases (EMBASE, Scopus, Web of Science, PubMed, CINAHL, and Cochrane) were searched for studies reporting longitudinal swallowing recovery in adults post-stroke. Dysphagia recovery was defined as improvement measured on a clinical swallowing scale or upgrade in oral and/or enteral feeding status by the end of the follow-up period. The search strategy returned 6598 studies from which 87 studies went through full-text screening, and 19 studies were included that met the eligibility criteria. Age, airway compromise identified on instrumental assessment, dysphagia severity, bilateral lesions, and stroke severity were identified as predictors of persistent dysphagia and negative recovery in multiple logistic regression analysis. The available literature was predominated by retrospective data, and comparison of outcomes was limited by methodological differences across the studies in terms of the choice of assessment, measure of recovery, and period of follow-up. Future prospective research is warranted with increased representation of haemorrhagic strokes and uniform use of standardized scales of swallowing function. [ABSTRACT FROM AUTHOR]

Despite evidence that stroke education is important and effective, low rates of stroke education are reported worldwide. Many stroke survivors and carers report that current stroke information does not meet their needs. The aim of the current study was to explore the perceptions of stroke survivors and carers towards stroke education in an Australian health context. A qualitative descriptive approach using focus groups was used to explore education received and preferred content, format and timing of education. Data were analysed inductively using qualitative content analysis to identify key categories, sub‐categories and an overarching theme. Fifteen stroke survivors and four carers participated. Four categories emerged: the timing of stroke education, the content of stroke education, the format of stroke education, and reactions to stroke education. Each category contained a number of sub‐categories. One overarching theme was woven through the transcripts: everyone is different and has different needs. Overall, participants generally expressed positive attitudes towards stroke education. Participants reported that education should occur at multiple timepoints and in a mixed format. All participants reported receiving stroke education in hospital, but not in the community. Stroke survivors preferred group education, while carers did not share this preference. Both stroke survivors and carers desired information about post‐stroke physical changes and computer use; however, stroke survivors desired additional information spanning a variety of areas such as motivation and driving. Tailoring of stroke education for each individual is critical to ensure that education meets the needs of stroke survivors and carers from the hospital to the community. [ABSTRACT FROM AUTHOR]

An evidence-based intervention and service delivery model for early acquired brain injury reading comprehension rehabilitation (involving multiple-strategy, hierarchical reading) was investigated with 3 clients <3 m post onset as part of their brain injury rehabilitation program. A multiple-baseline single case experimental design was used for each participant, with data analysed using Tau-U. Assessments of reading comprehension (impairment and activity level) were performed pre/post intervention, and at follow-up (3–6 months post-treatment). Participants' perceptions of the intervention and service delivery model were captured via semi-structured interviews. All participants demonstrated improved reading comprehension post-intervention on all formal measures. At follow-up, reading comprehension was grossly maintained by 2 participants. The single case experimental design results (Tau-U) showed moderate-large intervention effect sizes for factual and inferential reading comprehension, two participants had significant (p = 0.01) changes. Participants reported overall positive experiences with the intervention. The intervention and service delivery model were successfully implemented in clinical practice, and preliminary results show the intervention has clinical promise with an early acquired brain injury population. Cognitive communication reading comprehension deficits occur following acquired brain injury and impact participation during rehabilitation and in the community. An evidence-based intervention for the early rehabilitation of cognitive communication reading comprehension deficits following acquired brain injury has been developed and trialled in clinical practice with adults <3 months post-acquired brain injury, via a series of single-case experimental designs. Improvements in reading comprehension skill and activity/participation occurred for all participants post-intervention; statistically significant changes occurred for 2 of 3 clients. Early rehabilitation of cognitive communication reading comprehension deficits can be successfully implemented as a component of a multidisciplinary rehabilitation program. [ABSTRACT FROM AUTHOR]

To date, little research has explored clinical assessment practices in the management of dysarthria. The aim of the present study was to explore the practices and perspectives of Australian speech-language pathologists (SLPs) regarding outcome measures (OMs) in the management of dysarthria, including barriers and enablers to their use. A focus group methodology was used to explore the practices and perspectives of 16 SLPs working with adults with dysarthria. The 4 focus groups were transcribed and analysed using qualitative content analysis with barriers and enablers to the use of OMs analysed according to the Theoretical Domains Framework. Seven categories were identified regarding SLPs' practices and perspectives on the use of OMs in dysarthria management. These were related to the importance of assessments, OMs currently and not currently being utilised, ideal assessment features, perspectives on the development of a core set of OMs in dysarthria management, and perceived enablers and barriers to the use of OMs. Each category had a number of constituent subcategories. Overarching the categories was the theme: the who, why, when, where, what and how of dysarthria outcome measurement. The use of OMs in dysarthria is influenced by a range of factors including: the clinical setting, patient factors, and where and when the patient is in their recovery journey. Variability in the assessments used suggests that formal measures may not meet current clinical needs. [ABSTRACT FROM AUTHOR]

Dysphagia (impaired swallowing) is known to contribute to decreased quality of life, and increased length of hospital stay and mortality post‐stroke. Despite the advancements in stroke treatment with the introduction of thrombolysis and endovascular clot retrieval (ECR), patients continue to present with high rates of dysphagia. Speech and language therapists and stroke teams should consider the presence of haemorrhagic transformation, success of reperfusion and presence of communication deficits as risk factors for dysphagia post‐ECR and/or thrombolysis. Purpose: To establish incidence rates and patterns of dysphagia following the administration of reperfusion therapies in acute ischaemic stroke management. Method: A retrospective review of 193 patients admitted with acute ischaemic stroke to a quaternary stroke unit in Australia over a three year period was completed. Clinical information extracted included demographics, type (thrombolysis and/or endovascular clot retrieval) and success of reperfusion therapy, and the progression of dysphagia and related factors. Results: Over half of all patients treated with reperfusion therapies presented with dysphagia on initial assessment by speech‐language pathology (SLP). The type of reperfusion therapy administered was not significantly correlated with the presence of dysphagia. Dysphagia on initial assessment was significantly correlated with the presence of aphasia on initial assessment, the presence of haemorrhagic transformation, and the success of reperfusion. Increased rates of enteral feeding were also found in this study compared to figures reported in literature. Conclusion: This study identified ongoing high rates of dysphagia amongst this patient population regardless of treatment type, demonstrating the need for ongoing SLP management post stroke. Further research is required in this area to develop an evidence‐base for SLPs and the wider medical team and to inform clinical practice guidelines. What this paper adds: What is already known on the subject: Stroke is one of the leading causes of disability and death internationally. Dysphagia (impaired swallowing), a common sequalae of stroke, is known to contribute to decreased quality of life, increased length of hospital stay and mortality. With advancements in technology, treatments for acute ischaemic stroke (endovascular clot retrieval and thrombolysis) are increasing in popularity. However, limited research exists exploring the impact of these therapies on dysphagia. What this paper adds: Despite the advancements in stroke treatment, patients continue to present with high rates of dysphagia. Dysphagia following thrombolysis and/or ECR was found to be significantly correlated to the presence of aphasia, haemorrhagic transformation, and the success of reperfusion (regardless of treatment type). Additionally, increased rates of enteral feeding were found amongst this patient population compared to figures reported in the literature for patients following traditional stroke management. Clinical implications of this study: Speech‐language pathologists and the wider medical team should consider dysphagia as an ongoing consequence of stroke following reperfusion therapies, with consideration for success of reperfusion and adverse outcomes i.e., haemorrhagic transformation. Further research is required to provide an evidence‐base and specific guidelines for the management of dysphagia post reperfusion therapies, including use of enteral feeding. [ABSTRACT FROM AUTHOR]

Subsurface salt flow can deform overlying strata and influence contemporaneous sedimentary systems. Studying salt‐sediment interactions is challenging in the subsurface due to poor imaging adjacent to salt, and in the field due to the dissolution of halite. Discrete Element Modelling provides an efficient and inexpensive tool to model stratigraphy and deformation around salt structures, which is advantageous over other modelling techniques as it realistically recreates brittle processes such as faulting. Six 2D experiments were run representing 4.6 Myr to determine the effect of salt growth on syn‐kinematic stratigraphy. Halokinetic deformation of stratigraphic architecture was assessed by varying sediment input rates through time. Results show the realistic formation and evolution of salt‐related faults which define a zone of halokinetic influence ca. 3 times the width of the initial diapir. Outside of this, early diapiric and syn‐kinematic stratigraphy are undeformed. Within this zone, syn‐kinematic strata are initially isolated into primary salt withdrawal basins, onlapping and thinning towards the salt‐cored high. In most models, syn‐kinematic strata eventually thin across and cover the diapir roof. Thinning rates are up to six times greater within 350 m of the diapir, compared to further afield, and typically decrease upwards (with time) and laterally (with distance) from the diapir. Outputs are compared to a subsurface example from the Pierce field, UK North Sea, which highlights the importance of considering local fluctuations in diapir rise rate. These can create stratigraphic architectures that may erroneously be interpreted to represent increases/decreases in sedimentation rate. Exposed examples, such as the Bakio diapir, northern Spain, can be used to make inferences of the expected depositional facies, below model resolution. Our models aid the prediction of sedimentary unit thickness and thinning rates and can be used to test interpretations arising from incomplete or low‐resolution subsurface and outcrop data when building geological models for subsurface energy. [ABSTRACT FROM AUTHOR]

Background: Parental acquired communication disability has long-lasting impacts on children, including increased child stress and behavioural problems. However, speech-language pathologists' (SLPs) current practice in providing information, education and counselling support to these children is unknown. Therefore, we explored SLPs' perceived needs, current practices and barriers and facilitators to working with children of people with acquired communication disability (PwCD). Methods: An online survey sought information on Australian SLPs' current practices in providing education and counselling to children of PwCD. Perceived barriers and facilitators were mapped to the COM-B, a model that considers Capability, Opportunity and Motivation as domains that influence behaviour. Results: 75% of participants (n = 76) perceived a need to provide both information and counselling, but 'never' or 'rarely' provided either aspect of care. Barriers relating to 'Opportunity' were most frequently identified, such as not having access to children in therapy and lack of parental support/engagement. Capability (e.g., knowledge and skills) and Motivation (e.g., confidence) barriers were also identified. Conclusions: There is potential for SLPs to provide services to children of PwCD either directly through information and/or counselling-type interactions or indirectly through referral to other services. This study highlights the need for more research into these areas of practice. [ABSTRACT FROM AUTHOR]

Introduction: Providing evidence-based services in areas with emerging or low-level evidence is a challenge for many clinicians. The aim of the current study was to apply a newly designed novel methodology to develop and describe a new intervention for cognitive-communication reading comprehension deficits in early acquired brain injury rehabilitation. Methods: An emergent multi-phase mixed methods design allowed phases of different research activity to build an evidence base of quantitative and qualitative data. A pragmatic clinical framework was developed to combine these traditional research findings with principles from knowledge translation and implementation science, evidence-based practice and intervention development models, clinical contextual practice guidelines and the Medical Research Council's guidelines for developing and evaluating complex interventions, to create an evidence-based contextually driven clinical intervention. Results: The resulting reading comprehension intervention and service delivery model is presented and involves a multiple-strategy intervention across increasing level of reading comprehension complexity. In areas where traditional methodologies provide low-level evidence, this method provides an alternate way to conduct evidence-based clinical research. [ABSTRACT FROM AUTHOR]

To explore how people with minor stroke make sense of the stroke in the first weeks following hospital discharge to home. A qualitative descriptive approach using semi-structured interviews with 17 participants with minor stroke at approximately 2 weeks post-hospital discharge was used to explore their experiences of the early stage of recovery. Interview transcripts were analysed using qualitative content analysis. Three main themes were derived from the analysis 1) Reconciling personal reactions, 2) Emotional introspection after the stroke, and 3) Navigating the social side of stroke. Although participants had different experiences of minor stroke, there were common elements. The first weeks post-hospital discharge were a time of questioning and reconciling the stroke for many participants. Adjusting to post-stroke impairments and the impact of these on social participation was also prominent. There is a critical need for education about what to expect prior to discharge from hospital with minor stroke and a designated discharge pathway to avoid the development of secondary post-stroke issues in the community. People with minor stroke may experience ongoing post-stroke disabilities following discharge home. The transition period is characterised by questioning and reconciling what has happened by people with minor stroke. Information about what to expect prior to discharge from hospital for people with minor stroke and their families is essential. There is a critical need for a designated discharge pathway with follow up for people with minor stroke and their families. [ABSTRACT FROM AUTHOR]

Background: Prioritized research agendas are viewed internationally as an important method for ensuring that health research meets actual areas of clinical need. There is growing evidence for speech–language therapy‐prioritized research agendas, particularly in disorder‐specific areas. However, there are few general research priority agendas to guide speech–language therapy research. Aims: To collaboratively develop a prioritized research agenda for an Australian public health context with clinical speech–language therapists (SLTs), academic SLTs and consumers of speech–language therapy services. Methods & Procedures: An initial stimulus list of potential research areas for prioritization was collected from SLTs via an online survey. Two categories (service delivery and expanded scope of practice) were selected from this list for prioritization due to their relevance across multiple health services. The Nominal Group Technique (NGT) was used to develop a prioritized research agenda for each of the two categories. One NGT session was conducted with each of the three participant groups (clinical SLTs, academic SLTs, consumers) for each category (total NGT sessions = six). The prioritization data for each group within each category were summed to give a single, ranked prioritized research agenda for each category. Outcomes & Results: Two prioritized research agendas were developed. Within each agenda, SLTs and consumers prioritized a need for more research in areas related to specific practice areas (e.g., Alternative and Augmentative Communication, Communication Partner Training), as well as broader professional issues (e.g., telehealth, working with culturally and linguistically diverse families). Conclusions & Implications: The current findings support the need for funding proposals and targeted projects that address these identified areas of need. What this paper adds: What is already known on this subject: Evidence‐based practice is a critical component of SLT practice. There is often a disconnect between the research evidence generated and areas of clinical need, and in some areas a lack of evidence. Prioritized research agendas can help drive research in areas of clinical need. What this paper adds to existing knowledge: A collaborative, prioritized SLT research agenda was developed using the NGT according to the views of clinical SLTs, academic SLTs and consumers of speech–language therapy services in a conglomerate of public health services. SLTs and consumers identified a need for further research in specific areas of SLT practice as well as broader emerging professional issues What are the potential or actual clinical implications of this work?: Targeted research projects funded on a large scale are required to address these identified areas of need. Other health services around the world could replicate this prioritization process to drive research in areas of clinical need [ABSTRACT FROM AUTHOR]

Background: Despite evidence that Communication Partner Training (CPT) can enable health professionals to communicate more effectively with people with aphasia (PWA), an evidence–practice gap exists. To address this, a tailored implementation intervention was developed and trialled to improve health professionals' implementation of communication strategies in a subacute setting. Aims: To explore the outcomes and perceived feasibility, acceptability and potential effectiveness of an iterative CPT implementation intervention on multidisciplinary healthcare professionals' communication with PWA. Methods & Procedures: The CPT implementation intervention was delivered to two groups of healthcare professionals (n = 6 and 7) approximately 6 months apart. The intervention underwent two iterations targeting emerging barriers to implementation success, with Group 2 receiving a modified version of the Group 1 intervention. A concurrent qualitative process evaluation was conducted to understand key factors determining implementation outcomes. Quantitative outcomes were recorded at baseline and 3‐month follow‐up, including the Measure of Skill in Supported Communication (MSC), a customized behavioural determinants survey mapped to the Theoretical Domains Framework (TDF) and the Organizational Readiness for Change survey. Focus groups and semi‐structured interviews were conducted with health professional participants and the speech–language therapist trainer to explore perceptions of feasibility, acceptability and potential effectiveness. Content analysis was used to analyse the qualitative data, with categories and themes generated. Outcomes & Results: The Group 2 implementation intervention was adapted based on feedback and reflections from Group 1 participants to incorporate more time for practice interactions and discussion during training, individual follow‐up sessions and provision of accessible resources to aid communication attempts. There were greater improvements seen in the Group 2 outcomes on both the MSC and the TDF survey, suggesting that the iterative tailoring of the intervention was successful in addressing the barriers to change and led to improved implementation. The difference between the group's outcomes may also partly be explained by the impact of organizational readiness, which decreased during Group 1's implementation period. Despite similar themes emerging from the stakeholder perspectives in both groups (training factors, implementation facilitators, implementation barriers, and changes in knowledge and practice), these diverted in ways which served to explain the different implementation outcomes. Conclusions & Implications: An iteratively adapted CPT implementation intervention targeting healthcare professionals' use of supported communication strategies was feasible and acceptable for most participants. The implementation intervention was potentially effective in changing participants' communication with PWA, particularly for Group 2. Future CPT implementation efforts should continue to incorporate stakeholder input and tailor strategies to the organizational context, and measure whether outcomes are sustained in the long term. What this paper addsWhat is already known on the subjectCPT is a complex intervention that can improve communication access and outcomes for PWA. However, there are barriers to both delivering CPT programmes to staff, and for staff in modifying their communication behaviours. Despite increasing efforts to improve CPT implementation, it remains largely unclear whether CPT implementation interventions are effective in improving interactions between staff and patients, and what elements of an implementation intervention result in changed behaviour.What this study adds to existing knowledgeThis study showed that adopting an iterative, barriers‐focused approach to implementation facilitated practice change for one of the groups that participated in the programme. Incorporating stakeholder feedback in an ongoing way led to improvements in feasibility, acceptability and potential effectiveness, with several of the main barriers being effectively addressed by the intervention. Some key mechanisms of change were identified.What are the potential or actual clinical implications of this workIt is necessary to develop active, targeted implementation strategies to support healthcare professionals to modify their communication, monitor implementation barriers as they arise and modify behaviour‐change strategies accordingly. In a similar context, it is suggested that CPT implementation interventions should incorporate the use of audit feedback, physical resources and educational lectures paired with interactions with PWA in order to bring about change, with ongoing support and facilitation. [ABSTRACT FROM AUTHOR]

Background: Patients with severe stroke frequently present with substantial impairments but are often not prioritised for post-discharge rehabilitation. There is a need to determine where these patients are discharged to in order to facilitate appropriate allocation of post-discharge pathway resources. Aim: The present study aimed to describe the discharge pathways of patients with severe stroke and to identify predictors of discharge destination for these patients. Method: A descriptive, retrospective design was utilised to determine the discharge destination for 770 patients with severe stroke in Queensland, Australia. Binomial logistic regression was used to determine the variables that predicted discharge destination. Results: The results indicated that 58.44% of patients were discharged home (n = 450). Age, length of stay, discharge ward and geographical region emerged as significant predictors of discharge destination. The full model containing all predictors was statistically significant and, as a whole, explained 36.50% of the variance in discharge destination. Conclusion: These results highlight the importance of these variables in influencing the outcomes of patients with severe stroke, which may assist post-hospital discharge services in allocating resources for patients with severe stroke. [ABSTRACT FROM AUTHOR]

Aim: To identify management practices of Australian speech-language pathologists (SLPs) in the treatment of non-progressive dysarthria using a subsystem approach, and to explore SLPs' consideration and implementation of the theoretical underpinnings of non-progressive dysarthria management. Method: A 39-item online survey was distributed to Australian SLPs, with 80 responses suitable for data analysis. Results: Practices of SLPs were variable for the management of the speech subsystems. The Lee Silverman Voice Treatment (LSVT®) was the most commonly used manualised treatment program, and was employed by 63.77% of respondents. Almost all SLPs (>88%) provided strategies to improve functional communication. There was no clear preference for low tech alternative and augmentative communication (AAC) devices. Speech generating devices were the most commonly employed high tech device. Almost two-thirds of respondents used non-speech oral motor exercises (NSOMEs) in treatment. SLPs had varied frequencies and models of service delivery for intervention. SLPs valued interventions targeting the activity and participation domains of the ICF, however this was restricted by the treatment context and resources available. The majority of SLPs (92.06%) were aware of the principles of motor learning, however many were unsure regarding the specifics of implementation. Conclusion: There is a clear need for further research into the efficacy of treatment techniques to guide decision-making. [ABSTRACT FROM AUTHOR]

Background: Whilst dysphagia is a commonly reported complication of stroke, it has received relatively little attention in the literature for patients following non‐traumatic subarachnoid haemorrhage (SAH). Aims: To investigate dysphagia incidence, risk factors, clinical progression and recovery in patients following non‐traumatic SAH. Methods & Procedures: A prospective cohort study of 49 patients admitted to a tertiary neurosurgical referral unit with non‐traumatic SAH over a 12‐month period was conducted. Swallowing function was assessed by a speech–language pathologist within 72 h of medical stability and monitored throughout the acute inpatient admission. Outcomes & Results: Dysphagia incidence was 16.33% (n = 8/49). Risk factors associated with dysphagia included; Glasgow Coma Scale (GCS) score on admission, need for intensive care unit (ICU) admission, length of ICU stay, need for intubation and ventilation, and hydrocephalus. Participants with dysphagia were admitted to hospital 1.9 times longer than those without dysphagia (p < 0.05) and were more likely to be transferred to another inpatient facility for ongoing care (p < 0.05). Dysphagia remained present at hospital discharge for over half (62.5%) of participants who developed this complication. Conclusions & Implications: Care pathways for patients admitted to hospital with non‐traumatic SAH should include early screening for dysphagia risk. Further research using a larger prospective cohort is required to validate dysphagia incidence and risk factors in this patient cohort. What this paper addsWhat is already known on this subjectDysphagia is a negative complication following non‐traumatic SAH, and can occur as a result of primary injury or secondary to treatment complications (e.g., intubation and ventilation, surgical intervention). However, limited evidence regarding its incidence, risk factors, clinical progression and recovery in a prospective cohort exists.What this paper adds to existing knowledgeThis study is the first to examine prospectively patients with non‐traumatic SAH within 72 h of medical stability. It identifies dysphagia incidence, risk factors, clinical characteristics and recovery during the acute hospital admission for this patient cohort.What are the potential or actual clinical implications of this work?Early and regular screening for dysphagia in the presence of associated risk factors is essential for patients admitted with non‐traumatic SAH. Speech–language pathologist resources in the neurocritical care context should be available to support the assessment and management of dysphagia in this cohort. [ABSTRACT FROM AUTHOR]

There is currently limited information regarding dysphagia following non-traumatic subarachnoid haemorrhage (SAH), which impacts upon speech-language pathologists' (SLP) decisions when providing clinical care for this patient cohort. This scoping review aims to summarise the available evidence on the topic and identify gaps in the literature. The scoping review framework as described by Arskey and O'Malley (Soc Res Methodol 8(1):19-32, 2005) was used. Searches were undertaken in six databases. Inclusion criteria included that participants were adults (18+ years), with a primary diagnosis of non-traumatic SAH, and dysphagia occurred as a result of non-traumatic SAH. Data was extracted by the primary author independently and cross-checked by the second author. Data extracted included year of publication, study location, population, aims of the study, study design, method used to identify dysphagia, who completed the assessment, dysphagia incidence, dysphagia type and severity, risk factors, characteristics, and intervention details. Ten studies were included. Dysphagia was diagnosed based on staff reports, screening, clinical swallowing examination, and/or instrumental swallowing assessment with considerable variability identified across studies with regard to incidence (range 0.9–100%). Studies were highly heterogeneous with regard to dysphagia assessment practice, risk factors, characteristics, provision of intervention, and outcomes. The current evidence regarding dysphagia following non-traumatic SAH is insufficient to provide best practice guidelines for assessment and management recommendations. Emerging evidence will inform healthcare professionals managing dysphagia in individuals following non-traumatic SAH. Future research with more rigorous study designs will promote evidence-based clinical care standards for this population. [ABSTRACT FROM AUTHOR]

Medical advances have led to many of the severe consequences of stroke being averted. Consequently, more people are being discharged from hospital following treatment for what is classed as minor stroke. The needs of people with minor stroke have received little research attention. The aim of the current study was to conduct an exploratory prospective needs analysis to document the unmet health, rehabilitation and psychosocial needs of a recently hospitalised minor stroke cohort approximately 2 weeks (T1) and 2 months (T2) post‐hospital discharge. An exploratory cohort design was used to explore the unmet health, service and social needs of 20 patients with minor stroke. Participants completed questionnaires (Survey of Unmet Needs and Service Use, Mayo‐Portland Adaptability Inventory‐4, Exeter Identity Transition Scales, RAND 36‐Item Health Survey 1.0) at T1 and T2. Nine participants reported unmet needs at T1 and seven participants reported unmet needs at T2. Between T1 and T2, there was a significant improvement in perceived role limitations due to physical health. Participation in society was significantly better at T2. In conclusion, patients with minor stroke report health, service and social needs that are unmet by existing services. This patient cohort urgently requires co‐ordinated services to detect and manage these unmet needs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to conduct a systematic review of interventions for the treatment of non-progressive dysarthria in adults. Materials and methods: Five electronic databases (PubMed, Embase, CINAHL, PSYCINFO, Cochrane Collaboration) were searched for all studies that described and evaluated treatment used for non-progressive dysarthria in adults. Studies were included if (1) participants were adults (18+ years) with a confirmed diagnosis of non-progressive dysarthria, (2) participants received intervention with pre-post outcome data, and (3) the article was published between 2006 and 2017 (including early online publications). Data extracted included the number of participants; etiology; dysarthria type and severity; age; gender; presence of a control group; intervention tasks, frequency and duration; outcome measures; and conclusions. Data extraction was completed by a member of the research team independently and crosschecked by another team member. Results: Of the 6728 articles identified, 21 met the inclusion criteria. The predominant study design was a case study or case series. The methodological quality of the studies varied. Typically, the interventions included impairment-based and activity level tasks targeting conversation. Approximately half of the interventions adhered to a treatment manual. Conclusions: The evidence base to guide treatment for non-progressive dysarthria is increasing, with interventions showing promise in results, participant numbers, and positive participant feedback. The evidence base to guide treatment for non-progressive dysarthria is increasing, but remains limited. The majority of evidence is of moderate methodological quality. The emergence of new research indicates that health professionals need to be continuously aware and critically appraise new literature in the area. [ABSTRACT FROM AUTHOR]

Background: Speech-language pathologists (SLPs) measure outcomes to gauge the impact of their interventions and to inform best care for clients. Previous research has explored outcome measurement practices in aphasia rehabilitation, however the factors driving clinician behaviour have not been examined. Aim: To explore current clinical practice and perceived barriers and facilitators to aphasia outcome measurement. Methods and Procedures: Australian SLPs who worked clinically with people with aphasia completed a cross-sectional online survey. Current practice was explored using a combination of multiple-choice questions (with open-text response options) and Likert rating scales. Barriers and facilitators to outcome measurement were explored through ratings of statements aligned with the Theoretical Domains Framework. Data were analysed using descriptive statistics and cross-tabulations. Outcome and Results: Data from 74 Australian SLPs were included. All SLPs reported measuring outcomes and these most frequently related to communication and language. SLPs reported using a diverse range of outcome measures across construct areas and stage-post stroke of service provision, with more than 80 unique instruments/approaches identified. The most frequently used outcome measurement instruments/approaches were: The Western Aphasia Battery – Revised (WAB-R) for language; the Therapy Outcome Measures/Australia Therapy Outcome Measures (TOMs/AusTOMS) for communication, participation, and quality of life; and Goal Attainment Scaling for psychological and carer/significant other outcomes. Overall, SLPs identified more facilitators than barriers to outcome measurement. The main barriers related to the theoretical domains "behavioural regulation" (managing or changing actions) and "memory, attention and decision-making processes" (ability to retain information, focus selectively and choose between alternatives). The main facilitators related to the theoretical domains "beliefs about consequences" (acceptance of the truth, reality, or validity about outcomes of a behaviour) and "social/professional role and identity" (a coherent set of behaviours and displayed personal qualities in a social or work setting). Conclusions: All SLPs reported measuring outcomes with clients with aphasia and these primarily related to language and communication. The outcome measurement instruments/approaches used were heterogeneous within construct areas. SLPs see outcome measurement as part of their role and believe it to be an important activity, however report a need for training and workplace systems and strategies to support optimal practices. The results of this study may inform the development of theoretically informed implementation interventions which seek to improve SLP outcome measurement practice in aphasia rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Speech pathology students can experience low confidence when communicating with people with aphasia. Communication partner training (CPT) is one method to increase confidence and skills when communicating with people with aphasia. There is a paucity of research exploring the effects of delivering CPT to students via technology, such as telepractice. Aims: To explore the feasibility (acceptability, demand, implementation, practicality, limited efficacy) of a conversation with a person with aphasia via telepractice as part of a CPT programme with speech pathology students. A secondary aim was to explore the effects of feedback from the people with aphasia (i.e., patient feedback) on students' perceived confidence and proficiency in communicating with people with aphasia. Methods & Procedures: A Phase II feasibility study design was used, where both quantitative and qualitative data were collected. A total of 33 speech pathology students attended a lecture about the strategies used to communicate effectively with people with aphasia. They then participated in a 10‐min conversation via videoconferencing with a person with aphasia 1 week later. Students were randomly allocated to patient feedback or no patient feedback conditions. They completed a custom designed questionnaire pre‐ and post‐conversation. Outcomes & Results: The study had a low recruitment rate but good retention. The programme was delivered as intended. Students reported that they found the conversations to be a positive but challenging experience. Post‐conversation, statistically significant increases were found in students' self‐rated confidence communicating with people with aphasia, proficiency at engaging in an everyday conversation and proficiency obtaining a case history (all p < 0.001). There were no significant differences for these ratings between the groups according to feedback condition (all p > 0.01). Conclusions & Implications: CPT involving a conversation with a person with aphasia via telepractice is feasible and can provide a valuable learning experience for students. Further research is required. [ABSTRACT FROM AUTHOR]

Objective: To determine accessibility of the primary healthcare system for patients with stroke recently discharged from hospital. Methods: This project mapped retrospective patient location data and the location of primary healthcare services in the same region. Patient location data were from all patients with stroke (N = 1595: January 2011–January 2017) discharged from one metropolitan hospital to the local Primary Health Network. Geographic Information System technology was used to map the patient discharge locations and the spatial distribution of primary healthcare services (general practitioner, pharmacy, allied health) across the region. Road network data were used to measure the level of access from each patient's discharge location to the services. Results: Access to primary healthcare services was variable. Areas with larger proportions of patients with stroke did not necessarily have good service access. With an increase in travel time, the number of services accessible to patients also increased. However, the spatial variation of access to services remained largely unchanged. Conclusion: Access to primary healthcare services for patients with stroke varies spatially, with a trend towards relatively low levels of accessibility for many patients. There is an urgent need for future planning to consider geographical access to primary healthcare services for patients with stroke. [ABSTRACT FROM AUTHOR]

Purpose: Reperfusion therapies are medical treatments that restore blood flow either by surgical removal of a blood clot or with medications that dissolve clots. The introduction of reperfusion therapies has the potential to change the presentation of aphasia following acute ischaemic stroke (AIS). This scoping study will explore the relationship between aphasia and reperfusion therapies from a speech-language pathology perspective. Method: A systematic literature search was performed on studies published up until October 2016. Relevant studies that reported on aphasia and reperfusion therapy were assessed for quality and the relationship between the two. Results: Overall, 27 studies were identified, these studies were heterogeneous in nature. Despite speech-language pathologists filling a central role in management of aphasia, only seven of these studies mentioned involvement of speech-language pathologists, with minimal information about the precise nature of the involvement of speech-language pathology services. Conclusion: Based on this scoping review, reperfusion therapy appears to be impacting on the presentation of aphasia. A prospective study into reperfusion therapy and aphasia is required to inform speech-language pathologists on this patient population. [ABSTRACT FROM AUTHOR]

Gravity‐driven salt tectonics along passive margins is commonly depicted as comprising domains of updip extension and downdip contraction linked by an intermediate, broadly undeformed zone of translation. This study expands on recently published physical models using discrete‐element modeling to demonstrate how salt‐related translation over pre‐salt rift structures produce complex deformation and distribution of structural styles in translational salt provinces. Rift geometries defined by horsts and tilted fault‐blocks generate base‐salt relief affecting salt flow, diapirism and overburden deformation. Models show how flow across pairs of tilted fault‐blocks and variably‐dipping base‐salt ramps associated with pre‐salt faults and footwalls produce abrupt flux variations that result in alternation of contractional and extensional domains. Translation over tilted fault‐blocks defined by basinward‐dipping normal faults results in wide, low amplitude inflation zones above footwalls and abrupt subsidence over steep fault‐scarps, with reactive diapirs that are squeezed and extrude salt as they move over the fault. Translation over tilted‐blocks defined by landward‐dipping faults produces narrow inflation zones over steep fault‐scarps and overall greater contraction and less diapirism. As salt and cover move downdip, structures translate over different structural domains, being inverted and/or growing asymmetrically. Our models allow, for the first time, a detailed evolution of these systems in cross‐section and demonstrate the effects of variable pre‐salt relief, salt sub‐basin connectivity, width and slope of base‐salt ramps. Results are applicable to syn‐ and post‐rift salt basins; ultimately improving understanding of the effects of base‐salt relief on salt tectonics and working as a guide for interpretation of complex salt deformation. Key Points: Pre‐salt rift structures (horst and tilted blocks) generate base‐salt relief acting as a major control on salt deformationVariable base‐salt slope, step height and connectivity between salt sub‐basins affect the kinematics of salt‐related deformationModels present cross‐sectional evolution related to complex structural distribution related to salt flux variations over base‐salt relief [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the critical ingredients of successful Communication Partner Training (CPT) programmes. The aim of this randomised controlled trial was to investigate the effects of including an educational component before a conversation with a person with aphasia compared to a conversation only. Method: Thirty-eight speech-language pathology students were randomly allocated to either the Full programme or Conversation only groups. The Full programme group received a lecture about communication strategies then participated in a conversation with a person with aphasia, while the other group participated in the conversation only. Both groups received feedback on performance from the people with aphasia. Students completed a customised mixed-methods questionnaire at study commencement and following the conversation. Result: Generalised linear models indicated confidence ratings improved after receiving either the Full programme or Conversation only (p < 0.001), however, greater improvements were observed following the Full programme (p < 0.001). More communication strategies were identified after the interventions (p = 0.001) with greater improvement occurring among the Full programme group (p < 0.01). Conclusion: An educational lecture before a conversation with a person with aphasia is a critical component of CPT programmes, enhancing their knowledge base and increasing their confidence levels compared to only a conversation. [ABSTRACT FROM AUTHOR]

Abstract: Background: Communication partner training (CPT) has been used to support communication partners to interact successfully with people with aphasia (PWA). Through successful CPT interaction PWA's accessibility to healthcare is notably improved. The present study sought to build on prior studies by investigating the experiences of individuals with aphasia and healthcare providers to ascertain what they deemed to be beneficial from CPT and what could be refined or improved, dependent on the setting and skill set of those participating. Aims: To gain an understanding of the experiences of PWA involved in the provision of CPT to health professional (HP) students. Also to investigate the experiences of HP students who participated in the CPT programme. Methods & Procedures: Eight PWA and 77 HP students who had completed a CPT programme participated in a focus group/semi‐structured interview (PWA) and feedback session (HP students) moderated by two speech–language pathologists (SLPs). These sessions were recorded (audio and video), transcribed verbatim, including non‐verbal communication, and analyzed using qualitative content analysis. Outcomes & Results: Overall, the study sought to understand experiences of the training. Both the PWA and HP students reported positive experiences of CPT. PWA discussed their perception that CPT improved HPs and HP students’ understanding and interactions conversing with them and emphasized the need for training and education for all health related professions. HP students enjoyed the opportunity to experience interacting with PWA, without being ‘assessed’ and felt it consolidated their learning based on lecture content. Conclusions & Implications: Inclusive and accessible healthcare is paramount to ensure the engagement of patients and providers. Based on the experiences and feedback of the participants in this current study, CPT offers a salient and practical training method with potential to improve practice. Participants perceived CPT to be beneficial and validated the need for the training to support PWA accessing healthcare. [ABSTRACT FROM AUTHOR]

Abstract: The variety in fault geometry, fault interaction style, and evolution of the fault network above a weak planar preexisting fault as a result of a change in the strike angle (α) of the preexisting fault relative to the extension direction is investigated using three‐dimensional discrete element modeling. The preexisting fault shows three reactivation modes: (i) full reactivation (α ≥ 60°), (ii) partial reactivation (α = 45°), and (iii) little or no reactivation (α = 30°). A fully reactivated fault decreases the density, affects the orientation, and enhances the length and displacement of adjacent new faults. A partially reactivated fault generates some isolated fault segments along strike and also influences fault orientation. However, when the preexisting fault is not reactivated, its presence has little effect on the growth of new faults. Our study confirms that the reactivation pattern of a preexisting fault and its influence on new fault growth varies with its strike angle relative to the extension direction. It also demonstrates how a preexisting fault influences adjacent fault geometry and the fault network by changing the density, orientation, length, and displacement of newly formed faults. The work impacts understanding three‐dimensional fault geometries, the distribution, and evolution of fault networks in rift basins affected by preexisting faults and on predicting the extension direction of renewed rifting. [ABSTRACT FROM AUTHOR]