title: Evaluating the impact of Attention Process Training (APT) on attention deficit in the early stages of recovery from stroke

authors: Dudley, Margaret Diana

subjects: attention deficit

abstract: Attention deficits are a prominent sequel of stroke and impact negatively on rehabilitation outcomes. However, rehabilitation efforts are almost entirely concerned with the remediation of physical impairments that result from the stroke despite the involvement of attention in physical functioning. Attention Process Training (APT) is a cognitive retraining programme originally designed for the remediation of attention deficit following traumatic brain injury. However, the efficacy of APT post-stroke is not yet known, as to date, few studies have been conducted with small sample sizes. This study evaluated the effectiveness of APT in improving attention in stroke survivors within the 5 to 8 week period post-stroke. Seventy eight patients admitted to hospital with first-ever-stroke were identified as having an attention deficit by obtaining a score of 1 standard deviation below the normative mean on any of the following widely-used neuropsychological measures of attention; the Auditory Attention Quotient (AAQ) or Visual Attention Quotient (VAQ) of the Integrated Visual and Auditory Continuous Performance Test, (IVA-CPT), either trial of the Trail Making Test (TMT), the Paced Auditory Serial Addition Test (PASAT), or by 3 or more errors made on the left or right side of the Bells Cancellation Test. These measures were re-administered on completion of treatment. Participants were randomised to either the experimental group who received standard care and up to 30 hours of APT or to a control group that received standard care only. The primary outcome measure was the Full Scale Attention Quotient (FSAQ) of the IVA-CPT which is a measure of attention derived from both auditory and visual attention quotients. The secondary outcome measure was a health-related quality of life measure, the SF-36, (Short-Form-36). Both measures were administered before treatment and again on the completion of treatment. The results showed that on the primary outcome, the APT group showed improvement from baseline to post-treatment whereas the SC group had not. Significant improvement by the APT group was also demonstrated on two other measures of the IVA-CPT including the Auditory Attention Quotient and the Full Scale Response Quotient (a measure of impulsivity). On the quality of life measure neither the APT group nor the SC group demonstrated a significant change in scores. The results of this study provide further support for the efficacy of cognitive rehabilitation and in particular that APT is an effective cognitive treatment option for the remediation of attention deficit in the early stages of stroke recovery. The characteristics of stroke survivors who might benefit most from APT are identified as well as those factors that possibly influence the subjective experience of this particular intervention. The appropriateness of some measures such as the PASAT, the TMT, cancellation tests as well as continuous performance tests that are often used in research of attention deficit, are also discussed in the context of a stroke population. It is hopeful that the optimistic outcomes of this study will encourage further needed research in this area in order to inform stroke rehabilitation specialists to incorporate cognitive rehabilitation into predominantly physically-focussed programmes.

text: Evaluating the impact of Attention Process Training (APT) on attention deficit in the early stages of recovery from stroke Attention deficits are a prominent sequel of stroke and impact negatively on rehabilitation outcomes. However, rehabilitation efforts are almost entirely concerned with the remediation of physical impairments that result from the stroke despite the involvement of attention in physical functioning. Attention Process Training (APT) is a cognitive retraining programme originally designed for the remediation of attention deficit following traumatic brain injury. However, the efficacy of APT post-stroke is not yet known, as to date, few studies have been conducted with small sample sizes. This study evaluated the effectiveness of APT in improving attention in stroke survivors within the 5 to 8 week period post-stroke. Seventy eight patients admitted to hospital with first-ever-stroke were identified as having an attention deficit by obtaining a score of 1 standard deviation below the normative mean on any of the following widely-used neuropsychological measures of attention; the Auditory Attention Quotient (AAQ) or Visual Attention Quotient (VAQ) of the Integrated Visual and Auditory Continuous Performance Test, (IVA-CPT), either trial of the Trail Making Test (TMT), the Paced Auditory Serial Addition Test (PASAT), or by 3 or more errors made on the left or right side of the Bells Cancellation Test. These measures were re-administered on completion of treatment. Participants were randomised to either the experimental group who received standard care and up to 30 hours of APT or to a control group that received standard care only. The primary outcome measure was the Full Scale Attention Quotient (FSAQ) of the IVA-CPT which is a measure of attention derived from both auditory and visual attention quotients. The secondary outcome measure was a health-related quality of life measure, the SF-36, (Short-Form-36). Both measures were administered before treatment and again on the completion of treatment. The results showed that on the primary outcome, the APT group showed improvement from baseline to post-treatment whereas the SC group had not. Significant improvement by the APT group was also demonstrated on two other measures of the IVA-CPT including the Auditory Attention Quotient and the Full Scale Response Quotient (a measure of impulsivity). On the quality of life measure neither the APT group nor the SC group demonstrated a significant change in scores. The results of this study provide further support for the efficacy of cognitive rehabilitation and in particular that APT is an effective cognitive treatment option for the remediation of attention deficit in the early stages of stroke recovery. The characteristics of stroke survivors who might benefit most from APT are identified as well as those factors that possibly influence the subjective experience of this particular intervention. The appropriateness of some measures such as the PASAT, the TMT, cancellation tests as well as continuous performance tests that are often used in research of attention deficit, are also discussed in the context of a stroke population. It is hopeful that the optimistic outcomes of this study will encourage further needed research in this area in order to inform stroke rehabilitation specialists to incorporate cognitive rehabilitation into predominantly physically-focussed programmes.

year: 2011

title: Community composition and distribution of macroinvertebrates on natural and artificial substrates in North Island lakes and ponds

authors: Taitibe, Heather

subjects: Community composition

abstract: Artificial structures in freshwater ecosystems are becoming increasingly common. The introduction of these structures in marine systems lead to changes in the physical structure and the biotic assemblages. Even though artificial structures provide hard substrates for species to colonize and settle on, they are commonly shown to support a smaller number of taxa than natural substrates and are also known to facilitate the settlement of disproportionate numbers of non-native species. Nevertheless, little is known of their effects in freshwaters. 
In the second chapter of my thesis, I compare macroinvertebrate communities on three substrate types, macrophytes, sediments and artificial structures, among twenty-two ponds, to identify differences in community composition and distribution of macroinvertebrates between natural and artificial substrates. In addition, I investigated whether non-native macroinvertebrates prefer artificial substrates more than natural substrates. The similarities between artificial substrates and macrophytes can be attributed to the habitat structure, i.e., hard surfaces and the provision of refugia for macroinvertebrates from their predators. The differences between sediments and macrophytes, and artificial substrates were attributed to the difference in habitat structure and the fauna they supported (i.e., sediments contained large proportions of infauna). Non-native species that were collected in my study did not show preference for any of the habitats that were sampled.  
In the third chapter of my thesis, I identified important environmental factors that affect the distribution of macroinvertebrates communities across the twenty-two ponds sampled. The most important factor identified was temperature, nutrient gradients, pH and dissolved oxygen levels.  
Both chapters of my thesis offer an understanding of how existing artificial substrates and environmental variables in lakes and ponds on the North Island, New Zealand, affect macroinvertebrate community composition and distribution in relation to natural substrates.

text: Community composition and distribution of macroinvertebrates on natural and artificial substrates in North Island lakes and ponds Artificial structures in freshwater ecosystems are becoming increasingly common. The introduction of these structures in marine systems lead to changes in the physical structure and the biotic assemblages. Even though artificial structures provide hard substrates for species to colonize and settle on, they are commonly shown to support a smaller number of taxa than natural substrates and are also known to facilitate the settlement of disproportionate numbers of non-native species. Nevertheless, little is known of their effects in freshwaters. 
In the second chapter of my thesis, I compare macroinvertebrate communities on three substrate types, macrophytes, sediments and artificial structures, among twenty-two ponds, to identify differences in community composition and distribution of macroinvertebrates between natural and artificial substrates. In addition, I investigated whether non-native macroinvertebrates prefer artificial substrates more than natural substrates. The similarities between artificial substrates and macrophytes can be attributed to the habitat structure, i.e., hard surfaces and the provision of refugia for macroinvertebrates from their predators. The differences between sediments and macrophytes, and artificial substrates were attributed to the difference in habitat structure and the fauna they supported (i.e., sediments contained large proportions of infauna). Non-native species that were collected in my study did not show preference for any of the habitats that were sampled.  
In the third chapter of my thesis, I identified important environmental factors that affect the distribution of macroinvertebrates communities across the twenty-two ponds sampled. The most important factor identified was temperature, nutrient gradients, pH and dissolved oxygen levels.  
Both chapters of my thesis offer an understanding of how existing artificial substrates and environmental variables in lakes and ponds on the North Island, New Zealand, affect macroinvertebrate community composition and distribution in relation to natural substrates.

year: 2019

title: Te matakite - Te kupu whakaari

authors: Temara, Pou

subjects: Matakite

abstract: Ko te whāinga o tēnei tuhinga poto he matapaki i te matakite me te kupu whakaari, arā, he whakatakoto i tētahi tūāpapa kōrero e mārama ai te kaipānui ki te tikanga o ēnei kaupapa e rua e ai ki tā te Māori i matapaki ai. Otirā, he kōrero tā ngā iwi katoa o te ao mō te matakite me te kupu whakaari, kai tēnā iwi tāna kōrero, kai tēnā iwi tāna. Kāore tēnei tuhinga e rere ki te whakamārama i ā ētahi kōrero, engari mau tonu ki te ao Māori. Mēnā ka whakahua i ngā whakamārama a ētahi atu iwi, e whai ana kia mārama ai te tauira ki tā te Māori i kōrero ai.

text: Te matakite - Te kupu whakaari Ko te whāinga o tēnei tuhinga poto he matapaki i te matakite me te kupu whakaari, arā, he whakatakoto i tētahi tūāpapa kōrero e mārama ai te kaipānui ki te tikanga o ēnei kaupapa e rua e ai ki tā te Māori i matapaki ai. Otirā, he kōrero tā ngā iwi katoa o te ao mō te matakite me te kupu whakaari, kai tēnā iwi tāna kōrero, kai tēnā iwi tāna. Kāore tēnei tuhinga e rere ki te whakamārama i ā ētahi kōrero, engari mau tonu ki te ao Māori. Mēnā ka whakahua i ngā whakamārama a ētahi atu iwi, e whai ana kia mārama ai te tauira ki tā te Māori i kōrero ai.

year: 2016