The impact of communication disability on quality of life of people with aphasia and their caregivers

Aphasia is a chronic acquired communication disorder that may change people with aphasia (PWA) and their caregivers’ lives for ever. Social and emotional changes are frequently reported by both, although the impact of these changes in quality of life (QOL) needs further research. This study identifies predictors and variables that influence PWA’s and their caregivers’ QOL and social relationships (SR). A cross-sectional descriptive, correlational and comparative study was undertaken with 255 individuals from Portuguese general population (mean age 43 years, range 25-84 years; 148 females, 107 males), 25 PWA (mean age 54 years, range 20-71; 12 females and 13 males), and 25 caregivers (mean age 51 years, range 26-73; 17 females and 8 males). All the participants completed the World Health Quality of Life Bref instrument, the SR domain of the World Health Organization Quality of Life – 100 scale, and the Center for Epidemiologic Studies Depression Scale. Participants with aphasia completed the Lisbon Aphasia Assessment Battery, Barthel Index, Frenchay Activities Index, Communication Disability Profile and the Modified Mini-Mental State which evaluated language disability, aphasia coefficient, activities, participation and cognition. In addition, caregivers completed the Carers’ Assessment of Managing Index to assess coping strategies. PWA and their caregivers are less satisfied with their QOL and SR than Portuguese general population; whereas PWA have the worse QOL and SR. Thus, aphasia seems to impact negatively in their QOL and SR. Emotional status has great importance for QOL and SR among the three groups. PWA’s activities and participation have great impact in both PWA’s and caregivers’ QOL and SR. Additionally, emotional status and participation are the best predictors of PWA’s QOL. Along with these two variables, activities of the PWA are the best predictors of caregivers’ QOL. Participation is the best predictor of PWA’s SR; emotional status and number of cohabitants are best predictors for caregivers’ SR. Aphasia assessment and intervention should take into account all the factors that influence PWA’s and caregivers’ QOL and SR so the central goal of enhancing it can be achieved. These results are important for identifying and planning support needs and are useful in the orientation of the activities carried out by the service providers allowing the adjustment of health programs and policies based on people’s real life needs.

Materials and concepts for CO2 lean ironmaking by pyroelectrolysis

The main purpose of this PhD thesis was to provide convincing demonstration for a breakthrough concept of pyroelectrolysis at laboratory scale. One attempted to identify fundamental objections and/or the most critical constraints, to propose workable concepts for the overall process and for feasible electrodes, and to establish the main requirements on a clearer basis. The main effort was dedicated to studying suitable anode materials to be developed for large scale industrial units with molten silicate electrolyte. This concept relies on consumable anodes based on iron oxides, and a liquid Fe cathode, separated from the refractory materials by a freeze lining (solid) layer. In addition, one assessed an alternative concept of pyroelectrolysis with electron blocking membranes, and developed a prototype at small laboratory scale. The main composition of the molten electrolyte was based on a magnesium aluminosilicate composition, with minimum liquidus temperature, and with different additions of iron oxide. One studied the dynamics of devitrification of these melts, crystallization of iron oxides or other phases, and Fe2+/Fe3+ redox changes under laser zone melting, at different pulling rates. These studies were intended to provide guidelines for dissolution of raw materials (iron oxides) in the molten electrolyte, to assess compatibility with magnetite based consumable anodes, and to account for thermal gradients or insufficient thermal management in large scale cells. Several laboratory scale prototype cells were used to demonstrate the concept of pyroelectrolysis with electron blocking, and to identify the most critical issues and challenges. Operation with and without electron blocking provided useful information on transport properties of the molten electrolyte (i.e., ionic and electronic conductivities), their expected dependence on anodic and cathodic overpotentials, limitations in faradaic efficiency, and onset of side electrochemical reactions. The concept of consumable anodes was based on magnetite and derived spinel compositions, for their expected redox stability at high temperatures, even under oxidising conditions. Spinel compositions were designed for prospective gains in refractoriness and redox stability in wider ranges of conditions (T, pO2 and anodic overpotentials), without excessive penalty for electrical conductivity, thermomechanical stability or other requirements. Composition changes were also mainly based on components of the molten aluminosilicate melt, to avoid undue contamination and to minimize the dissolution rate of consumable anodes. Additional changes in composition were intended for prospective pyroelectrolysis of Fe alloys, with additions of different elements (Cr, Mn, Ni, Ti).