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PubMed1992

Thematic analysis in agrammatic comprehension: syntactic structures and task demands.

Aphasics' ability to assign thematic roles during sentence comprehension was investigated. The study was motivated by the hypothesis that capacity limitations, e.g., due to slowed processing operations, interact systematically with certain aspects of structural analysis more than with others. Experiments using a sentence-picture matching paradigm were conducted with several agrammatic Broca's and paragrammatic Wernicke's patients. Experiment 1 tested comprehension of various syntatic structures. The astoundingly good performance in Experiment 1 for both patient groups was attributed to the low task demands of the experiment. Raising the task demands, by delaying presentation of the relevant picture set in Experiment 2, resulted in a significant decrement of comprehension performance for agrammatic Broca's aphasics, but not for Wernicke's aphasics. Putting the main verb in the sentence-final position, as in Experiment 3, affected Wernicke's aphasics', but not Broca's aphasics' performance. In principle, one explanation for the performance differences between Experiments 1 and 2 for Broca's patient might be a deficit in these patients' verbal memory capacity. Therefore, verbal memory span on different word categories was tested in an additional experiment. No difference, however, was found between the Broca's patients' and the Wernicke's patients' capacity for verbal memory despite their different sentence comprehension profiles. The present data are taken to support the view that Broca's aphasics' comprehension behavior is due to the processing demands imposed by structural inference chains and not to a general reduction in verbal memory.

Adult↗

PubMed2006

The combined effect of lower-limb multilevel botulinum toxin type a and comprehensive rehabilitation on mobility in children with cerebral palsy: a randomized clinical trial.

OBJECTIVE: To evaluate the combined effect on mobility of treatment with multilevel botulinum toxin type A (BTX-A) and comprehensive rehabilitation in children with cerebral palsy (CP). DESIGN: Randomized clinical trial using a multiple baseline design. The intervention group was treated 6 weeks after randomization. The control group was treated after a longer period of 18 to 30 weeks. Repeated measurements in both groups were continued throughout the process, before and up to 48 weeks after treatment. SETTING: Four departments of rehabilitation medicine in The Netherlands. PARTICIPANTS: Forty-six children with spastic CP (mean age +/- standard deviation, 8.0+/-2.1y). INTERVENTION: The intervention group (n=23) was treated with multilevel BTX-A and comprehensive rehabilitation. Control group subjects (n=23) continued with their usual physical therapy (PT) for 18 to 30 weeks, and then also received multilevel BTX-A and comprehensive rehabilitation. MAIN OUTCOME MEASURES: The primary outcome measure was the Gross Motor Function Measure (GMFM-66); the secondary measures were problem score and energy cost. RESULTS: The treatment effect during the first 24 weeks of follow-up in the intervention group was compared with the effect of usual PT in the control group. Treatment with multilevel BTX-A and comprehensive rehabilitation provided a significantly greater improvement at 12 and 24 weeks in both the GMFM-66 (2.1 points, P=.02; and 3.5 points, P<.01, respectively) and problem score (1.8 and 1.7 points, P<.001, respectively) compared with usual PT. No difference was found in energy cost. Before-after analysis of the total group (n=46) showed a significant long-term improvement (48wk) on all outcome measures. CONCLUSIONS: Treatment with multilevel BTX-A and comprehensive rehabilitation significantly improves mobility as measured by the GMFM-66 and problem score in children with CP.

Botulinum Toxins, Type A↗

PubMed2006

Priming ditransitive structures in comprehension.

Many studies have shown evidence for syntactic priming during language production (e.g., Bock, 1986). It is often assumed that comprehension and production share similar mechanisms and that priming also occurs during comprehension (e.g., Pickering & Garrod, 2004). Research investigating priming during comprehension (e.g., Branigan, Pickering, & McLean, 2005; Scheepers & Crocker, 2004) has mainly focused on syntactic ambiguities that are very different from the meaning-equivalent structures used in production research. In two experiments, we investigated whether priming during comprehension occurs in ditransitive sentences similar to those used in production research. When the verb was repeated between prime and target, we observed a priming effect similar to that in production. However, we observed no evidence for priming when the verbs were different. Thus, priming during comprehension occurs for very similar structures as priming during production, but in contrast to production, the priming effect is completely lexically dependent.

Cognition↗

PubMed2006

Neural correlates of arithmetic and language comprehension: a common substrate?

There is debate as to the relationship between mathematical ability and language. Some research has suggested that common processes underlie arithmetic and grammar while other research has suggested that these are distinct processes. The current study aimed to address this issue in a large group of 68 left hemisphere stroke patients who were all tested on analogous arithmetic and language comprehension measures. The behavioral data revealed a significant correlation between performance on the comprehension and arithmetic measures, although a subset of patients showed a dissociation in performance on the two tasks. To determine the brain regions critical for performance on each measure, patients' lesions were analyzed using Voxel-based Lesion Symptom Mapping. Arithmetic was associated with a small number of foci, with the most significant region located in the left inferior parietal lobule (Brodmann areas 39 and 40). Comprehension was associated with a larger number of brain regions, most extensively in the left middle and superior temporal gyri. There was also overlap between the arithmetic and comprehension maps in a number of regions, such as the inferior frontal gyrus. Our findings suggest that arithmetic and language comprehension are mediated by partially overlapping brain networks. These findings are discussed in light of previous work on the neural basis of arithmetic ability and its relationship to language.

Adult↗

PubMed1995

Phonological errors in aphasic naming: comprehension, monitoring and lexicality.

This paper investigates the production of phonological errors in aphasic naming, examining the relationship between these errors and deficits in comprehension. The predictions of Dell and O'Seaghda's (1991) computational model of speech production were tested by lesioning. The set of lesioned models demonstrated a strong correlation between proportion of phonologically related errors in naming and comprehension accuracy. In contrast, no correlation between proportion of phonological errors in naming and comprehension accuracy was found for a group of fifteen aphasics. This paper also examines monitoring behaviours, such as the presence of self-corrections and interrupted responses, again finding no relationship with auditory comprehension. There was also no evidence for a lexical bias in the phonological errors for these aphasic subjects. Phonologically related errors were argued to be words only by chance; this was supported by the fact that they occurred more frequently on short words than long words, and that the proportion of real word errors was not significantly different to that observed in a pseudocorpus of errors. We conclude that a production-based monitor would be compatible with these results but that any comprehension-based monitor is not reliably employed by some or all of the aphasic subjects examined here. Additionally, these data are incompatible with models of language processing where speech input and output share the same processing components.

Adult↗

PubMed1975

Comprehending a word: the influence of speed and redundancy on auditory comprehension in aphasia.

To assess the contribution of various factors to comprehension of a target word, an auditory comprehension test was devised and administered to a series of aphasic patients. Patients were required to select from an array that picture which corresponded to a spoken target word. Each patient heard the target word under five conditions: (1) target spoken alone; (2) target embedded in a neutral (low redundancy) sentence enunciated at a normal rate of speaking; (3) target in a neutral sentence enunciated at a slow rate of speaking; (4) target embedded in a sentence containing semantic support (high redundancy); (5) target embedded in a sentence containing a semantically-deceptive element. Semantic redundancy and rate of presentation made contributions to comprehensibility. Semantic confusions were prevalent among all aphasics but, contrary to earlier reports, posterior patients were especially prone to acoustic confusions. Except for conduction aphasics, patients were more likely to confuse words which began with the same sounds than words which ended with the same sounds. Patients with adequate comprehension at the start of the testing displayed a uniform tendency to improve on the conditions administered later, while those with impaired comprehension at the start usually did not.

Aphasia↗

PubMed1987

Auditory syntactic comprehension in nine aphasia groups (with CT scans) and children: differences in degree but not order of difficulty observed.

Auditory syntactic comprehension was examined in nine groups of aphasics (60 stroke cases) and 3 and 6 year old children. Ten syntactic contrast pairs were studied. Differences in degree but not order of difficulty were observed. The 5 easier pairs were Gender; On/Under; Negative/Affirmative; Object-number; Subject-number; the 5 more difficult pairs were Past/Present; Subject/Object Reversible; Is/Are; Relative Clause; and Future/Present. The "marked" half-pair was significantly more difficult--i.e., Negative vs. Affirmative; Plural vs. Singular Subject; Future or Past vs. Present. Performance on the test was significantly correlated with the BDAE Auditory Comprehension z-score and Token Test. The 3 year old children most closely resembled the Severe Wernicke's (but were better than the Globals), and the 6 year old children were similar to aphasia cases with mild comprehension deficits and frontal or parietal perisylvian lesions which spared most of Wernicke's area. Wernicke's area (posterior two-thirds superior temporal gyrus area) appears to be the area most sensitive to auditory syntactic comprehension. However, the surrounding perisylvian areas including frontal and parietal lobes are also areas sensitive to syntactic comprehension.

Adult↗

PubMed1989

The role of individual difference in determining the nature of comprehension defects in aphasia.

This study was concerned with the relationship between locus of lesion and subtypes of language comprehension defect in aphasia. Previous studies had indicated that performance in sound recognition identified two subtypes of aural comprehension deficit and that performance in pantomime recognition identified two subtypes of reading comprehension defect. Defects in sound recognition and pantomime recognition were found in association with a variety of lesion loci. However, comprehension defective aphasics with normal sound recognition or pantomime recognition had lesions closely similar in location and size to those of aphasics who performed poorly on these tests. Findings suggest that whether an aphasic with a language comprehension defect is impaired in sound recognition or pantomime recognition depends, at least in part, on individually variable predisposing factors. It would appear possible that this phenomenon reflects a separate dimension of hemispheric cerebral dominance.

Adult↗

PubMed2003

Comprehensive two-dimensional liquid chromatography x gas chromatography: evaluation of the applicability for the analysis of edible oils and fats.

Edible fats and oils are complex mixtures containing a wide range of (classes of) compounds. The most important group of compounds are the triglycerides (triacylglycerides, TAGs). Because of the large number of possible fatty acid combinations, an enormous number of TAGs is possible. In the present feasibility study, the applicability of different modes of comprehensive two-dimensional LCXGC for detailed oil and fat analysis is evaluated. Comprehensive LCXGC was found to be an extremely powerful analytical method for the analysis of complex TAG samples. Using the new comprehensive set-ups, TAGs can be separated according to two independent parameters: carbon number vs. number of double bonds, or fatty acid composition vs. number of double bonds. The information content of comprehensive separations by far exceeds that of the current generation of analytical methods. The quantitative results of the separations show a good agreement with data obtained from standard analytical methods. The comprehensive methods studied can also be used for fingerprinting of oil samples, as well as for the analysis of target compounds or compound groups. Highly detailed separations of olive oil samples were obtained. Zooming in on one region of the chromatogram allowed reliable analysis of wax esters without interferences of sterol esters.

Chromatography, Gas↗

PubMed2001

Dopamine supports sentence comprehension in Parkinson's Disease.

OBJECTIVE: To determine the role of dopamine in the executive resource component of sentence comprehension. METHODS: We studied sentence-picture matching in 20 right-handed, non-demented, native English speakers with mild Parkinson's disease (PD) when 'on' and 'off' their levodopa, taking into account disease duration to control for endogenous dopamine metabolism. We also administered a verbal working memory measure that does not involve specific grammatical manipulations. RESULTS: PD patients 'off' levodopa demonstrated a significant discrepancy in their comprehension of grammatically complex sentences compared to grammatically simpler sentences that was not evident when PD patients were 'on' levodopa. An error analysis demonstrated that impaired comprehension of grammatically complex sentences when 'off' levodopa was associated with poorer performance on foils requiring working memory resources. Performance on an independent measure of verbal working memory correlated only with comprehension of grammatically complex sentences during levodopa supplementation, but working memory according to this measure did not differ during 'on' and 'off' states. CONCLUSION: Dopamine supports the executive resources contributing to sentence comprehension in PD.

Aged↗

PubMed1995

Comprehension of discharge instructions by patients in an urban emergency department.

STUDY OBJECTIVE: To assess patients' comprehension of their emergency department discharge instructions and to determine if inner-city patients' literacy levels are adequate to comprehend written discharge instructions. DESIGN: Prospective, observational study. SETTING: The ED of an inner-city university hospital. PARTICIPANTS: Two hundred seventeen patients consecutively discharged from the ED during 12 separate time slots. INTERVENTIONS: Patients were interviewed after discharge from the ED and asked to state their diagnosis, medication instructions, and follow-up instructions. Comparisons between patient recall and instructions as written in the chart were assessed by independent raters and scored from poor to excellent. Patients were administered a standardized test of reading ability. RESULTS: Overall comprehension rates were judged to be good, although 23% of patients exhibited no understanding of at least one component of their discharge instructions. Mean reading ability of the patients was at the sixth-grade level. The ED's printed discharge instructions were written at an 11th-grade reading level. Patients with low literacy scores were more likely to have poor comprehension of instructions. CONCLUSION: Overall comprehension rates in this population were good despite the fact that ED instruction sheets were written at an inappropriately high reading level. Verbal instructions given by the discharging physician likely have a significant effect on patients' comprehension of instructions.

Adult↗

PubMed2002

[Use and comprehensibility of statistical analysis in Archivos de Bronconeumología (1970-1999)].

OBJECTIVES: To describe the type of statistical analysis used most often in original research articles published in Archivos de Bronconeumología, and the evolution of statistical analysis over time in terms of complexity. To determine comprehensibility, taking bivariate analysis as the reference threshold. MATERIAL AND METHODS: All articles published in the original research section of Archivos de Bronconeumología from 1970 through 1999 were reviewed manually. For each article we recorded the category or categories of statistical analysis and its comprehensibility (with a reference threshold set at category 7). We studied the following factors: year of publication, type of analysis, comprehensibility, maximum category achieved, subject area and number of authors. RESULTS: Eight hundred sixty original articles, with a mean 5 2 authors per article were examined. The maximum category reached was a mean 4.15 4.61. The three types of analysis used most often in all articles were category 1 (descriptive only) at 49.4%, category 2 (t and z tests) at 26.4% and category 3 (bivariate tables) at 19.1%. Among the more complex analytical categories, the most often used were analysis of variance (category 8) at 9%, survival analysis (category 16) at 6.2%, and non-parametric correlations at 3.4%. Comparing results by decade, the proportion of articles with only descriptive analysis fell from 74% in the seventies to 63.9% in the eighties and to 36.1% in the nineties (90s vs. 80s, p < 0.05; 90s vs. 70s, p < 0.05; 80s vs. 70s, p < 0.05). The use of statistics from categories 3 and 6 increased (p < 0.05), and the use of the more complex categories 8, 10, 11 and 16 increased (p < 0.05). Comprehensibility decreased significantly to 68.1% in the 90s in relation to increased complexity of analysis. CONCLUSIONS: The complexity of statistical analysis in articles published in Archivos de Bronconeumología increased over time, while comprehensibility decreased.

Analysis of Variance↗

PubMed1998

A polio immunization pamphlet with increased appeal and simplified language does not improve comprehension to an acceptable level.

We used a randomized trial to compare two polio vaccine pamphlets written on a sixth grade level--the vaccine information statement prepared by the Centers for Disease Control (CDC) and an easy-to-read pamphlet we developed (LSU)--for reading ability, comprehension and preference among 610 parents with a broad range of demographic characteristics. Parents at all reading levels and incomes preferred LSU (76% vs. 21%, P < 0.001). Although readers of LSU achieved significantly higher comprehension (65% vs. 60%, P < 0.05) this difference may not be clinically significant. The information items presented with instructional graphics were the only items on which differences in comprehension levels achieved both clinical and statistical significance. Comprehension was lowest for the CDC mandated information on risks and the National Injury Compensation. Our findings demonstrate that simplifying written immunization material and making it more suitable will increase appeal, but such modification may not raise comprehension to an acceptable level without use of instructional graphics. Health education materials intended for general parent populations, which are written on a sixth grade reading level, may not adequately educate parents or prepare them for a discussion with their physicians.

Academic Medical Centers↗

PubMed2003

Trends in comprehensive service availability in outpatient drug abuse treatment.

Comprehensive medical and psychosocial services are essential to quality addiction treatment, but their availability declined in the 1980s. To determine whether this downward trend in the availability of comprehensive services continued in the 1990s, we analyzed data from a national panel study of outpatient substance abuse treatment units in 1990, 1995, and 2000. Response rates were greater than 85%. Regarding the availability of comprehensive services, including physical examinations, routine medical care, mental health services, financial counseling and employment counseling, administrators reported whether any substance abuse treatment client received the service in the past year. With the exception of physical examinations, whose reported availability increased from 1990 to 1995, and financial counseling, whose reported availability decreased during the same time, the reported availability of comprehensive services changed little during the 1990s. These findings highlight the continuing need to monitor access to comprehensive services and other quality markers in addiction treatment over time.

Data Collection↗

PubMed2004

Validation of comprehensive assessment of activities of daily living in stroke survivors.

This study determined whether the Functional Independence Measure (FIM) and the Frenchay Activities Index (FAI) could be used together as a more comprehensive score to assess the activities of daily living (ADL) in stroke survivors. Subjects were recruited from stroke patients consecutively admitted to the inpatient neurology or rehabilitation department at a university hospital in southern Taiwan. We interviewed 209 first stroke survivors at least 1 year after stroke onset during their clinical visits, at home, or in long-term care institutions. Combinations of FIM and FAI as a comprehensive assessment of ADL were measured. All items of the FIM and the FAI were included in a non-parametric factor analysis to determine their underlying constructs. Two comprehensive functional independence scores were then computed as functions of the FIM and FAI scores. The distributional characteristics of the comprehensive scores were examined. Approximately 90% of the total variation was explained by three factors. One single factor comprised all the items from FIM, while the FAI items loaded on two other factors, suggesting that FIM supplements FAI without overlap in content. We further demonstrated that the presence of ceiling or floor effects when either the FIM or the FAI was used could be removed using combined scores of the two instruments. The FIM and the FAI assessed different domains with good construct validity. A comprehensive assessment of functional independence obtained by combining the FIM and the FAI scores is potentially more appropriate and useful for clinical and research applications in stroke patients.

Activities of Daily Living↗

PubMed2001

Increasing the number of analyzable peaks in comprehensive two-dimensional separations through chemometrics.

Comprehensive two-dimensional (2-D) separations are emerging as powerful tools for the analysis of complex samples. The substantially larger peak capacity for a given length of time relative to 1-D separations is a well-known benefit of comprehensive 2-D separation methods. Unfortunately, with complex samples, the probability of peak overlap in 2-D separations is still quite high. This is especially true if one desires to speed up the analysis by reducing the run time and, thus, by reducing the resolving power along the first dimension separation. Chemometric methods hold considerable promise to overcome the limitations brought upon by the likelihood of peak overlap. Thus, chemometric methods should be able to effectively extend the resolving power of 2-D separation methods. In this paper, the theoretical enhancement provided by application of the generalized rank annihilation method (GRAM) for the analysis of unresolved peaks in comprehensive 2-D separations is carefully modeled and critically evaluated. First, Monte Carlo simulations are used to determine the conditions where the use of GRAM results in the successful analysis of unresolved peaks. A wide range of experimental conditions and performance criteria are modeled, typical to many available 2-D separation methods, including analyte/interference peak height ratio, first- and second-dimension resolutions, signal-to noise ratio, injection volume reproducibility, and run-to-run retention time reproducibility. Essentially, a wide range of experimental conditions and performance criteria are found to provide reliable data amenable to GRAM analysis. The information gleaned from this first set of simulations is then used in conjunction with Monte Carlo simulations of comprehensive 2-D separations. For these simulated 2-D separations, the total number of analyzable peaks when using GRAM was determined and found to be substantially better than using only traditional quantitative methods such as peak integration or height. For example, it was determined that the use of GRAM increases the average number of analyzable peaks by a factor of 2 for 2-D separations in which the peak capacity is 67% occupied by randomly distributed peaks. The results of the studies are general, and the use of GRAM should increase the number of analyzable peaks for all forms of comprehensive 2-D separations.

Journal Article↗

PubMed1992

Individual differences in working memory and comprehension: a test of four hypotheses.

A relationship has consistently been found between measures of working memory and reading comprehension. Four hypotheses for this relationship were tested in 3 experiments. In the first 2 experiments, a moving window procedure was used to present the operation-word and reading span tasks. High- and low-span subjects did not differentially trade off time on the elements of the tasks and the to-be-remembered word. Furthermore, the correlation between span and comprehension was undiminished when the viewing times were partialed out. Experiment 3 compared a traditional experimenter-paced simple word-span and a subject-paced span in their relationship with comprehension. The experimenter-paced word-span correlated with comprehension but the subject-paced span did not. The results of all 3 experiments support a general capacity explanation for the relationship between working memory and comprehension.

Adult↗

PubMed2005

Comprehension of third person singular /s/ in AAE-speaking children.

PURPOSE: This investigation examined the comprehension of third person singular /s/ in 30 African American English (AAE)-speaking children as a subject-number agreement marker on a comprehension task. METHOD: A comprehension task was presented to 30 typically developing AAE-speaking children between the ages of 4 and 6. The children were randomly assigned to 1 of 2 groups to hear prerecorded counterbalanced stimuli. The comprehension task was designed to mask plurality of subject; therefore, the children had to focus on the verb as an indicator of subject number. RESULTS: Repeated measure analysis revealed that AAE-speaking children in this investigation did not understand third person singular /s/ as a number agreement marker. An additional analysis, d' (pronounced "d prime"), indicated that the AAE-speaking children are not sensitive to the third person singular /s/ as a clue to subject number. CLINICAL IMPLICATIONS: The inclusion of comprehension tasks of third person singular /s/ to help diagnose language impairment in this population may be problematic.

Child↗