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PubMed1986

Anomia with and without lexical comprehension disorders.

Anomic patients are usually described as free from language comprehension disorders, but the status of lexical comprehension in anomia is still controversial. Most anomic patients are impaired on tasks of semantic-lexical discrimination, but some of them do not present clear signs of semantic-lexical deficit at the receptive level. The aim of the present research was to elucidate the nature of word-finding disturbances by contrasting results obtained by anomic patients with and without lexical comprehension disorders on a number of variables, namely severity of anomia, implicit knowledge of words that patients failed to name, presence of verbal-semantic paraphasias, and scores obtained on a test of phoneme discrimination and on the "Token Test." The results of our investigation seem to suggest that there are two types of anomia, caused by the impairment of two different sets of mechanisms. In "purely expressive anomia" the locus of defect seems to be near to the stage in which the selected lexical item is specified into the appropriate phonological form. In "anomia with lexical comprehension disturbances" the locus of defect seems to be much deeper within the lexicon, so that the semantic disorder affects both the expressive and the receptive levels in a roughly comparable manner.

Adult↗

PubMed1990

The effects of syntactic structure on discourse comprehension in patients with parsing impairments.

Syntactic complexity was systematically manipulated in sentence and discourse comprehension tasks. Aphasic patients, but not normal controls, showed effects of syntactic structure in the sentence comprehension task. Neither aphasic nor control subjects showed significant differences between the comprehension of syntactically simple and complex stories. This pattern confirms the clinical impression that some discourses can be understood by patients who cannot utilize syntactically based sentence comprehension mechanisms.

Adult↗

PubMed1991

Assessing comprehensive nursing performance: the Objective Structural Clinical Assessment (OSCA). Part 1--Development of the assessment strategy.

Nursing courses in Australia are preparing graduates for comprehensive practice within Universities. The evaluation of safe and effective comprehensive nursing performance requires the consideration of a much broader range of practice competencies than has previously been the case. In particular there is a need to explore integrated assessment approaches that closely resemble the realities of the health care setting. Part 1 of this paper provides an overview of the Objective Structured Clinical Assessment (OSCA) which it is suggested is an effective way of assessing student comprehensive nursing performance. Some theoretical considerations in OSCA development are discussed and then an outline of the processes involved in designing and implementing an OSCA provided. Part 2 describes an evaluation project supported by the NSW Nurses' Registration Board. The aim of the study was to determine the validity and reliability of the use of the OSCA as an integrated assessment tool as a measurement of the extent to which a student nurse can plan and deliver safe and effective comprehensive nursing care.

Australia↗

PubMed1990

Lesion localization in acquired deficits of emotional expression and comprehension.

This study investigated the relationship between intrahemispheric location of lesion and disturbances of emotional expression and comprehension. Twenty-eight right hemisphere strokes, 18 left hemisphere strokes, and 20 controls were examined on a standardized test of the expression, repetition, and comprehension of emotional prosody as well as the visual recognition of emotional situations and faces. The patients were classified into aprosodic syndromes according to the test scores. The lesions were independently traced, and overlapped for each aprosodic syndrome. The results, for lesions in either hemisphere, indicated involvement of the basal ganglia most frequently in aprosodic syndromes followed by anterior temporal lobe and insula lesions. Basal ganglia damage was also seen most frequently in patients with impaired comprehension of emotional facial expressions and situations. The anterior temporal lobe was also frequently involved in patients with such deficits. The basal ganglia emerged as a structure of particular importance in the mediation of emotional expression and comprehension.

Aged↗

PubMedDate not supplied

Comprehension monitoring skills of adults with mental retardation.

The ability of 30 adults with mild and moderate levels of mental retardation to monitor their comprehension while performing a direction-following task was examined. Subjects were "employed" to aid the investigator in compiling objects for gift bags. The task consisted of 60 directions (e.g., "Give me a blue pencil"), of which 6 contained trouble sources (ambiguous directions, unintelligible words, and compliance problems). Each subject's response to the directions involving trouble sources was scored to determine if the subject (a) demonstrated effective comprehension monitoring (as indicated by an immediate awareness of the problem and effective attempt to rectify the problem), (b) requested clarification after attempting to comply with the direction and being unable to do so, (c) demonstrated ineffective comprehension monitoring (as indicated by an awareness of the problem but an ineffective means of dealing with it), or (d) showed no awareness of the trouble source. The ability of subjects to monitor comprehension varied with type of trouble source. Ambiguous trouble sources were the most difficult for the subjects to detect, and compliance-problem trouble sources were the most frequently identified.

Adult↗

PubMed2006

Cultural variability in the effects of question design features on respondent comprehension of health surveys.

PURPOSE: The aim is to identify the characteristics of common health survey questions that may be associated with cross-cultural variability in question comprehension. METHODS: Interviews with respondents representing four cultural subgroups in the United States were analyzed through behavior coding to identify survey question characteristics that may be associated with cross-cultural variability in comprehension. Using survey responses as the unit of analysis, nested within survey respondents and survey questions, hierarchical linear modeling was used to examine the effects of four questionnaire design features on cultural variations in comprehension difficulties. RESULTS: Respondent culture was found to moderate the effects of response format, question length, and reading levels. CONCLUSIONS: Several question design strategies that reduce overall comprehension difficulty appear to also increase cross-cultural disparities.

Cognitive Science↗

PubMed2006

Comprehensive Aristotle score: implications for the Norwood procedure.

BACKGROUND: Aristotle score is emerging as a reliable tool to measure surgical performance. We estimated the comprehensive Aristotle score for the Norwood procedure, correlated it with survival, and considered its impact on surgical management of hypoplastic left heart syndrome. METHODS: Comprehensive Aristotle score was retrospectively calculated for 39 consecutive Norwood procedures performed from 2001 to 2004. Survival was estimated by the Kaplan-Meier method. RESULTS: The Aristotle scores ranged from 14.5 to 23.5 (mean, 19.12 +/- 2.52; median, 19.5). The score was 20 or greater in 44% (17 of 39) of cases. The most frequent patient-adjusted factors were aortic atresia (n = 16), interrupted aortic arch (n = 9), mechanical ventilation to treat cardiorespiratory failure (n = 19) and shock resolved at time of surgery (n = 13). Hospital mortality was 58.8% (10 of 17) in case of score of 20 or more and 9.1% (2 of 22) for score less than 20 (p = 0.0014). From 2003 on, all patients with a score less than 20 survived. Actuarial estimate of survival at 1 year is 56.2% +/- 7.9% and there have been no late deaths after 1 year. One-year survival is much lower (p = 0.001) for patients with scores of 20 or greater (29.4% +/- 11.05%) compared with those whose scores were less than 20 (77.3% +/- 8.9%). CONCLUSIONS: This study shows significant correlation of comprehensive Aristotle score with hospital mortality and late survival after Norwood palliation. It suggests that operative survival on the order of 90% may be achieved in patients with comprehensive complexity scores of less than 20. Efforts should be devoted to improve survival of high-risk patients (score > or = 20).

Cardiac Surgical Procedures↗

PubMed2006

Lipoprotein (a) and comprehensive lipid tetrad index as a marker for coronary artery disease in NIDDM patients in South India.

BACKGROUND: Coronary artery disease (CAD) is reaching epidemic proportions in India, in the absence of traditional risk factors. Lipoprotein (a) (Lp(a)) concentrations are related to both atherogenesis and thrombogenesis and may be a key link between lipid and CAD. We studied the role of Lp(a) and comprehensive lipid tetrad index as markers for CAD in South Indian patients with non-insulin-dependent diabetes mellitus (NIDDM). METHODS: Lp(a) concentrations and lipid profile were estimated in 53 NIDDM patients with CAD (Group 1), 53 NIDDM patients without CAD (Group 2), and 52 control subjects (Group 3). Comprehensive lipid tetrad index was calculated in all patients and controls. RESULTS: Lp(a) concentrations were significantly higher in Group 1 patients, when compared with Groups 2 and 3. In NIDDM patients with CAD, only total cholesterol and low-density cholesterol concentrations correlated significantly positively with lipoprotein (a) concentrations (r=0.184, p=0.03 and r=0.168, p=0.02). Mean comprehensive lipid tetrad index was 45,487+/-2747 in Group 1, 10,866+/-1163 in Group 2 and 4582+/-348 in Group 3 subjects. CONCLUSION: Based on the foregoing data, high Lp(a) concentrations show strong correlation with CAD in NIDDM patients of South India. High concentrations of Lp(a) and comprehensive lipid tetrad index, along with high prevalence of NIDDM, may render Indians particularly vulnerable to malignant atherosclerosis at a young age. As NIDDM is increasing in prevalence in India, the above observations have ominous dimensions in terms of total burden of CAD in India.

Adult↗

PubMed2005

Testing the limits of the semantic illusion phenomenon: ERPs reveal temporary semantic change deafness in discourse comprehension.

In general, language comprehension is surprisingly reliable. Listeners very rapidly extract meaning from the unfolding speech signal, on a word-by-word basis, and usually successfully. Research on 'semantic illusions' however suggests that under certain conditions, people fail to notice that the linguistic input simply doesn't make sense. In the current event-related brain potentials (ERP) study, we examined whether listeners would, under such conditions, spontaneously detect an anomaly in which a human character central to the story at hand (e.g., "a tourist") was suddenly replaced by an inanimate object (e.g., "a suitcase"). Because this replacement introduced a very powerful coherence break, we expected listeners to immediately notice the anomaly and generate the standard ERP effect associated with incoherent language, the N400 effect. However, instead of the standard N400 effect, anomalous words elicited a positive ERP effect from about 500-600 ms onwards. The absence of an N400 effect suggests that subjects did not immediately notice the anomaly, and that for a few hundred milliseconds the comprehension system has converged on an apparently coherent but factually incorrect interpretation. The presence of the later ERP effect indicates that subjects were processing for comprehension and did ultimately detect the anomaly. Therefore, we take the absence of a regular N400 effect as the online manifestation of a temporary semantic illusion. Our results also show that even attentive listeners sometimes fail to notice a radical change in the nature of a story character, and therefore suggest a case of short-lived 'semantic change deafness' in language comprehension.

Adult↗

PubMed1999

Comprehension of prosody in Parkinson's disease.

The evidence for a receptive prosodic loss in Parkinson's disease (PD) has remained inconclusive since the first reports in the early 1980s (Scott, Caird and Williams, 1984). The present study examined three aspects of comprehension in 11 PD patients and a group of age matched controls. Experiment 1 found no evidence of deficits in phonological discrimination or lexical access in the PD patients. Experiment 2 found that one patient (EA) was significantly impaired on a test of lexical stress discrimination. Experiment 3 examined the discrimination, comprehension and identification of utterance prosody. This experiment found that overall the PD patients were significantly impaired at the identification of utterance prosody. Patient TB was significantly worse than controls on the identification and comprehension of utterance prosody. The study has shown that PD patients can exhibit impairments in the comprehension of prosody and lexical stress. The evidence suggests that only some patients are impaired and the pattern of deficits can differ significantly.

Aged↗

PubMed2001

Basal ganglia dysfunction, working memory, and sentence comprehension in patients with Parkinson's disease.

To investigate the role of the basal ganglia in working memory and sentence comprehension, 14 patients with Parkinson's disease (PD) were administered experimental measures of semantic and phonological working memory, and a measure of sentence comprehension, while receiving dopaminergic medications and after a period of withdrawal from these medications. An age- and education- matched control group (N=14) received the same measures. Comparison with control subjects revealed deficits in patients with PD in sentence processing regardless of medication status, but no deficits in working memory. In contrast to previous studies, withdrawal of dopaminergic medications had no significant impact on task- related working memory functions or on sentence comprehension. Results suggest that basal ganglia dysfunction does not solely account for sentence comprehension deficits seen in PD.

Aged↗

PubMed2006

Oscillatory neuronal dynamics during language comprehension.

Language comprehension involves two basic operations: the retrieval of lexical information (such as phonologic, syntactic, and semantic information) from long-term memory, and the unification of this information into a coherent representation of the overall utterance. Neuroimaging studies using hemodynamic measures such as PET and fMRI have provided detailed information on which areas of the brain are involved in these language-related memory and unification operations. However, much less is known about the dynamics of the brain's language network. This chapter presents a literature review of the oscillatory neuronal dynamics of EEG and MEG data that can be observed during language comprehension tasks. From a detailed review of this (rapidly growing) literature the following picture emerges: memory retrieval operations are mostly accompanied by increased neuronal synchronization in the theta frequency range (4-7 Hz). Unification operations, in contrast, induce high-frequency neuronal synchronization in the beta (12-30 Hz) and gamma (above 30 Hz) frequency bands. A desynchronization in the (upper) alpha frequency band is found for those studies that use secondary tasks, and seems to correspond with attentional processes, and with the behavioral consequences of the language comprehension process. We conclude that it is possible to capture the dynamics of the brain's language network by a careful analysis of the event-related changes in power and coherence of EEG and MEG data in a wide range of frequencies, in combination with subtle experimental manipulations in a range of language comprehension tasks. It appears then that neuronal synchrony is a mechanism by which the brain integrates the different types of information about language (such as phonological, orthographic, semantic, and syntactic information) represented in different brain areas.

Brain↗

PubMed2002

Remediation of asyntactic sentence comprehension using a multimedia microworld.

We report the evaluation of a new automated protocol for the treatment of asyntactic comprehension. This is a follow-up study to the "Microworld for Aphasia" work of Crerer, Ellis, and Dean (1996). An efficacy study involving three patients is reported. All three patients achieved statistically significant improvements in written sentence comprehension as a result of eight hours of treatment focusing on active, passive, and object cleft sentence structures. Treatment effects generalized both to untreated Microworld sentences and to the more naturalistic sentences of the Philadelphia Comprehension Battery (Saffran, Schwartz, Linebarger, Martin, & Bochetto, 1988), with some further evidence of generalization to spoken sentence comprehension. Treatment effects were obtained with minimal input from a clinician.

Aged↗

PubMed2003

Sentence comprehension and working memory limitation in aphasia: a dissociation between semantic-syntactic and phonological reactivation.

The relation between working memory (WM) limitation and sentence comprehension was assessed in Hebrew-speaking aphasics, three conduction aphasics and three agrammatics. The study compared sentences that required different types of reactivation-syntactic-semantic reactivation, in relative clauses, and word form/phonological reactivation, in sentences with reanalysis of lexical ambiguity. The effect of phonological memory load, manipulated by number of words intervening between the activation and the reactivation, on comprehension of the two sentence types was examined. The findings were that agrammatic aphasics failed in the comprehension of object relatives but not on subject relatives irrespective of their antecedent-gap distance. Conduction aphasics, on the other hand, who showed severe WM limitation, comprehended well all types of relative clauses and were unaffected by antecedent-gap distance. The conduction aphasics failed to understand the sentences that required phonological reactivation when the phonological distance was long. These results suggest that the type of reactivation required by the sentence, as well as the type of memory overload are crucial in determining the effect of WM limitation on sentence comprehension.

Adult↗

PubMed2003

Neural basis for sentence comprehension deficits in frontotemporal dementia.

Many patients with frontotemporal dementia (FTD) have impaired sentence comprehension. However, the pattern of comprehension difficulty appears to vary depending on the clinical subgroup. The purpose of this study was to elucidate the neural basis for these deficits in FTD. We studied patients with two different presentations: Three patients with Progressive Non-Fluent Ahasia (PNFA), and five non-aphasic patients with a dysexecutive and social impairment (EXEC). The FTD patient subgroups were compared to a cohort of 11 healthy seniors with intact sentence comprehension. We monitored regional cerebral activity with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) while subjects read sentences featuring both a grammatically complex object-relative center-embedded clause and a long linkage between the head noun phrase (NP) and the gap where the NP is interpreted in the center-embedded clause. Subjects decided whether the agent of the action is a male or a female. Healthy seniors activated both ventral portions of inferior frontal cortex (vIFC) and dorsal portions of IFC (dIFC) in the left hemisphere, often associated with grammatical and working memory components of these sentences, respectively. PNFA patients differed from healthy controls since they have reduced activation of left vIFC, while EXEC patients have less recruitment of left dIFC. We conclude that FTD subgroups have distinct patterns of sentence comprehension difficulty in part because of selective interruptions of a large-scale neural network for sentence processing.

Aged↗

PubMed2003

Phonological processing during language production: fMRI evidence for a shared production-comprehension network.

Studies of phonological processes during language comprehension consistently report activation of the superior portion of Broca's area. In the domain of language production, however, there is no unequivocal evidence for the contribution of Broca's area to phonological processing. The present event-related fMRI study investigated the existence of a common neural network for phonological decisions in comprehension and production by using production tasks most comparable to those previously used in comprehension. Subjects performed two decision tasks on the initial phoneme of German picture names (/b/ or not? Vowel or not?). A semantic decision task served as a baseline for both phonological tasks. The contrasts between each phonological task and the semantic task were calculated, and a conjunction analysis was performed. There was significant activation in the superior portion of Broca's area (Brodmann's area (BA) 44) in the conjunction analysis, also present in each single contrast. In addition, further left frontal (BA 45/46) and temporal (posterior superior temporal gyrus) areas known to support phonological processing in both production and comprehension were activated. The results suggest the existence of a shared fronto-temporal neural network engaged in the processing of phonological information in both perception and production.

Adult↗

PubMed2003

Comprehensive solid-phase extraction method for persistent organic pollutants. Validation and application to the analysis of persistent chlorinated pesticides.

The Centers for Disease Control and Prevention (CDC) is involved in many epidemiological studies regarding the measurement of chlorinated pesticides and polychlorinated biphenyls in specimens obtained from humans. In addition to these commonly determined analytes, there is a need to include additional persistent organic pollutants (POPs) in our analyses, which further stresses the analyses because sample volumes remain small. Thus, a single method of analysis for all POPs in human serum is needed. CDC has recently developed a semiautomated and comprehensive solid-phase extraction method for POPs. The method is comprehensive since it was optimized for the extraction of many different POP compound classes. We then developed a purification and fractionation scheme that allows (a) separation of different compound classes by particular functionalities and (b) purification of those fractions to remove coextracted interferences. This paper describes the first step in the semiautomated comprehensive extraction and multiple fractionation method developed by CDC for monitoring POPs. In this paper, we validate the analysis of the persistent chlorinated pesticides, a compound class difficult to examine because of their structural diversity, in human plasma. The method was validated against an existing CDC method by using a spiked quality-control serum pool. The concentrations determined for all analytes using both methods were within 2%-14% relative standard deviations. A multilevel (i.e., 3-4 point) matrix spike showed good linearity for the analytes tested (r2 = 0.978-0.999). The method was then applied to 40-year-old archived plasma samples for the quantitative analysis of selected chlorinated pesticides. Mean recoveries of the 13C-labeled internal quantification standards ranged from 64% to 123% for the 11 monitored pesticides. The overall method proved to be robust by handling old coagulated plasma samples. It allowed faster throughput of samples than our previous methods and provided cleaner samples with less frequent interferences or background as analyzed by high-resolution mass spectrometry. The method represents a preliminary step in establishing an automated, comprehensive multiresidue analysis method for POPs in human serum.

Automation↗

PubMed2000

Discrimination and instructional comprehension: guided discretion, racial bias, and the death penalty.

This study links two previously unrelated lines of research: the lack of comprehension of capital penalty-phase jury instructions and discriminatory death sentencing. Jury-eligible subjects were randomly assigned to view one of four versions of a simulated capital penalty trial in which the race of defendant (Black or White) and the race of victim (Black or White) were varied orthogonally. Dependent measures included a sentencing verdict (life without the possibility of parole or the death penalty), ratings of penalty phase evidence, and a test of instructional comprehension. Results indicated that instructional comprehension was poor overall and that, although Black defendants were treated only slightly more punitively than White defendants in general, discriminatory effects were concentrated among participants whose comprehension was poorest. In addition, the use of penalty phase evidence differed as a function of race of defendant and whether the participant sentenced the defendant to life or death. The study suggest that racially biased and capricious death sentencing may be in part caused or exacerbated by the inability to comprehend penalty phase instructions.

Adult↗