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PubMed2005

Idiom comprehension deficits in relation to corpus callosum agenesis and hypoplasia in children with spina bifida meningomyelocele.

Idioms are phrases with figurative meanings that are not directly derived from the literal meanings of the words in the phrase. Idiom comprehension varies with: literality, whether the idiom is literally plausible; compositionality, whether individual words contribute to a figurative meaning; and contextual bias. We studied idiom comprehension in children with spina bifida meningomyelocele (SBM), a neurodevelopmental disorder associated with problems in discourse comprehension and agenesis and hypoplasia of the corpus callosum. Compared to age peers, children with SBM understood decomposable idioms (which are processed more like literal language) but not non-decomposable idioms (which require contextual analyses for acquisition). The impairment in non-decomposable idioms was related to congenital agenesis of the corpus callosum, which suggests that the consequences of impaired interhemispheric communication, whether congenital or acquired in adulthood, are borne more by configurational than by compositional language.

Adolescent↗

PubMed2004

Compliance amongst contact lens wearers: comprehension skills and reinforcement with written instructions.

UNLABELLED: Patient non-compliance is one of the key issues when considering contact lens failures and related ocular complications. Patient education is believed to be of paramount importance to improve compliance, especially when this education consists of written as well as oral instructions. METHODS: Patients received oral or oral plus written information depending on their score from a previously validated oral and written comprehension test. A survey containing theoretical and practical questions was given to the patient at the end of the study in order to establish compliance with the given instructions. RESULTS: No statistically significant difference was encountered between the group of patients receiving oral instructions only and the group receiving oral plus written information. A correlation was discovered between non-compliance and ocular complications and between ocular complications and the physical appearance of contact lenses and cases. DISCUSSION: The oral and written comprehension test served to establish the comprehension skills typology of the patients, thus allowing for the appropriate type of instructions (oral or written) to be given to each patient in accordance with their particular abilities. This methodology could lead to a relevant increase in compliance.

Journal Article↗

PubMed2006

Psychosocial work environment of hospital workers: validation of a comprehensive assessment scale.

BACKGROUND: Studies have shown that adverse workplace factors can increase the risk of ill-health in hospital workers, but more comprehensive measures of the psychosocial work environment are needed. OBJECTIVES: To test a comprehensive and theory-based psychosocial work environment questionnaire and analyze associations with mental health in a sample of Danish hospital workers. DESIGN AND PARTICIPANTS: Questionnaire-based cross-sectional study with 343 female employees from a large Danish hospital, including patient care workers (nurses, nurse assistants, midwives) and laboratory technicians. METHODS: The psychosocial work environment was measured with 14 scales from the Copenhagen psychosocial questionnaire, version I, covering three main areas: demands at work, work organization and interpersonal relations at work. We further measured self-rated mental health and sociodemographic and employment characteristics of the participants. Cronbach's alphas, analyses of covariance, one-sample t-tests, partial correlations and linear regression models were used to analyze data. RESULTS: Of the 14 work psychosocial workplace scales 12 showed a satisfactory internal consistency (alpha>0.70). Patient care workers had more quantitative, emotional and cognitive demands (all p-values <0.001), higher work pace (p<0.001) and more role conflicts (p=0.01) than laboratory technicians, but also better work organization, including more influence at work, better possibilities for development and a higher meaning of work (all p-values <0.001). Both patient care workers and laboratory technicians had substantially higher scores on the demand scales and lower scores on the influence at work scale than the general Danish working population. Further analyses showed that high levels of demands at work and low levels of work organization and problematic interpersonal relations at work were associated with lower self-rated mental health. CONCLUSION: The Copenhagen psychosocial questionnaire is a suitable instrument to measure the psychosocial work environment of hospital workers. The comprehensive assessment of the psychosocial work environment helps tailoring interventions to the specific needs of different occupational groups.

Adult↗

PubMed2005

Usefulness of a comprehensive cardiovascular magnetic resonance imaging assessment for predicting recovery of left ventricular wall motion in the setting of myocardial stunning.

OBJECTIVES: We sought to evaluate the usefulness of a comprehensive assessment of four cardiovascular magnetic resonance imaging (CMR)-derived myocardial viability indexes in the setting of myocardial stunning. BACKGROUND: Cardiovascular magnetic resonance imaging allows the simultaneous assessment of several viability indexes. METHODS: We studied 40 patients with a first ST-segment elevation myocardial infarction (MI) and an open infarct-related artery. At the first week, using CMR, wall motion (WM), and four viability indexes were determined: wall thickness, WM improvement with low-dose dobutamine, perfusion, and transmural extent of necrosis. We created a comprehensive score based on the presence and the relative power of these viability indexes for predicting normal WM at the sixth month. RESULTS: Of 153 dysfunctional segments at the first week, 59 (39%) exhibited normal WM at the sixth month. According to the odds ratio of viability indexes for predicting normal WM, we developed a five-level predictive score. The proportions of segments showing normal WM at sixth month were as follows; Level 1 (0 indexes): 0 of 13 (0%); Level 2 (normal thickness and/or perfusion): 14 of 82 (17%); Level 3 (dobutamine response): 5 of 11 (45%); Level 4 (non-transmural necrosis): 20 of 26 (77%); Level 5 (non-transmural necrosis and dobutamine response): 20 of 21 (95%), p < 0.0001 for the trend. These proportions were similar in a matched prospective validation group comprising 16 patients (0%, 18%, 62%, 77%, and 90% for levels 1 to 5, respectively, p < 0.0001 for the trend). CONCLUSIONS: A comprehensive analysis of the four more widely used CMR-derived viability indexes is useful for predicting late systolic function after myocardial infarction.

Female↗

PubMed2005

Toward a framework for understanding lay public's comprehension of disaster and bioterrorism information.

In the last decade, we have witnessed a significant increase in disaster preparedness and crisis communication efforts. This stands in sharp contrast with paucity of research that deals with the public's comprehension of disaster information and related decision-making. The objective of this paper is to outline a theoretical and methodological framework for research on lay comprehension of crisis information. The proposed framework integrates two bodies of research: (1) cognitive science literature on comprehension and decision-making and (2) studies of the effects of anxiety on performance. The paper reviews selected works and methods from both fields, discussing how cognitive perspective could be extended to include emotional factors. We also discuss how further research integrating the proposed framework with public health communication perspective could: (1) provide insights for developing effective disaster communication and (2) inform the development of technological support for disaster communication and for education of lay people and health professionals.

Bioterrorism↗

PubMed2006

Top-down and bottom-up processes in speech comprehension.

Speech comprehension includes both bottom-up and top-down processes, and imaging studies have isolated a frontal-temporal network of brain areas active during speech perception. However, the precise role of the various areas in this network during normal speech comprehension is not yet fully understood. In the present fMRI study, the signal-to-noise ratio (SNR) of spoken sentences was varied in 144 steps, and speech intelligibility was measured independently in order to study in detail its effect on the activation of brain areas involved in speech perception. Relative to noise alone, intelligible speech in noise evoked spatially extended activation in left frontal, bilateral temporal, and medial occipital brain regions. Increasing SNR led to a sigmoid-shaped increase of activation in all areas of the frontal-temporal network. The onset of the activation with respect to SNR was similar in temporal and frontal regions, but frontal activation was found to be smaller than temporal activation at the highest SNRs. Finally, only Broca's area (BA44) showed activation to unintelligible speech presented at low SNRs. These findings demonstrate distinct roles of frontal and temporal areas in speech comprehension in that temporal regions subserve bottom-up processing of speech, whereas frontal areas are more involved in top-down supplementary mechanisms.

Adult↗

PubMed2007

Effect of multilevel botulinum toxin a and comprehensive rehabilitation on gait in cerebral palsy.

To evaluate the effect of multilevel botulinum toxin A and comprehensive rehabilitation on gait pattern, muscle length, and spasticity, a multicenter randomized trial was performed in 46 children with spastic cerebral palsy who walk with flexed knees. Their mean age was 8.0 years (range 4 to 11 years). They were randomly allocated to the intervention group (multilevel botulinum toxin A and comprehensive rehabilitation) or the control group (usual care). After 6 weeks, a significant treatment effect in the intervention group was observed on: improved knee extension during midstance and terminal swing (7 degrees and 5 degrees , P < 0.01, respectively); hip rotation during terminal swing (4 degrees , P = 0.02); gait score (1.7, P < 0.01); decreased spasticity in hamstrings (11 degrees , P < 0.01), gastrocnemius (6 degrees , P = 0.01), and soleus (5 degrees , P = 0.02); and increased muscle length in hamstrings (9 degrees , P < 0.01) and gastrocnemius (5 degrees , P < 0.01). The improved muscle length was maintained up to 24 weeks. This study demonstrated that multilevel botulinum toxin A and comprehensive rehabilitation improves knee extension during gait, increases muscle length, and decreases spasticity in injected muscles after 6 weeks in children who walk with flexed knees. Although the effect on muscle length was maintained after 24 weeks, the effect on gait and spasticity had disappeared.

Botulinum Toxins, Type A↗

PubMed1998

Comprehensive multimodality blood conservation: 100 consecutive CABG operations without transfusion.

BACKGROUND: Despite the recent introduction of a number of technical and pharmacologic blood conservation measures, bleeding and allogeneic transfusion remain persistent problems in open heart surgical procedures. We hypothesized that a comprehensive multimodality blood conservation program applied algorithmically on the basis of bleeding and transfusion risk would provide a maximum, cost-effective, and safe reduction in postoperative bleeding and allogeneic blood transfusion. METHODS: One hundred consecutive patients undergoing coronary artery bypass grafting were prospectively enrolled in a risk factor-based multimodality blood conservation program (MMD group). To evaluate the relative efficacy and safety of this comprehensive approach, comparison was made with a similar group of 90 patients undergoing coronary artery bypass grafting to whom the multimodality blood conservation program was not applied but in whom an identical set of transfusion guidelines was enforced (control group). To evaluate the cost effectiveness of the multimodality program, comparison was also made between patients in the MMD group and a consecutive series of contemporaneous, diagnostic-related group-matched patients. RESULTS: One hundred consecutive patients in the MMD group underwent coronary artery bypass grafting without allogeneic transfusion. This compared favorably with the control population in whom a mean of 2.2 +/- 6.7 units of allogeneic blood was transfused per patient (34 patients [38%] received transfusion). In addition, the volume of postoperative blood loss at 12 hours in the control group was almost double that of the MMD group (660 +/- 270 mL versus 370 +/- 180 mL [p < 0.001]). Total costs for the MMD group in each of the three major diagnostic-related groups were equivalent to or significantly less than those in the consecutive series of diagnostic-related group-matched patients. CONCLUSIONS: Comprehensive risk factor-based application of multiple blood conservation measures in an optimized, integrated, and algorithmic manner can significantly decrease bleeding and need of allogeneic transfusion in coronary artery bypass grafting in a safe and cost-effective manner.

Algorithms↗

PubMed1991

Varieties of sentence comprehension deficits: a case study.

In recent publications, Grodzinsky (1984, 1986, 1990) has offered a new theory of the disruption of sentence comprehension in so-called agrammatic aphasics. In these works Grodzinsky contends that his account, which is based in various ways on the formal apparatus of current syntactic theory (Chomsky, 1981), is an accurate and explanatory characterization of the preserved language of all those who present with both agrammatic sentence production and asyntactic sentence comprehension. We argue that this claim is not in accord with the facts. We present a detailed case study of the sentence comprehension performance of a patient who is clinically categorized as agrammatic. This patient's performance on full and truncated passives, and on subject- and object-cleft sentences fails each of Grodzinsky's predictions for these sentence types. We argue that whether there exists any patient who does exhibit the predicted performance pattern is also in serious doubt.

Aphasia, Broca↗

PubMed1993

Spontaneous recovery of impaired memory span: does comprehension recover?

We have previously described a patient, T.B., who had a memory span of two digits and a sentence span of three words. He showed no evidence of effects of either phonological similarity or word length on span and his deficit was interpreted as reflecting the impaired functioning of the phonological loop component of working memory. Analysis of his language comprehension indicated normal processing of short sentences, together with a marked deficit in understanding long sentences, whether these were presented visually or auditorily (Baddeley and Wilson, 1988). When re-tested after several years, T.B.'s memory span had increased to nine digits, and showed clear effects of phonological similarity and word length. His performance on a series of language comprehension tests indicated a complete recovery, although he continued to show impairment on two tests of phonological awareness. These results are consistent with the proposed link between phonological working memory and language comprehension. In addition, they indicate a dissociation between short-term phonological memory and phonological awareness.

Awareness↗

PubMed1985

The comprehension and production of complex syntax in schizophrenia.

A new and syntactically more complex version of the Token Test was developed to investigate the comprehension of complex syntax in schizophrenia. Results suggested that schizophrenic patients as a group demonstrated an impairment of comprehension proportionate to a reduction in the syntactic complexity of their spoken language, which had been demonstrated in two separate studies. While manic patients also recorded poorer results on the new Token Test than control subjects, there were no significant correlations between their comprehension and production measures as there were for the schizophrenic patients. The speculation is made that manic patients may perform poorly because of state factors such as distractibility, while schizophrenic patients may do so because of an underlying language impairment.

Bipolar Disorder↗

PubMed1976

The nature of comprehension errors in Broca's conduction and Wernicke's aphasics.

The purpose of the study was to ascertain if Broca's aphasics have a comprehension defect which is dependent on syntactic relationships, to ascertain how this comprehension defect, if present, is different from that seen in Wernicke's and conduction aphasias. Twenty-six aphasic patients (nine Broca's eight conduction, nine Wernicke's) and eight controls were given a test which helped differentiate comprehension errors caused by syntactic incompetence from those caused by lexical incompetence. Wenicke's aphasics made significantly more lexical errors than each of the other groups. There were no significant differences between the lexical errors made by the other groups (Broca's, conduction, and control. There were no significant differences between Broca's and conduction aphasics, however both these groups made more syntactic errors than the controls.

Aphasia↗

PubMed1978

Sign comprehension in global aphasia.

Ten global aphasics and eight brain-damaged non-aphasics were given a test of sign comprehension. The test contained natural, animal and human signs. Subjects were matched for etiology, age and residual intellectual functioning. The global aphasics scored significantly lower than the nonaphasics on the test of sign comprehension, indicating that global aphasia might be reconsidered as a disorder of sign comprehension.

Aged↗

PubMed2003

Comprehensive two-dimensional gas chromatography: metrics, potentials, limits.

Metrics for evaluation of separation performance of comprehensive two-dimensional gas chromatography (GCxGC) and for quantitative comparison of that performance with similar performance of its 1D (one-dimensional) counterparts are described. The performance improvement can be expressed via reduction in the saturation of a chromatogram or-in the case of the uniform distribution of peaks along the second dimension--via the peak capacity gain due to GCxGC. An order of magnitude peak capacity gain due to the comprehensive GCxGC is possible under optimal conditions. Optimal parameters of the second dimension column as well as the optimal operational conditions for that column and for the modulator in a comprehensive GCxGC are also presented.

Chromatography, Gas↗

PubMed2003

Advantages and limitations of coupling isotachophoresis and comprehensive isotachophoresis-capillary electrophoresis to time-of-flight mass spectrometry.

Capillary isotachophoresis (ITP) and comprehensive isotachophoresis-capillary electrophoresis (ITP-CE) were successfully coupled to electrospray ionization (ESI) orthogonal acceleration time-of-flight mass spectrometry (TOF-MS) using angiotensin peptides as model analytes. The utility of ITP-TOF-MS and ITP-CE-TOF-MS for the analysis of samples containing analyte amounts sufficient to form flat-top ITP zones (30 microM) as well as for samples with trace analyte amounts (0.3 microM) was studied. Separations were performed in 150 microm internal diameter (I.D.) capillaries for the ITP experiments, and in 200 microm I.D. (ITP) and 50 microm I.D. (CE) capillaries for ITP-CE experiments. The fused-silica columns were coated with poly(vinyl alcohol) to suppress electroosmotic flow that can disrupt ITP zone profiles. The sample loading capacity in both ITP and comprehensive ITP-CE was greatly enhanced (up to 10 microl) compared with typical nanoliter-sized injection volumes in CE. It was concluded that ITP-TOF-MS alone was adequate for the separation and detection of high concentration samples. The outcome was different at lower analyte concentrations where mixed zones or very sharp peaks formed. With formation of mixed zones, ion suppression and discrimination could occur, complicating quantitative determination of the analytes. This problem was effectively overcome by inserting a CE capillary between the ITP and TOF-MS. In such an arrangement, samples were preconcentrated in the high load WTP capillary and then injected into a CE capillary where they were separated into non-overlapping peaks prior to their detection by TOF-MS. The advantage of this comprehensive arrangement, which we have described previously, is that there is no need to discard portions of the sample in order to avoid overloading of the CE capillary. The whole sample is analyzed by multiple injections from ITP to CE. Thus, this method can be used for the analysis of complex samples with wide ranges of component concentrations.

Electrophoresis↗

PubMed1989

The prune belly syndrome: a comprehensive approach to management.

Our approach to management of the prune belly syndrome entails a program of comprehensive early reconstruction, including abdominoplasty, bilateral orchiopexy, reduction cystoplasty, and selective ureteral tailoring and reimplantation. Of 20 patients with the prune belly syndrome treated at our institution during the last 18 years 15 underwent comprehensive reconstruction. Abdominoplasty was performed in 16 patients. Results were evaluated as to cosmetic appearance, functional performance, and preoperative and postoperative electromyography. Immediate good results were obtained in 9 patients. Of 16 patients 6 required more than 1 abdominal wall tailoring and 3 had minor complications that did not compromise the ultimate result. Transabdominal orchiopexy was performed on 32 testes; 28 (88 per cent) are in the scrotum and growing. Of the 4 failures 3 occurred in patients greater than 2 years old at repair. Selective urinary tract reconstruction has been performed; 13 patients underwent tapering and reimplantation of 1 or both ureters. Reduction cystoplasty was done in all 15 patients. Functional assessment of the upper urinary tract by improved radiological techniques and the necessity for long-term antibiotic prophylaxis have led to a more conservative approach in 5 recent patients. Renal function as measured by serum creatinine and/or glomerular filtration rate has remained stable in 12 of 15 patients (92 per cent) undergoing comprehensive reconstruction. Aggressive surgical management of patients with the prune belly syndrome provides improved abdominal wall function and appearance, and offers excellent testicular salvage. Surgical reconstruction of deformed ureters should be selective and decided on longitudinal studies of renal function.

Abdomen↗

PubMed1981

Comprehensive renal scintillation procedures in spinal cord injury: comparison with excretory urography.

A 131iodine orthoiodohippurate comprehensive renal scintillation procedure was performed and compared to results of excretory urography in 200 spinal cord injury patients. No severe urographic abnormalities were undetected by the comprehensive renal scintillation procedure. Only 1.4 per cent of renal units had greater than minimal pyelocaliectasis or ureterectasis in the presence of a normal radionuclide examination. A relatively large number of abnormalities were detected on the renal scintillation procedure when the excretory urogram was normal. Serial followup will be required to determine the significance of these findings but present data suggest that a comprehensive renal scintillation procedure and a plain film of the kidneys, ureters and bladder may be used for screening upper urinary tract abnormalities in lieu of an excretory urogram. This is particularly advantageous for the spinal cord injury population, since there have been no toxic or allergic reactions reported, no bowel preparation or dehydration is required and there is relatively low radiation exposure.

Humans↗

PubMed2003

The role of the anterior left hemisphere in real-time sentence comprehension: evidence from split intransitivity.

We investigate Broca's sentence comprehension as an impairment on normal syntactic composition: the slow-syntax hypothesis (SSH). Experiment 1 examines comprehension of object-relative clauses (Wh-movement). Experiment 2 examines comprehension of sentences with unaccusative verbs (NP-movement), which like passives, base-generate their theme-argument in object position. Guided by the SSH, both experiments test the prediction that syntax-dependent effects such as "gap-filling" are observable but in a delayed fashion. Results show that whereas no priming was obtained at the point of the trace, antecedent reactivation emerged 650 and 800 ms after the verb (for Wh- and NP-movement respectively). This shows, contrary to dependency-based generalizations, that Broca's patients are able to successfully implement dependencies, albeit in a protracted manner. Given the localization value provided by Broca's aphasia, this supports the notion that the temporal implementation of syntactic structure formation (i.e., the requirement that it be fast and automatic) depends on the integrity of the anterior left hemisphere.

Adult↗