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PubMed1986

Effects of imposed delay of response and item complexity on auditory comprehension by aphasics.

Ten aphasic and five control subjects were administered an auditory comprehension task similar to Levels I-IV of the Revised Token Test under conditions of 0, 5, 10, and 20 sec of imposed response delay. Responses were evaluated in terms of performance accuracy and response time. Aphasic subjects' response accuracy was significantly effected by an interaction between the length of delay imposed and the complexity of the stimulus. The aphasic group also demonstrated a significant main effect for item complexity. Control subjects' accuracy was not influenced by the treatment conditions. Latency measures indicated the aphasic subjects were slower to respond across all treatment conditions. Both groups' latency scores were significantly effected by item complexity. A comparison of mean latencies by condition did, however, suggest different patterns of response for the two groups. Results are discussed in terms of theoretical and clinical implications for the auditory comprehension deficits of aphasia.

Adult↗

PubMed1987

On comprehension of active/passive sentences and language processing in a Polish agrammatic aphasic.

This paper presents the results of a study of active/passive sentence comprehension by a Polish-speaking agrammatic aphasic. The patient showed good performance on canonically ordered active and passive structures, but performed poorly on inverted variants. The systematically normal and deviant comprehension patterns observed are accounted for by normal interpretative strategies applied to syntactic structures built around verbs with reduced inflectional morphology. The differences between our Polish data and the English data discussed in the literature are explained by the fact that Polish possesses a richer derivational verb morphology. The interpretation of inverted sentences demonstrates the importance of S-V-O word order preference. Our analysis draws upon the notion of grammatical functions to explain the data.

Adult↗

PubMed1988

Comprehension of sentence structure in anomic and conduction aphasia.

Picture-pointing auditory and reading comprehension tests were administered to anomic and conduction aphasics. Subjects responded to active sentences of the present progressive form. The possible errors which a subject could make on these experimental tasks included failure to correctly interpret noun order, number, or lexical meaning. Both groups made significantly more correct responses than error responses. Of their error responses, noun-order errors significantly exceeded number and lexical errors for which no differences were observed. When compared with results previously obtained for agrammatic Broca's aphasics, no differences in the pattern of errors were identified. These results are discussed relative to current theories of syntactic processing and for the mechanisms which account for these syntactic comprehension deficits following aphasia.

Adolescent↗

PubMed1989

Syntactic and semantic contributions to sentence comprehension in agrammatism.

Five aphasic subjects, who demonstrated agrammatic speech, and eight control subjects were presented with a sentence-picture matching task in which the factors of syntactic complexity, semantic reversibility, and sentence plausibility were independently varied. A subset of the sentences was patterned after that presented by A. Caramazza and E. Zurif (1976, Brain and Language, 5, 572-583) who concluded that Broca's aphasics rely on semantic constraints instead of syntactic information for sentence comprehension. Our aphasic subjects showed the same pattern of performance on this subset of sentences. However, the results from the full set of sentence materials we tested show that the aphasic subjects could perform some sentence level syntactic analyses, even when syntactic information conflicted with semantic constraints. The aphasic subjects correctly interpreted most active and passive sentences. They failed, however, to assign thematic roles and adjectives in center-embedded relative sentences, and instead relied on nonsyntactic information. These results show that both semantic and syntactic information contributed to sentence comprehension in the aphasic subjects we tested, in contrast to previous claims that syntactic and semantic processes are completely dissociated in this population.

Aged↗

PubMed1989

Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects).

Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation.

Adult↗

PubMed1990

Syntactic comprehension in Japanese aphasics: effects of category and thematic role order.

Syntactic comprehension disturbances in Japanese aphasics were investigated focusing on the role of category order and thematic role order. The data from Japanese aphasics show that the canonicity of thematic role order determines the ease of interpretation of different sentence types. This finding implies that language-specific factors, rather than language-universal factors, influence the sentence comprehension mechanisms that are retained by aphasic patients.

Aphasia↗

PubMed1991

Pronoun comprehension in aphasia: a comparison of three languages.

The research reported here investigated the effect of phonological and syntactic factors on the processing of pronouns by aphasics. The comprehension of these "closed-class" elements was studied in three different languages: French, Dutch, and German. The cross-linguistic design made it possible to vary phonological status (clitic/nonclitic) and phrasal category (noun phrase/prepositional phrase) as well as grammatical relation (direct/indirect object) while keeping class membership (closed class) and meaning constant. A sentence-picture matching task was given to 20 German-speaking, 16 Dutch-speaking, and 14 French-speaking aphasics, half of each language group being classified as agrammatic Broca's and half as paragrammatic Wernicke's aphasics. The results suggest that Broca's aphasics' limitations in retrieving pronouns, and therefore other closed-class elements, are not a function of either phonological status, phrasal category, or grammatical relation. These subjects' observed high level of performance on pronouns in language comprehension appears due to the kind of semantic and syntactic information they encode. Our findings indicate that a more refined distinction than closed class vs. open class is necessary.

Aphasia, Broca↗

PubMed1992

Contextual influences in reading comprehension in aphasia.

Aphasic subjects' auditory comprehension of reversible passive sentences is facilitated by preceding predictive and nonpredictive narratives (Hough, Pierce, & Cannito, 1989, Brain and Language, 36, 325-334). The present study found that aphasic subjects also comprehended written reversible passive sentences significantly more accurately when they were preceded by either predictive or nonpredictive five-sentence narratives than when they were presented in isolation. Also tested was the contention that predictive narratives do not improve aphasic subjects' ability to process target sentences but simply allow these sentences to be ignored. This contention was not supported. The aphasic subjects did not comprehend predictive narratives presented without the subsequent target sentences more accurately than they comprehended the target sentences presented in isolation. For comprehension to be enhanced, both the contextual narratives and the target sentences must be present.

Aged↗

PubMed1982

DSM III and consultation-liaison psychiatry: toward a comprehensive medical model of the patient.

The descriptive and multiaxial approaches in DSM III encourage comprehensive conceptualization of the patient. The use of explicit criteria for diagnosing syndromes facilitates communication between psychiatry and general medicine. The DSM III category Psychological Factors Affecting Physical Condition should be further elaborated into (a) Psychiatric Factors Affecting Physical Condition, and (b) Physical Condition Affecting Psychiatric Disorder. In addition, the phase of the illness these factors affect should be specified, i.e., the precipitation, course, and recovery. Somatoform Disorder should not be a diagnosis of exclusion, and the diagnostic criteria should clearly specify that conversion symptoms may be superimposed on a pre-existing physical disorder. The DSM III axes are not coherent: they include diagnostic categories, statements concerning possible relationships, and factors that might affect outcome. We propose an alternative to the DSM III Axes based on the Patient Evaluation Grid (PEG), a system comprised of four axes, including Biological Dimension, Personal Dimension, Environmental Dimension, and Assessment of Interaction Among Dimensions. Developing a comprehensive diagnostic model for both medical and psychiatric patients that can be shared by all physicians may be an important function of the liaison psychiatrist.

Depressive Disorder↗

PubMedDate not supplied

NEUROLAB, a comprehensive program for the analysis of neurophysiological and behavioural data.

A comprehensive and versatile computer software for IBM-compatible microcomputers has been developed. It is designed for quantitative off-line analysis of A/D-sampled intracellular or extracellular recordings and behavioural or stimulus data. The program works with single files or file sets. It supports data to be viewed on the monitor and allows sectioning of interesting data for common analysis. It offers 19 filters/operators for data processing and comprehensive possibilities to set and calculate trigger points. Data of trigger points can be exported as ASCII files. Standard neurophysiological histograms like interval-, PST-, phase histograms or auto- and cross-correlograms can be obtained. Time-dependent and phase-dependent averaging is possible for all original and filtered data. All graphical output on the display can directly be copied to a plotter/laser printer or HP-GL file by keyboard commands.

Animals↗

PubMedDate not supplied

Comprehensive policy analysis for health system reform.

This article presents the results of a comprehensive approach to policy analysis that may serve as an input for health system reform. The comprehensive character of this effort stems from the attempt to combine, in a coherent framework, various analytical tools that have been developed recently, such as measurement of the burden of disease, cost-effectiveness analysis to integrate packages of essential interventions, national health accounts, assessment of system performance, consumer surveys, and political mapping. These tools were all applied in a study that was carried out in Mexico from August 1993 through September 1994. After explaining the logic of the study, the paper summarizes the findings and recommendations under five headings that shape the form of reform: the problems, the principles, the purposes, the proposals, and the protagonists. Rather than describing these various elements in detail, the paper focuses on the strategic aspects, which are most relevant to other countries currently planning or implementing reform initiatives. The article concludes that, under the current wave of international interest in health system reform, it is necessary to establish a mechanism for shared learning at the global level. Only in this way will it be possible to reproduce the analytical skills and accumulate the body of evidence that health systems require for their sustained improvement.

Delivery of Health Care↗

PubMed1986

Sleep deprivation and reading comprehension.

Ten older subjects (50-60 years of age) took a college level reading comprehension test after two nights without sleep. Their performance was compared with performance on an alternate form given prior to sleep deprivation. The six subjects who completed the test showed little evidence of reduced reading rate or comprehension. However, only three subjects were able to sustain their levels of non-deprived performance.

Arousal↗

PubMed1991

Comprehensive multidisciplinary treatment of chronic pain: a follow-up study of treated and non-treated groups.

There are relatively few outcome studies of multidisciplinary chronic pain programs which have utilized no-treatment comparison groups. The present study compared a group of chronic pain patients (N = 42) treated in a comprehensive multidisciplinary pain program with a group of patients (N = 15) who were evaluated but not treated. Comparisons were made at evaluation and at a follow-up period averaging 11 months later. From evaluation to discharge, the treated group showed significant increases in physical functioning. From evaluation to long-term follow-up, both the treated and non-treated groups showed significant decreases in self-report pain ratings and interference with activities ratings. However, only the treated group showed a significant decrease in addictive medication use and increase in work functioning. The return-to-work rate for the treated group was 48% with an additional 28% of the patients being returned to vocational rehabilitation. None of the non-treated group returned to work or vocational rehabilitation. Results are discussed in terms of their support for the conclusion that comprehensive multidisciplinary pain programs produce marked subjective and functional changes.

Adult↗

PubMed1991

The impact of a comprehensive evaluation in the management of cancer pain.

To evaluate the importance of a comprehensive evaluation in the management of patients with cancer pain, we surveyed 276 consecutive consultations (226 retrospectively and 50 prospectively) performed by the pain consultant at Memorial Sloan-Kettering Cancer Center. For all consultations, the pain diagnosis, other medical and neurologic diagnoses, investigations and suggested therapeutic interventions were recorded. The pain consultation identified a previously undiagnosed etiology for the pain in 64% of patients in both surveys. Metastatic neoplasm was the most common lesion discovered. In addition, the prospective survey yielded new neurologic diagnoses in 36% of patients and an unsuspected infection in 4%. Eighteen percent of prospectively surveyed patients received radiotherapy, surgery or chemotherapy based on the findings of the pain consultant. These data confirm the importance of a comprehensive neuro-oncologic evaluation in the management of cancer pain. An understanding of oncology, neurology and medicine is critical to assess and treat these patients.

Adolescent↗

PubMed1996

Correlates of depression in chronic pain patients: a comprehensive examination.

This study examined the relations between depression and demographic, pain-related, and work-related variables in 254 chronic pain patients. Regression analyses were conducted, initially by category (i.e., demographic, pain-related, and work-related), and finally a comprehensive regression analysis was performed, containing the significant independent variables from each category. Among the demographic variables, education level and marital status were related to depression, and an interaction between age and gender was associated with depression, with younger women and older men reporting more depression. Among the pain-related variables, longer duration of pain was associated with increased depression. Among the work-related variables, unemployment was associated with depression, and there was an interaction between work status and litigation status, with working and litigating being associated with depression and not working and not litigating being associated with depression. In the comprehensive analysis, work status, education level, and marital status accounted for a significant amount of the variance in depression scores. These findings, together with future research directions, are discussed.

Adult↗

PubMed1988

Pharmacokinetics, biochemical mechanism and mutation accumulation: a comprehensive model of chemical carcinogenesis.

Chemical carcinogenesis is a process beginning with carcinogen absorption and ending with development of a malignant tumor. Individual elements of this process have been studied intensively but no comprehensive model has been developed. This report describes a comprehensive model which incorporates carcinogen pharmacokinetics, biochemical mechanism of action, and the resultant mutation of normal cells to malignancy. Model parameters correspond to specific physiological and biochemical structures and processes. The model was encoded in a simulation language and used to examined biochemical and cellular effects of exposure to an initiator and a promoter. With laboratory validation, the model should be useful for interpretation and design of studies on carcinogenic mechanisms and for risk assessment.

Carcinogens↗

PubMedDate not supplied

The development of the Comprehensive Addiction Severity Index for Adolescents (CASI-A). An interview for assessing multiple problems of adolescents.

The Comprehensive Addiction Severity Index for Adolescents (CASI-A) is a 45 to 90-minute comprehensive, semi-structured clinical interview for evaluating adolescents who present for treatment at various provider agencies. CASI-A modules and their individual items were selected and revised based on theory, clinical wisdom, and adolescent experiences obtained during pilot interviews and focus groups. The CASI-A assesses known risk factors, concomitant symptomatology, and consequences of adolescent alcohol/drug use within seven primary areas of functioning: education status, alcohol/drug use, family relationships, peer relationships, legal status, psychiatric distress, and use of free time. The CASI-A is not a diagnostic or screening instrument, but rather a clinical assessment tool that obtains clinically pertinent information designed to guide treatment planning and to evaluate treatment outcome. The CASI-A's design makes it suitable for administration in a variety of settings, for repeat administration at posttreatment follow-up evaluations, and for assessment of virtually all adolescents in treatment regardless of their admission problem. Overall, the CASI-A has encouraging but preliminary evidence of validity and internal consistency. Information collected soon after admission during administration of the CASI-A by nonclinical interviewers corresponded quite well with that obtained over the course of the adolescent's treatment stay by the entire treatment team. Revisions to the instrument are being made in those areas where correspondence between information on the CASI-A and that extracted from clinical records dropped below 75%, or in those early subscales, where alpha coefficients dropped below .6. As a result of the encouraging results reported in this paper, we are beginning additional psychometric testing, refining the proposed scoring system, and developing a computerized data entry, scoring, and report system.

Adolescent↗

PubMedDate not supplied

The effects of comprehensive inpatient alcoholism treatment on measures of loss and grief.

Current research has identified a grief reaction in alcoholics undergoing inpatient treatment. The addition of a loss/grief experience to an existing comprehensive treatment regimen is examined to determine its ability to enhance loss/grief awareness in an experimental group of patients. Loss identification and grief awareness measures for this group are compared with like measures for a group undergoing the regular treatment program. No significant difference between the groups is reported. It is proposed that existing models of comprehensive treatment increase loss awareness and initiate a grieving process without the addition of a specialized treatment component dealing with loss and grief.

Adult↗