Eficácia de uma abordagem integrada de intervenção neurolinguística na afasia progressiva primária

In the past few years, primary progressive aphasia has been acknowledged as an emerging field of practice. Considered a neurodegenerative-based syndrome, primary progressive aphasia requires a singular pathway that addresses the associated characteristics of the syndrome. Among the several treatment approaches that have been investigated, behavioural interventions seem to offer some promise. Despite evidence suggests that intervention should capitalize on spared language abilities and improve communication performance to increase functioning levels, a large number of interventions has focused on remediating impaired skills. Accordingly, the present work aimed to design, implement and evaluate the effects of an intervention that targets the maintenance of a core vocabulary and the training of communication strategies along with the use of augmentative and alternative communication devices. Particularly, this case report aimed to analyse the effect of a neurolinguistic intervention on naming performance for trained and untrained words, and quality of life. Two patients diagnosed with primary progressive aphasia participated in this study that took place over the period of five months. Data collection occurred before intervention, during intervention every two-week interval, immediately after the intervention and one month after treatment was complete. Outcome measures consisted of formal and standardized instruments, adapted and validated to Portuguese population. The intervention approach used in this study produced a limited but promising impact on participants. One participant improved naming accuracy and both participants retained therapy gains. Several methodological aspects limited the outcomes representativeness and generalization of conclusions to clinical practice, namely the reduced number of participants, the presence of different diagnosis and the design. This study provides preliminary data on the effects of combined intervention approaches and their impact on patients’ quality of life. The involvement of close family members on therapy sessions is highlighted as beneficial.A afasia progressiva primária tem sido reconhecida como uma área de intervenção emergente nos últimos anos. Considerando-se uma síndrome de origem neurodegenerativa, a afasia progressiva primária requer uma resposta diferenciada que vá ao encontro das características inerentes a esta condição. Várias abordagens de intervenção têm sido exploradas, de entre as quais se destacam as intervenções comportamentais, pelos resultados promissores que têm oferecido. Embora se defenda cada vez mais que a intervenção se deva focar na manutenção de competências linguísticas residuais e na maximização das competências comunicativas, no sentido de aumentar os níveis de funcionalidade da pessoa, grande parte das intervenções têm valorizado a reaprendizagem de competências perdidas. Neste sentido, o presente trabalho teve como principal objetivo desenhar, implementar e avaliar os efeitos de uma intervenção que promove a manutenção de um vocabulário funcional e o treino de estratégias comunicativas a par da utilização de meios de comunicação aumentativa e alternativa. Especificamente, este estudo de caso visou analisar o efeito de uma intervenção neurolinguística na capacidade de nomeação de palavras treinadas e não treinadas, e qualidade de vida. Dois pacientes diagnosticados com afasia progressiva primária participaram no estudo que teve uma duração total de cinco meses. Foram recolhidos dados antes da intervenção, durante a intervenção a cada duas semanas, imediatamente após a intervenção e um mês após o fim do tratamento. Para tal foram utilizados instrumentos de medida formais e estandardizados, adaptados e aferidos à população portuguesa. A abordagem de intervenção implementada teve um impacto limitado, mas promissor, nos participantes. Registou-se uma melhoria das competências de nomeação num dos casos, e manutenção de competências adquiridas em ambos os casos. Vários fatores metodológicos limitaram a representatividade dos resultados obtidos e aplicabilidade das conclusões à prática clínica, nomeadamente o reduzido número de participantes, a heterogeneidade no diagnóstico e o desenho do estudo. Os resultados deste estudo providenciam dados preliminares acerca do efeito de abordagens integradas de intervenção e impacto na qualidade de vida das pessoas com afasia progressiva primária. Destaca-se a importância do envolvimento de familiares diretos nas sessões terapêuticas, como fator facilitador.Programa Doutoral em Psicologi

The role of syntactic prediction in auditory word recognition

Context is widely understood to have some influence on how words are recognized from speech. This dissertation works toward a mechanistic account of how contextual influence occurs, looking deeply at what would seem to be a very simple instance of the problem: what happens when lexical candidates match with auditory input but do not fit with the syntactic context. There is, however, considerable conflict in the existing literature on this question. Using a combination of modelling and experimental work, I investigate both the generation of abstract syntactic predictions from sentence context and the mechanism by which those predictions impact auditory word recognition. In the first part of this dissertation, simulations in jTRACE show that the speed with which changes in lexical activation can be observed in dependent measures should depend on the size and composition of the set of response candidates allowed by the task. These insights inform a new design for the visual world paradigm that ensures that activation can be detected from words that are bad contextual fits, and that facilitatory and inhibitory mechanisms for the syntactic category constraint can be distinguished. This study finds that wrong-category words are activated, a result that is incompatible with an inhibitory syntactic category constraint. I then turn to a different approach to studying lexical activation, using information-theoretic properties of the set of words consistent with the auditory input while neural activity is recorded in MEG. Phoneme surprisal and cohort entropy are evaluated as predictors of the neural response to hearing single words when that response is modeled with temporal response functions. This lays the groundwork for a design that can test different versions of surprisal and entropy, incorporating facilitatory or inhibitory syntactic constraints on lexical activation when the stimuli are short sentences. Finally, I investigate a neural effect in MEG previously thought to reflect syntactic prediction during reading. When lexical predictability is minimized in a new study, there is no longer evidence for structural prediction occurring at the beginning of sentences. This supports the possibility of a tighter link between syntactic and lexical processing

RELIGION'S EVOLUTIONARY LANDSCAPE: COUNTERINTUITION, COMMITMENT, COMPASSION, COMMUNION

Religion is not an evolutionary adaptation per se, but a recurring by-product of the complex evolutionary landscape that sets cognitive, emotional and material conditions for ordinary human interactions. Religion involves extraordinary use of ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or “agency detector,” whose proper (naturally-selected) domain encompasses animate objects relevant to hominid survival - such as predators, protectors and prey - but which actually extends to moving dots on computer screens, voices in wind, faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order; however, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims

RELIGION'S EVOLUTIONARY LANDSCAPE: COUNTERINTUITION, COMMITMENT, COMPASSION, COMMUNION

Religion is not an evolutionary adaptation per se, but a recurring by-product of the complex evolutionary landscape that sets cognitive, emotional and material conditions for ordinary human interactions. Religion involves extraordinary use of ordinary cognitive processes to passionately display costly devotion to counterintuitive worlds governed by supernatural agents. The conceptual foundations of religion are intuitively given by task-specific panhuman cognitive domains, including folkmechanics, folkbiology, folkpsychology. Core religious beliefs minimally violate ordinary notions about how the world is, with all of its inescapable problems, thus enabling people to imagine minimally impossible supernatural worlds that solve existential problems, including death and deception. Here the focus is on folkpsychology and agency. A key feature of the supernatural agent concepts common to all religions is the triggering of an "Innate Releasing Mechanism," or “agency detector,” whose proper (naturally-selected) domain encompasses animate objects relevant to hominid survival - such as predators, protectors and prey - but which actually extends to moving dots on computer screens, voices in wind, faces on clouds. Folkpsychology also crucially involves metarepresentation, which makes deception possible and threatens any social order; however, these same metacognitive capacities provide the hope and promise of open-ended solutions through representations of counterfactual supernatural worlds that cannot be logically or empirically verified or falsified. Because religious beliefs cannot be deductively or inductively validated, validation occurs only by ritually addressing the very emotions motivating religion. Cross-cultural experimental evidence encourages these claims

Hard Reading

The fifteen essays collected in Hard Reading argue that science fiction has its own internal rhetoric, relying on devices such as neologism, dialogism, semantic shifts, the use of unreliable narrators. It is a “high-information” genre which does not follow the Flaubertian ideal of le mot juste, “the right word”, preferring le mot imprévisible, “the unpredictable word”. Science fiction derives much of its energy from engagement with vital intellectual issues in the “soft sciences”, especially history, anthropology, the study of different cultures, with a strong bearing on politics. Both the rhetoric and the issues deserve to be taken much more seriously than they have been in academia, and in the wider world. Hard Reading is also a memoir of what it was like to be a committed fan, from teenage years, and also an academic struggling to find a place, at a time when a declared interest in science fiction and fantasy was the kiss of death for a career in the humanities

Keys to The Gift

"Yuri Leving’s Keys to The Gift: A Guide to Vladimir Nabokov’s Novel is a new systematization of the main available data on Nabokov’s most complex Russian novel, The Gift (1934–1939). From notes in Nabokov’s private correspondence to scholarly articles accumulated during the seventy years since the novel’s first appearance in print, this work draws from a broad spectrum of existing material in a succinct and coherent way and provides innovative analyses. The first part of the monograph, “The Novel,” outlines the basic properties of The Gift (plot, characters, style, and motifs) and reconstructs its internal chronology. The second part, “The Text,” describes the creation of the novel and the history of its publication, public and critical reaction, challenges of English translation, and post-Soviet reception. Along with annotations to all five chapters of The Gift, the commentary provides insight into problems of paleography, featuring a unique textological analysis of the novel

Keys to The Gift

"Yuri Leving’s Keys to The Gift: A Guide to Vladimir Nabokov’s Novel is a new systematization of the main available data on Nabokov’s most complex Russian novel, The Gift (1934–1939). From notes in Nabokov’s private correspondence to scholarly articles accumulated during the seventy years since the novel’s first appearance in print, this work draws from a broad spectrum of existing material in a succinct and coherent way and provides innovative analyses. The first part of the monograph, “The Novel,” outlines the basic properties of The Gift (plot, characters, style, and motifs) and reconstructs its internal chronology. The second part, “The Text,” describes the creation of the novel and the history of its publication, public and critical reaction, challenges of English translation, and post-Soviet reception. Along with annotations to all five chapters of The Gift, the commentary provides insight into problems of paleography, featuring a unique textological analysis of the novel

Ludic Dysnarrativa : How Can Fictional Inconsistency in Games be Reduced?

The experience of fictional inconsistencies in games is surprisingly common. The goal was to determine if solutions exist for this problem and if there are inherent limitations to games as a medium that make storytelling uncommonly difficult. Termed ‘ludic dysnarrativa’, this phenomenon can cause a loss of immersion in the fictional world of a game and lead to greater difficulty in intuitively understanding a game’s rules. Through close textual analysis of The Stanley Parableand and other games, common trends are identified that lead a player to experience dysnarrativa. Contemporary cognitive theory is examined alongside how other media deal with fictional inconsistency to develop a model of how information (fictional and otherwise) is structured in media generally. After determining that gaps in information are largely the cause of a player feeling dysnarrativa, it is proposed that a game must encourage imaginative acts from the player to prevent these gaps being perceived. Thus a property of games, termed ‘imaginability’, was determined desirable for fictionally consistent game worlds. Many specific case studies are cited to refine a list of principles that serve as guidelines for achieving imaginability. To further refine these models and principles, multiplayer games such as Dungeons and Dragons were analysed specifically for how multiple players navigate fictional inconsistencies within them. While they operate very differently to most single-player games in terms of their fiction, multiplayer games still provide useful clarifications and principles for reducing fictional inconsistencies in all games. Negotiation between agents (designers, players, game rules) in a game is of huge value to maintaining coherent fictional worlds and social information in some multiplayer games takes on a role close to that of fictional information in single player games. Dysnarrativa can also be used to positive effect in certain cases such as comedy games, horror games or for satirical purposes