Shame as a social phenomenon: A critical analysis of the concept of dispositional shame

An increased clinical interest in shame has been reflected in the growing number of research studies in this area. However, clinically-orientated empirical investigation has mostly been restricted to the investigation of individual differences in dispositional shame. This paper reviews recent work on dispositional shame but then argues that the primacy of this construct has been problematic in a number of ways. Most importantly, the notion of shame as a context-free intrapsychic variable has distracted clinical researchers from investigating the management and repair of experiences of shame and shameful identities, and has made the social constitution of shame less visible. Several suggestions are made for alternative ways in which susceptibility to shame could be conceptualised, which consider how shame might arise in certain contexts and as a product of particular social encounters. For example, persistent difficulties with shame may relate to the salience of stigmatising discourses within a particular social context, the roles or subject positions available to an individual, the establishment of a repertoire of context-relevant shame avoidance strategies and the personal meaning of shamefulness

Stability of a Measure of Lexica Diversity (D) in Narrative Discourse

Research into treatment for improving word retrieval ability in aphasia is increasingly focused on assessing outcomes at a discourse level. One of the challenges in this regard is choosing a measure to assess word retrieval in discourse. Some researchers (Fergadiotis & Wright, 2011; MacWhinney, Fromm, Forbes, & Holland, 2011; Rider, Wright, Marshall, & Page, 2008; Wright & Capiluto, 2009; Wright, Silverman, & Newhoff, 2003) have proposed using a measure of lexical diversity (D) as a proxy measure of word retrieval in aphasic discourse, reasoning that as word retrieval ability improves, a wider variety of words should be produced. Fegadiotis and Wright (2011) define lexical diversity as the range of vocabulary deployed in a discourse sample by a speaker, reflecting the speaker’s capacity to access and retrieve target words. D is a measure of lexical diversity that is robust to length variation, allowing comparison of discourses over time or between participants (MacWhinney et al., 2011)

Stability of a Functional Measure of Word Retrieval in Narrative Discourse

Interest in the ability of people with aphasia to communicate in natural contexts has resulted in examination of their discourse production. There is an expectation that changes in discourse production may reflect meaningful treatment-related changes. In a recent special issue of Aphasiology, Wright (2011) stated that it is clinically important for researchers to establish clinician friendly, reliable, and valid methods for analyzing discourse in order to quantify meaningful changes. An important part of this endeavor requires assessment of the stability of such methods. This is important for a number of reasons. Currently, clinical researchers often analyze discourse production only once prior to treatment and again at the end of treatment. This is a risky practice unless the stability of the discourse measurement is known a priori. If the stability is not known, there is no way that change in discourse can be attributed to the treatment with any degree of confidence unless multiple pre-treatment measurements are collected and analyzed. Additionally, if the discourse measurements are not relatively stable before treatment, a relatively large treatment effect may be necessary to demonstrate that change is related to treatment and not to the normal variability of the measurement. Because this may prove to be challenging, a more strategic approach might be to use a measurement that is relatively stable before treatment. Finally, apart from treatment, the issue of stability of discourse measurements is also important if those measurements are used to describe and analyze aspects of an individual’s language impairment. If a measurement is not reasonably stable from session to session, it will probably not contribute to a valid assessment of the individual’s impairment

Word Retrieval Measures with the AphasiaBank Stimuli: Test-Retest Reliability Proposal for CAC 2014

Research into treatment for improving word retrieval ability in aphasia is increasingly focused on assessing outcomes at a discourse level. For example, the AphasiaBank project (http://talkbank.org/AphasiaBank/ ) uses a number of tasks to elicit discourses from individuals with aphasia. The discourses can then be analyzed with a set of analysis tools from the Computerized Language Analysis (CLAN) system. MacWhinney, Fromm, Holland, Forbes, & Wright (2010) have suggested that the AphasiaBank tools can be used to study recovery from aphasia and the effects of aphasia treatments. The AphasiaBank protocol is promising because of its ability to quickly and accurately perform a number of analyses that are time-consuming, cumbersome, and vulnerable to error when performed manually. However, except for a report on VOCD, a measure of lexical diversity that is part of the CLAN system (Boyle, 2013), there have been no reports about the test-retest reliability of the various language measures included in CLAN when they are used with the elicitation stimuli that are part of the AphasiaBank protocol. Test-retest reliability refers to the assessment of whether a test produces the same results on repeated application when the participants who are being tested have not changed on the domain that is being measured (Fitzpatrick, Davey, Buxton, & Jones, 1998). Before a measure is used as an outcome assessment, its test-retest reliability must be established, otherwise it is impossible to assert that changes on the measure are related to treatment rather than to spurious, day-to-day variability inherent in the measurement or the behavior it is measuring (Brookshire & Nicholas, 1994; Herbert, Hickin, Howard, Osborne, & Best, 2008). Test-retest reliability is as important for measures used to evaluate impairments as it is for those that measure change, since measures that are not stable will not provide valid or reliable assessments of impairments. Several measures available in the CLAN System can be used to assess word retrieval difficulty. To use CLAN, the discourses must first be transcribed and coded for errors and other behaviors of interest using a format specified in the CHAT Manual (http://talkbank.org/AphasiaBank/). CLAN can then be used to analyze the transcripts for the occurrence of the coded errors as well as for other language parameters. Word-finding problems that can be coded in CHAT include phonemic paraphasias, semantic paraphasias, neologisms, false starts, time fillers, and repetitions. The purpose of this investigation was to provide preliminary information about the test-retest reliability of these measurements in narrative discourses elicited with the AphasiaBank stimuli from speakers with aphasia

Stability of Word Retrieval and Discourse Measures in Aphasia

Discourse samples across three sessions from 12 individuals with aphasia were analyzed for the stability of measures of word finding, informativeness, efficiency, and main concept production. A general measure of word finding difficulty in discourse was stable from session to session, but the distribution of individual categories of word finding errors changed across sessions for all but one participant. Measures of informativeness, efficiency, and main concept production were stable at the group level, but one participant varied markedly from session to session. Discussion considers the implications for clinical researchers investigating changes in word finding and discourse production

Semantic treatments for word and sentence production deficits in aphasia.

The cognitive domains of language and memory are intrinsically connected and work together during language processing. This relationship is especially apparent in the area of semantics. Several disciplines have contributed to a rich store of data about semantic organization and processing, and several semantic treatments for aphasic word and sentence production impairments have been based on these data. This article reviews the relationships between semantics and memory as they relate to word and sentence production, describes the aphasic language impairments that result from deficits in these areas, and summarizes treatment approaches that capitalize on what we have learned about these domains and how they work together. (PsycINFO Database Record (c) 2017 APA, all rights reserved

Public, Private and University Collaboration: Applying a Retrospective Study of the Central Massachusetts Bio-Medical Cluster, Cluster Project Summary for Mosakowski Institute

Three Clark faculty members are studying the development of the Worcester Biotechnology Cluster for any lessons it might hold for current efforts to catalyze the growth of a sustainable energy/green jobs cluster in Worcester or elsewhere. Mary Ellen Boyle (GSOM), Jennie Stephens (IDCE/ESP), and Jing Zhang (GSOM) have conducted extensive in-depth interviews and combed the literature of cluster development to produce several articles and working papers

The Effect of a Self Directed Program on Locus Control and Control of Diabetes

Does a self directed program have a significant impact on an individual\u27s locus of control and the control of diabetes as measured by glycosolated hemoglobin

Falls in older people: Examining risk factors in specific subgroups and the effectiveness of a specialist-led falls prevention intervention

Accidental falls remain an important healthcare issue for older people. We report on three studies examining risk predictors for further falls, falls-related hospital attendances and mortality, and then test the effectiveness of a hospital-based falls prevention intervention. A prospective study of 498 older people who attended an Emergency Department (E.D.) with a fall showed that age 80 years and older was the greatest predictor of further falls, with a 2-fold increased adjusted risk by 5 years (HR 2.00; 95% C.I. 1.42 – 2.82). Mortality following an E.D. presentation with a fall was 19% at 1 year, increasing to 52% by 5 years. Increasing age and assistance with ADLs predicted both ED re-presentation and mortality. Being female and falls due to syncope were protective. The Concord Health and Ageing in Men (CHAMP), is a longitudinal study of 1705 men. Previous history of falls was the most significant predictor of future falls (IRR 3.12; 95% C.I. 2.49 – 3.91) and falls injury hospitalisations at 10 years (HR 1.48; 95% C.I. 1.09 – 1.99) in this cohort. Risk factors for falls included increasing age, disability in ADLs, being single, dementia, having 3 or more comorbidities, polypharmacy and reduced visual acuity. Dementia was associated with 2-fold increased risk of falls injury hospitalisation at 10 years (HR 2.67; 95% C.I. 1.69 – 4.22). Men born in a non-English-speaking country and men who were still working were less likely to be hospitalised die to a fall injury. A randomised controlled trial (n = 81) of a specialist-led CONFABs clinic versus enhanced G.P. coordinated care, showed an increased rate of falls (IRR 2.39; 95% C.I. 1.09 – 5.27) and risk of falls (RR 1.79; 95% C.I. 1.10 – 2.96) at 1 year with the CONFABS clinic intervention. There was no significant difference in the rate of injurious falls or in the number of fractures between the interventions. Compliance with recommendations was similar in both groups, although more falls prevention strategies were recommended to the falls clinic participants. There are shared risk factors for falls, fall hospitalisations and mortality, with increasing age, functional disability and dementia the most important to consider. Falls prevention strategies may be successfully provided in General Practice, supported by specialist risk assessment and recommendations

Indirect language therapy for children with persistent language impairment in mainstream primary schools : outcomes from a cohort intervention

A manualized language therapy developed via a randomized controlled trial had proved efficacious in the short-term in developing expressive language for mainstream primary school children with persistent language impairment. This therapy had been delivered to a predetermined schedule by speech and language therapists or speech and language therapy assistants to children individually or in groups. However, this model of service delivery is no longer the most common model in UK schools, where indirect consultancy approaches with intervention delivered by school staff are often used. A cohort study was undertaken to investigate whether the therapy was equally efficacious when delivered to comparable children by school staff, rather than speech and language therapists or speech and language therapy assistants. Children in the cohort study were selected using the same criteria as in the randomized controlled trial, and the same manualized therapy was used, but delivered by mainstream school staff using a consultancy model common in the UK. Outcomes were compared with those of randomized controlled trial participants. The gains in expressive language measured in the randomized controlled trial were not replicated in the cohort study. Less language-learning activity was recorded than had been planned, and less than was delivered in the randomized controlled trial. Implications for 'consultancy' speech and language therapist service delivery models in mainstream schools are outlined