Main Concept Production in Persons with Aphasia: A Comparison of Subtypes

Narrative abilities are negatively impacted in persons with aphasia (PWAs), with even the mildest PWAs producing narratives that, though well-structured, are characterized by reduced lexical diversity, complexity, content, length, coherence, and more (e.g., Andreetta, Cantagallo, & Marini, 2012; Capilouto, Wright, and Wagovich, 2006; Fergadiotis & Wright, 2011; Nicholas & Brookshire, 1995; Ulatowska, North, & Macaluso-Haynes, 1981). Even those categorized as “not aphasic by WAB” (NABW) produce significantly different story retell narratives compared to typical and aphasic peers (Author2, Dillow, & Author1, 2013). Diminished narrative abilities, and associated reduced functional communication, have a marked negative impact on quality of life (QoL) in PWAs, more so than physical limitations that accompany stroke (Hilari, 2011; Northcott & Hilari, 2011). Indeed, narrative ability may be a better predictor of life participation and QoL than traditionally administered outcome measures (Ross & Wertz, 1999), making imperative the advancement of narrative assessment and treatment. Three primary barriers to narrative assessment impede widespread use - standardization, norm-reference, and time constraints. AphasiaBank developers (http://talkbank.org/AphasiaBank/) addressed the first barrier by making available a standard discourse protocol. Regarding the second barrier, norm-referenced Main Concept (MC) lists based on 150+ control transcripts for three different types of discourse were recently developed using AphasiaBank (Author2, Campbell, Williams, Dillow, & Author1, 2013). The MC lists included concepts spoken by 50% of the control population. The authors elected to develop MC lists primarily because 1) MC analysis is a reliable and valid method of assessing narrative adequacy in PWAs (Nicholas & Brookshire, 1995), and 2) generation of standardized, norm-referenced, non-transcription-based MC lists would reduce the amount of time required for narrative assessment (third barrier). Previous MC research has revealed differences between controls and PWAs, and between fluent and non-fluent PWAs (Kong, 2009, 2011; Nicholas & Brookshire, 1995). Previous MC studies have also combined certain codes (see Discussion), which may lead to inaccurate representation of communicative abilities and/or masking of differences between subtypes. We extracted lengthy narrative samples of a large group of PWAs and analyzed the samples with a multi-level MC coding system using norm-referenced MCs in order to determine 1) if there were significant differences in MC production between different aphasia subtypes, and 2) if so, which subtypes were significantly different from each othe

Core Lexicon and Main Concept Production during Picture Description

Discourse is a highly complex and individualized communication act wherein individuals not only transmit and receive information for survival and cooperation, but also use spoken language for ritual purposes (e.g., relationships, fellowship, co-participation; Carey, 1988; Dimbleby & Burton, 1998). Discourse in typical and clinical populations has been investigated with a variety of structuralist, functionalist, and hybrid techniques (see Armstrong, 2000), and is known to be a good predictor of quality of life and life participation in persons with aphasia (PWAs). Discourse analysis, however, generally requires specialized training and can be time-consuming. MacWhinney, Fromm Holland, Forbes, & Wright (2010) suggested that analysis of a core lexicon during structured narrative tasks could provide a time-efficient and informative index of functional communication abilities. For example, clinicians could bypass lengthy transcriptions, instead generating a list of words spoken during narration for later comparison to a core lexicon (CoreLex). Using various methods, CoreLex has so far been investigated for the Cinderella story, a monologic story retell narrative task (Author1, Dillow, & Author2, 2013; MacWhinney et al., 2010) and a procedural narrative task where patients describe how to make a PB&J sandwich (Fromm, Forbes, Holland, & MacWhinney, 2013). CoreLex performance is strongly correlated with main concept (MC) production, a measure of narrative adequacy, during Cinderella retelling (Author1, Dillow, & Author2, 2013). Similar investigations for other narrative tasks are needed. The aims of this study were to 1) determine the CoreLex of a picture sequence description task included in the AphasiaBank protocol (Breaking Window), 2) calculate a CoreLex score for controls and PWAs, and 3) determine how well CoreLex predicts narrative adequacy, as judged by MC analysis

Story Grammar Analysis in Persons with Mild Aphasia

Narratives are often the basis of daily conversational interactions. When narrative skills are compromised, functional conversation is negatively impacted. Narrative coherence can be impacted even in clinical populations with mild word-finding deficits, such as anomic aphasia (Andreetta, Cantagallo, & Marini, 2012). The narrative abilities of those individuals who have had a stroke (and perhaps a previous aphasia diagnosis) but who perform within the normal range on standardized aphasia assessment measures have not been characterized. As every clinician/clinical researcher knows, this subgroup still includes individuals who have difficulty in conversation, who cannot return to work, and whose life participation is negatively impacted. Using AphasiaBank categorization (as this study relies on AphasiaBank transcripts), we refer to this subgroup as “not aphasic by WAB” (NABW). In both persons with anomic aphasia (PWaAs) and NABWs, deficits may be so minor that they are not apparent on traditional standardized assessment measures, but it should not be assumed that they do not exist and do not affect functional communication abilities. Unfortunately, there is often very little help to be offered for this population. In order to continue progressive development of interventions for PWaAs and NABWs, more information regarding narrative strengths and weaknesses in this population is needed. Story grammar analysis is a well-known method of analyzing narrative discourse in several clinical populations and is likely to be sensitive to differences between closely matched groups. The specific aims of this study are to 1) determine if there are differences between PWaAs, NABW, and non-brain injured controls (NBIs) on production of story grammar components during retelling of the Cinderella story, and 2) to examine the relationship between story grammar measures and an easily and quickly derived discourse measure called CoreLex to further characterize the relationship between micro- and macro-level processes in persons with mild aphasia

P-wave Pairing and Colossal Magnetoresistance in Manganese Oxides

We point out that the existing experimental data of most manganese oxides show the {\sl frustrated} p-wave superconducting condensation in the ferromagnetic phase in the sense that the superconducting coherence is not long enough to cover the whole system. The superconducting state is similar to the $A_{1}$ state in superfluid He-3. The sharp drop of resistivity, the steep jump of specific heat, and the gap opening in tunneling are well understood in terms of the p-wave pairing. In addition, colossal magnetoresistance (CMR) is naturally explained by the superconducting fluctuations with increasing magnetic fields. The finite resistivity may be due to some magnetic inhomogeneities. This study leads to the possibility of room temperature superconductivity.Comment: LaTex, 14 pages, For more information, please send me an e-mail. e-mail adrress : [email protected]

Optimizing the vertebrate vestibular semicircular canal: could we balance any better?

The fluid-filled semicircular canals (SCCs) of the vestibular system are used by all vertebrates to sense angular rotation. Despite masses spanning seven decades, all mammalian SCCs are nearly the same size. We propose that the SCC represents a sensory organ that evolution has `optimally designed'. Four geometric parameters are used to characterize the SCC, and `building materials' of given physical properties are assumed. Identifying physical and physiological constraints on SCC operation, we find that the most sensitive SCC has dimensions consistent with available data.Comment: 4 pages, 3 figure

Essential nonlinearities in hearing

Our hearing organ, the cochlea, evidently poises itself at a Hopf bifurcation to maximize tuning and amplification. We show that in this condition several effects are expected to be generic: compression of the dynamic range, infinitely shrap tuning at zero input, and generation of combination tones. These effects are "essentially" nonlinear in that they become more marked the smaller the forcing: there is no audible sound soft enough not to evoke them. All the well-documented nonlinear aspects of hearing therefore appear to be consequences of the same underlying mechanism.Comment: 4 pages, 3 figure

Information Flow through a Chaotic Channel: Prediction and Postdiction at Finite Resolution

We reconsider the persistence of information under the dynamics of the logistic map in order to discuss communication through a nonlinear channel where the sender can set the initial state of the system with finite resolution, and the recipient measures it with the same accuracy. We separate out the contributions of global phase space shrinkage and local phase space contraction and expansion to the uncertainty in predicting and postdicting the state of the system. Thus, we determine how the amplification parameter, the time lag, and the resolution influence the possibility for communication. A novel representation for real numbers is introduced that allows for a visualization of the flow of information between scales.Comment: 14 pages, 13 figure

Development and Implementation of an Influenza Point-of-Care Testing Service in a Chain Community Pharmacy Setting

Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% of patients testing positive received a prescription as a result. While health insurance cannot be billed for the service due to current pharmacy reimbursement practices, this did not appear to negatively affect patient willingness to participate. As point-of-care testing services become more commonplace in community pharmacy settings, patient awareness will similarly increase and allow for more widespread access to acute outpatient care