Aphasia in a linguistically diverse population: resources for turn construction and interactional adaptations of Malaysian adults

The central aim of this thesis is to explore resources for turn construction and interactional adaptations in the conversation of adults with aphasia (a language difficulty acquired most commonly after stroke) in the linguistically diverse Malaysian population. Malaysia has a long history of societal multilingualism, necessitating individual bi/multilingualism; the thesis investigates for the first time the impact of aphasia on conversational interactions in this population. As a result, the thesis applies Conversation Analysis (CA), with an emphasis on localised investigation of participants’ turns within particular sequences. The data are from two sources: video recorded natural conversations in the homes of three participants with aphasia and their regular conversation partners, and conversations outside the home with a friend, where languages other than the home language were reportedly used. The data driven procedures of CA reveal turn construction resources of topic-comment structure, co-construction and repetition are deployed by PWAs in conversation with regular and less familiar conversation partners and these resources cross the linguistic boundaries of the languages in their repertoire. These resources also occur in the non-aphasic conversation partners’ turns and exhibit similarities to those documented in studies of the conversations of monolingual English speakers with aphasia. Given that two or more sets of linguistic resources are available for each partnership, code-switching is found to be a compensatory resource for dealing with word finding difficulties as well as a resource for claiming or ascribing identity. A comparison of conversations with a friend indicates that a partnership’s familiarity influences interactional outcomes. However, the relationship between familiarity and interactional success is a complex one which appears to vary for each partnership. The findings of this thesis have theoretical and clinical implications for planning support services for aphasia in societies where bi/multilingualism is the norm. The significance of this contribution becomes evident when global trends in linguistic diversity are taken into consideration

A qualitative study of primary health care access, barriers and satisfaction among people with mental illness

Research has found that a substantial proportion of individuals with mental illness have high morbidity and mortality rates, and high under-diagnosis of major physical illnesses. Furthermore, people with a mental illness tend not to seek out or utilise health care services. The reasons for the negative attitudes and behaviour towards health care services among this population have not been investigated. This paper presents findings from a study that investigated the health care service needs of people with mental illness (n = 20), and views from health care providers (n = 16) regarding access to these services by people with a mental illness. Results indicated that psychiatric patients identified a range of barriers to their health care usage and low levels of health care satisfaction. These views were shared with health care professionals. Reasons for these findings and strategies to address these problems so that there is better access to health care services for people with mental illness are discussed. <br /

A Review of Pharmacologic Treatment for Compulsive Buying Disorder

At present, no treatment recommendations can be made for compulsive buying disorder. Recent studies have found evidence for the efficacy of psychotherapeutic options, but less is known regarding the best pharmacologic treatment. The purpose of this review is to present and analyze the available published evidence on the pharmacological treatment of compulsive buying disorder. To achieve this, we conducted a review of studies focusing on the pharmacological treatment of compulsive buying by searching the PubMed/MEDLINE database. Selection criteria were applied, and 21 studies were identified. Pharmacological classes reported included antidepressants, mood stabilizers, opioid antagonists, second-generation antipsychotics, and N-methyl-D-aspartate receptor antagonists. We found only placebo-controlled trials for fluvoxamine; none showed effectiveness against placebo. Three open-label trials reported clinical improvement with citalopram; one was followed by a double-blind discontinuation. Escitalopram was effective in an open-label trial but did not show efficacy in the double-blind phase. Memantine was identified as effective in a pilot open-label study. Fluoxetine, bupropion, nortriptyline, clomipramine, topiramate and naltrexone were only reported to be effective in clinical cases. According to the available literature, there is no evidence to propose a specific pharmacologic agent for compulsive buying disorder. Future research is required for a better understanding of both pathogenesis and treatment of this disorder.info:eu-repo/semantics/publishedVersio

Compulsive buying and branding phenomena

The purpose of this paper was to explore the impact of brand variables such as brand awareness, brand loyalty, brand attachment, and perceived brand quality on compulsive buying behavior. A self-administered questionnaire, containing demographic items and items related to compulsive buying, brand awareness, brand loyalty, brand attachment and perceived quality, was used to collect data. Participants were 269 US university students at a large mid-western university (138 men, 131 women; mean age = 21.96). Data were analyzed using descriptive statistics, t-test and MANOVA/ANOVA. Reliability of all scales was acceptable. In the current study, 18% of the participants were classified as compulsive buyers. Women showed higher compulsive buying tendency than men. Participants with greater compulsive buying tendency scored higher on brand attachment and brand loyalty and lower on brand awareness; there was no difference in scores on perceived brand quality. Results support that brand variables such as brand awareness, brand loyalty, and brand attachment are related to compulsive buying behavior. New perceptions and implications for both academicians and practitioners are provided

Review of Dental Impression Materials

Major advances in impression materials and their application have occurred during the last decade, with greater emphasis being placed on rubber impression materials than on dental compound, zinc oxide-eugenol, and agar and alginate. Of particular interest has been the effect of disinfection solutions on the qualities of impressions and the biocompatibility of impression materials. The principal advance in hydrocolloids has been the introduction of the agar/alginate impression technique, which has simplified the procedure and improved the quality of gypsum dies compared with those prepared in alginate impressions. The tear strength of some alginates has been improved, and some have been formulated so that the powder is dustless, thus reducing the health hazard as a result of patient inhalation of dust during the dispensing process. Polyether and silicone impression materials have been modified so that the working time, viscosity, and flexibility of the polyethers have been improved and, with the introduction of addition silicones, their accuracy has become exceptional. Although the early addition silicones liberated hydrogen after setting, thus delaying the pouring of models and dies, most addition silicones have been improved so that no hydrogen is released and dies can be poured immediately. The introduction of automatic mixing systems for addition silicones has simplified their manipulation, has reduced the number of voids in impressions, and has reduced the amount of material wasted. The incorporation of surfactants into addition silicones has made them hydrophilic, with wetting properties similar to those of polyethers, and has made pouring bubble-free gypsum dies easier. This review is confined to published and unpublished information of the past decade. It will also suggest trends that should be anticipated in the near future based on this information. The review will not present information developed before 1975, which is available in several textbooks on dental materials by Craig (1985a), Phillips (1982), and Williams and Cunningham (1979).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66604/2/10.1177_08959374880020012001.pd

Quetiapine augmentation of SRIs in treatment refractory obsessive-compulsive disorder: a double-blind, randomised, placebo-controlled study [ISRCTN83050762]

BACKGROUND: Although serotonin reuptake inhibitors are effective in the treatment of OCD, many patients fail to respond to these agents. Growing evidence from open-label and placebo-controlled trials suggests a role for augmentation of SRIs with atypical antipsychotics in OCD. Quetiapine is generally well tolerated and previous open-label data has produced mixed results in OCD and additional controlled data is needed. METHODS: We undertook a double-blind, randomised, parallel-group, flexible-dose, placebo-controlled study of quetiapine augmentation in subjects who had responded inadequately to open-label treatment with an SRI for 12 weeks. Following informed consent and screening, forty-two subjects were randomised to either placebo or quetiapine for six weeks. RESULTS: There was significant improvement from baseline to endpoint on the Yale-Brown Obsessive-Compulsive Scale in both the quetiapine and placebo groups (quetiapine, n = 20, p < 0.0001; placebo, n = 21, p = 0.001) with 40% (n = 8) of quetiapine and 47.6% (n = 10) of placebo treated subjects being classified as responders. Quetiapine did not demonstrate a significant benefit over placebo at the end of the six-week treatment period (p = .636). Similarly quetiapine failed to separate from placebo in the subgroup of subjects (n = 10) with co-morbid tics. Quetiapine was generally well tolerated. CONCLUSIONS: In this study, quetiapine augmentation was no more effective than placebo augmentation of SRIs. A number of limitations in study design make comparisons with previous studies in this area difficult and probably contributed to our negative findings. Future work in this important clinical area should address these limitations

Efficacy of tissue brushing as measured by the prosthodontic tissue index

This study was conducted to determine the efficacy of brushing the oral mucosa supporting complete dentures with a soft brush to see if this treatment would reduce inflammation. The oral mucosa health status of 60 patients was monitored for 120 days using the PTI to measure inflammation. For comparison the patients were divided into two groups, and every effort was made to balance the groups for those variables that may effect inflammation. The patients were also compared with themselves. The experiment consisted of three phases; Phase 1 established baseline data, and Phases 2 and 3 were information-gathering sessions. Each patient received brushing instructions at the start of the brushing test period and additional brushing instruction during a reinforcement session after 30 days. Tissue brushing did reduce the inflammation index of the oral mucosa examined.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74782/1/j.1754-4505.1984.tb00150.x.pd

A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression

Background Patients with chronic forms of major depression are difficult to treat, and the relative efficacy of medications and psychotherapy is uncertain. Methods We randomly assigned 681 adults with a chronic nonpsychotic major depressive disorder to 12 weeks of outpatient treatment with nefazodone (maximal dose, 600 mg per day), the cognitive behavioral-analysis system of psychotherapy (16 to 20 sessions), or both. At base line, all patients had scores of at least 20 on the 24-item Hamilton Rating Scale for Depression (indicating clinically significant depression). Remission was defined as a score of 8 or less at weeks 10 and 12. For patients who did not have remission, a satisfactory response was defined as a reduction in the score by at least 50 percent from base line and a score of 15 or less. Raters were unaware of the patients’ treatment assignments. Results Of the 681 patients, 662 attended at least one treatment session and were included in the analysis of response. The overall rate of response (both remission and satisfactory response) was 48 percent in both the nefazodone group and the psychotherapy group, as compared with 73 percent in the combined-treatment group (P Conclusions Although about half of patients with chronic forms of major depression have a response to short-term treatment with either nefazodone or a cognitive behavioral-analysis system of psychotherapy, the combination of the two is significantly more efficacious than either treatment alone