Reassessing Public Meetings As Participation in Risk Management Decisions

Using a U.S. case study, Ms. McComas and Dr. Scherer discuss how reliance on public meetings as tools for risk communication in public policy decisions affects relationships between stakeholders and risk managers

THE RELATIONSHIP BETWEEN SELECTIVE ATTENTION AND GLOBAL COHERENCE IN NARRATIVE DISCOURSE FOLLOWING RIGHT HEMISPHERE STROKE

Stroke is the leading cause of serious, long-term disability and nearly half of older stroke survivors experience moderate to severe disability. A common impairment following stroke is impaired discourse production. Functional outcome studies have proposed that the recovery of discourse abilities is critical to achieving a good quality of life. Communication impairments often persist into the chronic stages of recovery and can cause individuals to withdraw from social situations. Discourse production deficits may not be apparent in basic communication interactions, but become more obvious during complex conversations following non-aphasic brain injury (NABI) or right hemisphere stroke (RHD). The purpose of this three-part dissertation was to examine discourse production deficits following NABI and the current practices of speech-language pathologists in the assessment and treatment of discourse deficits. The first study examined the macrolinguistic processes of discourse, which included local coherence, global coherence and cohesion, following NABI. Ten individuals with NABI and 10 heathy controls, closely matched for age, gender, and education, provided a narrative recount of an event. Discourse samples were analyzed for local coherence, global coherence, and cohesion. Results indicated that individuals with NABI demonstrated impaired global coherence compared to healthy controls with relatively intact local coherence and cohesion. Although global coherence deficits were identified in the discourse of individuals with NABI, empirical evidence suggests that speech-language pathologists do not routinely assess or treat discourse production deficits. The second study explored the current practices of speech-language pathologists in the assessment and treatment of individuals with NABI with a specific focus on discourse production deficits using a phenomenological approach. Nine speech-language pathologists participated in semi-structured 1:1 interviews. Results indicated that speech-language pathologists do not routinely assess and treat discourse production deficits due to competing internal values and external or environmental demands. However, speech-language pathologists reported that discourse deficits are present following NABI and are characterized by impaired topic maintenance or global coherence. Participants reported that they were routinely assessing and treating the underlying cognitive process of attention in hopes that it would generalize to improved topic maintenance or global coherence. However, little is known about the relationship between selective attention and global coherence. The third study examined the maintenance of global coherence across discourse tasks and explored the relationship between selective attention and global coherence. Eleven participants with non-aphasic brain injury secondary to right hemisphere stroke participated in the study. Participants provided discourse samples in response to five discourse tasks in a single-task and dual-task condition. Additionally, participants completed the Stroop test to examine selective attention abilities. Results indicated that mean global coherence scores differed across discourse tasks, and that mean global coherence scores for stories was significantly higher than for simple recount and single picture description tasks. To examine the relationship between selective attention and global coherence, mean global coherence scores in the single-task and dual-task condition were compared. Mean global coherence scores were lower in the dual-task condition for all five discourse tasks. Mean global coherence scores for the complex recount task were significantly lower in the dual-task condition. This suggests that the maintenance of global coherence is influenced by attention abilities. There was no significant correlation between performance on the Stroop task and the maintenance of global coherence for any of the five discourse tasks

Promoting Informed Decision-Making: The Role of Message Structure

The authors analyze two empirical explorations of relationships between the composition of risk message and critical thinking within audiences

The Efficacy of Semantic Feature Analysis for the Treatment of Aphasia: A Systematic Review

Semantic feature analysis (SFA) is a common treatment for improving naming ability in persons with aphasia (PWA). To examine the effectiveness of SFA in improving naming abilities, we conducted an evidence-based systematic review. Seven studies met the inclusion criteria, were assigned appropriate levels of evidence, and were examined for methodological quality using the Single-Case Experimental Design (SCED) scale. Inter-rater reliability was established using Cohen’s weighted kappa statistic. To determine the clinical significance of SFA, effect sizes, or percent of non-overlapping data (PND), were calculated. Results of this study indicate that SFA may be most effective for persons with fluent aphasias

Will treatment facilitate learning of a problem solving strategy by persons with Alzheimer’s disease?

Deficits in problem solving are a prominent feature of Alzheimer’s disease (AD). The present study aimed to determine whether or not persons with AD could learn to use a strategy for solving problems. Four individuals with AD were taught to use a reduction strategy to solve twenty questions problems (20Q). Although results of this study indicate that individuals did not learn to use the stressed strategy, participants did improve their ability to solve problems using strategies already familiar to them. This suggests that treatment should focus on skills the person with AD is already using rather than teaching new strategies

Conflicted scientists: the “shared pool” dilemma of scientific advisory committees

Science advisors play a critical role in government policy making, yet these advisors are often equally attractive to regulated industry. Despite efforts to manage conflicts of interest among science advisors, allegations of conflict frequently plague advisory committee deliberations or outcomes. This article examines what we term the “shared pool” dilemma using data collected from 92 members of 11 US Food and Drug Administration advisory committees. The results suggested science advisors were generally positive about their experiences on advisory committees and viewed the committee process as impartial. Written comments suggested that advisors linked the neutrality of the process to the success of the FDA’s conflict-of-interest procedures. Even so, the advisors acknowledged the challenges associated with recruiting disinterested and qualified scientists to serve on advisory committees, reflecting the shared pool dilemma. Many advisors seemed more troubled about advisors participating when they lacked expertise than when they had minor conflicts of interest

A One Health message about bats increases intentions to follow public health guidance on bat rabies

Since 1960, bat rabies variants have become the greatest source of human rabies deaths in the United States. Improving rabies awareness and preventing human exposure to rabid bats remains a national public health priority today. Concurrently, conservation of bats and the ecosystem benefits they provide is of increasing importance due to declining populations of many bat species. This study used a visitor-intercept experiment (N = 521) in two U.S. national parks where human and bat interactions occur on an occasional basis to examine the relative persuasiveness of four messages differing in the provision of benefit and uncertainty information on intentions to adopt a rabies exposure prevention behavior. We found that acknowledging benefits of bats in a risk message led to greater intentions to adopt the recommended rabies exposure prevention behavior without unnecessarily stigmatizing bats. These results signify the importance of communicating benefits of bats in bat rabies prevention messages to benefit both human and wildlife health

Public Perceptions of Wildlife-Associated Disease: Risk Communication Matters

Wildlife professionals working at the interface where conflicts arise between people and wild animals have an exceptional responsibility in the long-term interest of sustaining society’s support for wildlife and its conservation by resolving human–wildlife conflicts so that people continue to view wildlife as a valued resource. The challenge of understanding and responding to people’s concerns about wildlife is particularly acute in situations involving wildlife-associated disease and may be addressed through One Health communication. Two important questions arise in this work: (1) how will people react to the message that human health and wildlife health are linked?; and (2) will wildlife-associated disease foster negative attitudes about wildlife as reservoirs, vectors, or carriers of disease harmful to humans? The answers to these questions will depend in part on whether wildlife professionals successfully manage wildlife disease and communicate the associated risks in a way that promotes societal advocacy for healthy wildlife rather than calls for eliminating wildlife because they are viewed as disease-carrying pests. This work requires great care in both formal and informal communication. We focus on risk perception, and we briefly discuss guidance available for risk communication, including formation of key messages and the importance of word choices. We conclude that the risk perception and communication research available is helpful but inadequate, and that thoughtful practice with respect to message and word choice is needed