Remembering 'zeal' but not 'thing':reverse frequency effects as a consequence of deregulated semantic processing

More efficient processing of high frequency (HF) words is a ubiquitous finding in healthy individuals, yet frequency effects are often small or absent in stroke aphasia. We propose that some patients fail to show the expected frequency effect because processing of HF words places strong demands on semantic control and regulation processes, counteracting the usual effect. This may occur because HF words appear in a wide range of linguistic contexts, each associated with distinct semantic information. This theory predicts that in extreme circumstances, patients with impaired semantic control should show an outright reversal of the normal frequency effect. To test this prediction, we tested two patients with impaired semantic control with a delayed repetition task that emphasised activation of semantic representations. By alternating HF and low frequency (LF) trials, we demonstrated a significant repetition advantage for LF words, principally because of perseverative errors in which patients produced the previous LF response in place of the HF target. These errors indicated that HF words were more weakly activated than LF words. We suggest that when presented with no contextual information, patients generate a weak and unstable pattern of semantic activation for HF words because information relating to many possible contexts and interpretations is activated. In contrast, LF words tend are associated with more stable patterns of activation because similar semantic information is activated whenever they are encountered

A particular difficulty in discriminating between mirror images

We investigated the selective impairment of mirror image discrimination in a patient with bilateral parieto-occipital lesions (FIM). We report a difficulty with the discrimination between mirror images more selective than has been previously reported (Turnbull OH, McCarthy RA. Failure to discriminate between mirror-image objects: a case of viewpoint-independent object recognition? Neurocase 1996;2:63). FIM was asked to judge, in five same/different experiments, whether pairs of simultaneously presented line drawings of objects were identical. FIM demonstrated only a minor impairment in discriminating between orientations in the picture plane but was at chance in making discrimination between mirror images. An experiment with normal observers established that our results were not due to differences in task difficulty. Two further experiments investigated the effects of rotation on the discrimination of letters and geometric shapes. FIM's impairment extended to geometric shapes but not to letters. These results would be consistent with the preservation of an abstract representation for object recognition that did not code the difference between mirror image views

Explaining semantic short-term memory deficits:evidence for the critical role of semantic control

Patients with apparently selective short-term memory (STM) deficits for semantic information have played an important role in developing multi-store theories of STM and challenge the idea that verbal STM is supported by maintaining activation in the language system. We propose that semantic STM deficits are not as selective as previously thought and can occur as a result of mild disruption to semantic control processes, i.e., mechanisms that bias semantic processing towards task-relevant aspects of knowledge and away from irrelevant information. We tested three semantic STM patients with tasks that tapped four aspects of semantic control: (i) resolving ambiguity between word meanings, (ii) sensitivity to cues, (iii) ignoring irrelevant information and (iv) detecting weak semantic associations. All were impaired in conditions requiring more semantic control, irrespective of the STM demands of the task, suggesting a mild, but task-general, deficit in regulating semantic knowledge. This mild deficit has a disproportionate effect on STM tasks because they have high intrinsic control demands: in STM tasks, control is required to keep information active when it is no longer available in the environment and to manage competition between items held in memory simultaneously. By re-interpreting the core deficit in semantic STM patients in this way, we are able to explain their apparently selective impairment without the need for a specialised STM store. Instead, we argue that semantic STM patients occupy the mildest end of spectrum of semantic control disorders

Preventing Pneumonia Through Early Mobilization of Critically Ill Adults

The purpose of this critically appraised topic (CAT) is to investigate early mobilization and its effect on preventing pneumonia in adults in the intensive care unit (ICU). The final portfolio contains four research articles from both national and international journals. Study designs included two meta-analyses, one case series, and one retrospective study. All four of the articles specifically described the effects of early mobilization on individuals in the hospital and ICU and showed positive results in reducing the likelihood of developing pneumonia. This CAT will be used to draft new practice guidelines for mentoring new managers in both occupational therapy and physical therapy

Deficits of knowledge versus executive control in semantic cognition: Insights from cued naming

Deficits of semantic cognition in semantic dementia and in aphasia consequent on CVA (stroke) are qualitatively different. Patients with semantic dementia are characterised by progressive degradation of central semantic representations, whereas multimodal semantic deficits in stroke aphasia reflect impairment of executive processes that help to direct and control semantic activation in a task-appropriate fashion [Jefferies, E., & Lambon Ralph, M. A. (2006). Semantic impairment in stroke aphasia vs. semantic dementia: A case-series comparison. Brain 129, 2132-2147]. We explored interactions between these two aspects of semantic cognition by examining the effects of cumulative phonemic cueing on picture naming in case series of these two types of patient. The stroke aphasic patients with multimodal semantic deficits cued very readily and demonstrated near-perfect name retrieval when cumulative phonemic cues reached or exceeded the target name's uniqueness point. Therefore, knowledge of the picture names was largely intact for the aphasic patients, but they were unable to retrieve this information without cues that helped to direct activation towards the target response. Equivalent phonemic cues engendered significant but much more limited benefit to the semantic dementia patients: their naming was still severely impaired even when most of the word had been provided. In contrast to the pattern in the stroke aphasia group, successful cueing was mainly confined to the more familiar un-named pictures. We propose that this limited cueing effect in semantic dementia follows from the fact that concepts deteriorate in a graded fashion [Rogers, T. T., Lambon Ralph, M. A., Garrard, P., Bozeat, S., McClelland, J. L., & Hodges, J. R., et al. (2004). The structure and deterioration of semantic memory: A neuropsychological and computational investigation. Psychological Review 111, 205-235]. For partially degraded items, the residual conceptual knowledge may be insufficient to drive speech production to completion but these items might reach threshold when they are bolstered by cues. (C) 2007 Elsevier Ltd. All rights reserved