Language and syntactic impairment following stroke in late bilingual aphasics.

PURPOSE: Bilingual aphasia generally affects both languages. However, the age of acquisition of the second language (L2) seems to play a role in the anatomo-functional correlation of the syntactical/grammatical processes, thus potentially influencing the L2 syntactic impairment following a stroke. The present study aims to analyze the influence of late age of acquisition of the L2 on syntactic impairment in bilingual aphasic patients. METHODS: Twelve late bilingual participants (speaking French as L2 and either English, German, Italian or Spanish as L1) with stroke-induced aphasia participated in the study. The MAST or BAT aphasia batteries were used to evaluate overall aphasia score. An auditory syntactic judgement task was developed and used to test participants syntactic performance. RESULTS: The overall aphasia scores did not differ between L1 and L2. In a multiple case analysis, only one patient had lower scores in L2. However, four patients presented significantly lower performances in syntactic processing in the late L2 than in their native language (L1). In these four patients the infarct was localized, either exclusively or at least partially, in the pre-rolandic region. CONCLUSION: This pilot study suggests that, in late bilingual aphasics, syntactic judgment abilities may be more severely impaired in L2, and that this syntactic deficit is most likely to occur following anterior lesions.

Measurement of parent satisfaction in french-speaking PICUs: a need for translation and cultural adaptation of the empathic questionnaire

Background and aims: Family-centred care is an expected standard in PICU and parent reported outcomes are rarely measured. The Dutch validated EMPATHIC questionnaire provides accurate measures of parental perceptions of family-centred care in PICU. A French version would provide an important resource for quality control and benchmarking with other PICUs. The study aimed to translate and to assess the French cultural adaptation of the EMPATHIC questionnaire. Methods: In September 2012, following approval from the developer, translation and cultural adaptation were performed using a structured method (Wild et al. 2005). This included forward-backward translation and reconciliation by an official translator, harmonization assessed by the research team, and cognitive debriefing with the target users' population. In this last step, a convenience sample of parents with PICU experience assessed the comprehensibility and cultural relevance of the 65-item French EMPATHIC questionnaire. The PICUs in Lausanne, Switzerland and Lille, France participated. Results: Seventeen parents, including 13 French native and 4 French as second language speakers, tested the cognitive equivalence and cultural relevance of the French EMPATHIC questionnaire. The mean agreement for comprehensibility of all 65 items reached 90.2%. Three items fell below the cut-off 80% agreement and were revised for inclusion in the final French version. Conclusions: The translation and the cultural adaptation permitted to highlight a few cultural differences that did not interfere with the main construct of the EMPATHIC questionnaire. Reliability and validity testing with a new sample of parents is needed to strengthen the psychometric properties of the French EMPATHIC questionnaire.

Conceptualisation et emploi du passé composé et de l'imparfait en français langue étrangère (L3) au Sri Lanka : l'impact du singhalais langue maternelle (L1) et de l'anglais langue seconde (L2)

Résumé: Notre étude chevauche deux domaines de recherche quasi indissociables : ceux de la linguistique et de la didactique des langues. Comme l'indique le sujet, elle examine la conceptualisation et l'emploi de deux notions aspecto-temporelles du français (le passé composé et l'imparfait), sous l'impact des connaissances grammaticales déjà acquises sur deux autres langues : le singhalais et l'anglais. Notre recherche relève des domaines de la psycholinguistique, de la linguistique acquisitionnelle et de la linguistique comparative. Toutefois, dans le cadre de cette étude, nous examinons ces notions grammaticales françaises et leurs équivalents présumés dans les deux autres langues comme étant des concepts relevant des langues à statuts sociaux spécifiques [à savoir, langue maternelle (L1), langue seconde (L2) et langue étrangère (L3)], dans un contexte particulier d'enseignement/apprentissage et d'acquisition de langue [à savoir, le contexte d'enseignement/apprentissage et d'acquisition du français langue étrangère (FLE) au Sri Lanka]. En ce sens, notre étude est également liée aux domaines de la sociolinguistique et de la didactique des langues, notamment, étrangères. Ce qui pourrait probablement distinguer cette recherche des autres, c'est qu'elle aborde certaines questions linguistiques et didactiques peu étudiées jusqu'ici. Entre autres, l'influence de deux langues sur l'enseignement/apprentissage d'une L3, l'enseignement/apprentissage des langues dans des contextes exolingues et le rôle des transferts dans la conceptualisation des notions grammaticales. Pourtant, lorsque nous avons choisi le contexte d'apprentissage du FLE au Sri Lanka comme terrain de recherche, nous avons également visé d'autres objectifs : examiner les systèmes verbaux de trois langues dont l'imbrication n'a pas encore été objet d'étude ; examiner le système verbal aspecto-temporel peu explicité du singhalais à la lumière des descriptions linguistiques occidentales ; vérifier certains préjugés concernant les liens de proximité et de distance entre les trois langues choisies et étudier les causes de ces préjugés. Notre corpus provient de plusieurs classes de FLE au Sri Lanka. Le public observé était constitué d'adolescents ou d'adultes bilingues ayant le singhalais en L1 et l'anglais en L2. Les cours choisis se distinguaient les uns des autres par plusieurs critères, mais travaillaient tous sur les notions du passé composé et de l'imparfait. A la conclusion de notre étude, nous avons constaté qu'un nombre important de nos hypothèses initiales se sont avérées véridiques. A titre d'exemples, les transferts entre les langues premières et la langue cible sont récurrents et non négligeables chez l'écrasante majorité des apprenants exolingues observés, et parfois, même chez leurs enseignants; si ces apprenants recourent à ces langues pour étayer leur apprentissage, ni leurs enseignants ni leurs manuels provenant de l'étranger ne les guident dans ce travail; les transferts ayant l'anglais pour origine l'emportent considérablement sur ceux provenant du singhalais. De même, suite à l'analyse contrastive des trois systèmes verbaux aspecto-temporels et à l'analyse du corpus, nous avons également eu un résultat imprévu : contrairement à une représentation répandue chez les apprenants singhalais, il existe des points convergents entre leur L1 et le français ; du moins, au niveau de l'emploi de certains temps du passé. Un fait dont on était jusqu'ici ignorants mais dont on peut sûrement profiter dans les cours de FLE au Sri Lanka. Suite à ces observations et à la fin de notre thèse, nous avons fait quelques recommandations didactiques afin d'améliorer les conditions d'enseignement/apprentissage des langues étrangères, au Sri Lanka et ailleurs. Abstract: Our research is related to the fields of both linguistics and didactics, two research areas which are almost inseparable. As the title shows, the thesis examines the issue of conceptualizing and using of two grammatical (aspectual and temporal) concepts of the French language (le passé composé and l'imparfait), under the influence of previously acquired grammatical knowledge of two other languages: Sinhalese and English. Thus, our research is linked to the domains of psycholinguistics, acquisitional linguistics and comparative linguistics. However, within the framework of this study, we will consider the above-mentioned two French grammatical concepts and their presumed equivalents in the other two languages as concepts belonging to three languages with specific social status [i.e. first language (L1), second language (L2) and foreign language (L3)], taught/learnt/acquired in a particular language teaching/learning context [the context of teaching/learning of French as a foreign language (FFL) in Sri Lanka]. In that sense, our study is also associated with the fields of sociolinguistics and language teaching, especially foreign language teaching. What could probably make this study outstanding is that it studies certain linguistic and didactic issues which have not yet been studied. For example, it examines, among other issues, the following: the influence of two languages (i.e. mother tongue -L1 & second language -L2) on the teaching/learning process of a third language (i.e. foreign language- L3); foreign language teaching and learning in an exolingual context (where the target language is not spoken outside the classroom); the role of language transfers in the process of grammatical notion conceptualization. However, in selecting the FFL teaching/learning context in Sri Lanka as our field of research, we had further objectives in mind : i.e. 1) studying the verb systems of three languages whose combination has never been studied before ; 2) studying the aspectual-temporal formation of the Sinhalese verb system (which is hardly taught explicitly) in the light of the linguistic descriptions of dominant European languages; 3) verifying certain preconceived ideas regarding the proximity and the distance between the three chosen languages, and 4) studying the causes for these preconceptions. Our corpus is obtained from a number of FFL classes in Sri Lanka. The observed student groups consisted of bilingual adolescents and adults whose first language (L1) was Sinhalese and the second language (L2) was English. The observed classes differed in many ways but in each of those classes, a common factor was that the students had been learning some aspect of the two grammatical concepts, le passé composé and l'imparfait. Having completed our study, we now see that a considerable number of our initial hypotheses are proven correct. For example, in the exolingual French language teaching/learning context in Sri Lanka where we carried out our research, language transfers between the first and target languages were recurrent and numerous in the work of the greater majority of the observed language learners, and even their teachers; these transfers were so frequent that they could hardly be ignored during the teaching/learning process ; although learners turned to their first languages to facilitate the learning process of a new language, neither their teachers, nor their text books helped them in this task; the transfers originating from English were far too numerous than those originating from Sinhalese; however, contrary to the popular belief among many Sinhalese learners of French, the contrastive analysis of the three aspectual-temporal verb systems and the study of our corpus helped us in proving that there are common linguistic features between the Sinhalese and the French languages ; at least, when it comes to using some of their past tenses. This is a fact which had been ignored up to now but which could probably be used to improve French teaching/learning in Sri Lanka. Taking all observations into account, we made some pedagogical recommendations in the concluding part of our thesis with the view of improving foreign language teaching/learning in Sri Lanka, and elsewhere.

Influence on screening performance of second reading strategies in two lowvolume programs

BACKGROUND: The European Guidelines specify a minimum of 5,000 screening cases to be read yearly by radiologists carrying out second reading in non-centralized programs. This professional requirement is difficult to reach and/or to implement in regional programs covering a sparse population with a high number of participating radiology units, so that alternative blind double reading strategies must be devised. OBJECTIVE: To evaluate the effect on breast cancer screening performances of two second reading strategies used in non-centralized, low-volume programs. METHODS: Reading performances in two Swiss regional breast cancer screening programs (cantons of Wallis and Vaud), covering female populations, aged 50-69, of about 31'000 and 72'000 inhabitants were computed and compared. Both programs had similar screening regimens and organizations, but differed with respect to second reading. One setting applied a selective strategy whereby only experienced radiologists performed second reading; the other elicited not to restrict second readers on the basis of their individual screening activity. Analysis included some 140,000 mammograms performed between 1999 and 2005. RESULTS: Overall, screening performances improved with increasing total volume of reading, albeit not in a linear fashion. Regardless of setting, radiologists attained a higher level of screening accuracy when performing second rather than first readings, and incident rather than prevalent screening cases. The effect of a selective, small group of second readers appeared to impact favorably on the false-positive rate and other indicators of screening quality. As the learning curve depends on the number of mammograms read, these distinct strategies may bear different outcome in the long run. Implications and practical issues for low-volume programs are discussed.

Regional and hemispheric determinants of language laterality: Implications for preoperative fMRI.

Language is typically a function of the left hemisphere but the right hemisphere is also essential in some healthy individuals and patients. This inter-subject variability necessitates the localization of language function, at the individual level, prior to neurosurgical intervention. Such assessments are typically made by comparing left and right hemisphere language function to determine "language lateralization" using clinical tests or fMRI. Here, we show that language function needs to be assessed at the region and hemisphere specific level, because laterality measures can be misleading. Using fMRI data from 82 healthy participants, we investigated the degree to which activation for a semantic word matching task was lateralized in 50 different brain regions and across the entire cortex. This revealed two novel findings. First, the degree to which language is lateralized across brain regions and between subjects was primarily driven by differences in right hemisphere activation rather than differences in left hemisphere activation. Second, we found that healthy subjects who have relatively high left lateralization in the angular gyrus also have relatively low left lateralization in the ventral precentral gyrus. These findings illustrate spatial heterogeneity in language lateralization that is lost when global laterality measures are considered. It is likely that the complex spatial variability we observed in healthy controls is more exaggerated in patients with brain damage. We therefore highlight the importance of investigating within hemisphere regional variations in fMRI activation, prior to neuro-surgical intervention, to determine how each hemisphere and each region contributes to language processing. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc.

Variation in performance across Swiss mammography screening programmes: the influence of reading strategy and experience.

[Abstract] Reading volume and mammography screening performance appear positively correlated. Performance was compared across organised Swiss screening programmes, which target relatively small populations. Except for accreditation of 2nd readers radiologists (restrictive vs non-restrictive strategy), Swiss programmes have similar screening regimen/procedures and duration, which maximises comparability. Variation in performance was explored in order to improve mammography practice and optimise screening performance. Indicators of quality and effectiveness were evaluated for about 200,000 screens performed over 4 screening rounds in the 3 longest-standing Swiss cantonal programmes (of Vaud, Geneva and Valais). Interval cancers were identified by linkage with cancer registries records. Most European standards of performance were met with a favourable cancer stage shift. Several performance indicators showed substantial variation across programmes. In subsequent rounds, compared with programmes (Vaud and Geneva) which accredited few 2nd readers to increase their individual reading volume, proportions of in situ lesions and of small cancers (? 1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. Differences in performance could partly be explained by a selective strategy for 2nd readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume Swiss programmes.

Lire l'oral : pour une typologie linguistique des représentations écrites de l'oralité (le cas du français)

Cette thèse propose de passer en revue les modalités de la représentation écrite de l'oralité en français. La pratique littéraire constitue le matériau et l'horizon de la théorisation. La problématique - comment l'écrit représente-t-il l'oral ? - est d'abord située et reformulée dans le cadre de la linguistique de la parole (I). Les rapports entre oralité et scripturalité sont ensuite étudiés sous trois angles. L'angle biotechnologique compare la matérialité et l'affordance des signaux graphiques et des signaux acoustiques (II 1). L'examen sémiotique reconnaît dans le français écrit un système dit phonographique dont la fonction est de représenter l'expression des signes du français oral. Sont analysées alors les relations entre les systèmes de signes impliqués, la diversité des actualisations possibles du système phonographique (effets d'écoute), ainsi que diverses sémiotiques analogiques (II 2). On étudie ensuite le rôle de la prosodie dans la lecture. La position adoptée est la suivante : bien qu'elle soit facultative dans l'activité de lecture, la prosodie est spécialement sollicitée par des écrits qu'on peut caractériser linguistiquement. L'interprétation prosodique apporte à ces écrits un surcroît de signification en même temps qu'il produit un mode spécifique de représentation de l'oral appelé effet prosodique (II 3). L'angle sémantique est esquissé finalement : il conduit à dégager deux modalités de représentation supplémentaire. Pour la première, l'oral se situe sur le plan sémantico-référentiel de l'expression écrite (écrire à propos d'oral) ; pour la seconde, l'oral est un extérieur discursif modalisant le dire écrit : l'écrit est reconnu comme énoncé à la manière de l'oral (effet de style oral). - This PhD thesis attempts to review the modalities of orality in written representation. Literary writings act as the material for theorization. First of all, the thesis statement - how does writing represent oral - is situated and then, reformulated within the frame of linguistique de la parole (the linguistic field of speech) (I). The connections between orality and writing are then studied under three angles. The biotechnological angle compares the materiality and the affordance of graphic signs and acoustic signals (II 1). A semiotic examination acknowledges, in French, a phonographical system whose function is to represent the expression of French oral signs. Thus, the relationships between the systems of implicated signs, the diversity of possible actualisations of the phonographic system (voice effects), as well as various analogical semiotics are analysed (II 2). Furthermore, the role of prosody is studied within reading. The stand taken is the following : even though it is optional during a reading activity, prosody is especially sought-after by linguistically characterised writings. The prosodie interpretation brings to these writings a surge of signification while producing a specific mode of oral representation called the prosodie effects (II 3). The semantic angle is finally drawn : it leads to two additional modalities of representation. For the first part, speech is located on the semantic and referential plan of the written expression (writing about speech); as for the second part, spoken language is a discursive exteriority : writing is recognised as an oral-like utterance {oral-like effect).