Identifying the communication activities of older people with aphasia: Evidence from naturalistic observation

Background: Increasingly there is a call from clinicians and researchers for measures that document the impact of aphasia on a person's everyday communication. Do existing assessments of communication disability adequately sample communication activities relevant to our clients? Communication skills and networks change with age. A need exists to determine the everyday communication activities of older people and in particular those with aphasia. Aims: The primary aim of this study was to describe and compare the everyday communication activities of older people with aphasia and healthy older people who are living in the community. A secondary aim was to investigate the content validity of the American Speech-Language Hearing Association Functional Assessment of Communication Skills for Adults (ASHA FACS, 1997) for older Australians. Methods & Procedures: Naturalistic observation was the method of choice for detailing the everyday communication of 15 older people with chronic aphasia following stroke and a matched group of 15 healthy older people who were living in the community. Researchers, in the role of participant observer, took field notes for 8 hours, over three occasions within a week. A total of 240 hours of observation have been coded in terms of communication activity, topic, communication partners, and place of communication. A brief 5-day diary served to check the representativeness of the observational data. After each hour of observation, the researcher checked which ASHA FACS items had been observed. Outcomes & Results: Naturalistic observation provided a rich, rigorous, and systematic methodology for detailing the dynamics and complexities of authentic communication. The most common communication activities for both groups were conversations at home and in social groups. Real-life communication was revealed to serve the dual purposes of transaction and interaction. Results indicate that older people with aphasia engage in similar communication activities to healthy older people although differences were evident in the frequency of communication and in specific activities such as story telling, writing, commenting, and acknowledging. ASHA FACS items were generally relevant to older Australians living in the community. Conclusions: This study demonstrated that communication activity is multifaceted in terms of the type of communication and contextual factors. The observational data describe the effects of aphasia on a person's everyday communication activity and reveal the impact of aphasia on the social functions of communication including sharing information, maintaining and establishing relationships, and telling one's story. Functional communication assessment requires a greater focus on the interactional and uniquely interpersonal aspects of social communication.

Acoustic analysis of speech through a hearing aid: perceptual effects of changes with two-channel compression

Compression amplification significantly alters the acoustic speech signal in comparison to linear amplification. The central hypothesis of the present study was that the compression settings of a two-channel aid that best preserved the acoustic properties of speech compared to linear amplification would yield the best perceptual results, and that the compression settings that most altered the acoustic properties of speech compared to linear would yield significantly poorer speech perception. On the basis of initial acoustic analysis of the test stimuli recorded through a hearing aid, two different compression amplification settings were chosen for the perceptual study. Participants were 74 adults with mild to moderate sensorineural hearing impairment. Overall, the speech perception results supported the hypothesis. A further aim of the study was to determine if variation in participants' speech perception with compression amplification (compared to linear amplification) could be explained by the individual characteristics of age, degree of loss, dynamic range, temporal resolution, and frequency selectivity; however, no significant relationships were found.

Testamentary capacity and aphasia: A descriptive case report with implications for clinical practice

Background: Testamentary capacity (the capacity to make a will) is recognised in the literature as an important issue for speech-language pathologists' assessment of people with aphasia, but current guidelines for clinical practice lack an empirical base. Aims: The research aimed to suggest some guidelines for clinical practice based on information considered relevant for the court in determining testamentary capacity. Methods & Procedures: A recent legal case involving a challenge to the will of a woman with severe aphasia was critically examined with reference to current guidelines in the literature regarding assessment of testamentary capacity. Outcomes & Results: Examination of the information available on the case indicated that the judge gave priority to accounts of the everyday communication of the person with aphasia (including reported discourse samples) over the information provided by expert medical witnesses. The extent to which communication effectiveness could be maximised was found to be a matter of key significance to the determination of capacity. Conclusions: This study has implications for speech-language pathologists' assessment practices and reports, as well as for scope of practice with regard to legal decision making of people with aphasia. These issues are discussed in relation to the World Health Organisation's ICF framework of functioning for social participation.

The effectiveness of aphasia-friendly principles for printed health education materials for people with aphasia following stroke

Background: Provision of health information to people with aphasia is inadequate. Current practice in providing printed health education materials to people with aphasia does not routinely take into consideration their language and associated reading difficulties. Aims: This study aimed to investigate if people with aphasia can comprehend health information contained in printed health education materials and if the application of aphasia-friendly principles is effective in assisting them to comprehend health information. It was hypothesised that participants with aphasia would comprehend significantly more information from aphasia-friendly materials than from existing materials. Other aims included investigating if the effectiveness of the aphasia-friendly principles is related to aphasia severity, if people with aphasia are more confident in responding to health information questions after they have read the aphasia-friendly material, if they prefer to read the aphasia-friendly brochures, and if they prefer to read the brochure type that resulted in the greatest increase in their knowledge. Methods & Procedures: Twelve participants with mild to moderately severe aphasia were matched according to their reading abilities. A pre and post experimental design was employed with repeated measures ANOVA (p

Reliability of scores between stroke patients and significant others on the Reintegration to Normal Living (RNL) Index

Purpose: This study measured reliability between stroke patients' and significant others' scores on items on the Reintegration to Normal Living (RNL) Index and whether there were any scoring biases. Method The 11-item RNL Index was administered to 57 pairs of patients and significants six months after stroke rehabilitation. The index was scored using a 10-point visual analogue scale. Patient and significant other demographic information and data on patients' clinical, functional and cognitive status were collected. Reliability was measured using the intra-class correlation coefficient (ICC) and percent agreement. Results: Overall poor reliability was found for the RNL Index total score (ICC=.36, 95% CI. 07 to .59) and the daily functioning subscale (ICC=.24, 95% CI -.003 to .46) and moderate reliability was found for the perception of self subscale (ICC=.55, 95 % CI .28 to .73). There was a moderate bias for patients to rate themselves as achieving better reintegration than was indicated by significant others, although no demographic or clinical factors were associated with this bias. Exact match agreement was best for the subjective items and worse for items reflecting mobility around the community and participation in a work activity. Conclusions: Caution is needed when interpreting patient information reported by significant others on the RNL Index. The use of a shorter scale to rate the RNL Index requires investigation.

Mitigated directness in Honglou meng: directive speech acts and politeness in eighteenth century Chinese

This paper is situated within a theoretical discussion that asserts a positive correlation between indirectness and politeness, and uses these claims as a springboard for an examination of polite ways of issuing directives in eighteenth century Chinese. On the basis of an analysis of directive speech acts from dialogue in the novel Honglou meng, it argues that the concept of indirectness, as it applies to the illocutionary transparency of individual speech acts, has no particular value in the culture and language of eighteenth century Chinese men. It is found that other linguistic devices such as particles, the reduplication of verbs, terms of address, and the presence and sequencing of supportive moves are far more significant to the communication of politeness. The findings suggest a need to rethink current theoretical positions on this subject and move beyond the analysis of individual speech acts to examine the role discourse structure and management play in the enactment of politeness. (C) 2002 Elsevier Science B.V. All rights reserved.

Evidence and information for health policy: a decade of change

Over the past decade or so, there has been increasing demand for greater clarity about the major causes of disease and injury, how these differentially affect populations, and how they are changing. In part, this demand has been motivated by resource constraints and a realisation that better health is possible with more informed allocation of resources. At the same time, there has been a change in the way population health and its determinants are quantified, with a much closer integration of the quantitative population sciences (such as epidemiology, demography and health economics) to strengthen and broaden the evidence base for healthcare policy.

O desenho da criança de cinco anos : investigando/refletindo as formas produzidas a partir de imagem da arte

O desenho infantil comprova significados e sentidos estabelecidos historicamente e revela experiências comuns da criança pensar e idealizar o mundo. Diante dessa constatação, o cerne desta pesquisa é investigar e refletir sobre as nuances no desenho da criança de cinco anos quando apresentadas às imagens de arte, analisando e compreendendo como ela se expressa verbal e graficamente diante de informações mediadas pelo professor de arte, quando manifestam suas experiências individuais e/ou em grupo, representando suas vivências e apropriando-se da linguagem artística, e assim constituindo-se como autoras. Para sustentar a pesquisa, adotamos os princípios da pesquisa qualitativa utilizando como recurso a observação participante em sala de aula, que vem ao encontro às nossas propostas por oportunizar o registro de dados in locus, potencializando assim, a estratégia da produção de dados. Os sujeitos dessa pesquisa são vinte e uma crianças de cinco anos que frequentaram o Grupo Cinco, do Centro de Educação Infantil Criarte/Ufes. A pesquisa buscou entender o desenho infantil como expressão intrínseca da criança, que, oportunizado por ações que colaboram para esse fazer, dará significados ao objeto, que, associado a sua história, sua vivência, possivelmente contribuirá para a formação artística e imagética da criança, significando sua expressão e criação. Trazemos para esse estudo conceitos do desenho infantil, bem como questões que abarcam todo o processo de elaboração e maturação do desenho, fundamentados nas pesquisas de Rosa Iavelberg, Analice Pilar, César Cola, Arno Stern e Viktor Lowenfeld, dentre outros, os quais possibilitaram nossa análise a partir do desenho e da fala das crianças. As reflexões apresentadas procuram contribuir para compreendermos o processo de diálogo, envolvimento e representação gráfica das crianças com as imagens de arte.

As relações sons e letras e letras e sons em livros didáticos de alfabetização (PNLD 2010) : limitações e desafios ao encontro de uma abordagem discursiva de linguagem

Este estudo teve como foco inicial de investigação o modo como livros didáticos de alfabetização propõem o estudo das relações entre sons e letras e letras e sons, e como essa dimensão se articula (ou não) a uma concepção de alfabetização que toma o texto como unidade de ensino. Caracteriza-se como uma pesquisa de cunho documental, trazendo para estudo produções acadêmico-científicas acerca da temática de investigação, tendências teóricas no estudo da alfabetização, o processo histórico da política de avaliação de livros didáticos no Brasil, o Guia de livros didáticos – PNLD 2010 – letramento e alfabetização – língua portuguesa – 2009 e duas coleções de livros didáticos de alfabetização, quais sejam: A Escola é Nossa – Letramento e Alfabetização Linguística; e Porta Aberta – Letramento e Alfabetização Linguística, avaliadas e selecionadas pelo Programa Nacional do Livro Didático (PNLD), na edição de 2009, para o ano letivo de 2010. Assume a hipótese de que a proposta de trabalho com as relações sons e letras e letras e sons trazida pelos livros didáticos de alfabetização, no contexto do letramento, por não tomar o texto como unidade de ensino, acaba por criar obstáculos para a própria compreensão dessas relações pelos estudantes. Toma como princípios teóricos e metodológicos a abordagem bakhtiniana de linguagem, bem como a concepção de alfabetização que baliza este estudo (GONTIJO; SCHWARTZ, 2009). Conclui que, ao não trazer os textos (gêneros discursivos) como enunciados, indiferentes à alternância dos sujeitos do discurso, os livros analisados, não obstante as poucas diferenças existentes entre um e outro, que se referem mais especificamente a informações que tangem à linguística, vão ao encontro de uma concepção de linguagem como um sistema de normas que devem ser anteriormente internalizadas pelo estudante para que este possa proceder à leitura e à escrita. Tratam, pois, a língua materna como uma língua estrangeira ou morta, como se esta fosse estática, permanecendo imune à evolução histórica. O estudo corroborou a hipótese de investigação, uma vez que, desconsiderando e/ou desconhecendo o aspecto dialógico do enunciado, os livros analisados minimizam a possibilidade da instauração de uma abordagem discursiva de linguagem, o que incide no tratamento das relações sons e letras e letras e sons que acabam por apresentarem-se dicotomizadas do texto e seu contexto discursivo e, dessa forma, sua reflexão e sistematização pelos estudantes distancia-se de um estudo dessas relações no bojo dos aspectos sócio-históricos, ideológicos, linguísticos, estilísticos, dentre outros que perpassam seu ensino. Logo, por não propiciarem um tratamento discursivo da linguagem, pouco contribuem para um tratamento “linguístico” adequado, acabando por criar obstáculos para a compreensão dessas relações pelos estudantes. Entende que conhecimentos linguísticos, principalmente referentes às variedades linguísticas e dialetais, tornam-se importantes quando da abordagem dessas relações, entretanto, estes por si sós não garantem sua apropriação. Ressalta o necessário conhecimento por parte dos professores (e autores) acerca da abordagem linguística tomada pelo livro didático de alfabetização e o resgate da autoria docente diante do ensino da língua materna, instaurando um processo autoral-dialógico da produção de conhecimentos junto aos estudantes.

Researchers' information needs in the bibliographic database : a literature review

This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License.

A negação no português falado em Vitória/ES

Todas as línguas possuem algum recurso para expressar a negação verbal, porém cada uma apresenta estratégias próprias para sua realização. No português brasileiro (PB), há três estratégias de negação: 1) pré-verbal (Não+SV); 2) dupla negação (Não+SV+Não) e 3) pós-verbal (SV+Não). À luz da Sociolinguística Variacionista e com base na amostra PortVix (Português Falado na Cidade de Vitória), que tem por parâmetros sociais o gênero/sexo do falante, sua faixa etária e seu nível de escolaridade, o presente trabalho analisa a variação no uso das estruturas de negação no português falado na cidade de Vitória/ES, a fim de situar, a partir desse fenômeno, a variedade capixaba no cenário do PB. Também toma por base a proposta de Schwenter (2005) de que as três variantes se alternam apenas quando o conteúdo negado é ativado no discurso. Sendo assim, se a proposição negada apresentar um estatuto de uma informação nova, apenas a negação pré-verbal pode ser empregada. Desse modo, em nossa pesquisa, buscamos entender quais fatores influenciam a alternância das formas de negação e verificar os contextos linguístico-discursivos que comportam essa variação. Ao confrontarmos nossos resultados com os de outras pesquisas, observamos que a dupla negação é bastante produtiva na fala capixaba, representando 21,1% de um total de 2263 dados. Ao realizarmos rodadas em que foram amalgamadas duas variantes e contrapostas a uma outra, foram selecionados pelo programa Goldvarb X (SANKOFF; TAGLIAMONTE; SMITH, 2005) e, portanto, considerados estatisticamente relevantes para a dupla negação, os seguintes fatores: as sequências dialogais, a ausência de reforço negativo, a ausência de marcadores conversacionais e as orações absolutas. Para a negação pós-verbal, foram selecionadas as seguintes variáveis: as proposições negadas diretamente ativadas e as sequências dialogais. Para a negação pré-verbal, os fatores estatisticamente relevantes foram: as sequências narrativas e as argumentativas, a presença de reforço negativo, a presença de marcadores conversacionais, as orações principais e o gênero masculino. Os resultados revelaram que a variação no uso das estruturas negativas é um fenômeno marcadamente discursivo, mas também com atuação de alguns fatores sintáticos.

Information and Technology Implementation Issues in AAL Solutions

With the population ageing effect, the technological developments, and pressure to reduce the cost with healthcare, are reunited the conditions for the development of Ambient Assisted Living (AAL) solutions. This work is a revision of the current state of the art. Its aim is the characterization of the AAL solutions, within the AAL4ALL scope. Therefore, it is presented features, scenarios and projects, referring the limitations and the opportunities for the future developments of prototypes using high level information and technology in AAL environments. Moreover, it is presented guidelines of operation, exposing the conceptual approach, and the discussion and conclusion, which present recommendations and current AAL4ALL project positions in terms of concepts and technologies.

Conditioning information in mutual fund performance evaluation: Portuguese evidence

We estimate and compare the performance of Portuguese-based mutual funds that invest in the domestic market and in the European market using unconditional and conditional models of performance evaluation. Besides applying both partial and full conditional models, we use European information variables, instead of the most common local ones, and consider stochastically detrended conditional variables in order to avoid spurious regressions. The results suggest that mutual fund managers are not able to outperform the market, presenting negative or neutral performance. The incorporation of conditioning information in performance evaluation models is supported by our findings, as it improves the explanatory power of the models and there is evidence of both time-varying betas and alphas related to the public information variables. It is also shown that the number of lags to be used in the stochastic detrending procedure is a critical choice, as it will impact the significance of the conditioning information. In addition, we observe a distance effect, since managers who invest locally seem to outperform those who invest in the European market. However, after controlling for public information, this effect is slightly reduced. Furthermore, the results suggest that survivorship bias has a small impact on performance estimates.