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Impaired self-awareness
No full textPersons with neurologie disorders often show impaired ability to accurately pereeive the effeets of their disorders on their physieal, cognitive, and behavioral abilities. For conditions that have a sudden onset such as stroke or traumatic brain injury (TBI) the degree of impairment of this ability is greatest early after onset so that, for example, soon after right hemisphere stroke, the person with stroke may not perceive motor impairment on the left side of the body, but gradually becomes more aware of this impairment as he/she recovers. For progressive conditions such as the various dementias, the degree of impairment of self-aware- ness worsens as the condition progresses so that a person with Alzheimer's disease may be aware of subtle memory impairment in early stages of the disease, but unaware of very severe memory impairment once the disease has progressed. In either case, the perception of impairment is least when the actual impairment is greatest and greatest when the actual impairment is least. Impaired self-appraisal of functioning is referred to as anosognosia in conditions such as the neglect syndrome after right hemisphere stroke or Anton's syndrome (unawareness of cortical blindness) after bilateral posterior cerebral artery strokes where the lack of awareness may be complete. In TBI, this condition is simply called impaired self-aware- ness (ISA) as persons with injury usually have some awareness of their deficits once they recover from the confused state (post-traumatic amnesia). For persons with TBI, severity of ISA is greatest in early recovery. By defi nition, patients in coma or the vegetative state have no self-awareness. Though not directly assessed, minimally conscious patients are assumed to have extremely limited self-awareness. Once patients recover to the confused state, they remain with very severe impairment of self-awareness. Often after resolution of confusion, patients may deny that they have sustained TBI at all and deny any residual effects of the injury. Even when acknowledging injury, we have seen patients insist that their cognitive abilities after severe TBI are much better than they were prior to sustaining TBI. Patients who are unable to walk safely may attempt to remove restraints to leave their beds or wheelchairs to go to the toilet or simply to attempt to leave the room. Patients may refuse therapies because they do not believe that they have impairments that need to be treated. In the post-acute period of recovery, patients may attempt to drive in spite of motor and sensory defi cits or pursue employment or independence goals that are at odds with their current functional limitations. To ensure patient safety, compliance with needed therapies, and the best possible outcomes for patients, neuropsychologists and others treating persons with TBI must assess and, when needed, provide treatment for defi cits in self-awareness. This chapter will: (1) review the nature of ISA after TBI and describe its impact on rehabilitation therapies and patient outcome, (2) describe approaches to assessment of ISA, (3) review the literature on interventions to improve self-awareness in persons with TBI, and (4) provide practical guidance illustrated with clinical cases for intervening with patients with ISA
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Treating and Collaborating With Family Caregivers in the Rehabilitation of Persons with Traumatic Brain Injury
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Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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