423 research outputs found
Age-related effects on language production: A combined psycholinguistic and neurolinguistic perspective
No full textInstitutional Racism and the Dynamics of Privilege in Public Health
No full textInstitutional racism, a pattern of differential access to material resources and power determined by race, advantages one sector of the population while disadvantaging another. Such racism is not only about conspicuous acts of violence but can be carried in the hold of mono-cultural perspectives. Overt state violation of principles contributes to the backdrop against which much less overt yet insidious violations occur. New Zealand health policy is one such mono-cultural domain. It is dominated by western bio-medical discourses that preclude and under-value Māori, the indigenous peoples of this land, in the conceptualisation, structure, content, and processes of health policies, despite Te Tiriti o Waitangi guarantees to protect Māori interests.
Since the 1980s, the Department of Health has committed to honouring the Treaty of Waitangi as the founding document of Māori-settler relationships and governance arrangements. Subsequent Waitangi Tribunal reports, produced by an independent Commission of Inquiry have documented the often-illegal actions of successive governments advancing the interests of Pākehā at the expense of Māori. Institutional controls have not prevented inequities between Māori and non-Māori across a plethora of social and economic indicators.
Activist scholars work to expose and transform perceived inequities. My research interest lies in how Crown Ministers and officials within the public health sector practice institutional racism and privilege and how it can be transformed. Through dialogue with Māori working within the health sector, fuelled by critical analysis and strategic advice from a research whānau (family) of Māori health leaders and a Pākehā Tiriti worker, and embracing the traditions of feminist and critical race theory I provide evidence of racism that can invoke strong emotional reactions. More disturbing is its normalisation to nigh imperceptibility within ones personal and professional life. The exposure of racism as a socially created phenomenon is a strength of the research presented here.
My action orientation is my ethical response. Honouring Te Tiriti o Waitangi is a pathway to transforming racism. Such change is likely to be resisted by the Pākehā majority. This anticipated resistance is not a credible reason to weaken responsibility for such necessary change. Transforming institutional racism needs to be driven by senior managers, professional bodies, unions, and by communities. Policies, practices and leadership that enable institutional racism need to be systematically eliminated from the health sector. Crown officials must be supported to strengthen their professional accountabilities and to embrace ethical bicultural practice. Greater transparency could enable more effective monitoring of Crown behaviour and support transformed practice
MEASUREMENT OF WORD RETRIEVAL IN THE DISCOURSE OF PERSONS WITH APHASIA: STANDARD CORE LEXICON ITEM DEVELOPMENT AND PSYCHOMETRIC PROPERTIES
No full textCore lexicon measures are a quantitative measure of lexical use in discourse for persons with aphasia. It is intended to provide clinicians with a clinician-friendly means to quantify lexical use in discourse based on normal expectations of discourse production for specific discourse elicitation tasks. The overarching aims of the current study were to develop a reliable and valid outcome measure for discourse-level assessment and to elucidate psychometric properties of the measure. The current investigation presents the early stages of development and validation of core lexicon measures. The aim of Study I was to outline procedures regarding development of core lexicon measures and to explore how well core lexicon measures can capture overall aphasia severity. Study II was to explore the possibility of the extension of core lexicon framework by developing checklists consisting of core function words to quantify function word use in discourse produced by persons with aphasia. Study III focused on demonstrating concurrent validity and inter-rater reliability of core lexicon measures in order to demonstrate potential clinical usability of the measure. Study IV was to investigate construct validity and item-level psychometric properties of core lexicon measures
Dialogue and Collaboration in the Creation of New Works for Clarinet
No full textThis PhD thesis explores dialogue-based, “intimate” collaboration through the creation of new works for clarinet. It borrows from Grounded Theory in order to facilitate an analysis through which emergent themes within a dialogue-based
collaboration are discovered. The aim has not been to insist on one model of collaboration, but to discover methods for improving one’s collaborative skills and to identify ways in which one benefits from a focus on dialogue in
collaboration. Furthermore, it aims to suggest that through collaboration one can make discoveries about the instrument: original contributions to clarinet technique are made within this thesis. The literature from which the research draws inspiration to further collaborative “technique” is cross-disciplinary and wide-ranging: it draws from social theory, collaborative creative writing, dance, the visual arts and of course, music. Added to this is a select discussion of collaboration throughout the repertoire of the clarinet. Finally, this consists of practice-based research. Seven new pieces for clarinet accompany the text
Discourse Process Training and Attention Process Training 2 in Adults with Traumatic Brain Injury
No full textPersons with traumatic brain injury (TBI) often present with relatively preserved lexical and grammatical skills but exhibit discourse level deficits which negatively affect functional communication. Discourse following TBI has been characterized as disorganized, tangential and uninformative. Cognitive deficits experienced by individuals with TBI may underlie these discourse deficits. A context sensitive approach to rehabilitation holds that linguistic and cognitive deficits should be targeted through functional tasks. By contrast, in a process specific approach to rehabilitation, discrete cognitive skills are trained through decontextualized tasks with the assumption that improvements in discrete cognitive skills will cause generalized improvements in functional tasks which rely on these cognitive skills. The purpose of the present study was to compare the effectiveness of a context sensitive approach, Discourse Processing Treatment (DPT) with a process specific approach, Attention Process Training 2 (APT-2) in improving discourse and cognition. DPT targeted discourse deficits with structured cues (comprehension questions and a visual story guide which depicted story grammar elements), metacognitive and metalinguistic strategies, and functional training in the form of narrative practice. APT-2 is a hierarchical, multilevel treatment program which targets five levels of attention (sustained, selective, alternating and divided attention) through decontextualized laboratory tasks. The research questions addressed by the present study were as follows: 1. Will the individual and combined effects of DPT and APT-2 improve performance on measures of discourse informativeness and coherence? 2. Do the individual and combined effects of DPT and APT-2 generalize to improvements on standardized measures of attention and memory? 3. Are the individual and combined treatment effects of DPT and APT-2 maintained for informativeness, coherence and cognitive measures following the entire treatment cycle (both DPT and APT-2) for a one month period? The results of this study suggest that DPT by itself had a greater effect on discourse informativeness and coherence than APT-2 by itself. However, DPT and APT-2 in combination resulted in greater gains in discourse informativeness for untreated picture stimuli. Additionally, all participants showed improvements in attention, as measured by raw completion times on the Comprehensive Trail Making Test (CTMT) following treatment but there was inter subject variability in terms of which treatment yielded the best effect; Participant 1 improved following APT-2, Participant 4 improved following DPT, and Participant 2 improved from both. Overall, our results suggest that DPT may improve discourse informativeness and coherence in adults with TBI but focused cognitive training in addition to DPT may maximize generalization. Our results also suggest that both APT-2 and DPT may result in improvements in attention
Multilevel Discourse Processing Analyses in Adults with a Cognitive Impairment
No full textParticipants with a cognitive impairment associated with Alzheimer's disease (AD) present with discourse impairments early within the disorder. These discourse impairment are associated with declines in episodic, semantic, and working memory. These impairments provide researchers with the opportunity to examine the linguistic and other cognitive systems responsible for discourse, as well as determine how impairments to other cognitive systems impact discourse. Moreover, since these linguistic impairments are often qualitatively and quantitatively different from healthy aging, researchers may be able to use a multilevel discourse analysis to improve screening methods for cognitive impairment. The purpose of this study, then, is two-fold: (1) determine how participants with AD fit into the construction-integration model of discourse processing with special attention given to the role semantic memory declines have on discourse and (2) determine if a multilevel discourse analysis can discriminate between the participants with AD and healthy controls. Participants include 12 participants with AD and 12 healthy controls matched for age and education. To assess cognitive and linguistic abilities, participants complete three tasks: cognitive tasks, semantic tasks, and a discourse tasks. The cognitive task will include measures of episodic and working memory from the Wechsler Memory Scale - III. The semantic tasks involved the Pyramid and Palm Tree Tests, Boston Naming Tests, and a Category Flunecy Test. The discourse task will require participants to tell a story from two wordless pictures books. The discourse samples were analyzed for micro- and macrolinguistic errors; percentage of living things; percentage of light verbs; and thematic elements and actions. For study aim one, a MANOVA determined that participants with a cognitive impairment associated with AD produced more micro- and macrolinguistic errors, as well as fewer thematic actions compared with healthy controls. For aim two, a binary logistic regression model correctly grouped 87.5% of the participants into their correct group. While this is promising, more research is needed to understand the impact AD has on discourse and whether or not discourse can be used to improve screening method
Discourse Processing in Neurologically Healthy Adults: A Cross-Modal Eye tracking Study
No full textOne of the methods to study discourse comprehension is inference revision. Inferencing can be defined as a controlled, information-generation process that requires deductive reasoning abilities (Kintsch, 1998). Studies reported in the literature have focused on investigating inference generation during sentence processing using priming paradigms. Eye tracking tasks have been used for priming research methods to study language processing (Odekar et al., 2009). Typical eye tracking priming tasks have included participants attending to the visual stimuli by looking at the computer screen naturally, without performing any of the overt tasks (Odekar et al., 2009). Eye tracking measures offer greater temporal resolution for capturing priming effects as eye movements are recorded in real time while participants are engaged in the task. The purpose of this study is: (1) to evaluate differences in discourse comprehension abilities in younger and older groups using eye tracking; and (2) to study the relationship between discourse processing and WM abilities in both groups. Ten participants from each group participated in this study. All participants were administered language and cognitive assessment tasks to screen for general language and cognitive impairments and estimate their naming, auditory comprehension, lexical processing, cognitive, episodic memory, and working memory abilities. A cross-modal eye-tracking while listening paradigm was used to study inference revision processing. For aim 1, multiple paired sample t-tests were conducted to study the fixation duration differences for target word and control word in lexical decision task (LDT 1) and revised inference and initial inference words in LDT 2 for both groups. Further, mixed ANOVA models were run to examine the group differences (young vs. older) for LDT1 and LDT 2 tasks using four dependent eye movement measures. Question response accuracies between groups were measured using independent samples t-tests. For aim 2, Pearson correlations were obtained among working memory scores and question response accuracy scores for each group. The results showed greater fixation durations on the target word than the control word in LDT 1; and revised inference than the initial inference in LDT 2. No significant correlations were seen for working memory scores and questions developed from the revised inference sentence pair
Impact of Manipulating Task Instructions on Narrative Discourse Performance
No full textQuantitative measures of structured discourse skills of adults with aphasia can be valuable in documenting evidenced-based practice. A number of researchers have shown that measures such as Yorkston and Beukelman’s (1980) content unit analysis and Nicholas and Brookshire’s (1993) correct information unit (CIU) analysis are helpful in monitoring changes in the connected speech of individuals with aphasia (Craig et al., 1993; Nicholas & Brookshire, 1993; Yorkston & Beukelman, 1980). Moreover, researchers suggest that any comprehensive assessment of structured discourse should also include a measure of the ability to relay main events (Capilouto, Wright & Cranfill, 2003; Nicholas & Brookshire, 1995).
van Dijk and Kintsch (1983) have suggested that one way speakers establish main ideas in conversation is by communicating the relations and causal links among units of information. Wright, Capilouto, Wagovich, Cranfill, and Davis (2005) developed a main event measure designed to focus on an individual’s ability to convey the relationships and causal connections between ideas in narrative discourse. Results of previous investigations have demonstrated that individuals without aphasia conveyed a higher proportion of main events than adults with aphasia (Capilouto, Wright, & Wagovich, 2005a). Further, findings indicated that participants, regardless of age or presence of aphasia, communicated a greater proportion of relationships between characters, actions, and ideas in response to sequential versus single pictures, but neurologically intact participants did not perform at or near ceiling level on the measure (Capilouto, Wright, & Wagovich, in press, 2005; Wright et al., 2005). Task instructions in the previous investigations requested participants to “tell what was going on in the picture(s)”. Olness (2005) suggested that instructions specifically requesting a beginning, middle, and end might yield qualitatively and quantitatively different narratives. The purpose of the present investigation, then, is two-fold. First, we compared the performance of two groups of healthy older adults on the ability to convey main events in pictured stimuli when two different task instructions were provided. Healthy older adults were used in this initial investigation to determine the impact of altered directions on discourse samples of speakers without specific language deficits. In doing so, the intent is to provide normative data on a measure of discourse, with different task instructions, that can then be used as a reference for evaluating the discourse abilities of adult clinical populations. Second, we established session-to-session reliability of the main event measure using the different task instructions
Discourse processing treatment for adults with aphasia.
No full textThe general goal of treatment for people with aphasia (PWA) is to improve their ability to communicate, which involves the discourse level. Treatment at this level is not a new concept, and there are many well-established procedures that utilize the discourse approach. Deficits that PWA exhibit during conversation are often undetectable by standardized testing. Although these deficits may not be detectable by standardized measures, they significantly impact the PWA's ability to maintain social relationships and engage in everyday communication. Multi-level analyses can identify strengths and weaknesses in PWA's discourse that relate to functional aspects of language processing and structural linguistics. Multi-level discourse analyses have revealed a more productive investigation of discourse production by more thoroughly documenting linguistic abilities in PWA. The purpose of this study was to determine if using an intensive discourse processing treatment improved discourse production in adults with aphasia. Study aims included a) determining if the discourse processing treatment improved performance on measures of micro- and macro- linguistic processes for individuals with aphasia for trained and untrained discourse productions, and b) determining if treatment effects were maintained. Participants included four PWA who met study criteria. The study included three phases: baseline, treatment, and maintenance. Baseline took place during week one of the study, treatment was during weeks two, three, and four, and the maintenance phase included data collection one week after treatment and one month post-treatment. Treatment involved twelve sequential picture stimuli and was administered in a four-step procedure. A multi-level discourse analyses was applied to analyze changes in PWA communication. Results indicated that the discourse processing treatment resulted in improvements in participant's discourse for trained and untrained productions. The multi-level analysis was more beneficial than standardized measures for analyzing discourse and documenting change in response to treatment. M.S
Semantic Knowledge Use in Different Discourse Types
No full textSemantic knowledge is an individual’s internal representations of a given object. In turn, semantic memory relates to the general knowledge and memory systems an individual uses for understanding concepts. Concepts are grouped into categories. Yet most research into semantic knowledge and category types is performed at the single concept level. Research is needed into the use of semantic knowledge and category types within discourse and across different discourse types. The purpose of this study, then, was to expand previous research by examining how semantic knowledge and category types were used in different types of discourse produced by adults across the adult lifespan. Cognitively healthy, younger (n=30, 20-39) and older (n=30; 60-89) participants told stories from single pictures and recounts that were transcribed and coded for 10 domains of semantic knowledge and also living and nonliving things. When exclusively examining living things, results indicated significant differences for stimuli but not for group. Additionally, there is no interaction between group and stimuli. For semantic knowledge types, there were significant differences for group and stimuli, but there was no interaction between group and stimuli. These findings extend previous research into the use of category and semantic knowledge types within discourse, and highlight the importance of examining multiple forms of discourse when analyzing the communication abilities of younger and older adults
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