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Comics are an increasingly popular medium in the twenty-first century. Combining words and images, comics enable the expression of individual and collective histories that straddle languages and cultures, reflecting the multimodality of the cognitive and narrative processes in a multilingual, globalising world. This article proposes an original framework to understand the power of comics as a transcultural medium by exploring the production of Takoua Ben Mohamed, a graphic journalist and comics author born in Tunisia and raised in Rome. These comics visualise histories of migration and translation in Italy and the Mediterranean, questioning notions of homogeneity, authenticity and canonicity of Italian memory and culture. The article engages with the theoretical and methodological framework of the Transnationalizing Modern Languages (TML) research project, exploring the interconnected linguistic and cultural dimensions of memory and translation. The analysis identifies a series of processes termed mediation-translation in Ben Mohamed's comics, which illuminate the constitutive nature of memory and translation in contemporary processes of identification.
Sentence repetition is part of the assessment tasks used to better characterise aphasic patients’ oral production. Moreover, impaired sentence and phrase repetition is a core feature of the logopenic variant of primary progressive aphasia. The aim of this study is to present the TEFREP (TEst Français de RÉpétition de Phrases), a French sentence repetition task that manipulates psycholinguistic variables known to affect the performance of aphasic patients. The final version of the TEFREP consists of 24 sentences in which length, semantic reversibility and type of sentence have been manipulated. The task shows good psychometric properties (validity and reliability). Norms according to age and education level have been developed from a sample of 80 healthy adults and older adults. In conclusion, the TEFREP fulfills the current need for a reliable assessment tool of sentence repetition in Canadian French-speaking populations and contributes to the differential diagnosis of language impairment.
In 2005 Elliott et al. published a paper entitled ‘Effect of posture on levels of arousal and awareness in vegetative and minimally conscious patients: a preliminary investigation’. Twelve patients, of whom 5 were in the vegetative state (VS) and 7 in the minimally conscious state (MCS), were assessed with the Wessex Head Injury Matrix (WHIM) when supine and when upright on a tilt table. The present study replicated and extended these findings by including a third position, sitting, in addition to supine and standing. We assessed 16 patients (8 in the VS and 8 in the MCS) with mixed aetiologies and compared the observed behaviours in three different positions (supine, sitting and standing) using the WHIM. Most patients (75%) showed more behaviours when in the upright position, compared to lying down (p < .003). Our findings are similar to those seen in the study reported by Elliott et al. With regard to sitting, 62.5% of patients were more responsive when assessed sitting in a wheelchair (p < .05) than in a supine position, and almost 69% were more responsive if assessed in an upright position compared to sitting. This was particularly true for patients in the MCS, where 87.5% did better if assessed on a tilt table or standing frame compared to sitting, suggesting that positional changes can have an effect on the level of arousal and awareness among patients in the VS and MCS.
Background: The extent to which care home residents with severe dementia show awareness is influenced by the extent to which the environment provides opportunities for engagement and by the way in which care staff interact with them. We aimed to establish whether training care staff to observe and identify signs of awareness in residents with severe dementia resulted in improved quality of life for residents.
Methods: In this pilot cluster randomized trial, care staff in four homes (n = 32) received training and supervision and carried out structured observations of residents using the AwareCare measure (n = 32) over an eight-week period, while staff in four control homes (n = 33) had no training with regard to their residents (n = 33) and no contact with the research team. The primary outcome was resident quality of life. Secondary outcomes were resident well-being, behavior and cognition, staff attitudes and well-being, and care practices in the home.
Results: Following intervention, residents in the intervention group had significantly better quality of life as rated by family members than those in the control group, but care staff ratings of quality of life did not differ. There were no other significant between-group differences. Staff participating in the intervention identified benefits in terms of their understanding of residents’ needs.
Conclusions: Staff were able to use the observational measure effectively and relatives of residents in the intervention homes perceived an improvement in their quality of life.
Literature published a decade ago reflected a pessimistic view of the market-oriented reforms that Latin America carried out in the 1980s and 1990s, and many politicians have attacked these reforms openly. Indeed, the atmosphere is so negative that it would be reasonable to assume that many of the reforms have been reversed. This paper will take a new look at the situation ten years later. Our argument is that the reforms have generally not been reversed. The reversal that has occurred has been with respect to privatisation in a few countries; negative public opinion is also concentrated on privatisation; and the reforms helped to enable Latin America to take advantage of favourable conditions leading to high growth in the 2004–8 boom period and a relatively strong performance during the 2008–9 crisis. While much remains to be done to raise growth and improve distribution, objective information about the reforms is needed when policies for the future are made.
This article considers 10 of the most important developments in neuropsychological rehabilitation over the past 5 years. While several leaders in the field were contacted to discover what they considered to be the most important developments, the selection discussed here is the author's alone and is, therefore, a personal view. Included are: computational models; support for people with dementia; new assessment procedures; new treatment strategies for cognitive, emotional and psychosocial problems; new theoretical models to improve our understanding of the consequences of brain injury; and recognition of the need to find new ways to evaluate the efficacy of rehabilitation. The final section of the article considers possible future developments in rehabilitation, including stronger links with basic neuro-science; better use of imaging procedures; collaboration with pharmaceutical companies; better evaluation of our programs; and the need to educate researchers and practitioners as to the meaning of rehabilitation.
Clinical experience and anecdotal written accounts suggest that school-age children with high-functioning autism spectrum disorders (ASD) have difficulties which can be described as ‘executive dysfunction’. Problems with organisation, planning and task completion impede academic achievement and cause disruption in daily routine. The authors review research of executive function in this population and conclude that clinicians will find little in the scientific literature to guide them in neuropsychological assessment and remediation. They describe their study of 23 clinic-referred children (18 boys, 5 girls; mean age of 9) illustrating the challenges facing clinicians who would measure executive function. Tests of executive function (including the NEPSY and the BADS-C) were administered. Parent and Teacher questionnaires (DEX-C, BRIEF and VABS) were completed. Scores on tests of executive function and other areas of cognition were found to be in the average or above average range. In contrast, responses on both teacher and parent questionnaires indicated significant executive dysfunction. Parents' responses on the BRIEF and on the DEX-C were not correlated with teacher responses on the BRIEF. The authors consider the importance of a “halo effect” on questionnaire responses and challenge the notion that questionnaire measures have more ecological validity than laboratory measures. Suggestions for future research include observation, interviews and graded modification of the testing environment.
Not enough attention is given to identifying individual neuropsychological deficits of children with ASD in the clinical setting with the aim of remediation despite being recommended by the National Autism Plan for Children (2003).
Studies have shown that various antioxidants are decreased in different age-related degenerative diseases and thus, oxidative stress would have a central role in the pathogenesis of many disorders that involve neuronal degeneration, including Alzheimer's disease (AD). The present study aimed to assess the nutritional status of Se in AD patients and to compare with control subjects with normal cognitive function. The case–control study was carried out on a group of elderly with AD (n 28) and compared with a control group (n 29), both aged between 60 and 89 years. Se intake was evaluated by using a 3-d dietary food record. Se was evaluated in plasma, erythrocytes and nails by using the method of hydride generation atomic absorption spectroscopy. Deficient Se intake was largely observed in the AD group. AD patients showed significantly lower Se levels in plasma, erythrocytes and nails (32·59 μg/l, 43·74 μg/l and 0·302 μg/g) when compared with the control group (50·99 μg/l, 79·16 μg/l and 0·400 μg/g). The results allowed us to suggest that AD has an important relation with Se deficiency.
Although memory deficits are typically the earliest and most profound symptoms of Alzheimer’s disease (AD) and mild cognitive impairment (MCI), there is increasing recognition of subtle executive dysfunctions in these patients. The purpose of the present study was to determine the sensitivity of the Behavioral Assessment of the Dysexecutive Syndrome (BADS), and to detect early specific signs of the dysexecutive syndrome in the transition from normal cognition to dementia. The BADS was administered to 50 MCI subjects, 50 mild AD patients, and 50 normal controls. Statistically significant differences were found among the three groups with the AD patients performing most poorly, and the MCI subjects performing between controls and AD patients. The Rule Shift Cards and the Action Program subtests were the most highly discriminative between MCI and controls; the Zoo Map and Modified Six Elements between MCI and AD; and the Action Program, Zoo Map, and Modified Six Elements between AD and controls. These results demonstrate that the BADS is clinically useful in discriminating between normal cognition and progressive neurodegenerative conditions. Furthermore, these data confirm the presence of a dysexecutive syndrome even in mildly impaired elderly subjects. (JINS, 2009, 15, 751–757.)
The Oliver Zangwill Centre (OZC) for Neuropsychological Rehabilitation opened in 1996 and was modelled on the American holistic programmes developed by Yehuda Ben-Yishay and George Prigatano. It was named after Oliver Louis Zangwill, Professor of Psychology at Cambridge University between 1954 and 1984. He was also a pioneer of brain injury rehabilitation in Great Britain during the Second World War when he worked in Edinburgh with brain injured soldiers. The Centre follows many of the principles laid down by Ben-Yishay (1978), Prigatano et al. (1986) and Christensen and Teasdale (1995), and is also significantly influenced by the critical ‘scientist practitioner’ model of clinical psychology adopted in the United Kingdom.
A holistic approach to brain injury rehabilitation ‘… consists of well-integrated interventions that exceed in scope, as well as in kind, those highly specific and circumscribed interventions which are usually subsumed under the term “cognitive remediation”’ (Ben-Yishay and Prigatano, 1990; p. 40). The holistic approach recognizes that it does not make sense to separate the cognitive, emotional and social consequences of brain injury as how we feel and think affects how we behave. Ben-Yishay's (1978) model follows a hierarchy of stages through which the patient or client should work in rehabilitation. These stages are engagement, awareness, mastery, control, acceptance and identity. Individual and group sessions are provided to enable patients to work through these stages.
The origins of the OZC go back to 1993 when one of us (BAW) spent several weeks at Prigatano's unit in Phoenix Arizona.
Peter was one of the early clients at the Oliver Zangwill Centre for Neuropsychological Rehabilitation and this chapter gives a typical picture of the process of assessment and rehabilitation for our clients. We begin with a summary of the report from his preliminary (one-day) assessment as this details his major problems, his own and his wife's perceptions of his difficulties together with the staff's assessment of these.
Preliminary assessment report
History of injury
Peter was involved in a road traffic accident in July 1997 in which he sustained a severe traumatic head injury. At the time he was 33 years old. He was taken to the nearest hospital and then transferred to the Regional Neurointensive Critical Care Unit where he remained for one week, before being referred back to his local hospital. He stayed there for seven weeks. It is not clear how long he remained unconscious, but the notes from the Critical Care Unit say he had a head-on collision in a built-up area. His Glasgow Coma Score at the scene was 15 but by the following day had deteriorated to 11 and then to 7. It would appear that he had a post-traumatic amnesia of around 5–6 weeks. His retrograde amnesia, however, lasted only a few seconds. A CT scan of Peter's brain showed bilateral areas of attenuation in the temporo-parietal regions consistent with a cerebrovascular accident. This was subsequently found to be due to bilateral carotid artery dissection.
Acquired cognitive deficits can present themselves in many ways and can be confusing for the people affected as well as for those around them. This case illustrates the use of cognitive models for understanding an unusual neuropsychological syndrome that was not initially apparent.
Initial meeting and background
We first met Malcolm at Headway House in Cambridge in 1991. At that time his difficulty with the localization of objects was thought to be due to poor eyesight. We were starting a memory group there and wanted to administer a number of tests to the people coming to the group. One of the tests was the Raven's Standard Progressive Matrices (Raven, 1960). This test requires the person being tested to look at a matrix with a piece missing and then choose one of six or eight stimuli at the bottom of the page that will complete the matrix. Although Malcolm was articulate and had a fund of general knowledge, it was immediately obvious that he had difficulty with the Raven's test. He appeared to have problems seeing the missing part in the matrix and he could not point accurately to the stimuli at the bottom of the page. He frequently pointed to a blank part of the page or else placed his finger over two adjacent stimuli. Given that one of the major characteristics of Balint's syndrome (Balint, 1909) is an inability to localize in space (optic ataxia), we wondered if that was the explanation for Malcolm's poor pointing ability.