Search PubMed⌕ Search

Biomedical subjects

S Birch

Publications and source records attributed to S Birch.

135 records · Page 8Linked to original sources

Focus, accent, and argument structure: effects on language comprehension.

Four experiments investigated the effect of syntactic argument structure on the evaluation and comprehension of utterances with different patterns of pitch accents. Linguistic analyses of the relation between focus and prosody note that it is possible for certain accented constituents within a broadly focused phrase to project focus to the entire phrase. We manipulated focus requirements and accent in recorded question-answer pairs and asked listeners to make linguistic judgments of prosodic appropriateness (Experiments 1 and 3) or to make judgments based on meaningful comprehension (Experiments 2 and 4). Naive judgments of prosodic appropriateness were generally consistent with the linguistic analyses, showing preferences for utterances in which contextually new noun phrases received accent and old noun phrases did not, but suggested that an accented new argument NP was not fully effective in projecting broad focus to the entire VP. However, the comprehension experiments did demonstrate that comprehension of a sentence with broad VP focus was as efficient when only a lexical argument NP received accent as when both NP and verb received accent. Such focus projection did not occur when the argument NP was an "independent quantifier" such as nobody or everything. The results extend existing demonstrations that the ease of understanding spoken discourse depends on appropriate intonational marking of focus to cases where certain structurally-defined words can project focus-marking to an entire phrase.

Humans↗

GP views of nurse-led telephone referral for paediatric assessment.

Following the introduction of a new nurse-led telephone referral service to a dedicated paediatric emergency assessment unit (PEAU), a study was conducted to determine the views of general practitioners (GPs) who use the service. The PEAU operates between 10 am and 10 pm on weekdays and between 10 am and 6 pm at weekends. The unit has four beds and treatment and stabilization areas, plus associated services in a dedicated area of a regional child health unit. The design utilized a faxed questionnaire over a 1-month period to all consenting GPs using the PEAU with a postal questionnaire follow-up. Non-parametric Likert scores and qualitative data were used to determine levels of satisfaction with the service and the subsequent management of the referred children. Sixty-nine GPs referred 80 children to the PEAU via the service over a period of 1 month. All consented to participate and were sent a faxed questionnaire, which generated 39 (57%) responses. A follow-up questionnaire sent to the 39 respondents achieved a return of 25 (64%) responses. Thirty-four GPs agreed that referral via the dedicated nurse service was easier than the previous senior house officer referral system. Of the 25 GP respondents to the follow-up postal survey, the majority (17) agreed that the follow-up morning after discharge telephone call to parents by the PEAU nurses was helpful. Four GPs indicated that the 24-hour open access system, offered by the nursing staff, in which a parent may attend PEAU with a discharged child causing concern without a previous appointment, does not always work. This study has shown that a nurse-led telephone referral system to a PEAU for GPs and the subsequent management of the children has been favourably received.

Attitude of Health Personnel↗

Effects of ultrasonically nebulized distilled water on respiratory resistance and breathing pattern in normals and asthmatics.

The purpose of this study was to analyze changes in respiratory resistance (Rrs) and breathing pattern in normal and asthmatic subjects after exposure to ultrasonically nebulized distilled water (UNDW). After measurement of baseline Rrs and breathing pattern, ten normals inhaled UNDW for 30, 60, 120, 240 and 480 s administered at 15 min intervals. After the 480 s exposure, subjects inhaled two puffs of metaproterenol. Rrs was measured immediately before and after each exposure to UNDW and after metaproterenol while breathing pattern was continuously monitored. Ten asthmatics were exposed to UNDW and metaproterenol in a similar time sequence, but the durations of exposure to UNDW were 15, 30, 60, 120 and 240 s. Mean (+/- SD) and frequency histograms of minute ventilation (VE), tidal volume (VT), frequency, inspiratory time, fractional inspiratory time, mean inspiratory flow (VT/TI) and end-expiratory level at baseline were compared to values after each exposure to UNDW and after metaproterenol. All subjects experienced laryngeal irritation or cough during the exposure. In normals, there were no changes in Rrs or any of the components of breathing pattern. In asthmatics, 15 and 30 s exposures produced no changes in Rrs or breathing pattern. With subsequent longer exposures, mean Rrs showed a stepwise significant increase, along with parallel increases of VT/TI and end-expiratory level. VE increased after 60 and 120 s exposure, but reached a plateau after 240 s exposure despite continued increase in Rrs.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A population needs-based approach to health-care resource allocation and planning in Ontario: a link between policy goals and practice?

This paper presents a way of planning and allocating health-care resources in Ontario, based on population health needs. It is argued that this approach is consistent not only with the principles of the Canada Health Act but also with the vision of health for Ontario. The paper reviews various direct and indirect indicators of need for health care, concluding that our present state of knowledge allows use of the SMR (indicating premature mortality) and for the application of a population needs-based approach which is itself uncontaminated by existing service availabilities and distributions and hence avoids perpetuating any inequalities.

Data Collection↗

Modelling the community as a determinant of health.

Widespread recognition is given to the idea that an individual's health is influenced by the ways an individual works, rests and plays as well as genetic endowments. More recently, some researchers have suggested that the relationships between individual 'characteristics' and health are influenced by the context or community of the individual. Although the notion of the community as a determinant of health is not new, the incorporation of the community in empirical research on the determinants of health has been based on simple statistical models that fail to reflect the complex nature of the individual-community interface. In this paper we use the methods developed in educational research to show how separate statistical models for variations in health between communities and between individuals can be combined to provide a multi-level model for the determinants of health of populations.

Community Networks↗