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PubMed1990

Differential recovery of languages in a bilingual patient: a case study using selective amytal test.

We performed a selective Wada test on a bilingual patient. While a left middle cerebral artery (MCA) injection produced global aphasia for both (Spanish and English) languages, the patient could only speak Spanish (his mother tongue) 1 min after he started to speak English. No language disturbances were observed after a right MCA amytal injection. These findings suggest that all of a multilingual's languages are stored within the verbal-dominant perisylvian region, and while the second language may be organized within the central Sylvian core, the first language may be better represented in more distal perisylvian areas.

Adult↗
PubMed1996

The research in semantics behind the OpenLabs coding system.

The OpenLabs coding system is an established, comprehensive, dynamic, flexible, open, multilingual European system which is tailored to meet the electronic data interchange (EDI) needs of medical laboratory users. The OpenLabs coding system, having many specific, independent classes and considerable flexibility, serves two different objectives: (i) unambiguous coding of entities present in messages used for EDI in clinical pathology; and (ii) interfacing with other nomenclatures and coding schemes to map concepts between different systems.

Classification↗
PubMed1996

Self-report disability in an international primary care study of psychological illness.

We assessed the replicability of reliability and validity of a brief self-report disability scale, adapted from the Medical Outcomes Survey (short form), in a 15-center, cross-national, multilingual study of psychological illness among primary care patients (n = 5438). Across all 15 centers in the World Health Organization Collaborative Study of Psychological Problems in General Health Care, the reliability of the disability scale was high and individual items were responsive at similar levels of disability. Self-report disability was consistently correlated with disability in work role (including housework) as rated by interviewers according to the Groningen Social Disability Schedule, a semistructured method taking local norms into account. Disability as measured by the self-report questionnaire was also consistently correlated with depressive symptoms as measured by the General Health Questionnaire. At each center, the disability items formed a moderately to strongly hierarchical (Guttman-like) scale. These findings support the feasibility of using self-report disability scales in cross-national primary care research.

Depression↗
PubMed2005

The temporal stability of cluster and switch scores using a modified COWAT procedure.

This study examined the impact of instructional changes on the temporal stability of cluster and switch scores for the Controlled Oral Word Association Test [COWAT; Benton, A. L., Hamsher, K., & Sivan, A. B. (1994). Multilingual Aphasia Examination (3rd ed.). Iowa City, IA: AJA Associates]. Healthy undergraduates were assigned randomly into experimental (N = 60) and control (N = 60) groups. Experimental group participants were administered three letters as customary, then informed about clustering strategies prior to completing three additional letters. Control group participants received the original instructions only for all six letters. All participants were examined on two separate occasions. The mean inter-assessment interval was 38.6 days (ranging from 29 to 47 days). Stability coefficients for cluster and switch scores on the last set of letters differed significantly between groups, as higher coefficients were observed for the experimental group. In contrast, stability coefficients for the total words produced and mean cluster size did not differ between groups. Although the temporal stability improved, the resulting coefficients were modest (e.g., r(icc) = .76 for clusters; r(icc) = .79 for switches). We present implications of these findings and considerations for future research.

Adult↗
PubMedDate not supplied

The sensitivity of quality-of-life scale WHOQOL-100 to psychopathological measures in schizophrenia.

We aimed to investigate the reliability and the clinical sensitivity of the World Health Organization Quality of Life (WHOQOL-100) scale for patients diagnosed with schizophrenia because of its multilingual, multidimensional, and cross-cultural properties. Fifty-four stabilized outpatients with schizophrenia and 49 age-, sex-, and occupation-matched healthy control subjects were recruited. The scale showed high internal consistency (Cronbach alpha = 0.94). While there was no correlation between total scores of psychopathology measures (Brief Psychiatric Rating Scale [BPRS], Scale for the assessment of Negative Symptoms [SANS], Scale for the Assessment of Positive Symptoms [SAPS], and Clinical Global Impression [CGI]), significant negative correlations were obtained especially between subscales of the BPRS, SANS, SAPS, and QOL domains. Stepwise multiple regression analysis also revealed that the BPRS anxiety/depression and SANS anhedonia subcales were the predictor variables in five of six QOL domains in the schizophrenia group. The better quality-of-life scores of the mild group on physical and psychological domains indicate that the WHOQOL-100 could be used as an outcome measure in clinical studies. Thus, the WHOQOL-100 scale is a reliable, subjective quality-of-life scale for patients diagnosed with schizophrenia. The clinical sensitivity should also be assessed in large follow-up studies.

Adolescent↗
PubMed2005

Health search engine with e-document analysis for reliable search results.

OBJECTIVE: After a review of the existing practical solution available to the citizen to retrieve eHealth document, the paper describes an original specialized search engine WRAPIN. METHOD: WRAPIN uses advanced cross lingual information retrieval technologies to check information quality by synthesizing medical concepts, conclusions and references contained in the health literature, to identify accurate, relevant sources. Thanks to MeSH terminology [1] (Medical Subject Headings from the U.S. National Library of Medicine) and advanced approaches such as conclusion extraction from structured document, reformulation of the query, WRAPIN offers to the user a privileged access to navigate through multilingual documents without language or medical prerequisites. RESULTS: The results of an evaluation conducted on the WRAPIN prototype show that results of the WRAPIN search engine are perceived as informative 65% (59% for a general-purpose search engine), reliable and trustworthy 72% (41% for the other engine) by users. But it leaves room for improvement such as the increase of database coverage, the explanation of the original functionalities and an audience adaptability. CONCLUSION: Thanks to evaluation outcomes, WRAPIN is now in exploitation on the HON web site (http://www.healthonnet.org), free of charge. Intended to the citizen it is a good alternative to general-purpose search engines when the user looks up trustworthy health and medical information or wants to check automatically a doubtful content of a Web page.

Europe↗
PubMedDate not supplied

Associations with Minspeak icons.

UNLABELLED: Although the Minspeak approach is used on communication devices worldwide, little research has been conducted on its applicability within specific cultural contexts. The impact that users' familiarity of symbols and associations can have on learnability necessitates more systematic research. This study was an investigation into the associations which young South African adults from a tertiary education institution make with selected Minspeak icons, used in Unity software. Associations with the 12 core icons of the UniChat program were elicited from 480 able-bodied tertiary education students, using a cueing questionnaire. Each participant completed one questionnaire on one icon, so that 40 response questionnaires were obtained per icon. The responses from the questionnaires were pruned and computerised. Two analyses were done from these data: Firstly, the percentage of common associations per icon was calculated, and secondly, the elicited associations were compared to the current Unity vocabulary on a word and conceptual level. The results indicate that some of the icons and their encoded vocabulary items might be used successfully in the South African context, while others need to be adapted to be locally relevant. The results emphasize that iconic encoding systems based on commercially available graphic representational systems cannot merely be imported to South Africa due to the multicultural and multilingual nature of the context. LEARNING OUTCOMES: As a result of this activity (1) the participant will be able to understand different types of associational responses based on icons used in Minspeak; (2) the participant will be able to understand the cultural relevance of some aspects of the Unity application programme; and (3) the participant will be able to identify different strategies that can be used to describe the cultural relevance o of the Unity application programme.

Adolescent↗
PubMed2006

Drugs on the web; the Psychonaut 2002 EU project.

PURPOSE: Only a few formal assessments of websites with drug-related contents have been carried out. We aimed here at fostering collection and analysis of data from web pages related to information on consumption, manufacture and sales of psychoactive substances. GENERAL METHODS: An 8-language, two-engine, assessment of the information available in a purposeful sample of 1633 unique websites was carried out. FINDINGS: A pro-drug and a harm reduction approach were evident, respectively, in 18% and 10% of websites accessed. About 1 in 10 websites offered either psychoactive compounds for sale or detailed data on drugs' synthesis/extraction procedures. Information on a number of psychoactive substances and on unusual drugs' combinations not found in the Medline was elicited. CONCLUSIONS: This represents the first review which is both comprehensive and multilingual of the online available information on psychoactive compounds. Health professionals may need to be aware of the web being a new drug resource for information and possibly purchase.

Analysis of Variance↗
PubMed1984

OR nursing in the future. Impact of projected demographics.

Implications of these population factors for operating room nursing are summarized as follows. Continued need for obstetric-related surgery throughout this decade and into the 21st century. Continued need for multilingual skills to care for non-English speaking individuals and continued need for sensitivity by health care professionals to other cultural norms with regard to illness and treatment. Increasing number of older adults needing perioperative care. Increasing use of surgery common to older adults. Continued pressure to reduce costs of care. Operating room nurses can ask several questions to discover demographic trends affecting their hospitals and areas. What is the age profile of patients in the health care facility? What are the patients' geographical origins? What percent of that population is served by the health care facility? What are the population trends in the geographical area from which they draw their patients? age proportions over time, fertility rate, migration trends, mortality rates over time, life expectancy What proportion of the hospital days are used by elderly? What is the rate per 1,000 for surgery among the elderly? Answers to these questions will give OR nurses the basis for anticipating change and planning to meet that change in their perioperative areas.

Age Factors↗
PubMed1997

Acquired dysgraphia in alphabetic and stenographic handwriting.

We report the unusual case of AZO, who professionally used handwritten shorthand writing, and became dysgraphic after a stroke. AZO suffered from a complex cognitive impairment, and part of her spelling errors resulted from damage to auditory input processing, to phonology-orthography conversion procedures and to the ortographic output lexicon. However, analysis of her writing performance showed that the same variables affected response accuracy in alphabetic and shorthand writing; and, that the same error types, including transpositions, were observed in all tasks in the two types of writing. These observations are consistent with damage to the graphemic buffer. They suggest that, in multiple-code writing systems (e.g., stenography, Japanese, or in the case of multilingual speakers of languages that use different spelling codes), the graphemic buffer is shared by all codes.

Agraphia↗
PubMed1999

Measuring quality of life in Britain: introducing the WHOQOL-100.

Quality of life is an important outcome measure in the evaluation of treatments for a range of chronic physical and psychological disorders. The psychometric properties of a new British quality-of-life instrument-the WHOQOL-100--are presented, as part of an international project to create a multilingual, multidimensional profile for cross-cultural use. The WHOQOL was completed by an adult sample (N = 320) of well people and patients attending GP surgeries and out-patient clinics and from inpatient wards. The sick represented 16 disease categories and all were selected for age, gender, and disease severity. The levels of quality of life of different disease groups and sociodemographic categories are reported. The presence or absence of positive feelings provides the best single predictor of quality of life in Britain today, and this improves when supplemented by information about mobility and energy. The scores of the scale discriminate well between sick and well people and concur with reported health status. The concept of quality of life covering 25 facets (hierarchically organized within six domains) was largely confirmed by mapping intercorrelations. The WHOQOL-100 shows excellent overall internal consistency reliability and can be used with individuals. This level of reliability extends to all domains and patient subgroups. Seven UK national items were also assessed for inclusion. The results show that WHOQOL-100 promises to be a comprehensive profile for generic use in the evaluation of contemporary health care.

Activities of Daily Living↗
PubMed1998

Investigating the relationship between pain and discomfort and quality of life, using the WHOQOL.

The aim of this study was to examine the impact of pain on quality of life and its components in a representative sample of 320 well people, and patients selected from all major categories of illness. Quality of life was assessed using a new, multidimensional, multilingual, generic profile designed for cross-cultural use in health care, i.e. the WHOQOL. Within the WHOQOL, pain and discomfort is one of 29 areas or facets of quality of life, grouped into six domains. It was found that pain and discomfort made a significant impact on perceptions of general quality of life related to health. Furthermore, the presence of pain affected perceptions of five of the six domains of quality of life; the domain of spirituality, religion and personal beliefs being the exception. When quality of life is assessed, negative feelings are most closely associated with reports of pain and discomfort than any other facet. But quality of life surrounding pain and discomfort is more fully explained by the inclusion of six additional facets; the availability of social care, mobility, activities of daily living, positive mood and to a lesser extent, sleep and dependence on medication. Together, these seven facets represent criteria against which the success of pain treatments may be evaluated. As predicted, those who were pain-free had significantly better quality of life than those in pain. A longer duration of pain is associated with increasingly poorer quality of life. Intense affective pain is particularly detrimental to a good quality of life. The psychometric properties of the pain and discomfort facet of the WHOQOL and WHOQOL-100 were assessed. Internal consistency (reliability), discriminant and criterion/concurrent validity were found to be good to excellent, justifying the use of this instrument with a range of chronic and acute pain patients.

Acute Disease↗
PubMed2001

Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland.

BACKGROUND: To study the psychometric properties of a modified Alcohol Use Disorders Identification Test in the multilingual context of Switzerland. METHODS: Data were obtained from the most extensive health survey to date in Switzerland, with a response rate of 69%. Seven core items of AUDIT were used. The first two items of AUDIT (frequency of drinking, quantity of drinking) were not used in their original form, but reconstructed from a quantity-frequency instrument (QF) measuring alcohol consumption, and categorized according to the AUDIT. The third AUDIT item (frequency of binge drinking) was similarly not used in its original form, but 8+ drinks instead of 6+ drinks was used. All 10 items of the modified AUDIT were completed by 10321 subjects - 6677 in the German-speaking region and 3644 in the Latin-language (French, Italian) regions. The dimensionality of the modified AUDIT was modelled by confirmatory factor analysis. The contribution of each item to the total modified AUDIT score was investigated by the prevalence of positively screened subjects when items were deleted, and factor loadings of the unidimensional model. RESULTS: In Switzerland the modified AUDIT fitted neither a unidimensional nor the hypothesized tri-dimensional model. Consumption items, especially frequency of drinking, showed almost no correlation with items measuring alcohol-related problems, but the latent constructs 'harmful drinking' and 'alcohol dependence' were highly correlated, indicating a shared underlying factor. Frequency of drinking was the item that most influenced whether an individual screened positively or not. Except for the correlation of frequency and binge drinking, results were almost identical for both linguistic regions. CONCLUSIONS: The current form of the modified AUDIT may have to be changed for screening in Switzerland, as the study raised questions about the suitability of the frequency-of-drinking item as an indicator of a screening device for alcohol-related problems in this country.

Adult↗
PubMed1999

Are we getting the message out to all? Health information sources and ethnicity.

BACKGROUND: Over 80% of the excess deaths in minority and economically disadvantaged populations are from diseases with preventable or controllable contributing factors. However, mainstream health education targeting behavior change often fails to reach minority populations. OBJECTIVE: To identify the health and cancer information sources used by a multi-ethnic population and to determine whether information sources differ by ethnic group, age, gender, and socioeconomic status. METHODS: A multilingual, random-digit dial telephone survey of 2,462 Hispanic (Colombian, Dominican, Ecuadorian, and Puerto Rican) and black (Caribbean, Haitian, and U.S.-born) persons, aged 18-80 years, from a population-based quota sample, New York City, 1992. RESULTS: All ethnic and age groups cited a health professional as the most common source of health information (40% overall). The next most commonly cited sources overall were: television (21%), hospitals or doctor's offices (18%), books (17%), magazines (15%), brochures/pamphlets (11%), and radio (8%). Responses on sources of cancer information followed a similar pattern. Black subgroups were all significantly more likely than Hispanic subgroups to get their health information from a doctor or other health professional (p = 0.001). Use of the radio as a source of health information was highest among Haitians (20.8%) and Colombians (12.5%), and lowest among U.S.-born blacks (4.2%) (p = 0.001), but there was no difference in the use of television. Among immigrants, as the proportion of life spent in mainland U.S. rose, increasing percentages cited magazines (p = 0.001) and decreasing percentages cited radio (p = 0.025) as a health information source. Less educated persons and more recent immigrants were most likely to report inability to get health information (p = 0.001). CONCLUSIONS: Given the variation in sources of health and cancer information, identification of those most commonly used is important to health educators' and public health practitioners' efforts to target hard-to-reach ethnic minorities.

Adult↗
PubMed1999

Cross-cultural adaptation of a psychometric instrument: two methods compared.

Cross-cultural adaptations of questionnaires are needed in multilingual research, but little is known about the effectiveness of specific translation methods. We compared properties of two French-language adaptations of the SF36 health survey: (a) a rapid translation developed over 3 months in Geneva in 1992 (Geneva version), based on three initial translations, one synthesis, and two pretests, and (b) a comprehensive adaptation developed by the International Quality of Life Assessment Project between 1991 and 1994 (IQOLA version), which involved back-translations, focus groups, development of equidistant response options, item difficulty and quality ratings, and multiple pretests. Wordings of 34 of 36 items differed. These two instruments were administered 1 year apart to the same sample of 946 young adults. Ceiling effects were somewhat lower for the IQOLA than for the Geneva version (means 30.4% and 35.5%), and missing scores slightly less frequent (IQOLA: mean 0.5%; Geneva: 1.2%). Floor effects (means 2.7% and 2.4%), proportions of consistent respondents (93.4% and 94.0%), and internal consistency coefficients (IQOLA: 0.78-0.89, Geneva: 0.80-0.92) were similar. Factor analysis supported the existence of two main aspects of health (physical and mental) for both versions. A majority of known-group comparisons were compatible with theory, for both versions. In conclusion, the two French-language versions of the SF36 had similar psychometric properties, despite extensive differences in the development process. This suggests that a moderately resource-intensive translation may produce adequate results. More empirical research is needed to understand what translation methods yield the best results.

Adaptation, Psychological↗
PubMed2000

GALEN: a third generation terminology tool to support a multipurpose national coding system for surgical procedures.

Generalised architecture for languages, encyclopedia and nomenclatures in medicine (GALEN) has developed a new generation of terminology tools based on a language independent model describing the semantics and allowing computer processing and multiple reuses as well as natural language understanding systems applications to facilitate the sharing and maintaining of consistent medical knowledge. During the European Union 4 Th. framework program project GALEN-IN-USE and later on within two contracts with the national health authorities we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures named CCAM in a minority language country, France. On one hand, we contributed to a language independent knowledge repository and multilingual semantic dictionaries for multicultural Europe. On the other hand, we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW (for classification workbench) to process French professional medical language rubrics produced by the national colleges of surgeons domain experts into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation, on one hand, we generate with the LNAT natural language generator controlled French natural language to support the finalization of the linguistic labels (first generation) in relation with the meanings of the conceptual system structure. On the other hand, the Claw classification manager proves to be very powerful to retrieve the initial domain experts rubrics list with different categories of concepts (second generation) within a semantic structured representation (third generation) bridge to the electronic patient record detailed terminology.

Abstracting and Indexing↗
PubMed1998

Practical development of re-usable terminologies: GALEN-IN-USE and the GALEN Organisation.

Medical terminology is now playing a key role in medical software. This requires new techniques with which many clinical users, classification experts and applications developers are unfamiliar. There is a conflict in that the more re-usable techniques for terminology needed to support sharing of information among many different applications are more difficult to use for any one application. A layered approach to re-use is described which combines techniques from first generation systems and relatively easily understood second generation systems with the formal rigour of third generation systems to resolve this conflict. The methodology also provides a potentially rigorous approach to defining the relationship between terminology and structure in the electronic healthcare record architecture. It provides a natural migration pathway from existing systems to powerful re-usable multilingual terminologies.

Expert Systems↗
PubMedDate not supplied

Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

MERMAID is an EU financed telemedicine project with global reach and 24-h, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (digital land lines, cellular/wireless, satellite and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

Computers↗