Comprehensive community plan for meeting the problems of chronic illness: the comprehensive plan: what it is & how its can be used.
Explore the source record for details and available documents.
Chronic Disease↗
SEARCH · Search PubMed
Results for “Comprehension”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[The status of nursing education at the Aichi Prefectural Junior College of Nursing. X. Teaching of comprehensive nursing theory. (3). Nursing technology and clinical nursing course based on comprehensive nursing theory].
Explore the source record for details and available documents.
Education, Nursing↗
Comprehensive geriatric assessment: is it too comprehensive for compliance and cost-effectiveness?
Explore the source record for details and available documents.
Aged↗
South East Asia: intercountry consultative meeting on comprehensive school health education. A call for action to implement and strengthen comprehensive approaches to school health education in South East Asia.
Explore the source record for details and available documents.
Asia, Southeastern↗
Can reading accuracy and comprehension be separated in the Neale Analysis of Reading Ability?
BACKGROUND: The Neale Analysis of Reading Ability (NARA) (Neale, 1997) is widely used in education and research. It provides measures of reading accuracy (decoding) and comprehension, which are frequently interpreted separately. AIMS: Three studies were conducted to investigate the degree to which the NARA measures could be separated. SAMPLES: British 7- and 8-year-olds participated in Study 1 (N=114) and Study 2 (N=212). In Study 3, 16 skilled and less-skilled comprehenders were identified from the Study 2 sample. METHODS: Study 1: By investigating their contribution to silent reading comprehension, the independence of NARA decoding and comprehension scores was determined. Study 2: Decoding groups matched for listening comprehension were compared on the NARA comprehension measure, and population performance was compared across listening comprehension and NARA reading comprehension. Study 3: Comprehension groups were compared on ability to answer open-ended and forced-choice questions. RESULTS: Firstly, NARA comprehension performance depended on decoding, to the extent that children with high listening comprehension ability but low decoding ability attained low NARA comprehension scores. Secondly, 32% of children who attained low NARA comprehension scores exhibited high listening comprehension. Thirdly, comprehension groups differed when assessed with open-ended questions but not when assessed with forced-choice questions. CONCLUSIONS: The NARA can underestimate the comprehension ability of children with weak decoding skills and children who have some difficulty with open-ended questions. The decoding and comprehension measures of the NARA cannot be separated. These findings have important implications for the interpretation of the measures provided by the NARA, in education and research.
Aptitude↗
Verb comprehension in frontotemporal degeneration: the role of grammatical, semantic and executive components.
Verb comprehension has been associated with the left frontal cortex, but assessments of verb comprehension in frontotemporal degeneration (FTD) have been rare. This study assessed word-picture matching for verbs and nouns under two conditions: alone (baseline) and during concurrent performance of a secondary task. In addition, we correlated FTD patients' verb comprehension with their performance on measures of executive resources and language. We found that FTD patients were significantly less accurate and required significantly longer to make word-picture matching decisions about verbs compared with nouns at baseline. During concurrent performance of a secondary task, accuracy decreased and response latencies became prolonged for nouns to the point that these measures equaled the performance with verbs at baseline. Verb comprehension accuracy was significantly correlated with the performance on executive measures such as category naming fluency, the Stroop test, and the Trail Making Test Part B (Trails B test). Assessment of FTD patient subgroups revealed distinct profiles of performance, suggesting that several factors contribute to verb comprehension in FTD. Verb comprehension in FTD patients with a dysexecutive syndrome (EXEC, n = 10) was sensitive to concurrent performance of a secondary task, and their verb comprehension accuracy correlated with the time required to complete executive measures such as the Stroop test and the Trails B test. This suggested a relationship between impaired verb comprehension and limited information-processing speed in EXEC patients. Verb comprehension in patients with a progressive non-fluent aphasia (PNFA, n = 7) was not selectively influenced by executive resources. Instead, verb comprehension accuracy in PNFA was significantly correlated with sentence comprehension accuracy, suggesting that grammatical aspects of verbs play a crucial role in their verb comprehension difficulty. Although we studied only a small number of patients with semantic dementia (SD, n = 4), we observed significant verb comprehension difficulty that was minimally influenced by executive resources and was unrelated to sentence comprehension. It is possible that impaired verb comprehension in SD is related in part to the degradation of semantic feature knowledge.
Adult↗
Discourse comprehension test performance of elders with dementia of the Alzheimer type.
Spoken language comprehension, including comprehension for inferential material in narrative discourse, is diminished in dementia of the Alzheimer type (DAT). There are, however, no empirical data concerning comprehension by adults with DAT of main ideas versus details in narratives. Evidence from other groups with and without brain damage has shown that comprehension for main ideas is relatively better than for details and that comprehension for stated material is relatively better than comprehension for inferential material. Participants in the present investigation were 24 older adults, 8 with early-stage DAT (EDAT), 8 with middle-stage DAT (MDAT), and 8 with no brain damage (NBD). Selected narratives and associated sets of yes-no questions from the Discourse Comprehension Test (DCT) (Brookshire and Nicholas, 1993) were presented on videotape. Participants with EDAT and MDAT had significantly poorer overall comprehension of DCT narratives than did those in the NBD group (p < .0001), but they did not differ significantly from each other. Responses to DCT narratives by participants in the NBD, EDAT, and MDAT groups followed the same pattern of relatively better comprehension for main ideas than for details and relatively better comprehension for stated than for implied information. Working memory and episodic memory were shown to be significantly associated with DCT overall scores. Together, these findings suggest that although overall narrative comprehension is diminished in those with DAT, individuals appear to retain a mental representation for narratives that facilitates better comprehension of main ideas than of details as well as better comprehension of stated information than of implied information. This interpretation is consistent with schema-based accounts of narrative comprehension.
Aged↗
Sentence comprehension in children with specific language impairment: effects of input rate and phonological working memory.
BACKGROUND: Many children with specific language impairment (SLI) exhibit sentence comprehension difficulties. In some instances, these difficulties appear to be related to poor linguistic knowledge and, in other instances, to inferior general processing abilities. Two processing deficiencies evidenced by these children include reduced linguistic processing speed and diminished phonological working memory (PWM) capacity. While providing children with SLI a slower input rate appears to facilitate their immediate (real-time) processing of language; it is not known whether such a manipulation might also promote better offline (conventional) sentence comprehension. Complicating the potential benefits of a slower input rate on these children's offline comprehension is that a slower input rate might negatively interact with their PWM deficit. That is, a slower presentation rate may have the unintended consequence of placing too great a temporal burden on these children's vulnerable PWM system, thereby leading to even poorer comprehension. That is, a slower input rate presumably requires the listener to store previously processed information for a longer period while new, incoming material is being processed. AIMS: To investigate the interaction of input rate and PWM capacity on the sentence comprehension of children with SLI. It was hypothesized that if a slower input rate negatively affects the PWM functioning of children with SLI, these children would comprehend significantly fewer sentences presented at a slower rate versus sentences presented at a normal rate. It was also hypothesized that input rate should have no differential effect on the typically developing control children. METHODS & PROCEDURES: A group of 12 school-age children with SLI, a group of 12 age-matched children (CA), and a group of 12 receptive syntax-matched (RS) children (all with normal-range non-verbal IQ and hearing) completed a conventional picture-pointing sentence comprehension task. Sentences were presented at a normal speaking rate and a slower rate (25% time expanded). Children also completed a non-word repetition task, which served as an index of PWM capacity. OUTCOMES & RESULTS: Results of the PWM task revealed that the children with SLI repeated fewer three- and four-syllable non-words than both the CA and RS children, suggesting they had reduced PWM capacity. On the sentence comprehension task, a significant group by input rate interaction emerged. The children with SLI yielded significantly poorer comprehension of normal-rate sentences compared with both the CA and RS children. Whereas input rate had no differential effect on CA and RS children's comprehension, the comprehension of the children with SLI improved to the level of RS children in the slow-rate condition. Correlational analyses showed no significant association between PWM and sentence comprehension in either rate condition for any of the groups. CONCLUSIONS: Together, these findings suggest that the simple manipulation of altering speaking rate to children with SLI indeed can facilitate sentence comprehension, with no apparent detrimental effect on the operations of their PWM system.
Child↗
Consistency of the effects of rate of speech on brain-damaged adults' comprehension of narrative discourse.
An experiment was carried out to assess the effects of slow and fast speech rate on comprehension of narrative discourse by aphasic, right-hemisphere-damaged, and non-brain-damaged adults. Aphasic subjects were divided into a high-comprehension group and a low-comprehension group based on their performance on the auditory comprehension subtests from the Boston Diagnostic Aphasia Examination. Subjects listened to 10 narrative stories. Half the stories were presented at slow speech rate (110-130 wpm) and half were presented at fast speech rate (190-210 wpm). After each story, subjects' comprehension and retention of stated and implied main ideas and details were tested. Brain-damaged subjects were tested twice, with at least 2 weeks intervening between sessions. Results demonstrated that salience had strong effects on comprehension for all groups of subjects--main ideas consistently were comprehended better than details. Directness affected subjects' comprehension of details, but not their comprehension of main ideas--stated details consistently were comprehended better than implied details. Non-brain-damaged subjects' comprehension was unaffected by differences in speech rate. Brain-damaged subjects comprehended details better in slow rate than in fast rate condition in the first test session, but the effects of rate on brain-damaged subjects' comprehension essentially disappeared by the second test. Furthermore, there were many instances in which individual subjects failed to demonstrate rate effects exhibited by their group.
Aged↗
A longitudinal study of sentence comprehension difficulty in primary progressive aphasia.
CONTEXT: Patients with primary progressive aphasia have sentence comprehension difficulty, but the longitudinal course of this deficit has not been investigated. OBJECTIVE: To determine how grammatical, single word meaning, and working memory factors contribute to longitudinal decline of sentence comprehension in primary progressive aphasia. We hypothesised partially distinct patterns of sentence comprehension difficulty in subgroups of patients with progressive non-fluent aphasia (PNFA) and semantic dementia (SD). DESIGN: Cohort. SETTING: Institutional out patient referral centre. PATIENTS: PNFA (n = 14), SD (n = 10). MAIN OUTCOME MEASURE: Sentence comprehension accuracy. RESULTS: PNFA patients were significantly impaired at understanding grammatically complex sentences when first seen, and this was more evident than impairment of their comprehension of grammatically simple sentences (p<0.05). Comprehension of grammatically complex sentences correlated with their working memory deficit at presentation (p<0.05). PNFA patients showed modest decline over time in grammatical comprehension. In SD, comprehension of grammatically complex sentences was not more impaired than comprehension of grammatically simple sentences when first seen, but these patients demonstrated a significant longitudinal decline in understanding grammatically complex sentences (p<0.05). Cox regression analyses showed that a deficit in single word meaning contributes to the progressive impairment for grammatically complex sentences in SD (p<0.05), but working memory does not contribute to longitudinal decline in PNFA. CONCLUSION: Patients with PNFA and SD have sentence comprehension difficulty, but distinct factors contribute to this impairment during the course of their disease.
Aged↗
Assessing children's inference generation: what do tests of reading comprehension measure?
BACKGROUND: Previous research suggests that children with specific comprehension difficulties have problems with the generation of inferences. This raises important questions as to whether poor comprehenders have poor comprehension skills generally, or whether their problems are confined to specific inference types. AIMS: The main aims of the study were (a) using two commonly used tests of reading comprehension to classify the questions requiring the generation of inferences, and (b) to investigate the relative performance of skilled and less-skilled comprehenders on questions tapping different inference types. SAMPLE: The performance of 10 poor comprehenders (mean age 110.06 months) was compared with the performance of 10 normal readers (mean age 112.78 months) on two tests of reading comprehension. METHOD: A qualitative analysis of the NARA II (form 1) and the WORD comprehension subtest was carried out. Participants were then administered the NARA II, WORD comprehension subtest and a test of non-word reading. RESULTS: The NARA II was heavily reliant on the generation of knowledge-based inferences, while the WORD comprehension subtest was biased towards the retention of literal information. Children identified by the NARA II as having comprehension difficulties performed in the normal range on the WORD comprehension subtests. Further, children with comprehension difficulties performed poorly on questions requiring the generation of knowledge-based and elaborative inferences. However, they were able to answer questions requiring attention to literal information or use of cohesive devices at a level comparable to normal readers. CONCLUSIONS: Different reading tests tap different types of inferencing skills. Lessskilled comprehenders have particular difficulty applying real-world knowledge to a text during reading, and this has implications for the formulation of effective intervention strategies.
Child↗
Comprehensive follow-up care and life-threatening illnesses among high-risk infants: A randomized controlled trial.
CONTEXT: Inner-city high-risk infants often receive limited and fragmented care, a problem that may increase serious illness. OBJECTIVE: To assess whether access to comprehensive care in a follow-up clinic is cost-effective in reducing life-threatening illnesses among high-risk, inner-city infants. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: A total of 887 very-low-birth-weight infants born in a Texas county hospital between January 1988 and March 1996 and followed up in a children's hospital clinic. One hundred four infants who became ineligible or died after randomization but before nursery discharge were excluded from the analysis. INTERVENTIONS: Infants were randomly assigned to receive routine follow-up care (well-baby care and care for chronic illnesses; n = 441) or comprehensive care (which included the components of routine care plus care for acute illnesses, with 24-hour access to a primary caregiver; n = 446). MAIN OUTCOME MEASURES: Life-threatening illnesses (ie, causing death or hospital admission for pediatric intensive care) occurring between nursery discharge and age 1 year, assessed by blinded evaluators from inpatient charts and state Medicaid and vital statistics records; and hospital costs (estimated from department-specific cost-to-charge ratios). RESULTS: Comprehensive care resulted in a mean of 3.1 more clinic visits and 6.7 more telephone conversations with clinic staff (P<.001 for both). One-year outcomes were unknown for fewer comprehensive-care infants than routine-care infants (9 vs 28; P =.001). Identified deaths were similar (11 in comprehensive care vs 13 in routine care; P =.68). The comprehensive-care group had 48% fewer life-threatening illnesses (33 vs 63; P<.001), 57% fewer intensive care admissions (23 vs 53; P =.003), and 42% fewer intensive care days (254 vs 440; P =.003). Comprehensive care did not increase the mean estimated cost per infant for all care ($6265 with comprehensive care and $9913 with routine care). CONCLUSION: Comprehensive follow-up care by experienced caregivers can be highly effective in reducing life-threatening illness without increasing costs among high-risk inner-city infants. JAMA. 2000;284:2070-2076.
Acute Disease↗
Comprehension of wh-questions in two Broca's aphasics.
This study investigated comprehension of wh-questions in two Broca's aphasics. Patients were presented for comprehension with two types of wh-questions: questions headed by which and questions headed by who. These two types were chosen because according to recent syntactic analyses they give rise to different types of syntactic "chains." These questions were presented in both subject gap versions (e.g., which cat chased the dog?) and object gap versions (e.g., which cat did the dog chase?). Comprehension of which questions was asymmetric, with subject gap versions comprehended significantly better than object gap versions, the latter yielding chance-level performance. This finding is consistent with previous reports of subject-object asymmetries in comprehension of relative clauses and clefts, as well as active-passive comprehension asymmetries. In contrast, comprehension of who questions was symmetrical over subject gap and object gap versions: Both patients performed equally well (significantly better than chance) on subject gap and object gap who questions. These findings are inconsistent with current formulations of "chain" or "trace"-based theories of agrammatic comprehension which assume a deficit that affects both types of syntactic chains. We suggest that linguistic descriptions of agrammatic comprehension should be limited to deficits involving only one type of chain. We also suggest that there are processing differences underlying the syntactic distinctions between which-type and who-type questions and that this may account for different patterns of comprehension on these and other constructions.
Aged↗
Field testing of consumer safety signs: the comprehension of pictorially presented messages.
This paper describes one of a series of studies on the investigation of desirable characteristics of a labelling system for use on potentially dangerous household products. The suitability of a range of signs based on symbolic coding of hazards has been investigated. The hazards investigated were: Fire, Poison, Caustic, Electrical and General. The first stage of the programme involved a survey of all known symbols used for these and similar applications, followed by some preliminary testing to determine a range of symbols for more detailed testing. This subsequent testing of the symbols involved their incorporation into a range of sign variants, with differing colours of image and background together with variations in the shape and colour of enclosure containing symbol. These symbolically coded sign variants were tested in the field using a structured national random sample of 4000 respondents. The data were analyzed using a variable, but systematically controlled, criterion for correct comprehension, which allowed reliable discrimination between certain of the sign variants in terms of comprehension performance. In absolute terms, comprehension of even the best of the signs was not markedly high, ranging from around 20% with s stringent criterion up to 50% if a less stringent criterion of correct comprehension was used. Some of the poorer signs tested failed to achieve better than 5% correct comprehension rate even with a lax criterion for comprehension. Prior experience of the sign was found to enhance comprehension, increasing the correct comprehension rate by a factor of 1.5-2.0 times the correct comprehension rates obtained with those respondents who affirm that they have not seen the sign before.
Journal Article↗
Testing comprehension abilities in users of British Sign Language following CVA.
Recent imaging (e.g., MacSweeney et al., 2002) and lesion (Hickok, Love-Geffen, & Klima, 2002) studies suggest that sign language comprehension depends primarily on left hemisphere structures. However, this may not be true of all aspects of comprehension. For example, there is evidence that the processing of topographic space in sign may be vulnerable to right hemisphere damage (e.g., Hickok, Say, Bellugi, & Klima, 1996), and the influence of iconicity on comprehension has yet to be explored. In this study, comprehension testing was conducted with 15 signers with unilateral brain damage, and with elderly Deaf controls. Four tests were administered: a test of iconic and non-iconic noun comprehension, a test of verb and sentence comprehension, a test of locative sentence comprehension, and a test of classifier comprehension. All tests were administered in British Sign Language (BSL), a language that has only recently been explored with lesioned signers (see Atkinson, Marshall, Thacker, & Woll, 2004; Marshall, Atkinson, Thacker, Woll, & Smulevitch, 2004; Marshall, Atkinson, Woll, & Thacker, in press). People with left hemisphere damage were impaired relative to controls on all tests. Those with right hemisphere damage performed well in the first two tests, but were impaired on locative sentences and classifiers. Neither group showed any effect of iconicity. The results shed further light on the laterality of sign language comprehension.
Aged↗
Role of the left hemisphere in sign language comprehension.
We investigated the relative role of the left versus right hemisphere in the comprehension of American Sign Language (ASL). Nineteen lifelong signers with unilateral brain lesions [11 left hemisphere damaged (LHD) and 8 right hemisphere damaged (RHD)] performed three tasks, an isolated single-sign comprehension task, a sentence-level comprehension task involving simple one-step commands, and a sentence-level comprehension task involving more complex multiclause/multistep commands. Eighteen of the participants were deaf, one RHD subject was hearing and bilingual (ASL and English). Performance was examined in relation to two factors: whether the lesion was in the right or left hemisphere and whether the temporal lobe was involved. The LHD group performed significantly worse than the RHD group on all three tasks, confirming left hemisphere dominance for sign language comprehension. The group with left temporal lobe involvement was significantly impaired on all tasks, whereas each of the other three groups performed at better than 95% correct on the single sign and simple sentence comprehension tasks, with performance falling off only on the complex sentence comprehension items. A comparison with previously published data suggests that the degree of difficulty exhibited by the deaf RHD group on the complex sentences is comparable to that observed in hearing RHD subjects. Based on these findings we hypothesize (i) that deaf and hearing individuals have a similar degree of lateralization of language comprehension processes and (ii) that language comprehension depends primarily on the integrity of the left temporal lobe.
Aphasia↗
Reading comprehension skills of young adults with childhood diagnoses of dyslexia.
This study explores the contribution of cognitive processes to comprehension skills in adults who suffered from childhood developmental dyslexia (CD). The performance of adults with CD (ages 17 to 23), chronological age-matched (CA) adults, and reading level-matched (RL) children was compared on measures of phonological processing, naming speed, working memory (WM), general knowledge, vocabulary, and comprehension. The results showed that adults with CD scored lower on measures of phonological processing, naming speed, WM, general knowledge, and vocabulary when compared to CA readers but were comparable to RL children on the majority of process measures. Phonological processing, naming speed, vocabulary, general knowledge, and listening comprehension contributed independent variance to reading comprehension accuracy, whereas WM, intelligence, phonological processing, and listening comprehension contributed independent variance to comprehension fluency. Adults with CD scored lower than CA adults and higher than RL children on measures of lexical processing, WM, and listening comprehension when word recognition and intelligence were partialed from the analysis. In summary, constraints in phonological processing and naming speed mediate only some of the influence of high-order processes on reading comprehension. Furthermore, adults with CD experience difficulties in WM, listening comprehension, and vocabulary independently of their word recognition problems and intellectual ability.
Adolescent↗
Individual differences in text comprehension as a function of test anxiety and prior knowledge.
This study investigated the relationship between reading comprehension and comprehension monitoring with undergraduates (223 women, 69 men). Further, the effect of test anxiety and of prior knowledge on reading comprehension and on comprehension monitoring was examined in groups of students of equal intellectual ability. Students with high scores on reading comprehension performed better on a comprehension monitoring task as well. Individual differences in reading comprehension with a multiple-choice response format emerged as a function of the interaction between test anxiety and prior knowledge. Students with low prior knowledge and high test anxiety performed worst of all. We found a far less detrimental effect of test anxiety and prior knowledge on monitoring comprehension than on reading comprehension.
Adolescent↗