Building rapport through neuro-linguistic programming.
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We investigated the influence of noise on brain responses to spoken sentences in MEG. Sixteen subjects had to listen to acoustically presented sentences and judge their syntactic correctness. Sentences were either presented on a silent background or with noise. Noise had differential effects on early auditory and syntactic processes. While noise affected early auditory processes only in the right hemisphere, noise had a general effect on syntactical processes. The evoked responses to syntactic violations compared with correct sentences, namely an early left anterior negativity, were significantly suppressed when noise was present The noise suppression effect, however, was not lateralized.
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Inadequate medical interpretation services are a barrier to the delivery of optimal health care to persons with limited English proficiency. Even though Title VI of the Civil Rights Act of 1964 requires that interpretation services be available to persons speaking limited English, many health care institutions are struggling to reach full compliance. Communication through untrained interpreters is likely to include mistranslations or omissions of physicians' questions, truncated or slanted patient responses, and inadequate information to facilitate accurate diagnosis and treatment. The Interpreter's Aide Program (IAP) is a service-learning program that was implemented at Brown Medical School in 1997. The IAP is a collaborative effort among Brown students, the Rhode Island Hospital Department of Social Work, and Brown Medical School. This three-way partnership strengthens the IAP and expands interpretation services to Spanish- and Portuguese-speaking patients at Rhode Island Hospital. Bilingual undergraduate and medical students become trained medical interpreters and render community service while developing cross-cultural skills. The authors review the development and implementation of the IAP. There is potential for other academic health centers to develop similar partnerships with local colleges and universities, and to provide service-learning opportunities for future physicians and health care consumers.
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The Mini-Mental State Evaluation (MMSE) was used in an epidemiological survey of a community of mixed ethnicity (Hispanic, white non-Hispanic) as part of the Los Angeles Epidemiologic Catchment Area Program. Results of the study showed that age, educational level, ethnicity, and language of the interview influenced the number of MMSE errors. Items on which the effects of ethnicity and language were most pronounced were identified, and suggestions on ways to minimize such sociocultural artifacts are provided in efforts to improve the epidemiological significance of the instrument, particularly as it concerns cross-cultural research.
Formal thought disorder (i.e., abnormal utterances and communication problems) is a prominent feature of schizophrenia. To investigate the hypothesis that formal thought disorder in schizophrenics represents a disturbance of language functioning, we compared 21 thought-disordered and 16 non-thought-disordered schizophrenics on the Porch Index of Communicative Ability. The thought-disordered schizophrenics were significantly more impaired. We also examined nonlinguistic factors potentially impacting language performance in schizophrenics (e.g., disturbed attention, intellect, and/or thought content). Reduced attention was the best predictor of language performance in the thought-disordered group, whereas low intellect and reduced attention were predictive of language dysfunction in the non-thought-disordered group. Disturbed thought content was not predictive of language impairment in either group. These findings provide partial support for the idea that formal thought disorder in schizophrenics represents defective language functioning.
The purposes of this article are to increase pediatric nurses' awareness of language use and to suggest strategies that foster therapeutic communication for the benefit of children and parents. The use of jargon, labels, metaphors, and parental expressions of stress are examined from the context of therapeutic communication in nursing practice. Evidence of language use is substantiated by theory, submissions to a Web site that features narratives from youngsters coping with disease and disability, and interactions with children in hospitals. Practice recommendations are made for the integration of language that protects children's self-esteem.
BACKGROUND: Rapid growth in the diversity of the US population makes it increasingly likely that emergency clinicians will encounter greater numbers of patients from different cultures, but little is known about the importance of culture and language in the emergency care of children. OBJECTIVE: To conduct a critical review and synthesis of published studies on culture and language in the emergency care of children. METHODS: PubMed was used to perform a literature search (using 17 search terms) of all articles on culture, language, and the emergency care of children published in English or Spanish from 1966 to 1999. RESULTS: More than 2000 citations initially were identified; consensus review yielded 400 papers that were photocopied. A final database of 117 articles revealed the following: certain normative cultural values, such as the Navajo hozhooji (the importance of thinking and speaking positively), can have profound effects on informed consent and discussions of medical risk. For limited English proficient children and their families, studies document that medical interpreters frequently are not used, there is a lack of trained interpreters, there are more access barriers, and those who need but do not get interpreters have poor understanding of their diagnosis and treatment. Numerous folk illnesses, such as among Latinos, can affect care, because symptoms often overlap with important biomedical conditions, the first clinical contact may be with folk healers, and certain folk remedies are harmful or even fatal. Certain parent beliefs and practices can result in serious morbidity and fatalities (from lead poisoning, liver failure, and other causes), costly or unnecessary medical evaluations (eg, Fenugreek teas), and clinical findings easily confused with child abuse (eg, coining). Biased provider attitudes and practices can have profound clinical consequences, including ethnic disparities in prescriptions, analgesia, test ordering, sexual history taking, asthma care quality, and diagnostic evaluations. CONCLUSIONS: Failure to appreciate the importance of culture and language in pediatric emergencies can result in multiple adverse consequences, including difficulties with informed consent, miscommunication, inadequate understanding of diagnoses and treatment by families, dissatisfaction with care, preventable morbidity and mortality, unnecessary child abuse evaluations, lower quality of care, clinician bias, and ethnic disparities in prescriptions, analgesia, test ordering, and diagnostic evaluations.
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Complex physiologic signals may carry unique dynamical signatures that are related to their underlying mechanisms. We present a method based on rank order statistics of symbolic sequences to investigate the profile of different types of physiologic dynamics. We apply this method to heart rate fluctuations, the output of a central physiologic control system. The method robustly discriminates patterns generated from healthy and pathologic states, as well as aging. Furthermore, we observe increased randomness in the heartbeat time series with physiologic aging and pathologic states and also uncover nonrandom patterns in the ventricular response to atrial fibrillation.
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Argues that by interpreting the semantic content of different actions, it will be possible to draw boundaries between those aspects of a system that can be computerized and those that will best serve the purpose if left alone. This will dissuade systems developers from being caught in the technology trap. The argument is conducted in the context of developing IT-based medical thesauri for drug use management.
In this paper, we draw on recent developments in several areas of cognitive science that suggest that the lexicon is at the core of grammatical generalizations at several different levels of representation. Evidence comes from many sources, including recent studies on language processing in adults and on language acquisition in children. Phonological behavior is influenced very early by pattern frequency in the lexicon of the ambient language, and we propose that phonological acquisition might provide the initial bootstrapping into grammatical generalization in general. The phonological categories over which pattern frequencies are calculated, however, are neither transparently available in the audiovisual signal nor deterministically fixed by the physiological and perceptual capacities of the species. Therefore, we need several age-appropriate models of how the lexicon can influence a child's interactions with the ambient language over the course of phonological acquisition.