Comprehension of idioms in adolescents with language-based learning disabilities compared to their typically developing peers

Adolescents with language-based learning disabilities (LBLD) often interpret idioms literally. When idioms are provided in an enriched context, comprehension is compromised further because of the LBLD student's inability to assign multiple meanings to words, assemble and integrate information, and go beyond a local referent to derive a global, coherent meaning. This study tested the effects of context and familiarity on comprehension of 24 idioms in 22 adolescents with LBLD. The students completed the Idiom Comprehension Test (ICT) [Language, Speech, and Hearing Services in Schools 30 (1999) 141; LSHSS 34 (2003) 69] in one of two conditions: in a story or during a verification task. Within each condition were three familiarity levels: high, moderate, and low. The LBLD adolescents' data were then compared to previously collected data from 21 age-, gender-, and reading ability-matched typically developing (TD) peers. The relations between reading and language literacy and idiom comprehension were also examined in the LBLD adolescents. Results showed that: (a) the LBLD adolescents generally performed poorly relative to their TD counterparts; however, the groups performed comparably on the high and moderate familiarity idioms in the verification condition; (b) the LBLD adolescents performed significantly better in the verification condition than in the story condition; and (c) reading ability was associated with comprehension of the low familiarity idioms in the story condition only. Findings are discussed relative to implications for speech-language pathologists (SLPs) and educators working with adolescents with LBLD. LEARNING OUTCOMES: As a result of this activity, the participant will be able to (1) describe the importance of metalinguistic maturity for comprehension of idioms and other figures of speech; (2) understand the roles of context and familiarity when assessing idiom comprehension in adolescents with LBLD; and (3) critically evaluate assessments of idiom comprehension and determine their appropriateness for use with adolescents with LBLD.     

Absence of robust ischemic preconditioning by five 1-minute total umbilical cord occlusions in fetal sheep

OBJECTIVE: To determine to what extent a series of five 1-minute total umbilical cord occlusions, intended to induce ischemic preconditioning (IP), affects the physiologic responses to a 10-minute total umbilical cord occlusion (damaging insult [DI]) 1 hour later and provides cardio- and neuroprotection. METHODS: In 14 chronically catheterized late gestation fetal sheep (127-131 days' gestation), we performed a 10-minute total umbilical cord occlusion (DI), preceded by a series of five 1-minute total cord occlusions with 2-minute intervals (5CO, n = 7) or sham occlusions (n = 7) 1 hour prior to DI. RESULTS: The 5CO induced a reduction in the arterial partial pressure of oxygen (Po(2)) from 21 +/-1 to 14 +/-3 Torr, arterial O(2) content from 6.9 +/- 0.4 to 3.1 +/- 0.7 vol%, and increases in the partial pressure of carbon dioxide (Pco(2)) from 46 +/- 2 to 58 +/- 3 Torr, and [H(+)] from 43 +/- 1 to 54 +/- 2 nM. 5CO reduced fetal heart rate from 178 +/- 6 to 151 +/- 6 beats per minute (bpm), and increased arterial pressure from 45 +/- 1 to 57 +/- 2 mmHg, cerebral blood flow (CBF) from 100 +/- 3 to 129 +/- 10%, and cerebral heat production (H(brain)) from 25 +/- 2 to 29 +/- 1% degrees C. The responses to DI were not significantly different between the groups without and with 5CO; values for Po(2) were 5.6 +/- 1.5 and 5.8 +/- 1.9 Torr, O(2) content 0.6 +/- 0.1 and 0.8 +/- 0.1 vol%, lactate 10.7 +/- 0.7 and 10.8 +/- 0.7 mM, fetal heart rate 97 +/- 5 and 87 +/- 8 bpm, mean arterial pressure 22 +/- 3 and 21 +/- 2 mmHg, CBF 50 +/- 10 and 36 +/- 5%, and H(brain) 7.0 +/- 1.4 and 5.9 +/- 1.1% degrees C, respectively, except for Pco(2) (126 +/- 4 and 112 +/- 2 Torr) and [H(+)] (126 +/- 3 and 114 +/- 3 nM). Histologic proof of cardio- or neuroprotection by 5CO could not be obtained because five fetuses died before they were to be killed at day 3 after the experiment; two fetuses in the 5CO group demonstrated major histologic damage of myocardium and brain. CONCLUSION: In the late gestation fetal sheep, a series of five 1-minute total umbilical cord occlusions did not result in major changes in physiologic responses to a hypoxic-ischemic DI 1 hour later. In addition, the procedure did not result in robust cardio- and neuroprotection, in contrast to IP reported in adults.     

Basal ganglia activity remains elevated after movement in focal hand dystonia

Although previous studies of focal hand dystonia have detected cortical sensorimotor abnormalities, little is known about the role of the basal ganglia in this disorder. We report here that when focal hand dystonic patients performed finger-tapping tasks, functional magnetic resonance imaging showed persisting elevations of basal ganglia activity after the tasks ended. We posit that inhibitory control of the basal ganglia may be faulty in focal hand dystonia, and that the increases we observe in "resting" activity may mask basal ganglia abnormalities in standard imaging contrast analyses.     

Functional magnetic resonance imaging in the determination of dominant language cerebral area

Functional magnetic resonance imaging (fMRI) is a technique for detecting minimal changes in brain perfusion and oxygenation secondary to neuronal activation. Its application in the pre-surgical evaluation of epileptic patients with temporal mesial sclerosis is currently being under investigation in several centers. This study aims to describe an activation paradigm for the evaluation of language and memory functions, as an alternative to the worldwide used Wada test, which is an invasive procedure. In order to propose a paradigm adapted to the Portuguese language, we report our experience in determining the dominant cerebral area for language through fMRI with a verbal fluency task. The results of the fMRI from 19 patients studied in Curitiba in a period of approximately two years were studied. Sixteen of them presented with left hemispheric cerebral language dominance. In five patients, results from fMRI and Wada test could be compared and agreed in localization. Our results reinforce the view that fMRI may become an essential tool for medical practice, perhaps for the determination of eloquent areas in the evaluation of candidates for epilepsy surgery.     

Cord blood transplantation from unrelated donors: a preliminary report from the Japanese Cord Blood Bank Network

As a source for hematopoietic stem cell transplantation (HSCT), cord blood transplantation from unrelated donors (UCBT) is now considered as an acceptable alternative to patients who need unrelated HSCT. To confirm the findings that mismatched UCBT is feasible, we discussed here the results for 477 patients with hematologic malignancies and non-malignancies who were subjected to UCBT coordinated by the Japanese Cord Blood Bank Network (JCBBN). From February 1997 to October 2001, 411 patients with malignancies and 66 with non-malignancies had UCBT through the cord blood bank in the JCBBN; 311 patients had HLA 0-1 mismatched UCBT; 165, had a 2-4 HLA mismatch. The Kaplan-Meier estimates for 3-year disease-free survival rate (DFS) were 35.2 ±2.8% in malignant diseases, and 33.6 ±7.2% in patients with non-malignant diseases. The HLA disparity had no effect on DFS, incidence of acute graft-versus-host disease, or engraftment. As reported previously, we also noted the importance of graft cell dose in determining survival in UCBT. Major advantages of UCBT include its rapid availability compared with unrelated donor bone marrow, and tolerance of an HLA mismatch at 2 loci, which will enable extension of the donor pool. This review outlines the latest UCBT progress, with emphasis on practical considerations in HLA-mismatched umbilical cord blood selection.     

Occupational blood and body fluids exposures in health care workers: four-year surveillance from the Northern France network

The risk of accidental blood and body fluid (BBF) exposure is a daily concern for health care workers throughout the world, and various strategies have been introduced during the past decade to help reduce that risk. To assess the impact of multifocal reduction strategies introduced in hospitals affiliated with the Northern France network, we recently examined data from 4 years of BBF-exposure reports filed by network employees. A total of 7,649 BBF exposures were reported by health care workers to occupational medicine departments in 61 hospitals. Nurses and nursing students accounted for 4,587 (60%) of exposures, followed by nurses' aides and clinicians. Most (77.6%) of the reports were related to needlestick injury (NSI). In addition, we examined BBF exposure trends over time by analyzing data from 18 hospitals (29.5%) with data available for the time period of 1995 to 1998. These were assessed in nurses, who have the highest and most consistent reporting rate. We noted that the BBF-exposure incidence rate for all BBF exposures in nurses decreased from 10.8 to 7.7 per 100 nurses per year between 1995 and 1998 (P <.001), whereas the NSI rate decreased 8.9 per 100 nurses per year in 1995 to 6.3 in 1998 (P <.001). The percentage of NSIs that resulted from noncompliance with universal precautions also decreased significantly (P =.04). Widespread improvements in procedures and engineering controls were implemented in the Northern France network before and during the study period. Significant reductions were observed in reports of BBF exposures and NSIs, particularly in nurses. These findings are similar to those in other countries and reflect the overall improvement in the management of occupational risk of BBF in health care workers.     

Lexicalization of idioms in urban fifth graders: a reaction time study

Idioms are an important aspect of language that comprises a sizeable portion of our vocabulary. However, lexical access research has largely been limited to understanding how literal words are accessed and processed in the mental lexicon. Adult data show that idioms are quickly accessed from the lexicon and are likely processed as long words [J. Verbal Learn. Verbal Behav. 18 (1979) 523]. The purpose of this study was to examine lexicalization of idioms in a group of school-aged children. Using a phrase classification design, this research tested the Lexical Representation Hypothesis [J. Verbal Learn. Verbal Behav. 18 (1979) 523] in 19 urban fifth graders (5 boys, 14 girls; M age=10.16 years). On a computer, the students classified 54 phrases, including 24 idioms (high, moderate, and low familiarity [J. Speech Hear. Res. 36 (1993) 728]), 24 grammatical control word strings and 6 unrelated foils as either idioms or nonidioms. The idioms were identified with 62% accuracy. Unexpectedly, the boys tended to show higher rates of accuracy than the girls. Response latencies were shorter on the idioms compared to the controls and high familiarity idioms were processed faster than moderate and low familiarity idioms. These findings provide developmental data for lexicalization of idioms and the relationship between lexicalization and familiarity. At the cocnlusion of this articel, the reader will be able to: (1). discuss the various theories of idiom access and processing, (2). discuss how lexical access relates to idiom knowledge in school-aged children, and (3). consider the association between lexical access and familiarity relative to idiom comprehension in school-aged children.