Intra-operative mapping of cortical areas involved in reading in mono- and bilingual patients. (25/406)

In order to identify the cortical areas involved in the reading process and to spare them during surgery, we systematically studied cortical areas by direct cortical stimulation in patients operated on for brain tumours. Seventy-six cortical stimulation mapping studies for language were performed in 35 monolingual and 19 bi- or multilingual patients over a 5-year period. We systematically searched for reading interference areas in addition to standard naming areas using an 'awake surgery' technique for brain mapping. A 'reading aloud' task (translated into different languages in multilingual patients) was used. Brain mapping was performed in left (44 patients) and right (10 patients) hemispheres. Cortical areas involved in reading were identified according to the type of interference, location and distinctness from naming areas. Stimulation of several major hemispheric regions resulted in significant interference with reading aloud: (i) the lower part of the pre- and postcentral gyri (P < 0.00001); (ii) the dominant supramarginal, angular and the posterior part of the superior temporal gyri (P < 0.00001); (iii) in the dominant inferior and middle frontal gyri (P < 0.001); and (iv) in the posterior part of the dominant middle temporal gyrus (P < 0.05). Interferences in reading were generally found in small cortical areas, with intervening areas evoking no reading interferences. Only partial overlap between reading and naming sites was found. Reading-specific sites were preferentially found when stimulating dominant inferior parietal or posterior temporal areas. Different types of reading interferences were noted. While 'articulatory' interferences were found in pre- and postcentral gyri bilaterally, and ocular-induced movements in bilateral middle frontal gyri, paraphasias were found mainly in the dominant supramarginal and posterior superior temporal gyri. Reading arrest sites were found in many regions. Reading interference sites were also occasionally found in the non-dominant hemisphere. In bilingual patients, if common cortical areas could be found, language- and reading-specific areas were sometimes detected, lending support to the concept that bilinguals can have relatively distinct cortical representation of their language skills. Finally, in this series, the location of reading interference sites and their relative specialization showed considerable individual variability.  (+info)

Western medical ethics taught to junior medical students can cross cultural and linguistic boundaries. (26/406)

BACKGROUND: Little is known about teaching medical ethics across cultural and linguistic boundaries. This study examined two successive cohorts of first year medical students in a six year undergraduate MBBS program. METHODS: The objective was to investigate whether Arabic speaking students studying medicine in an Arabic country would be able to correctly identify some of the principles of Western medical ethical reasoning. This cohort study was conducted on first year students in a six-year undergraduate program studying medicine in English, their second language at a medical school in the Arabian Gulf. The ethics teaching was based on the four-principle approach (autonomy, beneficence, non-malfeasance and justice) and delivered by a non-Muslim native English speaker with no knowledge of the Arabic language. Although the course was respectful of Arabic culture and tradition, the content excluded an analysis of Islamic medical ethics and focused on Western ethical reasoning. Following two 45-minute interactive seminars, students in groups of 3 or 4 visited a primary health care centre for one morning, sitting in with an attending physician seeing his or her patients in Arabic. Each student submitted a personal report for summative assessment detailing the ethical issues they had observed. RESULTS: All 62 students enrolled in these courses participated. Each student acting independently was able to correctly identify a median number of 4 different medical ethical issues (range 2-9) and correctly identify and label accurately a median of 2 different medical ethical issues (range 2-7) There were no significant correlations between their English language skills or general academic ability and the number or accuracy of ethical issues identified. CONCLUSIONS: This study has demonstrated that these students could identify medical ethical issues based on Western constructs, despite learning in English, their second language, being in the third week of their medical school experience and with minimal instruction. This result was independent of their academic and English language skills suggesting that ethical principles as espoused in the four principal approach may be common to the students' Islamic religious beliefs, allowing them to access complex medical ethical reasoning skills at an early stage in the medical curriculum.  (+info)

Linguistic diversity in a deaf prison population: implications for due process. (27/406)

The entire deaf prison population in the state of Texas formed the basis for this research. The linguistic skills of prison inmates were assessed using the following measures: (1) Kannapell's categories of bilingualism, (2) adaptation of the diagnostic criteria for Primitive Personality Disorder, (3) reading scores on the Test of Adult Basic Education, and (4) an evaluation of sign language use and skills by a certified sign language interpreter who had worked with deaf inmates for the past 17 years. Deaf inmates with reading scores below the federal standard for literacy (grade level 2.9) were the group most likely to demonstrate linguistic incompetence to stand trial, meaning that they probably lacked the ability to understand the charges against them and/or were unable to participate in their own defenses. Based on the language abilities and reading scores of this population, up to 50% of deaf state prison inmates may not have received due process throughout their arrest and adjudication. Despite their adjudicative and/or linguistic incompetence, these individuals were convicted in many cases, possibly violating their constitutional rights and their rights under the Americans with Disabilities Act.  (+info)

Education of deaf students in Spain: legal and educational politics developments. (28/406)

This article examines the legal instruments and educational politics affecting deaf persons' educational rights in Spain. We present a historical view of deaf education in Spain before and after the Congress of Milan (1880) and then introduce educational legislation and practices in recent decades. At present, Spanish legislation is moving toward recognition of sign languages and the suitability of bilingual education for deaf students at all educational levels. This is a consequence of taking into account the low academic achievement of two generations of deaf students educated in a monolingual model. Bilingual projects are now run throughout Spain. We emphasize that efforts must be made in the legal sphere to regulate the way in which professionals who know sign language and Deaf culture-teachers, interpreters, deaf adult models-are incorporated in bilingual deaf schools.  (+info)

Accessing university education: perceptions, preferences, and expectations for interpreting by deaf students. (29/406)

This paper provides a brief review of the history of deaf education in Australia, Australian Sign Language (Auslan), and Auslan interpreting. A panel of Australian deaf university students from diverse linguistic and educational backgrounds provides insights into their perceptions of sign language interpreting provision in university lectures. They commented on their interpreting preferences after viewing two videotaped segments of university lecture interpretation, one demonstrating a predominantly free approach and the other a predominantly literal approach. Expectations of the deaf students were explored in relation to the educational backgrounds and qualifications of university interpreters; comprehension of interpreters is also discussed. Results suggest that the university students preferred interpreters to combine both interpretation styles, switching between literal and free approaches when appropriate. In doing so, students can access lecture content in Auslan while accessing subject-specific terminology or academic language in English. In terms of qualifications, the students advocated for interpreters to have a university qualification in general, especially if they are working in a university context. However, the students also acknowledged that interpreting did not provide them with full access in educational settings.  (+info)

Use of a corporate needs assessment to define the information requirements of an arthritis resource centre in Birmingham: comparison of patients' and professionals' views. (30/406)

OBJECTIVES: Education and information are important components of the management of chronic disease, though provision of these in the routine clinic setting may be suboptimal. We carried out a corporate needs assessment, both to evaluate stakeholders' perceived usefulness of potential facilities that could be offered by a community-based arthritis resource centre in Birmingham and to compare the views of patients with rheumatological conditions and health professionals. METHODS: Rheumatology patients (n = 201 responders/309 contacted) and health professionals (n = 232/430) were asked to complete a questionnaire to assess both current rheumatology service provision and perceived needs for further information that could be offered within the proposed resource centre. Views of patients and professionals were compared using odds ratios. Logistic regression analysis determined patient characteristics associated with perceived usefulness of various information types. RESULTS: The overall response rate was 58%. Most patients were currently receiving medication but only 38% received written information on arthritis. Over 80% of responders felt that more information would be useful, particularly information in written leaflets. Compared with professionals, patients gave higher value to certain types of medical, non-medical, support and skills information, particularly individual information from trained volunteers, and specific information on benefits, diet and alternative therapy, and symptom management. Non-Caucasian patients gave higher value to the provision of material in different languages and the availability of multilingual volunteer staff. CONCLUSION: Rheumatology patients and professionals identified a relative lack of information for patients. There was wide interest in the provision of more information, with value placed on the provision of material in different languages, at an educational resource centre. This work has been used to develop the facilities currently offered at the Birmingham Arthritis Resource Centre. Further research is needed to investigate the effectiveness of the provision of good quality information to patients with arthritis.  (+info)

Left insula activation: a marker for language attainment in bilinguals. (31/406)

Several lines of evidence suggest the importance of phonological working memory (PWM) in language acquisition. We investigated the neural correlates of PWM in young adults who were under compelling social pressure to be bilingual. Equal bilinguals had high proficiency in English and Chinese as measured by a standardized examination, whereas unequal bilinguals were proficient in English but not Chinese. Both groups were matched on several measures of nonverbal intelligence and working memory. In-scanner behavioral results did not show between-group differences. Of the regions showing load-dependent increments in activation, the left insula showed greater activation in equal bilinguals. Unequal bilinguals showed greater task-related deactivation in the anterior medial frontal region and greater anterior cingulate activation. Although unequal bilinguals kept apace with equal bilinguals in the simple PWM task, the differential cortical activations suggest that more optimal engagement of PWM in the latter may correlate with better second-language attainment.  (+info)

Language-related activations in the left prefrontal regions are differentially modulated by age, proficiency, and task demands. (32/406)

It remains to be elucidated how cortical activations are modulated by factors of age, proficiency, and language task demands when mastering first language (L1) and a second language (L2). Using functional magnetic resonance imaging, we tested subjects aged 13 (the age 13 group) and 19 (the age 19 group), thereby comparing the cortical activations involved in past-tense verb identification with those involved in verb matching. We found that the activation in the dorsal triangular part of the left inferior frontal gyrus (IFG) was lower, corresponding to a higher proficiency in English (L2) in the older subjects, suggesting that the proficiency level plays a major role in the activation of this region during L2 acquisition. Moreover, the lower activation in the triangular and orbital parts of the left IFG (F3t/F3O) for the irregular past tense corresponding to a higher proficiency in L2, together with the nonsignificant activation for the regular past tense when its performance almost reached perfection for age 19, suggests that the modulation of the left F3t/F3O activation reflects language task demands for identifying correct past-tense forms. On the other hand, the left F3t/F3O activation in Japanese (L1) for age 13 was significantly greater than that for age 19, despite the matched performances in L1. These results suggest that the left IFG subserves language-specific functions that are critically required when mastering any language.  (+info)