RESUMO
During dialogue, speakers attempt to adapt messages to their addressee appropriately by taking into consideration their common ground (i.e., all the information mutually known by the conversational partners) to ensure successful communication. Knowing and remembering what information is part of the common ground shared with a given partner and using it during dialogue are crucial skills for social interaction. It is therefore important to better understand how we can measure the use of common ground and to identify the potential associated psychological processes. In this context, a systematic review of the literature was performed to list the linguistic measures of common ground found in dialogue studies involving a matching task and to explore any evidence of cognitive and social mechanisms underlying common ground use in this specific experimental setting, particularly in normal aging and in neuropsychological studies. Out of the 23 articles included in this review, we found seven different linguistic measures of common ground that were classified as either a direct measure of common ground (i.e., measures directly performed on the referential content) or an indirect measure of common ground (i.e., measures assessing the general form of the discourse). This review supports the idea that both types of measures should systematically be used while assessing common ground because they may reflect different concepts underpinned by distinct psychological processes. Given the lack of evidence for the implication of other cognitive and social functions in common ground use in studies involving matching tasks, future research is warranted, particularly in the clinical field.
Assuntos
Comunicação , Linguística , Humanos , Rememoração Mental , EnvelhecimentoRESUMO
BACKGROUND: Delirium occurs frequently in acute internal medicine wards and may worsen the patient's prognosis; it deserves a fast, systematic screening tool. OBJECTIVE: Develop a delirium screening score for inpatients admitted to acute internal medicine wards. DESIGN: A monocentric prospective study between November 2019 and January 2020. PARTICIPANTS: Two hundred and seventeen adult inpatients. MAIN MEASURES: Within 48 h of hospital admission, physicians administered an index test to participants which explored potential predictors associated with the fluctuation of mental state, inattention, disorganised thinking and altered level of consciousness. On the same day, patients underwent a neuropsychological evaluation (reference standard) to assess for delirium. The score was constructed using a backward stepwise logistic regression strategy. Areas under the receiver operating curves (AUC) and calibration curves were drawn to calculate the score's performance. The score was tested on subgroups determined by age, sex and cognitive status. RESULTS: The AL-O-A score ("abnormal or fluctuating ALertness, temporospatial Orientation and off-target Answers") showed excellent apparent (AUC 0.95 (95% CI 0.91-0.99)) and optimism-corrected discrimination (AUC 0.92 (95% CI 0.89-0.96)). It performed equally well in subgroups with and without cognitive impairment (AUC 0.93 (95% CI 0.88-0.99) vs 0.92 (95% CI 0.80-0.99)); in men and women (AUC 0.96 (95% CI 0.94-0.99) vs 0.95 (95% CI 0.89-0.99)); and in patients younger and older than 75 years old (AUC 0.98 (95% CI 0.95-0.99) vs 0.93 (95% CI 0.87-0.99)). CONCLUSIONS: A simple, 1-min screening test (AL-O-A score), even administered by an untrained professional, can identify delirium in internal medicine patients.
