An Interactional Profile to Assist the Differential Diagnosis of Neurodegenerative and Functional Memory Disorders.

OBJECTIVE: Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behavior of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with functional memory disorder (FMD). METHODS: In part 1 of this study, a diagnostic scoring aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features. An optimal cut-off differentiating ND and FMD was established by applying the DSA to 30 initial patient-doctor memory clinic encounters. In part 2, the DSA was tested prospectively in 10 additional cases analyzed independently by 2 conversation analysts blinded to medical information. RESULTS: In part 1, the median score of the DSA was +5 in ND and -5 in FMD (P<0.001). The optimal numeric DSA cut-off (+1) identified patients with ND with a sensitivity of 86.7% and a specificity of 100%. In part 2, DSA scores of rater 1 correctly predicted 10/10 and those of rater 2 predicted 9/10 diagnoses. CONCLUSIONS: This study indicates that interactional and linguistic features can help distinguish between patients developing dementia and those with FMD and could aid the stratification of patients with memory problems.

War-making and sense-making: some technical reflections on an instance of 'friendly fire'.

In this paper we analyse a 'friendly fire' incident from the second Gulf War and the controversy which came to envelop it during a coroner's inquest in 2007. Focusing on the cockpit video of the incident that was leaked to the media during that inquest, we examine what the military and civilian investigators were involved in reconstructing: the incident as it unfolded in real time. Our analysis is grounded in a praxeological perspective that draws on and links ethnomethodological studies of work, research into 'normal' accidents, disasters and risks, and recent ethnographies of the military. Based on our analysis, we suggest that the accounts offered after the event by the military and civilian inquiries should be treated less as competing descriptions than different ways of problematizing particular aspects of the military-political 'machineries' the pilots' actions were enmeshed within.