The Listening Shift: Evaluating a Communication-Strategies Training Program for Telepractice Nurses Experiencing Hearing Challenges

Workers who wish to remain employed should be supported in doing so, even if they are experiencing age-related disabilities, such as hearing loss. I aimed to better understand the strategies from which workers with hearing loss might benefit, and how they can be supported in adopting these strategies. To collect rich data, I recruited telepractice nurses who rely on listening to make critical decisions about triaging and health care recommendations. My first research question was: What strategies exist for making telephone speech more intelligible for health care providers and patients with hearing challenges? I performed a scoping review following the Joanna Briggs Institute’s protocol. I identified 11 types of strategies, many of which required cooperation from, and disclosure to, providers’ employers, co-workers, and clients. This led me to consider the public narrative workers associated themselves with when they disclosed. Thus, my second research question was: How do Canadian newspapers portray workers with hearing loss? Through a thematic analysis of newspapers articles on this topic, I found they are predominantly portrayed as striving cheerfully both towards functioning normally and towards differentiating themselves and their hearing loss as unique and positive. To further explore how a subset of adults with hearing loss strive to work with a hearing loss, I developed an online communication-strategies training program tailored to nurses with hearing challenges. I then used a multiple case study to answer the following research question: How do nurses with hearing challenges change in terms of their telephone performance and workplace wellbeing in response to participation in an online communication strategies training program? Results suggested that nurses engaged in a problem-solving process before adopting strategies, and that strategy adoption could positively contribute to their performance. Together, the findings from these studies suggest that strategies exist to enhance the performance of workers with hearing loss, but the process of adopting these strategies can be demanding. Organizations should take steps to proactively support their nurses, health-care providers, and potentially other workers with hearing loss in identifying communication strategies and adapting them to their unique context

Government 2.5: The Impact of Social Media on Public Sector Accessibility

Innovative approaches to communicating with the masses continue to evolve in the private sector, while accessibility of goods, services, and public information within federal, state, and local government organizations has been declining for decades. This situation has resulted in a lack of trust and sense of isolation from communities. At the same time, the implementation and use of social media have increased exponentially. Despite the simultaneous occurrence of these events, limited research has explored the connection between them. Specifically, the purpose of this case study was to address the central research question of whether the adoption of social media platforms results in increased accessibility of goods and services within the public sector. Rogers\u27s diffusion of innovations theory founded the framework for this study. Data were collected within a local government organization through semistructured interviews with 15 employees and 15 clients, observations of daily operations, and analyses of postings made on selected social media platforms. Inductive coding and a comparative method of analysis generated emerging themes and patterns. Key findings of this study indicated significant increases in public accessibility of goods and services as the result of the implementation and use of social media. Relative to diffusion of innovations theory, findings illustrated the spread of new technology through certain channels among employees and clients. Recommendations focus on establishing strategies to ensure widespread diffusion of social media and to address socioeconomic disparities. Government agencies can use this research as a means to advance social change through open communication, an engaged workforce, and increased transparency

Virtual Reality Games for Motor Rehabilitation

This paper presents a fuzzy logic based method to track user satisfaction without the need for devices to monitor users physiological conditions. User satisfaction is the key to any product’s acceptance; computer applications and video games provide a unique opportunity to provide a tailored environment for each user to better suit their needs. We have implemented a non-adaptive fuzzy logic model of emotion, based on the emotional component of the Fuzzy Logic Adaptive Model of Emotion (FLAME) proposed by El-Nasr, to estimate player emotion in UnrealTournament 2004. In this paper we describe the implementation of this system and present the results of one of several play tests. Our research contradicts the current literature that suggests physiological measurements are needed. We show that it is possible to use a software only method to estimate user emotion

Fixing meaning: intertextuality, inferencing and genre in interpretation

The intertextual theories of V. N. Voloshinov, Mikhail Bakhtin and the early Julia Kristeva provide the most convincing account of the processes of textual production, conceived as constitutively social, cultural and historical. However, the ways in which intertextual accounts of reading (or 'use') have extended such theories have foreclosed their potential. In much contemporary literary and cultural theory, it is assumed that reading, conceived intertextually, is no simple decoding process, but there is little interest in what interpretation, as a process, is, and its relations to reading. It is these questions which this thesis seeks to answer. The introduction sets the scene both for the problem and its methodological treatment: drawing certain post-structuralist and pragmatic theories of meaning into confrontation, and producing a critical synthesis. Part one (chapters one to three) elaborate these two traditions of meaning and stages the encounter. Chapter one offers detailed expositions of Voloshinov, Bakhtin and Kristeva, contrasting these with other intertextual theories of production and reception. Chapter two examines inferential accounts of communication within pragmatics, focusing on Paul Grice and on Dan Sperber and Deirdre Wilson's Relevance theory. Chapter three stages an encounter between these radically different traditions. A common ground is identified: both are rhetorical approaches to meaning, focusing on the relations between texts, contexts and their producers and interpreters. Each tradition is then subjected to the theoretical scrutiny of the other. Inferential theories expose the lack of specificity in intertextual accounts which completely ignore inferencing as a process. Intertextual theories reveal that text and context have semantically substantive intertextual dimensions, most particularly genre and register (conceived intertextually) which are ignored by inferential theories. Text and context are therefore far more semantically fixed than such theories suppose. Both traditions ignore the role of production practices other than 'speech' or 'writing', i.e. they ignore how publishing practices - editing, design, production and marketing - constitute genre and shape reading. In Part Two (chapters four to six), the critique is developed into an account of interpretation. Interpretation, conceived intertextually, is significantly, though not exclusively, inferential, but inferential processes do not 'work' in the ways proposed by existing inferential theories. Patterns of inference are ordered by the relations between discourses (in Foucault's sense) and genres in the text, the reader's knowledge and the conditions of reading. Chapter four elaborates the concepts required for such an account of interpretation, centring on the role of publishing processes and the text's material form in shaping interpretation. The limits of existing accounts of the edition and publishing, specifically Gerard Genette's Paratexts and work in the 'new' textual studies, call for a more expansive account of how publishing shapes genre and interpretation. Chapters five and six develop two case-studies which extend these concepts and arguments. These examine two contemporary publishing categories: 'classics' (Penguin, Everyman etc.) and literary theory textbooks (Introductions and Readers). Through the detailed analyses of particular editions, I develop and substantiate a stronger and richer account of interpretation as process and practice and its relation to reading. This is expanded in the final chapter

Health care needs and health policy : the case of renal services.

PhDThis thesis presents a critical ethnography of decision making with respect to the assessment of health care needs in the UK health system. Theories of need, justice and rights are reviewed in relation to structural changes to the National Health Service, together with the different theoretical approaches underpinning health policy based on human needs. The research on which this thesis is based focuses on a case study of an independent review of renal services in London, concentrating on the needs assessment work of the review group set up by the government and the decision making debates this review group engaged in. The methods used are based on a participatory, critical ethnography. The review process is evaluated critically by relating the technical knowledge produced by the group to a theoretical framework for assessing needs and by using a Habermasian perspective to investigate the ways in which the language of need is used to legitimise the agendas of various vested interests. This work is linked with an analysis of quasi-markets in the health service to explore the capacity that the technical discourses of markets and contracting have for reinforcing the ideological distortions identified in the analysis of the group's debates concerning need. Finally, by linking an analysis based on a case study of renal services to theoretical understandings of health care needs and health policy, a general critique of the UK health system is constructed

Learning Functional Prepositions

In first language acquisition, what does it mean for a grammatical category to have been acquired, and what are the mechanisms by which children learn functional categories in general? In the context of prepositions (Ps), if the lexical/functional divide cuts through the P category, as has been suggested in the theoretical literature, then constructivist accounts of language acquisition would predict that children develop adult-like competence with the more abstract units, functional Ps, at a slower rate compared to their acquisition of lexical Ps. Nativists instead assume that the features of functional P are made available by Universal Grammar (UG), and are mapped as quickly, if not faster, than the semantic features of their lexical counterparts. Conversely, if Ps are either all lexical or all functional, on both accounts of acquisition we should observe few differences in learning. Three empirical studies of the development of P were conducted via computer analysis of the English and Spanish sub-corpora of the CHILDES database. Study 1 analyzed errors in child usage of Ps, finding almost no errors in commission in either language, but that the English learners lag in their production of functional Ps relative to lexical Ps. That no such delay was found in the Spanish data suggests that the English pattern is not universal. Studies 2 and 3 applied novel measures of phrasal (P head + nominal complement) productivity to the data. Study 2 examined prepositional phrases (PPs) whose head-complement pairs appeared in both child and adult speech, while Study 3 considered PPs produced by children that never occurred in adult speech. In both studies the productivity of Ps for English children developed faster than that of lexical Ps. In Spanish there were few differences, suggesting that children had already mastered both orders of Ps early in acquisition. These empirical results suggest that at least in English P is indeed a split category, and that children acquire the syntax of the functional subset very quickly, committing almost no errors. The UG position is thus supported. Next, the dissertation investigates a \u27soft nativist\u27 acquisition strategy that composes the distributional analysis of input, minimal a priori knowledge of the possible co-occurrence of morphosyntactic features associated with functional elements, and linguistic knowledge that is presumably acquired via the experience of pragmatic, communicative situations. The output of the analysis consists in a mapping of morphemes to the feature bundles of nominative pronouns for English and Spanish, plus specific claims about the sort of knowledge required from experience. The acquisition model is then extended to adpositions, to examine what, if anything, distributional analysis can tell us about the functional sequences of PPs. The results confirm the theoretical position according to which spatiotemporal Ps are lexical in character, rooting their own extended projections, and that functional Ps express an aspectual sequence in the functional superstructure of the PP

Strategic advantages of visual violence

This research discusses the role of visual violence as it relates to non-state actors within asymmetric warfare as a form of indirect coercion, siting the logic of Thomas Schelling. It argues that irrationality, as a perception from the state actor toward the non-state actor is a rational approach in order to produce the desired fear and publicity. The amount of fear and publicity is measured by the amount of inhumanity that is presented within the visual narration and the amount of irrational hysteria that comes from the audience. In using a comparative and visual analysis, two non-state actors who utilized visual violence, the Red Brigades and ISIS, have shown varying effects of visual violence on their targeted audience. It concludes that the visual violence, as a concept, being distinguished from its visual component and its violent component, does not have the desired impact unless the image contains the aforementioned features: the perception of irrationality and a high level of inhumanity

The Challenge of Spoken Language Systems: Research Directions for the Nineties

A spoken language system combines speech recognition, natural language processing and human interface technology. It functions by recognizing the person's words, interpreting the sequence of words to obtain a meaning in terms of the application, and providing an appropriate response back to the user. Potential applications of spoken language systems range from simple tasks, such as retrieving information from an existing database (traffic reports, airline schedules), to interactive problem solving tasks involving complex planning and reasoning (travel planning, traffic routing), to support for multilingual interactions. We examine eight key areas in which basic research is needed to produce spoken language systems: (1) robust speech recognition; (2) automatic training and adaptation; (3) spontaneous speech; (4) dialogue models; (5) natural language response generation; (6) speech synthesis and speech generation; (7) multilingual systems; and (8) interactive multimodal systems. In each area, we identify key research challenges, the infrastructure needed to support research, and the expected benefits. We conclude by reviewing the need for multidisciplinary research, for development of shared corpora and related resources, for computational support and far rapid communication among researchers. The successful development of this technology will increase accessibility of computers to a wide range of users, will facilitate multinational communication and trade, and will create new research specialties and jobs in this rapidly expanding area