Recommendations for Improving the End-Of-Life Care System for Homeless Populations: A Qualitative Study of the Views of Canadian Health and Social Services Professionals

BACKGROUND:Homeless populations have complex and diverse end-of-life care needs. However, they typically die outside of the end-of-life care system. To date, few studies have explored barriers to the end-of-life care system for homeless populations. This qualitative study involving health and social services professionals from across Canada sought to identify barriers to the end-of-life care system for homeless populations and generate recommendations to improve their access to end-of-life care.METHODS:Semi-structured qualitative interviews were conducted with 54 health and social services professionals involved in end-of-life care services delivery to homeless persons in six Canadian cities (Halifax, Hamilton, Ottawa, Thunder Bay, Toronto and Winnipeg). Participants included health administrators, physicians, nurses, social workers, harm reduction specialists, and outreach workers. Interviews were audio-recorded, transcribed verbatim and analysed thematically.RESULTS:Participants identified key barriers to end-of-life care services for homeless persons, including: (1) insufficient availability of end-of-life care services; (2) exclusionary operating procedures; and, (3) poor continuity of care. Participants identified recommendations that they felt had the potential to minimize these barriers, including: (1) adopting low-threshold strategies (e.g. flexible behavioural policies and harm reduction strategies); (2) linking with population-specific health and social care providers (e.g. emergency shelters); and, (3) strengthening population-specific training.CONCLUSIONS:Homeless persons may be underserved by the end-of-life care system as a result of barriers that they face to accessing end-of-life care services. Changes in the rules and regulations that reflect the health needs and circumstances of homeless persons and measures to improve continuity of care have the potential to increase equity in the end-of-life care system for this underserved population

The phonetics and phonology of tonal systems

Thesis (Ph. D.)--Harvard University--MIT Division of Health Sciences and Technology, 2005.Includes bibliographical references (p. 141-148).Pitch variations are used in different languages in a variety of communicative ways, from cueing lexical item identity to conveying meaning through phrasing and accentuation. Previously, linguistic theories of intonation and tone which have sought a unifying account for tonal phenomena have not defined a clear and systematic relation between phonological representations and phonetic output in terms of acoustically observable fundamental frequency (FO) variations. This is problematic, because meaningful pitch patterns cannot be related to underlying phonological primitives in any clear way, so that it is difficult to empirically verify or falsify the theory. This thesis addresses this problem by proposing a phonological description of intonation and tone for which there is a clear and systematic relationship between observed FO variations and underlying phonological primitives. The theory is based on a construct called the tone interval, which represents an abstraction of a ratio of two fundamental frequencies. A syntagmatic tone interval relates two sequentially-ordered tones, while a paradigmatic tone interval relates a tone and a speaker-specific referent level. Tone intervals define one of three relations: a tone may be higher, lower, or the same level as its referent. Additional language-specific categories may be formed which restrict the pitch distance between a tone and its referent. Tones in syntagmatic tone intervals are assumed to be arranged at the phrasal level with respect to a metrical grid, which represents the relative prominence and timing of syllables.(cont.) This permits interactions between nonsequential tones occupying metrically prominent syllables, accounting for cross-linguistic observations involving control of relative height relations on nonadjacent syllables. Six experiments tested the predictions of tone interval theory and other phonological theories for English. Experiments 1 and 3 involved discrimination of pairs of stimuli in which the timing of an FO extremum had been varied along a continuum with respect to segments, while Experiments 2 and 4 involved imitation of these stimuli. Experiments 5 and 6 involved imitating stimuli in which absolute FO level had been varied along a continuum. Consistent with the tone interval theory, these results demonstrate the importance of relative pitch level for phonological representations. In particular, discrimination maxima and discreteness in production data were observed for positions in stimulus series in which either (i) the timing of an FO extremum was varied across a vowel onset, or (ii) the FO level of one syllable switched from higher than another syllable to lower than that syllable.by Laura Christine Dilley.Ph.D

Inter-transcriber reliability for two systems of prosodic annotation: ToBI (Tones and Break Indices) and RaP (Rhythm and Pitch)

Speech researchers often rely on human annotation of prosody to generate data to test hypotheses and generate models. We present an overview of two prosodic annotation systems: ToBI (Tones and Break Indices) (Silverman et al., 1992), and RaP (Rhythm and Pitch) (Dilley & Brown, 2005), which was designed to address several limitations of ToBI. The paper reports two large-scale studies of inter-transcriber reliability for ToBI and RaP. Comparable reliability for both systems was obtained for a variety of prominence- and boundary-related agreement categories. These results help to establish RaP as an alternative to ToBI for research and technology applicationsNational Science Foundation (U.S.) (NSF grant BCS 0847653

Statistical distributions of consonant variants in infant-directed speech: evidence that /t/ may be exceptional

Statistical distributions of phonetic variants in spoken language influence speech perception for both language learners and mature users. We theorized that patterns of phonetic variant processing of consonants demonstrated by adults might stem in part from patterns of early exposure to statistics of phonetic variants in infant-directed (ID) speech. In particular, we hypothesized that ID speech might involve greater proportions of canonical /t/ pronunciations compared to adult-directed (AD) speech in at least some phonological contexts. This possibility was tested using a corpus of spontaneous speech of mothers speaking to other adults, or to their typically-developing infant. Tokens of word-final alveolar stops – including /t/, /d/, and the nasal stop /n/ – were examined in assimilable contexts (i.e., those followed by a word-initial labial and/or velar); these were classified as canonical, assimilated, deleted, or glottalized. Results confirmed that there were significantly more canonical pronunciations in assimilable contexts in ID compared with AD speech, an effect which was driven by the phoneme /t/. These findings suggest that at least in phonological contexts involving possible assimilation, children are exposed to more canonical /t/ variant pronunciations than adults are. This raises the possibility that perceptual processing of canonical /t/ may be partly attributable to exposure to canonical /t/ variants in ID speech. Results support the need for further research into how statistics of variant pronunciations in early language input may shape speech processing across the lifespan

Mothers Reveal More of Their Vocal Identity When Talking to Infants

Voice timbre – the unique acoustic information in a voice by which its speaker can be recognized – is particularly critical in mother-infant interaction. Correct identification of vocal timbre is necessary in order for infants to recognize their mothers as familiar both before and after birth, providing a basis for social bonding between infant and mother. The exact mechanisms underlying infant voice recognition remain ambiguous and have predominantly been studied in terms of cognitive voice recognition abilities of the infant. Here, we show – for the first time – that caregivers actively maximize their chances of being correctly recognized by presenting more details of their vocal timbre through adjustments to their voices known as infant-directed speech (IDS) or baby talk, a vocal register which is wide-spread through most of the world’s cultures. Using acoustic modelling (k-means clustering of Mel Frequency Cepstral Coefficients) of IDS in comparison with adult-directed speech (ADS), we found in two cohorts of speakers - US English and Swiss German mothers - that voice timbre clusters of in IDS are significantly larger to comparable clusters in ADS. This effect leads to a more detailed representation of timbre in IDS with subsequent benefits for recognition. Critically, an automatic speaker identification using a Gaussian-mixture model based on Mel Frequency Cepstral Coefficients showed significantly better performance in two experiments when trained with IDS as opposed to ADS. We argue that IDS has evolved as part of an adaptive set of evolutionary strategies that serve to promote indexical signalling by caregivers to their offspring which thereby promote social bonding via voice and acquiring linguistic systems

Climate-Related Hazards: A Method for Global Assessment of Urban and Rural Population Exposure to Cyclones, Droughts, and Floods

Global climate change (GCC) has led to increased focus on the occurrence of, and preparation for, climate-related extremes and hazards. Population exposure, the relative likelihood that a person in a given location was exposed to a given hazard event(s) in a given period of time, was the outcome for this analysis. Our objectives were to develop a method for estimating the population exposure at the country level to the climate-related hazards cyclone, drought, and flood; develop a method that readily allows the addition of better datasets to an automated model; differentiate population exposure of urban and rural populations; and calculate and present the results of exposure scores and ranking of countries based on the country-wide, urban, and rural population exposures to cyclone, drought, and flood. Gridded global datasets on cyclone, drought and flood occurrence as well as population density were combined and analysis was carried out using ArcGIS. Results presented include global maps of ranked country-level population exposure to cyclone, drought, flood and multiple hazards. Analyses by geography and human development index (HDI) are also included. The results and analyses of this exposure assessment have implications for country-level adaptation. It can also be used to help prioritize aid decisions and allocation of adaptation resources between countries and within a country. This model is designed to allow flexibility in applying cyclone, drought and flood exposure to a range of outcomes and adaptation measures

Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research

In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research

Evidence for Shared Cognitive Processing of Pitch in Music and Language

Language and music epitomize the complex representational and computational capacities of the human mind. Strikingly similar in their structural and expressive features, a longstanding question is whether the perceptual and cognitive mechanisms underlying these abilities are shared or distinct – either from each other or from other mental processes. One prominent feature shared between language and music is signal encoding using pitch, conveying pragmatics and semantics in language and melody in music. We investigated how pitch processing is shared between language and music by measuring consistency in individual differences in pitch perception across language, music, and three control conditions intended to assess basic sensory and domain-general cognitive processes. Individuals’ pitch perception abilities in language and music were most strongly related, even after accounting for performance in all control conditions. These results provide behavioral evidence, based on patterns of individual differences, that is consistent with the hypothesis that cognitive mechanisms for pitch processing may be shared between language and music.National Science Foundation (U.S.). Graduate Research Fellowship ProgramEunice Kennedy Shriver National Institute of Child Health and Human Development (U.S.) (Grant 5K99HD057522

Speech Communication

Contains table of contents for Part V, table of contents for Section 1, reports on six research projects and a list of publications.C.J. Lebel FellowshipDennis Klatt Memorial FundNational Institutes of Health Grant R01-DC00075National Institutes of Health Grant R01-DC01291National Institutes of Health Grant R01-DC01925National Institutes of Health Grant R01-DC02125National Institutes of Health Grant R01-DC02978National Institutes of Health Grant R01-DC03007National Institutes of Health Grant R29-DC02525National Institutes of Health Grant F32-DC00194National Institutes of Health Grant F32-DC00205National Institutes of Health Grant T32-DC00038National Science Foundation Grant IRI 89-05249National Science Foundation Grant IRI 93-14967National Science Foundation Grant INT 94-2114

Global assessment of marine plastic exposure risk for oceanic birds

Plastic pollution is distributed patchily around the world’s oceans. Likewise, marine organisms that are vulnerable to plastic ingestion or entanglement have uneven distributions. Understanding where wildlife encounters plastic is crucial for targeting research and mitigation. Oceanic seabirds, particularly petrels, frequently ingest plastic, are highly threatened, and cover vast distances during foraging and migration. However, the spatial overlap between petrels and plastics is poorly understood. Here we combine marine plastic density estimates with individual movement data for 7137 birds of 77 petrel species to estimate relative exposure risk. We identify high exposure risk areas in the Mediterranean and Black seas, and the northeast Pacific, northwest Pacific, South Atlantic and southwest Indian oceans. Plastic exposure risk varies greatly among species and populations, and between breeding and non-breeding seasons. Exposure risk is disproportionately high for Threatened species. Outside the Mediterranean and Black seas, exposure risk is highest in the high seas and Exclusive Economic Zones (EEZs) of the USA, Japan, and the UK. Birds generally had higher plastic exposure risk outside the EEZ of the country where they breed. We identify conservation and research priorities, and highlight that international collaboration is key to addressing the impacts of marine plastic on wide-ranging species