When “okay” is not okay : acoustic characteristics of single-word prosody conveying reluctance

The present study explored the acoustic characteristics of prosodic cues that indicate a speaker’s reluctance when giving permission or agreement using a single word (“okay”). Eight speakers (four male, four female) produced the recorded materials that were subsequently validated through a listening experiment using 12 normal-hearing listeners. Acoustic analyses revealed that significantly longer word duration was the cue used most consistently across speakers to communicate reluctance. Voice quality, fundamental voice frequency, and intensity cues also differed significantly between the two prosodic conditions, but the manner in which these cues were applied varied greatly across speakers.The research was funded in part by the National Research Foundation of South Africa.http://www.sherpa.ac.uk/romeo/issn/0001-4966/am2017Electrical, Electronic and Computer Engineerin

Translated or culturally adapted audiology tests and questionnaires : balancing regional and international interests and resources

No abstract available.https://www.tandfonline.com/loi/iija20hj2023Speech-Language Pathology and Audiolog

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Perception of prosody by cochlear implant recipients

Recipients of present-day cochlear implants (CIs) display remarkable success with speech recognition in quiet, but not with speech recognition in noise. Normal-hearing (NH) listeners, in contrast, perform relatively well with speech recognition in noise. Understanding which speech features support successful perception in noise in NH listeners could provide insight into the difficulty that CI listeners experience in background noise. One set of speech features that has not been thoroughly investigated with regard to its noise immunity is prosody. Existing reports show that CI users have difficulty with prosody perception. The present study endeavoured to determine if prosody is particularly noise-immune in NH listeners and whether the difficulty that CI users experience in noise can be partly explained by poor prosody perception. This was done through the use of three listening experiments. The first listening experiment examined the noise immunity of prosody in NH listeners by comparing perception of a prosodic pattern to word recognition in speech-weighted noise (SWN). Prosody perception was tested in a two-alternatives forced-choice (2AFC) test paradigm using sentences conveying either conditional or unconditional permission, agreement or approval. Word recognition was measured in an open set test paradigm using meaningful sentences. Results indicated that the deterioration slope of prosody recognition (corrected for guessing) was significantly shallower than that of word recognition. At the lowest signal-to-noise ratio (SNR) tested, prosody recognition was significantly better than word recognition. The second experiment compared recognition of prosody and phonemes in SWN by testing perception of both in a 2AFC test paradigm. NH and CI listeners were tested using single words as stimuli. Two prosody recognition tasks were used; the first task required discrimination between questions and statements, while the second task required discrimination between a certain and a hesitant attitude. Phoneme recognition was measured with three vowel pairs selected according to specific acoustic cues. Contrary to the first experiment, the results of this experiment indicated that vowel recognition was significantly better than prosody recognition in noise in both listener groups. The difference between the results of the first and second experiments was thought to have been due to either the test paradigm difference in the first experiment (closed set versus open set), or a difference in stimuli between the experiments (single words versus sentences). The third experiment tested emotional prosody and phoneme perception of NH and CI listeners in SWN using sentence stimuli and a 4AFC test paradigm for both tasks. In NH listeners, deterioration slopes of prosody and phonemes (vowels and consonants) did not differ significantly, and at the lowest SNR tested there was no significant difference in recognition of the different types of speech material. In the CI group, prosody and vowel perception deteriorated with a similar slope, while consonant recognition showed a steeper slope than prosody recognition. It is concluded that while prosody might support speech recognition in noise in NH listeners, explicit recognition of prosodic patterns is not particularly noise-immune and does not account for the difficulty that CI users experience in noise. ## Ontvangers van hedendaagse kogleêre inplantings (KI’s) behaal merkwaardige sukses met spraakherkenning in stilte, maar nie met spraakherkenning in geraas nie. Normaalhorende (NH) luisteraars, aan die ander kant, vaar relatief goed met spraakherkenning in geraas. Begrip van die spraakeienskappe wat suksesvolle persepsie in geraas ondersteun in NH luisteraars, kan lei tot insig in die probleme wat KI-gebruikers in agtergrondgeraas ervaar. Een stel spraakeienskappe wat nog nie deeglik ondersoek is met betrekking tot ruisimmuniteit nie, is prosodie. Bestaande navorsing wys dat KI-gebruikers sukkel met persepsie van prosodie. Die huidige studie is onderneem om te bepaal of prosodie besonder ruisimmuun is in NH luisteraars en of die probleme wat KI-gebruikers in geraas ondervind, deels verklaar kan word deur swak prosodie-persepsie. Dit is gedoen deur middel van drie luistereksperimente. Die eerste luistereksperiment het die ruisimmuniteit van prosodie in NH luisteraars ondersoek deur die persepsie van ’n prosodiese patroon te vergelyk met woordherkenning in spraakgeweegde ruis (SGR). Prosodie-persepsie is getoets in ’n twee-alternatiewe-gedwonge-keuse- (2AGK) toetsparadigma met sinne wat voorwaardelike of onvoorwaardelike toestemming, instemming of goedkeuring oordra. Woordherkenning is gemeet in ’n oopstel-toetsparadigma met betekenisvolle sinne. Resultate het aangedui dat die helling van agteruitgang van prosodieherkenning (gekorrigeer vir raai) betekenisvol platter was as dié van woordherkenning, en dat by die laagste sein-tot-ruiswaarde (STR) wat getoets is, prosodieherkenning betekenisvol beter was as woordherkenning. Die tweede eksperiment het prosodie- en foneemherkenning in SGR vergelyk deur die persepsie van beide te toets in ’n 2AGK-toetsparadigma. NH en KI-luisteraars is getoets met enkelwoorde as stimuli. Twee prosodieherkenningstake is gebruik; die eerste taak het diskriminasie tussen vrae en stellings vereis, terwyl die tweede taak diskriminasie tussen ’n seker en onseker houding vereis het. Foneemherkenning is gemeet met drie vokaalpare wat geselekteer is na aanleiding van spesifieke akoestiese eienskappe. In teenstelling met die eerste eksperiment, het resultate van hierdie eksperiment aangedui dat vokaalherkenning betekenisvol beter was as prosodieherkenning in geraas in beide luisteraarsgroepe. Die verskil tussen die resultate van die eerste en tweede eksperimente kon moontlik die gevolg wees van óf die verskil in toetsparadigma in die eerste eksperiment (geslote- teenoor oop-stel), óf ’n verskil in stimuli tussen die eksperimente (enkelwoorde teenoor sinne). Die derde eksperiment het emosionele-prosodie- en foneempersepsie van NH en KI-luisteraars getoets in SGR met sinstimuli en ’n 4AGK-toetsparadigma vir beide take. In NH luisteraars het die helling van agteruitgang van die persepsie van prosodie en foneme (vokale en konsonante) nie betekenisvol verskil nie, en by die laagste STR wat getoets is, was daar nie ’n betekenisvolle verskil in die herkenning van die twee tipes spraakmateriaal nie. In die KI-groep het prosodie- en vokaalpersepsie met soortgelyke hellings agteruitgegaan, terwyl konsonantherkenning ’n steiler helling as prosodieherkenning vertoon het. Die gevolgtrekking was dat alhoewel prosodie spraakherkenning in geraas in NH luisteraars mag ondersteun, die eksplisiete herkenning van prosodiese patrone nie besonder ruisimmuun is nie en dus nie ’n verklaring bied vir die probleme wat KI-gebruikers in geraas ervaar nie.Thesis (PhD)--University of Pretoria, 2014.lk2014Electrical, Electronic and Computer EngineeringPhDunrestricte

Modernising speech audiometry : using a smartphone application to test word recognition

OBJECTIVE : This study aimed to develop and assess a method to measure word recognition abilities using a smartphone application (App) connected to an audiometer. DESIGN : Word lists were recorded in South African English and Afrikaans. Analyses were conducted to determine the effect of hardware used for presentation (computer, compact-disc player, or smartphone) on the frequency content of recordings. An Android App was developed to enable presentation of recorded materials via a smartphone connected to the auxiliary input of the audiometer. Experiments were performed to test feasibility and validity of the developed App and recordings. STUDY SAMPLE : Participants were 100 young adults (18–30 years) with pure tone thresholds ≤15 dB across the frequency spectrum (250–8000 Hz). RESULTS : Hardware used for presentation had no significant effect on the frequency content of recordings. Listening experiments indicated good inter-list reliability for recordings in both languages, with no significant differences between scores on different lists at each of the tested intensities. Performance-intensity functions had slopes of 4.05%/dB for English and 4.75%/dB for Afrikaans lists at the 50% point. CONCLUSIONS : The developed smartphone App constitutes a feasible and valid method for measuring word recognition scores, and can support standardisation and accessibility of recorded speech audiometry.http://www.tandfonline.com/loi/iija202019-04-20hj2018Electrical, Electronic and Computer EngineeringSpeech-Language Pathology and Audiolog

When “okay” is not okay: Acoustic characteristics of single-word prosody conveying reluctance

The present study explored the acoustic characteristics of prosodic cues that indicate a speaker’s reluctance when giving permission or agreement using a single word (“okay”). Eight speakers (four male, four female) produced the recorded materials that were subsequently validated through a listening experiment using 12 normal-hearing listeners. Acoustic analyses revealed that significantly longer word duration was the cue used most consistently across speakers to communicate reluctance. Voice quality, fundamental voice frequency, and intensity cues also differed significantly between the two prosodic conditions, but the manner in which these cues were applied varied greatly across speakers.The research was funded in part by the National Research Foundation of South Africa.http://www.sherpa.ac.uk/romeo/issn/0001-4966/am2017Electrical, Electronic and Computer Engineerin

Modernising speech audiometry: using a smartphone application to test word recognition

<p><b>Objective:</b> This study aimed to develop and assess a method to measure word recognition abilities using a smartphone application (App) connected to an audiometer.</p> <p><b>Design:</b> Word lists were recorded in South African English and Afrikaans. Analyses were conducted to determine the effect of hardware used for presentation (computer, compact-disc player, or smartphone) on the frequency content of recordings. An Android App was developed to enable presentation of recorded materials via a smartphone connected to the auxiliary input of the audiometer. Experiments were performed to test feasibility and validity of the developed App and recordings.</p> <p><b>Study sample:</b> Participants were 100 young adults (18–30 years) with pure tone thresholds ≤15 dB across the frequency spectrum (250–8000 Hz).</p> <p><b>Results:</b> Hardware used for presentation had no significant effect on the frequency content of recordings. Listening experiments indicated good inter-list reliability for recordings in both languages, with no significant differences between scores on different lists at each of the tested intensities. Performance-intensity functions had slopes of 4.05%/dB for English and 4.75%/dB for Afrikaans lists at the 50% point.</p> <p><b>Conclusions:</b> The developed smartphone App constitutes a feasible and valid method for measuring word recognition scores, and can support standardisation and accessibility of recorded speech audiometry.</p

Occupational therapy intervention intosteo-arthritis of the carpometacarpal joint of the thumb in the South African context

CITATION: Teuchert, R. M., et al. 2017. Occupational therapy intervention intosteo-arthritis of the carpometacarpal joint of the thumb in the South African context. South African Journal of Occupational Therapy, 47(1):41-45, doi:10.17159/2310-3833/2017/v47n1a8The original publication is available at http://www.sajot.co.zaIntroduction: The carpometacarpal joint (CMCJ) plays a pivotal role in thumb function and essentially, hand function. Investigation concerning the most preferable occupational therapy treatment approach for osteoarthritis (OA) of the CMCJ was therefore indicated. Factors that affect the course of treatment in the South African context were to be identified. Methodology: A descriptive qualitative research design was implemented with a purposive sample of occupational therapists in the Western Cape. Semi-structured interviews were held. These were transcribed and analysed. Results: A fixed treatment regimen was not followed by participants of the study. Factors contributing to the choice of treatment emerged from the data. These included the source of the referral, aspects of the OT process and the patient. Results demonstrated that it would not be practical to set up a rigid regimen, due to the diverse nature by which OA of the CMCJ presents in patients as well as the contributing factors participants reported to impact intervention. Discussion: The compilation of a basic guideline is proposed. Each phase of the occupational therapy process according to the stage of OA of the CMCJ should be included to provide meaningful intervention. A proposed guideline is presented based on the results of the study.http://www.sajot.co.za/index.php/sajot/article/view/355Publisher's versio