Speech rhythm: the language-specific integration of pitch and duration

Experimental phonetic research on speech rhythm seems to have reached an impasse. Recently, this research field has tended to investigate produced (rather than perceived) rhythm, focussing on timing, i.e. duration as an acoustic cue, and has not considered that rhythm perception might be influenced by native language. Yet evidence from other areas of phonetics, and other disciplines, suggests that an investigation of rhythm is needed which (i) focuses on listeners’ perception, (ii) acknowledges the role of several acoustic cues, and (iii) explores whether the relative significance of these cues differs between languages. This thesis, the originality of which derives from its adoption of these three perspectives combined, indicates new directions for progress. A series of perceptual experiments investigated the interaction of duration and f0 as perceptual cues to prosody in languages with different prosodic structures – Swiss German, Swiss French, and French (i.e. from France). The first experiment demonstrated that a dynamic f0 increases perceived syllable duration in contextually isolated pairs of monosyllables, for all three language groups. The second experiment found that dynamic f0 and increased duration interact as cues to rhythmic groups in series of monosyllabic digits and letters; the two cues were significantly more effective than one when heard simultaneously, but significantly less effective than one when heard in conflicting positions around the rhythmic-group boundary location, and native language influenced whether f0 or duration was the more effective cue. These two experiments laid the basis for the third, which directly addressed rhythm. Listeners were asked to judge the rhythmicality of sentences with systematic duration and f0 manipulations; the results provide evidence that duration and f0 are interdependent cues in rhythm perception, and that the weighting of each cue varies in different languages. A fourth experiment applied the perceptual results to production data, to develop a rhythm metric which captures the multi-dimensional and language-specific nature of perceived rhythm in speech production. These findings have the important implication that if future phonetic research on rhythm follows these new perspectives, it may circumvent the impasse and advance our knowledge and model of speech rhythm.This work was funded by an AHRC doctoral award to the author

Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice

This author accepted manuscript (post print) is made available following a 12 month embargo from date of publication (3 October 2016) in accordance with the publisher copyright policy.Background: The first evidence based Clinical Practice Guidelines and Principles of Care for People with Dementia in Australia have been released. The Guidelines detail a number of important evidence based recommendations for occupational therapists. Aim: The aim of this paper is (1) to provide an overview of Guideline development, and (2) to describe the evidence supporting a recommendation for occupational therapy. Common characteristics of effective occupational therapy programs for people with dementia are described. Methods: Guideline development involved adaptation of existing high quality guidelines developed overseas and 17 systematic reviews to ensure that the most recent high quality evidence was included. One of the systematic reviews involved examining the evidence for interventions to promote independence in people with dementia. Specifically, we looked at the evidence for occupational therapy and its effect on activities of daily living, quality of life and carer impact. Results: A total of 109 recommendations are included in the Guidelines. Occupational therapy was found to significantly increase independence in activities of daily living and improve quality of life. Effective occupational therapy programs involve: environmental assessment, problem solving strategies, carer education and interactive carer skills training. Conclusion: Occupational therapists working with people with dementia in community settings should ensure that their time is spent on those aspects of intervention that are shown to be effective

Speech rhythm : the language-specific integration of pitch and duration

Experimental phonetic research on speech rhythm seems to have reached an impasse. Recently, this research field has tended to investigate produced (rather than perceived) rhythm, focussing on timing, i.e. duration as an acoustic cue, and has not considered that rhythm perception might be influenced by native language. Yet evidence from other areas of phonetics, and other disciplines, suggests that an investigation of rhythm is needed which (i) focuses on listeners' perception, (ii) acknowledges the role of several acoustic cues, and (iii) explores whether the relative significance of these cues differs between languages. This thesis, the originality of which derives from its adoption of these three perspectives combined, indicates new directions for progress. A series of perceptual experiments investigated the interaction of duration and f0 as perceptual cues to prosody in languages with different prosodic structures - Swiss German, Swiss French, and French (i.e. from France). The first experiment demonstrated that a dynamic f0 increases perceived syllable duration in contextually isolated pairs of monosyllables, for all three language groups. The second experiment found that dynamic f0 and increased duration interact as cues to rhythmic groups in series of monosyllabic digits and letters; the two cues were significantly more effective than one when heard simultaneously, but significantly less effective than one when heard in conflicting positions around the rhythmic-group boundary location, and native language influenced whether f0 or duration was the more effective cue. These two experiments laid the basis for the third, which directly addressed rhythm. Listeners were asked to judge the rhythmicality of sentences with systematic duration and f0 manipulations; the results provide evidence that duration and f0 are interdependent cues in rhythm perception, and that the weighting of each cue varies in different languages. A fourth experiment applied the perceptual results to production data, to develop a rhythm metric which captures the multi-dimensional and language-specific nature of perceived rhythm in speech production. These findings have the important implication that if future phonetic research on rhythm follows these new perspectives, it may circumvent the impasse and advance our knowledge and model of speech rhythm.EThOS - Electronic Theses Online ServiceAHRCGBUnited Kingdo

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31â127 anaesthetic procedures in 30â874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0â5·5) with an incidence of respiratory critical events of 3·1% (2·9â3·3). Cardiovascular instability occurred in 1·9% (1·7â2·1), with an immediate poor outcome in 5·4% (3·7â7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10â000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86â0·90; p<0·0001), medical history, and physical condition (1·60, 1·40â1·82; p<0·0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0·99, 0·981â0·997; p<0·0048 for respiratory critical events, and 0·98, 0·97â0·99; p=0·0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia. Funding European Society of Anaesthesiology

Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6.35 years (SD 4.50) were included. The incidence of perioperative severe critical events was 5.2% (95% CI 5.0-5.5) with an incidence of respiratory critical events of 3.1% (2.9-3.3). Cardiovascular instability occurred in 1.9% (1.7-2.1), with an immediate poor outcome in 5.4% (3.7-7.5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0.88, 95% CI 0.86-0.90; p<0.0001), medical history, and physical condition (1.60, 1.40-1.82; p<0.0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0.99, 0.981-0.997; p<0.0048 for respiratory critical events, and 0.98, 0.97-0.99; p=0.0039 for cardiovascular critical events), rather than the type of health institution or providers. Interpretation This study highlights a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist societies to target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia