Oesophageal speech: enrichment and evaluations

167 p.After a laryngectomy (i.e. removal of the larynx) a patient can no more speak in a healthy laryngeal voice. Therefore, they need to adopt alternative methods of speaking such as oesophageal speech. In this method, speech is produced using swallowed air and the vibrations of the pharyngo-oesophageal segment, which introduces several undesired artefacts and an abnormal fundamental frequency. This makes oesophageal speech processing difficult compared to healthy speech, both auditory processing and signal processing. The aim of this thesis is to find solutions to make oesophageal speech signals easier to process, and to evaluate these solutions by exploring a wide range of evaluation metrics.First, some preliminary studies were performed to compare oesophageal speech and healthy speech. This revealed significantly lower intelligibility and higher listening effort for oesophageal speech compared to healthy speech. Intelligibility scores were comparable for familiar and non-familiar listeners of oesophageal speech. However, listeners familiar with oesophageal speech reported less effort compared to non-familiar listeners. In another experiment, oesophageal speech was reported to have more listening effort compared to healthy speech even though its intelligibility was comparable to healthy speech. On investigating neural correlates of listening effort (i.e. alpha power) using electroencephalography, a higher alpha power was observed for oesophageal speech compared to healthy speech, indicating higher listening effort. Additionally, participants with poorer cognitive abilities (i.e. working memory capacity) showed higher alpha power.Next, using several algorithms (preexisting as well as novel approaches), oesophageal speech was transformed with the aim of making it more intelligible and less effortful. The novel approach consisted of a deep neural network based voice conversion system where the source was oesophageal speech and the target was synthetic speech matched in duration with the source oesophageal speech. This helped in eliminating the source-target alignment process which is particularly prone to errors for disordered speech such as oesophageal speech. Both speaker dependent and speaker independent versions of this system were implemented. The outputs of the speaker dependent system had better short term objective intelligibility scores, automatic speech recognition performance and listener preference scores compared to unprocessed oesophageal speech. The speaker independent system had improvement in short term objective intelligibility scores but not in automatic speech recognition performance. Some other signal transformations were also performed to enhance oesophageal speech. These included removal of undesired artefacts and methods to improve fundamental frequency. Out of these methods, only removal of undesired silences had success to some degree (1.44 \% points improvement in automatic speech recognition performance), and that too only for low intelligibility oesophageal speech.Lastly, the output of these transformations were evaluated and compared with previous systems using an ensemble of evaluation metrics such as short term objective intelligibility, automatic speech recognition, subjective listening tests and neural measures obtained using electroencephalography. Results reveal that the proposed neural network based system outperformed previous systems in improving the objective intelligibility and automatic speech recognition performance of oesophageal speech. In the case of subjective evaluations, the results were mixed - some positive improvement in preference scores and no improvement in speech intelligibility and listening effort scores. Overall, the results demonstrate several possibilities and new paths to enrich oesophageal speech using modern machine learning algorithms. The outcomes would be beneficial to the disordered speech community

Occupy by design

The Occupy movement has been one of the most noticeable global citizen-led movements in the last decade. While the media attention and citizen participation have seemingly thinned now, three years since its inception, there is continued interest within academia and governments to study these movements to better understand the motivations, reach and consequences. Occupy by design investigates the failures in the current institutionalised methods that have driven citizens towards contentious politics, and asks the question, what role can design play to rethink democracy and citizenship for the common good? The aim is to map the philosophies, structures and platforms for direct democracy those have emerged through such movements, and to identify opportunities for curating new cultures in citizenship and governance; and, in the process, seek to redefine the role of design in addressing complex social and political phenomenon. Based on key insights from the research, I propose an alternative to the current “really existing capitalist democracy” or RECD (Chomsky, 2013), called the “now emergent wholesome democracy” or NEWD. It is based on six key principles, SCARRS – Small is beautiful, Coexistence, Acceleration, Resilience, Reciprocity, and Speculation. In order to establish this new system, a new form of design is proposed – contentious design, which is defined as the creative use of disruptive techniques for the purpose of deconstructing and (re)designing ‘things’ for the common good. The potential application and value of these concepts are further defined in the context of a renewed energy and mobility proposal for Scotland in 2020

Enabling Genuine Participation in Co-design with Young People with Learning Disabilities

This paper shares key learnings and emerging principles on ways of enabling genuine participation from young people with learning disabilities in co-design. Reviewing previous research focusing on co-design with young people and people with learning disabilities, we highlight key gaps including – a lack of approaches engaging young people with learning disabilities throughout a co-design process; and limited examples of genuine participation focusing on lived experience and engagement in creative and conceptual decision-making. We present our work with young people with learning disabilities to design a game-based learning tool, with a focus on the co-design process. The work illustrates a situated, tailored Participatory Design approach for engaging participants across all stages of co-design. Findings highlight the importance of contextual preparation by embedding in situ to support multi-vocal, multi-method engagement; and asset-based narratives to empower young people and support expression of voice, enabling creativity and conceptual decision-making. Synthesising key learnings and reflections, we present emerging principles underpinned by a rights-based ethos, with an emphasis on creating the right conditions and developing capacities to enable genuine participation

The Rainbow Bridge: Connecting Policy and Creative Practice

With the shift towards evidence-based policy-making, approaches such as ‘realist’ policy evaluation have been proposed to enable practitioners and decision-makers to gain a deeper understanding of complex social interventions. Research needs to inform policy through ideas rather than data (Pawson et al, 2005). Rainbow Bridge is a research collaboration between the authors, a design researcher and a policy expert, to explore in what ways policy is finding meaning and expression through the practice at the Creative Campus (CC), developed by The Glasgow School of Art with support from the Highlands and Islands Enterprise. The aim is to map connections of current practice and its intent with policy, and explore ways in which evolving practice can contribute to shaping policy in the future. Policy is generally expressed in words. In creative practices ‘visible thinking’ forms an integral part of the transformational process of learning. Through iteration and dialogue with oneself and others, drawing and writing can help to transform thought, rather than represent it (McAra-McWilliam, 2007). Rainbow bridge uses a combination of text-based explorations of policy along with drawing and making to understand the practice and articulate ‘theories of change’ (Shucksmith, 2016). According to Moffett (2011), drawing is ‘a form of moving’ and, when we attempt to think through drawing we attend to what we’re doing. Through the process of drawing and making of artefacts the goal is to make connections between policy and practice visible and tactile, while creating and sharing knowledge that is transformative. The research is in the exploratory stage and through presenting our work we hope to invite discussion on the effectiveness of this approach for showing connections, explaining effects and organising action to meaningfully connect the two distinct worlds of policy and creative practices

Design-led Approach to Co-production of Values for Collective Decision-Making

Experience Labs are design-led spaces for co-creating preferable futures by bringing academic, business and civic stakeholders to work together with citizens using a participatory design approach. Differing value systems of stakeholders, however, can pose challenges when working collaboratively. Experience Labs support exchange and co-production of values among diverse stakeholders by making them articulate and visible through design, to resolve conflict and to support meaningful decision-making towards progressing ideas whilst integrating a multiplicity of perspectives. In this paper, we discuss the creation of an ‘ethical imagination space’ to explore preferable futures with diverse stakeholders; the core values of the Experience Labs which support the creation of this space; and the key qualities that support the exchange and co production of shared values to enable collective decision-making. We propose that the ‘next thinking’ for design involves consideration of the ways in which we engage with values in cross-sectoral collaborations to enable collective decision-making

Enrichment of Oesophageal Speech: Voice Conversion with Duration-Matched Synthetic Speech as Target

Pathological speech such as Oesophageal Speech (OS) is difficult to understand due to the presence of undesired artefacts and lack of normal healthy speech characteristics. Modern speech technologies and machine learning enable us to transform pathological speech to improve intelligibility and quality. We have used a neural network based voice conversion method with the aim of improving the intelligibility and reducing the listening effort (LE) of four OS speakers of varying speaking proficiency. The novelty of this method is the use of synthetic speech matched in duration with the source OS as the target, instead of parallel aligned healthy speech. We evaluated the converted samples from this system using a collection of Automatic Speech Recognition systems (ASR), an objective intelligibility metric (STOI) and a subjective test. ASR evaluation shows that the proposed system had significantly better word recognition accuracy compared to unprocessed OS, and baseline systems which used aligned healthy speech as the target. There was an improvement of at least 15% on STOI scores indicating a higher intelligibility for the proposed system compared to unprocessed OS, and a higher target similarity in the proposed system compared to baseline systems. The subjective test reveals a significant preference for the proposed system compared to unprocessed OS for all OS speakers, except one who was the least proficient OS speaker in the data set.This project was supported by funding from the European Union’s H2020 research and innovation programme under the MSCA GA 675324 (the ENRICH network: www.enrich-etn.eu (accessed on 25 June 2021)), and the Basque Government (PIBA_2018_1_0035 and IT355-19)

Experience Labs: Co-Creating Health and Care Innovations Using Design Tools and Artefacts

For healthcare innovations to be successful, the voices of those receiving or delivering such innovations need to be heard much earlier in the design process. This is not easy as there are likely to be multiple stakeholders involved, and their different backgrounds make it difficult to challenge or evaluate potential innovation in the early stage of development. This paper positions the Experience Lab as a means of co-creating sustainable, innovative solutions to healthcare challenges. The Experience Lab offers participants, both receiving and delivering healthcare, the opportunity to engage in the design process, share insights, experience new concepts and imagine new ways of responding to challenges. The material artefacts and bespoke tools provide the conditions through which to create new meanings and shared experiences. This paper presents the Experience Lab approach, artefacts and tools, providing examples of these in context. The paper concludes with the need for further research to understand the role of artefacts and tools in supporting detail design and implementation beyond the Lab, and the potential of the Lab approach for other contexts

Designing in Rural Highland Contexts: Exploring the Role of Technology in Facilitating Human Connections

There is a need when introducing new technology in health and social care settings to involve those who will use the technology, or be affected by it, at an early stage of the design process. Experience Labs employ a participatory approach for different stakeholders to share lived experiences, and collaboratively create ideas and solutions for health and social care challenges. The Labs serve the whole of Scotland, including the remote Highland areas, and are designed bespoke to the project goal and context. In this paper, we propose that the participatory approach of the Experience Labs provides a valuable space for collaboration to explore the potential and impact of supportive technology in rural communities. Initial findings suggest that participating in Experience Labs leads to a better understanding of communities of care as established by individuals and support structures in place, and how these can be mediated by technology. We conclude that the introduction of technology in these rural Highland communities of care needs to support existing networks, unique to each community, and consider the impact on changing existing structures

Future transitions in palliative care:care across the life course for people with life-limiting conditions

Funded by the Scottish Universities Insight Institute (SUII), Future Transitions in Palliative Care: Care Across the Life Course for People with Life Limiting Conditions programme explored the future of palliative care for people living with life limiting conditions to build a contextual understanding of care needs and aspirations across the life course and scope future care models that support the development of person-centred care towards Scotland 2030. There is a need to focus on positive and preferable destinations of care where the ethos and values of services provide a seamless transition for people living with life limiting conditions, regardless of life stage. Transitions of care are not simply focused on the person receiving care but also the wider care circles, such as family, friends, volunteers, practitioners delivering care, as well as policy and decision makers who impact the care experience. As such, the programme built upon the existing active network of cross sector organisations, practitioners, families and people with lived experience of services together, ensuring all voices are heard. The programme is a multi-institutional collaboration led by The Glasgow School of Art and the University of Dundee. The programme provides a way to build the foundations for innovation in palliative care pathways for people living with life limiting conditions at the ‘front line’ at points of transition to set the direction towards 2030. Our approach is underpinned by the need to develop innovations based on the ‘right’ conditions and principles by placing interactions between people and their care circle at the core of care delivery to enable conversations that are centered around aspirations for care and thus contribute to seamless transitions for people of all ages

Future transitions in palliative care: care across the life course for people with life-limiting conditions

Funded by the Scottish Universities Insight Institute (SUII), Future Transitions in Palliative Care: Care Across the Life Course for People with Life Limiting Conditions programme explored the future of palliative care for people living with life limiting conditions to build a contextual understanding of care needs and aspirations across the life course and scope future care models that support the development of person-centred care towards Scotland 2030. There is a need to focus on positive and preferable destinations of care where the ethos and values of services provide a seamless transition for people living with life limiting conditions, regardless of life stage. Transitions of care are not simply focused on the person receiving care but also the wider care circles, such as family, friends, volunteers, practitioners delivering care, as well as policy and decision makers who impact the care experience. As such, the programme built upon the existing active network of cross sector organisations, practitioners, families and people with lived experience of services together, ensuring all voices are heard. The programme is a multi-institutional collaboration led by The Glasgow School of Art and the University of Dundee. The programme provides a way to build the foundations for innovation in palliative care pathways for people living with life limiting conditions at the ‘front line’ at points of transition to set the direction towards 2030. Our approach is underpinned by the need to develop innovations based on the ‘right’ conditions and principles by placing interactions between people and their care circle at the core of care delivery to enable conversations that are centered around aspirations for care and thus contribute to seamless transitions for people of all ages