Analysis of stroke patients' and carers' reading ability and the content and design of written materials: Recommendations for improving written stroke information

Objective: This study (a) evaluated the reading ability of patients following stroke and their carers and the reading level and content and design characteristics of the written information provided to them, (b) explored the influence of sociodemographic and clinical characteristics on patients' reading ability, and (c) described an education package that provides well-designed information tailored to patients' and carers' informational needs. Methods: Fifty-seven patients and 12 carers were interviewed about their informational needs in an acute stroke unit. Their reading ability was assessed using the Rapid Estimate of Adult Literacy in Medicine (REALM). The written information provided to them in the acute stroke unit was analysed using the SMOG readability formula and the Suitability Assessment of Materials (SAM). Results: Thirteen (22.8%) patients and 5 (41.7%) carers had received written stroke information. The mean reading level of materials analysed was 11th grade while patients read at a mean of 7-8th grade. Most materials (89%) scored as only adequate in content and design. Patients with combined aphasia read significantly lower (4-6th grade) than other patients (p = 0.001). Conclusion: Only a small proportion of patients and carers received written materials about stroke and the readability level and content and design characteristics of most materials required improvement. Practice implications: When developing and distributing written materials about stroke, health professionals should consider the reading ability and informational needs of the recipients, and the reading level and content and design characteristics of the written materials. A computer system can be used to generate written materials tailored to the informational needs and literacy skills of patients and carers. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

An Internet-based telerehabilitation system for the assessment of motor speech disorders: A pilot study

Purpose: This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment. Method: Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with dysarthria on a battery of perceptual assessments. The assessments included a 19-item version of the Frenchay Dysarthria Assessment (FDA; P. Enderby, 1983), the Assessment of Intelligibility of Dysarthric Speech (K. M. Yorkston & D. R. Beukelman, 1981), perceptual analysis of a speech sample, and an overall rating of severity of the dysarthria. One assessment was conducted in the traditional face-to-face manner, whereas the other assessment was conducted using an online, custom-built telerehabilitation application. This application enabled real-time videoconferencing at 128 kb/s and the transfer of store-and-forward audio and video data between the speaker and speech-language pathologist sites. The assessment methods were compared using the J.M.Bland and D.G.Altman (1986, 1999) limits-of-agreement method and percentage level of agreement between the 2 methods. Results: Measurements of severity of dysarthria, percentage intelligibility in sentences, and most perceptual ratings made in the telerehabilitation environment were found to fall within the clinically acceptable criteria. However, several ratings on the FDA were not comparable between the environments, and explanations for these results were explored. Conclusions: The online assessment of motor speech disorders using an Internet-based telerehabilitation system is feasible. This study suggests that with additional refinement of the technology and assessment protocols, reliable assessment of motor speech disorders over the Internet is possible. Future research methods are outlined.

Speech production in Parkinson's disease: II. Acoustic and electropalatographic investigation of sentence, word and segment durations

Previous investigations employing electropalatography (EPG) have identified articulatory timing deficits in individuals with acquired dysarthria. However, this technology is yet to be applied to the articulatory timing disturbance present in Parkinson's disease (PD). As a result, the current investigation aimed to use EPG to comprehensively examine the temporal aspects of articulation in a group of nine individuals with PD at sentence, word and segment level. This investigation followed on from a prior study (McAuliffe, Ward and Murdoch) and similarly, aimed to compare the results of the participants with PD to a group of aged (n=7) and young controls (n=8) to determine if ageing contributed to any articulatory timing deficits observed. Participants were required to read aloud the phrase I saw a ___ today'' with the EPG palate in-situ. Target words included the consonants /1/, /s/ and /t/ in initial position in both the /i/ and /a/ vowel environments. Perceptual investigation of speech rate was conducted in addition to objective measurement of sentence, word and segment duration. Segment durations included the total segment length and duration of the approach, closure/constriction and release phases of EPG consonant production. Results of the present study revealed impaired speech rate, perceptually, in the group with PD. However, this was not confirmed objectively. Electropalatographic investigation of segment durations indicated that, in general, the group with PD demonstrated segment durations consistent with the control groups. Only one significant difference was noted, with the group with PD exhibiting significantly increased duration of the release phase for /1a/ when compared to both the control groups. It is, therefore, possible that EPG failed to detect lingual movement impairment as it does not measure the complete tongue movement towards and away from the hard palate. Furthermore, the contribution of individual variation to the present findings should not be overlooked.

Handedness in twins: Joint analysis of data from 35 samples

Simultaneous analysis of handedness data from 35 samples of twins (with a combined sample size of 21,127 twin pairs) found a small but significant additive genetic effect accounting for 25.47% of the variance (95% confidence interval [CI] 15.69-29.51%). No common environmental influences were detected (C = 0.00; 95% Cl 0.00-7.67%), with the majority of the variance, 74.53%, explained by factors unique to the individual (95% Cl 70.49-78.67%). No significant heterogeneity was observed within studies that used similar methods to assess handedness, or across studies that used different methods. At an individual level the majority of studies had insufficient power to reject a purely unique environmental model due to insufficient power to detect familial aggregation. This lack of power is seldom mentioned within studies, and has contributed to the misconception that twin studies of handedness are not informative.

The sociolinguistic stratification of a connected speech process - The case of the T to R rule in the Black Country

This paper examines the connected speech process described by Wells (1982b) as the T to R rule in the West Midlands speech variety associated with the Black Country. The T to R rule is well known as a linguistic marker of local varieties of the middle and far north of England. Less well understood is its position in the phonological systems of Midlands varieties. Varieties of the Midlands of England are underresearched in comparison with varieties of the north, and what is known about the application of the T to R rule in this transitional dialect area is correspondingly nebulous. This paper focuses on the Black Country area, and examines the possible outputs in the contexts which give rise to /t/ becoming [?] in local varieties of the north. I examine the written and spoken evidence which suggests that the T to R rule does indeed operate in the Black Country variety. My analysis focuses on possible phonetic outcomes of the T to R rule across time. In my conclusion, I discuss briefly the possibility that, lying on a bundle of isoglosses separating north from south, the variety of the Black Country reflects this in that a T to [?] rule, rather than a T to R rule, is the dominant output of this connected speech process in the Black Country.

Quantifying evidence for forensic authorship analysis

The judicial interest in ‘scientific’ evidence has driven recent work to quantify results for forensic linguistic authorship analysis. Through a methodological discussion and a worked example this paper examines the issues which complicate attempts to quantify results in work. The solution suggested to some of the difficulties is a sampling and testing strategy which helps to identify potentially useful, valid and reliable markers of authorship. An important feature of the sampling strategy is that these markers identified as being generally valid and reliable are retested for use in specific authorship analysis cases. The suggested approach for drawing quantified conclusions combines discriminant function analysis and Bayesian likelihood measures. The worked example starts with twenty comparison texts for each of three potential authors and then uses a progressively smaller comparison corpus, reducing to fifteen, ten, five and finally three texts per author. This worked example demonstrates how reducing the amount of data affects the way conclusions can be drawn. With greater numbers of reference texts quantified and safe attributions are shown to be possible, but as the number of reference texts reduces the analysis shows how the conclusion which should be reached is that no attribution can be made. The testing process at no point results in instances of a misattribution.

Analysis and simulation of computer controlled cellular mobile radio systems

Cellular mobile radio systems will be of increasing importance in the future. This thesis describes research work concerned with the teletraffic capacity and the canputer control requirements of such systems. The work involves theoretical analysis and experimental investigations using digital computer simulation. New formulas are derived for the congestion in single-cell systems in which there are both land-to-mobile and mobile-to-mobile calls and in which mobile-to-mobile calls go via the base station. Two approaches are used, the first yields modified forms of the familiar Erlang and Engset formulas, while the second gives more complicated but more accurate formulas. The results of computer simulations to establish the accuracy of the formulas are described. New teletraffic formulas are also derived for the congestion in multi -cell systems. Fixed, dynamic and hybrid channel assignments are considered. The formulas agree with previously published simulation results. Simulation programs are described for the evaluation of the speech traffic of mobiles and for the investigation of a possible computer network for the control of the speech traffic. The programs were developed according to the structured progranming approach leading to programs of modular construction. Two simulation methods are used for the speech traffic: the roulette method and the time-true method. The first is economical but has some restriction, while the second is expensive but gives comprehensive answers. The proposed control network operates at three hierarchical levels performing various control functions which include: the setting-up and clearing-down of calls, the hand-over of calls between cells and the address-changing of mobiles travelling between cities. The results demonstrate the feasibility of the control netwvork and indicate that small mini -computers inter-connected via voice grade data channels would be capable of providing satisfactory control

Is it all tough talking at the top? A post-structuralist analysis of the construction of gendered speaker identities of British business leaders within interview narratives

This paper uses a feminist post-structuralist approach to examine the gendered identities of a sample of British business leaders in Britain. While recent national surveys offer many material reasons why women are acutely under-represented as business leaders, the role of language is rarely addressed. This paper explores the ways in which ten senior women and men construct their sense of leadership identities through the medium of interview narratives. Drawing upon two poststructuralist models of analysis (Derrida’s 1987 theory of deconstruction and Bakhtin’s 1927/1981 concept of double-voiced discourse), the paper shows how both females and males are able to shift pragmatically between interwoven corporate discourses, which demand competing cultural allegiances from one moment to the next, allegiances constantly tested by the rapid change and uncertainty that characterise global business. While male leaders experience a relative freedom of movement between different cultural discourses, female leaders are circumscribed by negative and reductive representations of female speech and behaviour. In sum, senior women are required constantly to observe, review, police and repair their use of leadership language, which potentially undermines their confidence and authority as leaders.