The Classroom Communication and Collaboration Appraisal: A Comprehensive Tool for Assessing Communication and Collaboration in Classroom Environments.

PURPOSE: The aim of this research note is to introduce a new appraisal form, the Classroom Communication and Collaboration (C3) Appraisal, designed to evaluate communication and collaboration within classroom settings. METHOD: A comprehensive synthesis of the key skills from a broad range of publications on successful communication and collaboration in the classroom was conducted. The resulting appraisal comprises 39 items across six scales: crafting clear messages, appropriateness of communication exchange, active listening, pragmatics and discourse, communication breakdown, and collaboration. To demonstrate its application, an exemplar usage of the C3 Appraisal involving a hearing child and a child with hearing loss engaged in a collaborative learning task is presented. RESULTS: The C3 Appraisal allowed for the quality and successfulness of the collaborative learning task between the two children to be assessed and quantified across the six scales. CONCLUSIONS: These findings highlight the utility of the C3 Appraisal as a valuable tool for evaluating communication and collaboration in classroom environments. Next steps are to test the reliability and validity of the C3 Appraisal on a large data set.

Feasibility of an Adaptive Version of the Everyday Conversational Sentences in Noise Test.

PURPOSE: To investigate potential reasons for the mismatch between laboratory/clinic-based sentence-in-noise performance and real-world listening abilities, we recently developed a corpus of natural, spontaneously spoken speech with three vocal effort levels (Everyday Conversational Sentences in Noise [ECO-SiN]). Here, we examined the feasibility of using the ECO-SiN corpus for adaptive speech-in-noise testing, which might be a desirable format in certain situations (e.g., during a clinical visit). METHOD: Ten young, normal-hearing adults, along with 20 older adults with hearing loss participated in the study. Speech reception thresholds (SRTs) were obtained using ECO-SiN sentences, which were systematically compared to the SRTs obtained using traditional Bamford-Kowal-Bench-like sentences. RESULTS: Results demonstrated the properties of the test compared favorably with those of a standard test based on scripted and clearly spoken sentences. Moreover, whereas normal-hearing listeners received a benefit from an increase in vocal effort, the participants with hearing loss showed a disbenefit that increased with increasing hearing loss. CONCLUSION: The adaptive version of the ECO-SiN test is feasible for research and clinical testing. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25146338.

Behavioral dynamics of conversation, (mis)communication and coordination in noisy environments.

During conversations people coordinate simultaneous channels of verbal and nonverbal information to hear and be heard. But the presence of background noise levels such as those found in cafes and restaurants can be a barrier to conversational success. Here, we used speech and motion-tracking to reveal the reciprocal processes people use to communicate in noisy environments. Conversations between twenty-two pairs of typical-hearing adults were elicited under different conditions of background noise, while standing or sitting around a table. With the onset of background noise, pairs rapidly adjusted their interpersonal distance and speech level, with the degree of initial change dependent on noise level and talker configuration. Following this transient phase, pairs settled into a sustaining phase in which reciprocal speech and movement-based coordination processes synergistically maintained effective communication, again with the magnitude of stability of these coordination processes covarying with noise level and talker configuration. Finally, as communication breakdowns increased at high noise levels, pairs exhibited resetting behaviors to help restore communication-decreasing interpersonal distance and/or increasing speech levels in response to communication breakdowns. Approximately 78 dB SPL defined a threshold where behavioral processes were no longer sufficient for maintaining effective conversation and communication breakdowns rapidly increased.

Measuring Speech Intelligibility and Hearing-Aid Benefit Using Everyday Conversational Sentences in Real-World Environments.

Laboratory and clinical-based assessments of speech intelligibility must evolve to better predict real-world speech intelligibility. One way of approaching this goal is to develop speech intelligibility tasks that are more representative of everyday speech communication outside the laboratory. Here, we evaluate speech intelligibility using both a standard sentence recall task based on clear, read speech (BKB sentences), and a sentence recall task consisting of spontaneously produced speech excised from conversations which took place in realistic background noises (ECO-SiN sentences). The sentences were embedded at natural speaking levels in six realistic background noises that differed in their overall level, which resulted in a range of fixed signal-to-noise ratios. Ten young, normal hearing participants took part in the study, along with 20 older participants with a range of levels of hearing loss who were tested with and without hearing-aid amplification. We found that scores were driven by hearing loss and the characteristics of the background noise, as expected, but also strongly by the speech materials. Scores obtained with the more realistic sentences were generally lower than those obtained with the standard sentences, which reduced ceiling effects for the majority of environments/listeners (but introduced floor effects in some cases). Because ceiling and floor effects limit the potential for observing changes in performance, benefits of amplification were highly dependent on the speech materials for a given background noise and participant group. Overall, the more realistic speech task offered a better dynamic range for capturing individual performance and hearing-aid benefit across the range of real-world environments we examined.

Conversational distance adaptation in noise and its effect on signal-to-noise ratio in realistic listening environments.

Everyday environments impose acoustical conditions on speech communication that require interlocutors to adapt their behavior to be able to hear and to be heard. Past research has focused mainly on the adaptation of speech level, while few studies investigated how interlocutors adapt their conversational distance as a function of noise level. Similarly, no study tested the interaction between distance and speech level adaptation in noise. In the present study, participant pairs held natural conversations while binaurally listening to identical noise recordings of different realistic environments (range of 53-92 dB sound pressure level), using acoustically transparent headphones. Conversations were in standing or sitting (at a table) conditions. Interlocutor distances were tracked using wireless motion-capture equipment, which allowed subjects to move closer or farther from each other. The results show that talkers adapt their voices mainly according to the noise conditions and much less according to distance. Distance adaptation was highest in the standing condition. Consequently, mainly in the loudest environments, listeners were able to improve the signal-to-noise ratio (SNR) at the receiver location in the standing condition compared to the sitting condition, which became less negative. Analytical approximations are provided for the conversational distance as well as the receiver-related speech and SNR.

Development of the Everyday Conversational Sentences in Noise test.

To capture the demands of real-world listening, laboratory-based speech-in-noise tasks must better reflect the types of speech and environments listeners encounter in everyday life. This article reports the development of original sentence materials that were produced spontaneously with varying vocal efforts. These sentences were extracted from conversations between a talker pair (female/male) communicating in different realistic acoustic environments to elicit normal, raised and loud vocal efforts. In total, 384 sentences were extracted to provide four equivalent lists of 16 sentences at the three efforts for the two talkers. The sentences were presented to 32 young, normally hearing participants in stationary noise at five signal-to-noise ratios from -8 to 0 dB in 2 dB steps. Psychometric functions were fitted for each sentence, revealing an average 50% speech reception threshold (SRT50) of -5.2 dB, and an average slope of 17.2%/dB. Sentences were then level-normalised to adjust their individual SRT50 to the mean (-5.2 dB). The sentences may be combined with realistic background noise to provide an assessment method that better captures the perceptual demands of everyday communication.

A review of experimental design in forensic taphonomy: moving towards forensic realism.

Forensic taphonomy as a discipline requires standardization to satisfy Daubert criteria for scientific data to be admissible in court. In response, there has been a shift towards quantification of methodology and estimating the postmortem interval. Despite these advances, there are still biases and limitations within the discipline not explicitly addressed in the early stages of experimental design nor in final published works. In this article, unresolved debates with respect to the conductance and reporting of forensic taphonomic research are reviewed, beginning with the nature of experimental cadavers, human or animal analogues and their body size, and second, the forensic realism of experimental setups, specifically with respect to caging, clothing and number of carcases. Pigs, albeit imperfect, are a good model to gain a general idea of the trends that may be seen in humans in subsequent validation studies in facilities where human donors are available. To date, there is no consensus among taphonomists on the extent of the effect that body mass has on decomposition progression. More research is required with both human cadavers and non-human analogues that builds on our current knowledge of forensic taphonomy to answer these nagging questions. This will enable the discipline to make the reliable assumption that pigs and donor decomposition data can be applied to homicide cases. A suite of experimental design aspects is suggested to ensure systematic and standardized data collection across different biogeoclimatic circumstances to identify and quantify the effects of potential confounding variables. Such studies in multiple, varied biogeographic circumstances with standardized protocols, equipment and carrion will facilitate independent global validation of patterns. These factors are reviewed to show the need for adjustments in experimental design to ensure relevance and applicability of data within locally realistic forensic situations. The initiation of a global decomposition data network for forensic taphonomists is recommended.Key pointsPigs are a valuable, albeit imperfect, proxy for human decomposition studies.There are few or conflicting data on effects of carcase size, carrion ecology, exclusion cages and scavengers.We recommend single, clothed, uncaged carcases for baseline research to reflect regionally specific forensic casework.

Inaccuracy of accumulated degree day models for estimating terrestrial post-mortem intervals in Cape Town, South Africa.

In forensic death investigations, estimating the postmortem interval (PMI) is critical. An accurate PMI estimate increases the speed and accuracy of identifying the remains by narrowing the time frame in which the death occurred, thus reducing the pool of possible decedents. Cape Town, South Africa has a high level of unnatural death, and due to a burdened death investigation system, many remain unidentified. There has been a tendency to broadly apply quantitative models of decomposition across biogeographically unique circumstances. A prime example is the widespread application of the total body score (TBS)/accumulated degree day (ADD) model developed by Megyesi et al. (2005), later refined by Moffatt et al. (2016). However, the appropriateness of applying a single model to a wide range of locations with unique geography and climates remains in question. The aim of the study was to evaluate and compare the accuracy of Megyesi and Moffatt models for estimating PMI in Cape Town, South Africa. Using pig carcasses, Finaughty established baseline data on the rates and patterns of terrestrial decomposition in summer and winter in two different locations in a forensically significant area of Cape Town. Among the baseline data, Finaughty derived TBS values using the Megyesi criteria. The present study used these values to estimate the ADD per the Megyesi and Moffatt models, which would correspond to an estimated PMI. These estimated values were compared to actual ADD values. Estimates of ADD were inaccurate for both models in winter, and only partially in summer. The Moffatt model was more accurate in earlier decomposition stages, with the Megyesi model more accurate in later decomposition stages. These results indicate the Cape Town environments may contain factors that the two models do not consider, producing inaccurate PMI estimations at various TBS' values. ADD does not depict the entire taphonomic story; the decomposition process appears to be too complex for universal modelling based on a single or narrow suite of variables. Seasonality was an important factor in determining the accuracy of the models, primarily resulting in underestimations of the true PMI values. These findings show the impracticality of applying models developed for- or in one region to any other and support the need to establish regionally-specific equations for estimating PMI in a forensic context. Alternatively, more complex models employing "big data" from a more comprehensive suite of variables which influence the rate and pattern of decay could be developed.

Objective Assessment of Listening Effort: Coregistration of Pupillometry and EEG.

Listening to speech in noise is effortful, particularly for people with hearing impairment. While it is known that effort is related to a complex interplay between bottom-up and top-down processes, the cognitive and neurophysiological mechanisms contributing to effortful listening remain unknown. Therefore, a reliable physiological measure to assess effort remains elusive. This study aimed to determine whether pupil dilation and alpha power change, two physiological measures suggested to index listening effort, assess similar processes. Listening effort was manipulated by parametrically varying spectral resolution (16- and 6-channel noise vocoding) and speech reception thresholds (SRT; 50% and 80%) while 19 young, normal-hearing adults performed a speech recognition task in noise. Results of off-line sentence scoring showed discrepancies between the target SRTs and the true performance obtained during the speech recognition task. For example, in the SRT80% condition, participants scored an average of 64.7%. Participants' true performance levels were therefore used for subsequent statistical modelling. Results showed that both measures appeared to be sensitive to changes in spectral resolution (channel vocoding), while pupil dilation only was also significantly related to their true performance levels (%) and task accuracy (i.e., whether the response was correctly or partially recalled). The two measures were not correlated, suggesting they each may reflect different cognitive processes involved in listening effort. This combination of findings contributes to a growing body of research aiming to develop an objective measure of listening effort.

Monitoring Alpha Oscillations and Pupil Dilation across a Performance-Intensity Function.

Listening to degraded speech can be challenging and requires a continuous investment of cognitive resources, which is more challenging for those with hearing loss. However, while alpha power (8-12 Hz) and pupil dilation have been suggested as objective correlates of listening effort, it is not clear whether they assess the same cognitive processes involved, or other sensory and/or neurophysiological mechanisms that are associated with the task. Therefore, the aim of this study is to compare alpha power and pupil dilation during a sentence recognition task in 15 randomized levels of noise (-7 to +7 dB SNR) using highly intelligible (16 channel vocoded) and moderately intelligible (6 channel vocoded) speech. Twenty young normal-hearing adults participated in the study, however, due to extraneous noise, data from only 16 (10 females, 6 males; aged 19-28 years) was used in the Electroencephalography (EEG) analysis and 10 in the pupil analysis. Behavioral testing of perceived effort and speech performance was assessed at 3 fixed SNRs per participant and was comparable to sentence recognition performance assessed in the physiological test session for both 16- and 6-channel vocoded sentences. Results showed a significant interaction between channel vocoding for both the alpha power and the pupil size changes. While both measures significantly decreased with more positive SNRs for the 16-channel vocoding, this was not observed with the 6-channel vocoding. The results of this study suggest that these measures may encode different processes involved in speech perception, which show similar trends for highly intelligible speech, but diverge for more spectrally degraded speech. The results to date suggest that these objective correlates of listening effort, and the cognitive processes involved in listening effort, are not yet sufficiently well understood to be used within a clinical setting.

The prosodic licensing of coda consonants in early speech: interactions with vowel length.

English has a word-minimality requirement that all open-class lexical items must contain at least two moras of structure, forming a bimoraic foot (Hayes, 1995).Thus, a word with either a long vowel, or a short vowel and a coda consonant, satisfies this requirement. This raises the question of when and how young children might learn this language-specific constraint, and if they would use coda consonants earlier and more reliably after short vowels compared to long vowels. To evaluate this possibility we conducted an elicited imitation experiment with 15 two-year-old Australian English-speaking children, using both perceptual and acoustic analysis. As predicted, the children produced codas more often when preceded by short vowels. The findings suggest that English-speaking two-year-olds are sensitive to language-specific lexical constraints, and are more likely to use coda consonants when prosodically required.

The syllabic status of final consonants in early speech: a case study.

Young children's first attempts at CVC words are often realized with the final consonant being heavily aspirated or followed by an epenthetic vowel (e.g. cat /kæt/ realized as [kæth] or [kætə]). This has led some to propose that young children represent word-final (coda) consonants as an onset-nucleus sequence (CV.Cv) (e.g. Goad & Brannen, 2003), raising questions about the syllabic status of the final consonant. To address this issue, we conducted an acoustic analysis of a child's early production of CVC, CVCh, and CVCV words between the ages of 1;3 and 1;5. Aside from aspiration, the results showed that there were no significant acoustic differences between the CVC and CVCh forms. In contrast, there were systematic acoustic differences in C2 closure duration between the CVC/CVCh and CVCV target words, suggesting that at least some children learning English have early coda representations for monosyllabic CVC words, whether heavily aspirated or not.

Creating a personalized professional practice framework for nursing.

Any organization on the journey to nursing excellence might initiate its search for a professional practice framework by exploring the many nursing-specific theories, frameworks, and conceptual models that are readily available in the literature. Although adopting an "off the shelf" professional practice framework for nursing may sound easier for a nursing organization than creating its own framework, achieving a good fit into an existing culture is more difficult when adopting rather than creating a practice framework. ven though creating a customized framework requires a considerable amount of upfront time, dedication, and a willingness to make some mistakes along the way, in the end a customized framework ensures cultural alignment. SThis framework describes the foundational structures and guiding principles, the key processes that influence how work is conducted, and the outcomes desired as the result of the work. Identifying evaluative methods for determining progress on identified strategic intents was crucial in bridging the gap between theory and outcomes. This model continues to provide flexibility and adaptability to meet needs in a constantly changing health care environment and difficult economic times.

Successful implementation of a family and patient activated rapid response team in an adult level 1 trauma center.

BACKGROUND: When cardiac arrests occur in hospitalized patients, delays in treatment are associated with lower survival and poorer outcomes. Patients often show a physiological deterioration hours before cardiac or pulmonary arrest. As a result, many hospitals have implemented a rapid response team (RRT) as part of their involvement in the 100,000 Lives Campaign sponsored by the Institute for Healthcare Improvement. METHOD: In conjunction with the University Health System Consortium (UHC) Patient- and Family-Centered Care Implementation Collaborative, Shands Jacksonville Medical Center (SJMC) launched a pilot RRT program in October 2006 followed by campus-wide implementation in July 2007. The program was enhanced to allow patient and family activation of the RRT in October 2007. RESULTS: A review of the first 2 years of data indicates that the SJMC RRT received 25 patient or family activated calls. Forty-eight percent of the calls were initiated by a family member and 52% by the actual patient. Reasons for the calls have varied but the most frequent reason identified by the patient or family member was "something just doesn't feel right" with the patient. Other leading reasons for calls were similar to criteria that are used by staff-initiated calls, such as shortness of breath and pain issues. CONCLUSION: This is one of the first initiations of a family activated component of the RRT in an adult hospital that has led to improvements in outcomes such as reduction in mortality rates and non-ICU codes, without an overload of false positive calls.