Recognition of Accented Speech by Cochlear-Implant Listeners: Benefit of Audiovisual Cues.

OBJECTIVES: When auditory and visual speech information are presented together, listeners obtain an audiovisual (AV) benefit or a speech understanding improvement compared with auditory-only (AO) or visual-only (VO) presentations. Cochlear-implant (CI) listeners, who receive degraded speech input and therefore understand speech using primarily temporal information, seem to readily use visual cues and can achieve a larger AV benefit than normal-hearing (NH) listeners. It is unclear, however, if the AV benefit remains relatively large for CI listeners when trying to understand foreign-accented speech when compared with unaccented speech. Accented speech can introduce changes to temporal auditory cues and visual cues, which could decrease the usefulness of AV information. Furthermore, we sought to determine if the AV benefit was relatively larger in CI compared with NH listeners for both unaccented and accented speech. DESIGN: AV benefit was investigated for unaccented and Spanish-accented speech by presenting English sentences in AO, VO, and AV conditions to 15 CI and 15 age- and performance-matched NH listeners. Performance matching between NH and CI listeners was achieved by varying the number of channels of a noise vocoder for the NH listeners. Because of the differences in age and hearing history of the CI listeners, the effects of listener-related variables on speech understanding performance and AV benefit were also examined. RESULTS: AV benefit was observed for both unaccented and accented conditions and for both CI and NH listeners. The two groups showed similar performance for the AO and AV conditions, and the normalized AV benefit was relatively smaller for the accented than the unaccented conditions. In the CI listeners, older age was associated with significantly poorer performance with the accented speaker compared with the unaccented speaker. The negative impact of age was somewhat reduced by a significant improvement in performance with access to AV information. CONCLUSIONS: When auditory speech information is degraded by CI sound processing, visual cues can be used to improve speech understanding, even in the presence of a Spanish accent. The AV benefit of the CI listeners closely matched that of the NH listeners presented with vocoded speech, which was unexpected given that CI listeners appear to rely more on visual information to communicate. This result is perhaps due to the one-to-one age and performance matching of the listeners. While aging decreased CI listener performance with the accented speaker, access to visual cues boosted performance and could partially overcome the age-related speech understanding deficits for the older CI listeners.

Different dimensions of religiousness/spirituality are associated with health behaviors in breast cancer survivors.

OBJECTIVE: Religiousness/spirituality (R/S) may influence cancer survivors' health through multiple pathways. We aimed to examine one potentially key pathway that has seldom been examined: relationships between survivors' R/S and their health behaviors. METHODS: The present study investigated links between four core dimensions of R/S (beliefs, behaviors, identity, and coping) and three health behaviors (fruit/vegetable consumption, physical activity, and maintenance of a healthy weight) in 172 breast cancer survivors. RESULTS: Both spiritual identity and use of religious coping were positively related to fruit and vegetable intake, while private prayer was marginally positively related. Both service attendance and religious identity (marginally) were related to engaging in less physical activity, while private prayer was positively related. Afterlife beliefs and private prayer were positively associated with BMI. CONCLUSIONS: R/S has complex but meaningful associations with health behaviors in breast cancer survivors. More research is needed to understand these relationships and to determine whether different dimensions of R/S may play useful roles in lifestyle change interventions.

Self-Management and Yoga for Older Adults with Chronic Stroke: A Mixed-Methods Study of Physical Fitness and Physical Activity.

OBJECTIVE: This study investigated changes in physical fitness and physical activity among older patients with chronic stroke (stroke ≥ 6 months previous) after participation in a yoga infused self-management intervention. METHODS: A mixed-methods secondary data analysis examined quantitative measures of endurance, strength, and gait speed and qualitative perspectives of intervention participants. RESULTS: Based on Wilcoxon analysis, physical fitness outcome measures including endurance and lower and upper body strength significantly (p < .02) improved. Based on qualitative results of 2 focus groups and 14 individual interviews, participants expressed positive changes in endurance, strength, gait speed, flexibility, and balance. They also reported improvements in walking ability and duration, and expressed a desire to continue yoga and increase levels of exercise. CONCLUSIONS: With the objective of improving physical fitness and exercise for older adults with chronic stroke, it is important for self-management interventions to provide specific safe and feasible physical activity components, such as yoga. CLINICAL IMPLICATIONS: Health professionals may improve offered chronic stroke self-management interventions by incorporating yoga.

Staff perspectives regarding the implementation of a yoga intervention with chronic pain self-management in a clinical setting.

Chronic pain affects millions of Americans and can be addressed through multiple modalities, interventions, and strategies. Yoga and self-management have been proven effective in treating chronic pain, but little research has been conducted on the feasibility and implementation barriers related to these alternative intervention forms. In our qualitative study, we examined staff perceptions regarding the feasibility of implementing yoga along with established self-management at a pain management clinic in Colorado. We utilized the Implementation Drivers of Competency, Organizational, and Leadership, and our added Hypothetical Driver to explore barriers and facilitators related to project implementation. Our findings suggest that positive staff and patient attitudes were crucial for successful implementation. We also identified physical space, transportation, and supportive leadership as necessary components of project implementation. Further research is needed to examine barriers such as funding to ensure intervention sustainability and the need for adequate staffing.