A Multiple Discourse Approach to Health Communication: Translational Research and Ethical Practice

from the Journal of Applied Communication Research

Experiences with the pursuit of health communication research are discussed in terms of barriers and facilitators to conducting this work. These experiences are considered for generalizable principles relating to the conduct of translational research. The importance of acknowledging the values and agendas which underlie the pursuit of translational research is emphasized. The contributions of both qualitative and quantitative methodologies to pursuits of translational projects are acknowledged. Finally, the need for communication scholars to participate in interdisciplinary endeavors is advanced as a goal with benefits for sharing the field’s theory and research insights, and to expand our own knowledge about other disciplines.

Centered but not Caught in the Middle: Stepchildren’s Perceptions of Dialectical Contradictions in the Communication of Co-Parents

from the Journal of Applied Communication Research

The researchers adopted a dialectical perspective to study how stepchildren experience and communicatively manage the perception of feeling caught in the middle between their parents who are living in different households. The metaphor of being caught in the middle is powerful for stepchildren and this metaphor animated their discourse. A central contribution of the present study was to understand the alternative to being caught in the middle and what this alternative means to stepchildren. Reflected in the discourse of stepchildren is that to feel not caught in the middle is to feel centered in the family. Stepchildren’s desire to be centered in the family was animated by the dialectic of freedom-constraint, which co-existed within the contradictions of openness-closedness and control-restraint. These contradictions are detailed in the analysis, along with advice to parents from the perspective of stepchildren. Implications for the interaction of stepchildren and their parents are discussed.

Financial Feeling: An Investigation of Emotion and Communication in the Workplace

from the Journal of Applied Communication Research

There is growing interest in the role of emotion when considering communication in the workplace. This work has most often considered workers in front-line service positions in investigations of emotional labor, and human service workers in investigations of empathy and emotional work. In this study, we consider processes of both emotional labor and emotional work in the financial planning profession. Financial planners occupy a role requiring ongoing relationships with clients, conversations about the often emotional topic of money, and a need to manage emotion in a variety of interaction contexts. Thus, from extant theory and literature regarding emotion and communication, we proposed research questions regarding the roles of emotional labor and emotional work in the financial planning profession. These questions were investigated in a web-based survey study of almost 300 professional financial planners and supporting interviews with 14 financial planners. Results indicate support for existing theory on emotional work, extensions to current research regarding emotional labor, and important implications for the role of emotion and communication in a range of professional service roles.

The Assimilation of In-Laws: The Impact of Newcomers on the Communication Routines of Families

from the Journal of Applied Communication Research

Although our popular culture stereotypes relationships with in-laws as problematic, these relationships have largely been overlooked by communication researchers. In contrast to existing studies focusing on dyadic relationships, this study looked at how in-laws are assimilated into the family group as newcomers, using structuration theory to examine how routines are reproduced in families. In personal interviews, participants described how their families had assimilated newcomers or how they themselves were received into their spouse’s families. A thematic analysis revealed specific communication routines that had to be adjusted upon entry of newcomers, including conversational topics, expected amount of interaction, use of joking, and conversational styles. Adjustments to these routines, although difficult to negotiate because they were not openly discussed, helped to transform the family of childhood into the family of adulthood. Structuration theory would suggest that the perceived stress in relationships with in-laws occurs because newcomers upset the comfort of families by disrupting their communication routines.

Flexible Laryngoscopy: A Comparison of Fiber Optic and Distal Chip Technologies. Part 1: Vocal Fold Masses

from the Journal of Voice

This study was designed to evaluate the usefulness of fiber optic (FO) and distal chip (DC) flexible imaging platforms in the diagnosis of true vocal fold pathology when compared to the gold standard rigid transoral laryngeal telescopic examination. The recorded strobovideolaryngoscopic examinations of 34 consecutive patients were evaluated retrospectively by five raters. All stroboscopy segments were evaluated by two laryngologists, an otolaryngologist, a laryngology fellow, and an otolaryngology resident. Seventeen patients were examined with a high-quality, large-diameter, FO flexible laryngoscope (FO group) and 17 random patients were examined with a DC flexible laryngoscope (DC group). Each patient was also examined using rigid laryngeal videostroboscopy at the same sitting. Examinations of three patients from each group were presented twice to monitor internal consistency. Diagnoses of intrinsic vocal fold pathology made with the flexible laryngoscopes were compared for accuracy to the diagnoses provided using the rigid laryngeal telescope. The ability to make clinical diagnoses via stroboscopy was statistically equivalent with FO technology and DC technology. Rigid examination provided more information than the flexible examination in 27% of the FO examinations and in 32% of the DC examinations. DC technology did not add diagnostic information to the examination when compared to a high-quality, large-diameter, FO endoscope. Rigid endoscopy provides superior images of the true vocal folds and is necessary for precise diagnosis in patients with true vocal fold pathology. Thus, the most cost-effective means of evaluation of voice disorders remains FO flexible endoscopy for dynamic voice assessment and the neurolaryngologic examination followed by rigid stroboscopy for evaluation of the vocal fold edge and mucosal wave. Strobovideolaryngoscopy using high-quality FO or DC flexible equipment should be reserved for patients who cannot tolerate transoral rigid examination, such as children and those with a very strong gag reflex.

Multidimensional Assessment of Voice After Vertical Partial Laryngectomy: A Comparison With Normal and Total Laryngectomy Voice

from the Journal of Voice

The aim of this cross-sectional cohort study was to analyze the acoustic, stroboscopic, and perceptual parameters in patients who had undergone vertical partial laryngectomy (VPL) and to compare them with normal subjects (N) and total laryngectomy (TL) patients. This study was carried out in a tertiary referral Cancer Services Centre. We analyzed data from a total of 51 individuals; six VPL patients, 27 TL patients, and 18 N subjects. Acoustic analysis and videostroboscopy were performed using a computerized speech studio. Perceptual analysis was carried out using the GRBAS scoring system. The mean ages in the three groups were 40.9+/-13.5 (N), 54.3+/-9.5 (VPL), and 63.9+/-10.5 years (TL). Acoustic analysis yielded the following results for N, VPL, and TL, respectively: median fundamental frequency (155.2, 224.9, 106.3Hz), shimmer (0.6, 1.9, 1.3dB), and jitter (0.3%, 3.3%, 4.2%). The median maximum phonation time was 21.8 (N), 9.4 (VPL), and 10.3 seconds (TL). The median words per minute (WPM) were 168.5 (N), 126 (VPL), and 127 WPM (TL). Acoustic analysis of VPL voice was significantly different from normal voice (Mann-Whitney, P<0.05) and approximated better to TL parameters. The results of TL and VPL groups show poorer values and larger variability for nearly all the quantitative measures as compared to N subjects. Videostroboscopy demonstrated variable level and amount of closure of the vibrating segment in the reconstructed larynx of the VPL group. VPL GRBAS scores were similar to TL scores with good interrater reliability. The multidimensional assessment of voice in VPL patients is significantly worse than in N subjects and more closely resembles that of patients who have undergone TL with surgical voice restoration.

Muscle Tension Dysphonia in Vietnamese Female Teachers

from the Journal of Voice

There has been no published research on muscle tension dysphonia (MTD) in speakers who use a tonal language. Using a sample of 47 Northern Vietnamese female primary school teachers with MTD, we aimed to discover whether professional voice users of tonal languages presented with the same symptoms of MTD as speakers of nontonal languages and whether they presented with additional symptoms as a result of speaking a tonal language. The vocal characteristics were assessed by use of a questionnaire and expert perceptual evaluation. Laryngeal features were assessed by photolaryngoscopy. The results showed that MTD was associated with a larger number of vocal symptoms than previously reported. However, the participants did not have the same vocal symptoms reported in English speakers, for example, hard glottal attack, pitch breaks, unusual speech rate, and glottal fry. Factor analysis of the vocal symptoms revealed three factors: “vocal fatigue/hyperfunction,” “physical discomfort,” and “voice quality,” all of which demonstrated high reliability. The major laryngeal characteristic was a glottal gap. The glottal shapes observed included: 44.7% had an incomplete closure, 29.8% a posterior gap, 12.8% an hourglass-shaped gap, 8.5% a spindle-shaped gap, and 4.3% had complete glottal closure. The findings implied a potential contribution of linguistic-specific factors and teaching-related factors to the presentation of this voice disorder in this group of teachers.

Laryngeal and Aerodynamic Adjustments for Voicing Versus Devoicing of /h/: A Within-Speaker Study

from the Journal of Voice

The aim of this within-speaker case study was to explore how effectively a phonetically trained speaker could alter the likelihood of voicing around abduction, and what changes he made to do so. An American English-speaking male produced intervocalic /h/ in varying loudness and vowel contexts. When given no specific instructions about voicing (block 1), he produced almost entirely voiced /h/. He was then asked to devoice /h/ (block 2). Measures of voicing, baseline airflow, pulse amplitudes, fundamental frequency (F0), open quotient, and speed quotient were made from oral airflow signals. Subglottal pressure was estimated from intraoral pressures during /p/. In block 2, the speaker produced 70% devoiced /h/. He achieved this by making several changes associated with higher phonation threshold pressures: greater abduction degrees, lower subglottal pressures, greater longitudinal tension of the vocal folds, and altered laryngeal settings. Qualitative inspection of the DC flow contours along with correlational and principal components analyses indicated widespread changes in respiratory, laryngeal, and supralaryngeal settings, and differing interrelationships among variables. Our speaker showed tacit knowledge of the range of parameters affecting voicing. Differing relationships among variables across the two blocks support a view of phonation as a dynamic process, where speakers adjust multiple parameters, simultaneously.

When hearsay trumps evidence: How generic language guides preschoolers’ inferences about unfamiliar things

from Language and Cognitive Processes

Two experiments investigated 4-year-olds’ use of descriptive sentences to learn non-obvious properties of unfamiliar kinds. Novel creatures were described using generic or nongeneric sentences (e.g., These are pagons. Pagons/These pagons are friendly). Children’s willingness to extend the described property to a new category member was then measured. The results of Experiment 1 demonstrated that children reliably extended the property to new instances after hearing generic but not nongeneric sentences. Further, the influence of generic language was much greater than effects related to the amount of tangible evidence provided (the number of creatures bearing the critical property). Experiment 2 revealed that children continued to extend properties mentioned in generic descriptions even when incompatible evidence was presented (e.g., an example of an unfriendly ‘pagon’). The findings underscore preschoolers’ keen understanding of the semantics of generic sentences and suggest that inferences based on generics are more robust than those based on observationally grounded evidence.

Improving the quality of abstracts – a CONSORT statement for abstracts

from the National electronic Library for Medicines (NeLM)

The authors of this Comment present the argument for including specific guidance on abstracts in the CONSORT statement. This provides recommendations on reporting randomised controlled trials, and has been endorsed by the editors of most of the World’s major biomedical journals. The abstract of a journal article may be the only available information for many health professionals, and for conference papers they may provide the only permanent record. Nevertheless it is well known that abstracts can have deficiencies (e.g. BMJ 2006; 333: 231-4) and may not include important information. At present, the CONSORT statement has little to say on abstracts – although it encourages a structured format, this is not a formal requirement.

The authors, on behalf of the CONSORT group, have therefore devised an extension to the CONSORT statement. This provides a checklist of essential items that should be included in an abstract reporting the results of a randomised controlled trial, whether for a conference or in a journal, that will fit within the usual space constraints (250-300 words). It is not intended to define the format of the abstract, as journals will have their own styles for this, but just to ensure that the most important information is included. Items included in the checklist are: details of the trial’s objectives; trial design (e.g., method of allocation, blinding); participants in the trial (i.e., description, numbers randomised and analysed); interventions intended for each randomised group and their effect on primary efficacy outcomes and harms; the trial’s conclusions; the trial’s registration name and number; and source of funding.

The authors note that extensions or adaptations to the list may be needed for other trial designs, and hope that journals and conference organisers will endorse the use of CONSORT for abstracts by modifying their statements to authors.

Language testing and citizenship: A language ideological debate in Sweden

from Language in Society

This article explores a public debate that took place in Sweden in 2002 in relation to the Swedish Liberal Party’s proposal to introduce a language test for naturalization. On the basis of textual analysis of relevant policy documents and newspaper articles, it examines the explicit and implicit facets of an ideology of language testing. It is argued that a seemingly liberal, anti-racist, and anti-discriminatory ideology is emerging, which, in its explicit facet, calls for the introduction of a language test for citizenship as a practical way of diminishing social differentiation. However, drawing upon Bourdieu’s notion of rites of institution, it is shown that such a test would actually contribute to, rather than challenge, the reproduction of social differentiation, thereby legitimizing the exclusion of certain groups from both the civic and symbolic domains of Sweden as a nation-state. a

A Test of Static and Dynamic Balance Function in Children With Cochlear Implants

from Archives of Otolaryngology–Head and Neck SurgeryObjectives To determine the incidence of static and dynamic balance dysfunction in a group of children with profound sensorineural hearing loss receiving a cochlear implant and to assess the impact of cochlear implant activation on equilibrium. Design Observational cross-sectional study of children with single-sided implants, tested under 2 conditions: (1) implant on and (2) implant off in a random order. Setting Ambulatory setting within an academic, tertiary care children’s hospital. Participants Forty-one children (ages 4-17 years) with cochlear implants comprised the study group. Fourteen children with normal hearing served as controls. Intervention All participants performed a standardized test of static and dynamic balance function (Bruininks-Oseretsky Test of Motor Proficiency 2 [BOT2], balance subset). Children with implants performed the BOT2 under the 2 randomized conditions. Main Outcome Measures Overall performance on the balance subset of the BOT2 and the influence of implant activation on performance. Results The mean (SD) age-adjusted scale score for our control group was 17 (5) points (95% confidence interval [CI], 14-20), which was not significantly different (P = .15) from the published age-adjusted mean for the BOT2 balance subset (15 [5] points). The group that had undergone implantation, however, performed significantly more poorly (12 [ 6] points; 95% CI, 10-14) than either the control group or the published test mean (P = .004). Children with implants performed better with their implants on than with their implants off (mean [SD] difference, 1.3 [2.7] points; 95% CI, 0.3-2.3; P = .01). Conclusions Large differences exist in the balance ability of children with sensorineural hearing loss requiring cochlear implantation compared with age-matched controls. Implant activation, however, conferred a slight advantage in accomplishing balance-related tasks. These results substantiate the need to further quantify the baseline vestibular dysfunction of our study population of children with cochlear implants, as well as the impact of implant activation on the input and output of the vestibular system.

Utility of Temporal Bone Computed Tomographic Measurements in the Evaluation of Inner Ear Malformations

from Archives of Otolaryngology–Head and Neck Surgery

Objective To investigate whether normative inner ear measurements can assist in the evaluation of sensorineural hearing loss (SNHL).

Design Retrospective cohort review.

Setting A tertiary care hospital.

Patients Computed tomography or magnetic resonance imaging was performed on 188 ears with SNHL and 220 ears without SNHL (204 children) between 2001 and 2004.

Intervention Two readers measured the basal turn of cochlea (BTC) lumen, lateral semicircular canal (LSCC) bony island width, superior semicircular canal (SSCC) bony island width, and cochlear height (CH).

Main Outcome Measures A t test was performed comparing measurements in patients with and without SNHL. Interobserver variability was characterized by intraclass correlation coefficients and Bland-Altman plots.

Results The t test results demonstrated no statistically significant differences between inner ear measurements in those with and without SNHL. The intraclass correlation coefficients for BTC lumen, CH, LSCC bony island width, and SSCC bony island width measurements was 0.612, 0.632, 0.869, and 0.912, respectively. Bland-Altman plots revealed systematic biases of 1%, 8%, 10%, and 21% for the BTC lumen, SSCC bony island width, LSCC bony island width, and CH measurements, respectively.

Conclusions Inner ear measurements in children with and without SNHL are not statistically different. Moreover, the measurements are difficult to interpret because while they demonstrate good reproducibility, they are susceptible to systematic biases. However, use of inner ear measurements is more sensitive in identifying vestibulocochlear dysplasias and should be considered to complement visual analysis.

Phonological Awareness and Decoding in Deaf/Hard-of-Hearing Students Who Use Visual Phonics

from the Journal of Deaf Studies and Deaf Education

Visual phonics, a system of 45 hand and symbol cues that represent the phonemes of spoken English, has been used as a tool in literacy instruction with deaf/hard-of-hearing (DHH) students for over 20 years. Despite years of anecdotal support, there is relatively little published evidence of its impact on reading achievement. This study was designed to examine the relationship between performance on a phonological awareness task, performance on a decoding task, reading ability, and length of time in literacy instruction with visual phonics for 10 DHH kindergarten through Grade 3 students receiving academic instruction with sign-supported English and American Sign Language. Findings indicate that these students were able to use phonological information to make rhyme judgments and to decode; however, no relationship between performance on reading ability and length of time in literacy instruction with visual phonics was found.

Role Salience and Anticipated Work–Family Relations Among Young Adults With and Without Hearing Impairment

from the Journal of Deaf Studies and Deaf Education

This study examined the effect of hearing status on role salience and anticipated work–family relations among 101 unmarried young adults aged 20–33 years: 35 with hearing impairment (19 hard of hearing and 16 deaf) and 66 hearing. Participants completed the Life Role Salience scale, anticipated conflictual relations scale, anticipated facilitory relations scale, and a background questionnaire. The deaf participants demonstrated a significantly higher level of commitment to work but anticipated the significantly lowest level of conflict. Hearing status was a significant variable in predicting anticipated conflictual relations among all participants. Mode of communication was a significant predictor of conflictual relations among the hearing impairment group. Implications for theory and practice were discussed.