Software development is governed by guidelines that aim to improve the codes qualities, such as maintainability. However, whilst coding guidelines are commonplace for software, guidelines for testware are much less common. In particular, for GUI-based tests driven with image recognition, also referred to as Visual GUI Testing (VGT), explicit coding guidelines are missing. In this industrial case study, performed at the Swedish defence contractor Saab AB, we propose a set of coding guidelines for VGT and evaluate their impact on test scripts for an industrial, safety-critical system. To study the guidelines effect on maintenance costs, five representative manual test cases are each translated with and without the proposed guidelines in the two VGT tools SikuliX and EyeAutomate. As such, 20 test scripts were developed, with a combined development cost of more than 100 man-hours. Three of the tests are then maintained by one researcher and two practitioners for another version of the system and costs measured to evaluate return on investment. This analysis is complemented with observations and interviews to elicit practitioners perceptions and experiences with VGT. Results show that scripts developed with the guidelines had higher maintenance costs than scripts developed without guide-lines. This is supported by qualitative results that many of the guidelines are considered inappropriate, superfluous or unnecessary due to the inherent properties of the scripts, e.g. their natural small size, linear flows, natural separation of concerns, and more. We conclude that there are differences between VGT scripts and software that prohibit direct translation of guidelines between the two. As such, we consider our study as a failure but argue that several lessons can be drawn from our results to guide future research into guidelines for VGT and GUI-based test automation.

The mevalonate (MEV) cascade is responsible for cholesterol biosynthesis and the formation of the intermediate metabolites geranylgeranylpyrophosphate (GGPP) and farnesylpyrophosphate (FPP) used in the prenylation of proteins. Here we show that the MEV cascade inhibitor simvastatin induced significant cell death in a wide range of human tumor cell lines, including glioblastoma, astrocytoma, neuroblastoma, lung adenocarcinoma, and breast cancer. Simvastatin induced apoptotic cell death via the intrinsic apoptotic pathway. In all cancer cell types tested, simvastatin-induced cell death was not rescued by cholesterol, but was dependent on GGPP-and FPP-depletion. We confirmed that simvastatin caused the translocation of the small Rho GTPases RhoA, Cdc42, and Rac1/2/3 from cell membranes to the cytosol in U251 (glioblastoma), A549 (lung adenocarcinoma) and MDA-MB231( breast cancer). Simvastatin-induced Rho-GTP loading significantly increased in U251 cells which were reversed with MEV, FPP, GGPP. In contrast, simvastatin did not change Rho-GTP loading in A549 and MDA-MB-231. Inhibition of geranylgeranyltransferase I by GGTi-298, but not farnesyltransferase by FTi-277, induced significant cell death in U251, A549, and MDA-MB-231. These results indicate that MEV cascade inhibition by simvastatin induced the intrinsic apoptosis pathway via inhibition of Rho family prenylation and depletion of GGPP, in a variety of different human cancer cell lines.

Purpose: The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Method: Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. Results: More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [ PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. Conclusions: When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in PTA for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers.

An alteration in the function of the brain caused by an external force is called a Traumatic Brain Injury (TBI). There are language features located in different areas of the brain, and depending on where a person gets a TBI, the person can experience different communicative difficulties. These can manifest as aphasia, dysarthria or cognitive communicative disorders. The experiences of TBI that have been discovered in previous studies are for instance about how persons with TBI experience their diminished functions, life adjustment after the injury, the role and support of the relatives, that the environment treats them differently after the injury and emotional consequences. For the purpose of investigation and intervention, ICF is a useful tool since the difficulties that a person may have can be connected to its various components.

The purpose of this study is to examine what experiences persons with TBI have regarding their brain injury and their communicative difficulties, and also how these can be connected to ICF. To answer the research questions, a qualitative method involving content analysis was used, based on semi-structured interviews with four participants.

The participants expressed that their TBI had affected them in various ways, communicative, cognitive, physically and socially. The participants experienced their injuries and difficulties as limiting and that some periods had been lonely. However they also stated that there were some positive aspects in the situation, for example improved family relations and that they valued life in another way.

Although the injuries, difficulties and rehabilitation of the participants have differed, the participants stories have been similar to some extent. In the future it would be interesting to conduct further studies in Sweden that examine which experiences persons with TBI have regarding the injury itself, but particularly regarding their communication after the TBI. It is important with more studies since that would give speech language pathologists a greater understanding for how people with TBI experience their situation and their communication after the injury. 

The voice quality symbols (VoQS) transcription system for voice quality was introduced some 20 years ago, and no major revision has been undertaken since then. In this account we describe the first major revision of the VoQS chart, these changes being mostly in the form of additions to the section on phonation types, but include also changes to the layout of the supralaryngeal settings section. These reflect recent developments in the understanding of the physiological underpinnings of sounds produced in the larynx including certain phonation types.

This paper describes changes to the extIPA (Extensions to the IPA) symbol set, the motivation for these changes, and areas where future changes by the IPA might be helpful to clinical transcribers. The extIPA symbol set was introduced some twenty-five years ago. Since that time, some minor changes have been introduced to the extIPA chart but no major rearrangement has been attempted. The 2010 Oslo meeting of ICPLA (International Clinical Phonetics and Linguistics Association) started a revision of the extIPA chart, and this process was recently completed. A revised extIPA chart was approved at the 2016 ICPLA meeting. The revision involved the addition, modification and removal of categories and symbols. All changes derive from the need to denote sounds encountered in disordered speech that were not covered by the original chart.

Background and aim: Few studies have explored childrens emotional and behavioural reactions to cleft surgery and treatment-related stress. The objective was to investigate parents evaluations of appearance and treatment outcomes in their 5-year-old child with unilateral cleft lip and palate (UCLP), and their perceptions of how their child was coping with treatment, comparing this information with recorded postsurgical complications.Design: Three parallel group randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK.Methods: Three different surgical procedures for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. A total of 356 parents completed the Scandcleft Parent Questionnaire, and 346 parents completed the Cleft Evaluation Profile.Results: The results indicated that the majority of parents were satisfied with cleft-related features of their childs appearance. Further, most children coped well with treatment according to their parents. Nevertheless, 17.5% of the children showed minor or short-term reactions after treatment experiences, and 2% had major or lasting difficulties. There were no significant relationships between parent perceptions of treatment-related problems and the occurrence of post-surgical medical complications.Conclusions: Most parents reported satisfaction with their childs appearance. However, treatment-related problems were described in some children, urging cleft centres to be aware of potential negative emotional and behavioural reactions to treatment in some young children, with a view to preventing the development of more severe treatment-related anxiety.

Hearing loss manifests as a reduced ability to understand speech, particularly in multitalker situations. In these situations, younger normal-hearing listeners' brains are known to track attended speech through phase-locking of neural activity to the slow-varying envelope of the speech. This study investigates how hearing loss, compensated by hearing aids, affects the neural tracking of the speech-onset envelope in elderly participants with varying degree of hearing loss (n = 27, 62–86 yr; hearing thresholds 11–73 dB hearing level). In an active listening task, a to-be-attended audiobook (signal) was presented either in quiet or against a competing to-be-ignored audiobook (noise) presented at three individualized signal-to-noise ratios (SNRs). The neural tracking of the to-be-attended and to-be-ignored speech was quantified through the cross-correlation of the electroencephalogram (EEG) and the temporal envelope of speech. We primarily investigated the effects of hearing loss and SNR on the neural envelope tracking. First, we found that elderly hearing-impaired listeners' neural responses reliably track the envelope of to-be-attended speech more than to-be-ignored speech. Second, hearing loss relates to the neural tracking of to-be-ignored speech, resulting in a weaker differential neural tracking of to-be-attended vs. to-be-ignored speech in listeners with worse hearing. Third, neural tracking of to-be-attended speech increased with decreasing background noise. Critically, the beneficial effect of reduced noise on neural speech tracking decreased with stronger hearing loss. In sum, our results show that a common sensorineural processing deficit, i.e., hearing loss, interacts with central attention mechanisms and reduces the differential tracking of attended and ignored speech.

The present study examines 1- to 5-year-old childrens emotion socialization in an early childhood educational setting (a preschool) in Sweden. Specifically, it examines social situations where teachers respond to childrens negative emotional expressions and negatively emotionally charged social acts, characterized by anger, irritation, and distress. Data consisted of 14 h of video observations of daily activities, recorded in a public Swedish preschool, located in a suburban middle-class area and include 35 children and 5 preschool teachers. By adopting a sociocultural perspective on childrens development and socialization, the study examines the communicative practices through which the expressions of negative emotions are responded to and the norms and values that are communicated through these practices. The data are analyzed by using multimodal analysis of interaction that provides a tool for detailed analysis of participants verbal and embodied actions and sense-making. The analyses show that teachers responded to childrens negatively charged emotional expressions as social acts (that were normatively evaluated), and the adults instructed children how to modify their social conduct (rather than deploying explicit discussions about emotions). The teachers used communicative genres that prioritized general moral principles and implemented the non-negotiability of norms over individual childrens emotional-volitional perspectives and individual preferences. The teachers instructive socializing activities were characterized by movement between multiple temporal horizons, i.e., general (emotional) discourse that transcended the hereand-now, and specific instructions targeting the childrens conduct in a current situation. The study discusses how emotion socialization can be related to the institutional characteristics and collective participatory social conditions of early childhood education.

Bone conduction is usually understood as the hearing sensation based on the vibrations of the skull bone and surrounding tissues. The fact that vibration of the skull bones can result in a sound percept has been known for a long time. However, it is difficult to give a general definition of BC sound. Normally, BC sound is described as the sound energy transmitted through the body (comprising the solid and fluid parts) then the outer, middle and inner ear are involved and finally produce a perception of sound.

Even if BC sound perception has been studied for more than a century, the whole pattern of BC sound transmission is still not complete. There are limitations for experimental investigation of BC sound, such as the complexity of experimental manipulations and individual differences between subjects resulting in difficult to interpret outcomes. One way to overcome some of those issues is the use of a simulation model for BC sound. However, until now, the published models are unable to provide a holistic response of BC sound in the human. Therefore, the primary aim of this thesis is to develop a finite element model that could simulate BC sound transmission in the human. Based on cryosectional images of a female, the LiUHead was developed as a FE model of the human head with the structure and material properties of real human. Most the structures and tissues which could contribute to the BC transmission were included in the LiUHead. The simulation results of the LiUHead agreed with experimental data obtained in both cadaver heads and live humans.

After the development and validation of the LiUHead, the model was used to investigate BC sound.  Since BC sound is transmitted in and between the tissues, the power transmission of BC sound was investigated in the LiUHead in the frequency domain. When the stimulation was applied on the surface of the skull at the mastoid position, the results of the simulations show that, as the name suggest, the skull bone dominants the BC sound transmission. The soft tissues and cartilages are as the second most important media of the BC sound while the skull interior is the least important for the BC transmission. Moreover, according to the power flux in the skull, the BC vibrations are mainly concentrated at the skull base. Other important transmission pathways are located at the occipital bone at the posterior side of the head, but the power transmitted over the face, forehead and vertex is minor. There is power interaction between the skull bone and skull interior near the stimulation position but the transmission of sound power through the brain seem to be minimal. Since the power or energy is difficult to measure in an experimental setting, this investigation gave unique knowledge about BC sound transmission in the head and the interaction between the tissues.

As a common application for BC sound, bone-conduction devices are used to stimulate the hearing and is a method for hearing loss rehabilitation. Nowadays many different kinds of BCDs are available. However, most studies failed to compare the different types of BCDs in the same conditions as well as between several BCDs as it is not possible to compare several BCDs within the same subject due to the implantation required for several BCDs. The model gives a unique opportunity to evaluate various BCDs in the same head. Eight different BCDs, including four kinds of skin-drive BCDs, three kinds of direct-drive BCDs, and one in-the-mouth device, were applied to the LiUHead and the simulation results were evaluated. The results proved that the direct-drive BCDs and the in-the-mouth device gave similar vibration responses at the cochlea. At low frequencies, the skin-drive BCDs had similar or even better cochlear responses than the direct-drive BCDs. However, the direct-drive BCDs gave stable responses at mid-frequencies and gave higher responses than the skin-drive BCDs at high frequencies. These results are beneficial evaluating and for designing and improving current BCDs.

The ultimate goal of this thesis is to provide a computational model for BC sound that can be used for evaluation of BC sound transmission. This was accomplished by the LiUHead that gave results comparable to experimental data and enabled investigations that cannot easily be conducted in experiments.

Bone conduction (BC) sound is the perception of sound transmitted in the skull bones and surrounding tissues. To better understand BC sound perception and the interaction with surrounding tissues, the power transmission of BC sound is investigated in a three-dimensional finite-element model of a whole human head. BC sound transmission was simulated in the FE model and the power dissipation as well as the power flow following a mechanical vibration at the mastoid process behind the ear was analyzed. The results of the simulations show that the skull bone (comprises the cortical bone and diploe) has the highest BC power flow and thereby provide most power transmission for BC sound. The soft tissues was the second most important media for BC sound power transmission, while the least BC power transmission is through the brain and the surrounding cerebrospinal fluid (CSF) inside the cranial vault. The vibrations transmitted in the skull are mainly concentrated at the skull base when the stimulation is at the mastoid. Other vibration transmission pathways of importance are located at the occipital bone at the posterior side of the head while the transmission of sound power through the face, forehead and vertex is minor. The power flow between the skull bone and skull interior indicate that some BC power is transmitted to and from the skull interior but the transmission of sound power through the brain seem to be minimal and only local to the brain-bone interface.

Nowadays, many different kinds of bone-conduction devices (BCDs) are available for hearing rehabilitation. Most studies of these devices fail to compare the different types of BCDs under the same conditions. Moreover, most results are between two BCDs in the same subject, or two BCDs in different subjects failing to provide an overview of the results between several of the BCDs. Another issue is that some BCDs require surgical procedures that prevent comparison of the BCDs in the same persons. In this study, four types of skin-drive BCDs, three direct-drive BCDs, and one oral device were evaluated in a finite-element model of the human head that was able to simulate all BCDs under the same conditions. The evaluation was conducted using both a dynamic force as input and an electric voltage to a model of a BCD vibrator unit. The results showed that the direct-drive BCDs and the oral device gave vibration responses within 10 dB at the cochlea. The skin-drive BCDs had similar or even better cochlear vibration responses than the direct-drive BCDs at low frequencies, but the direct-drive BCDs gave up to 30 dB higher cochlear vibration responses at high frequencies. The study also investigated the mechanical point impedance at the interface between the BCD and the head, providing information that explains some of the differences seen in the results. For example, when the skin-drive BCD attachment area becomes too small, the transducer cannot provide an output force similar to the devices with larger attachment surfaces.

Background: Bone conduction (BC) is an alternative to air conduction to stimulate the inner ear. In general, the stimulation for BC occurs on a specific location directly on the skull bone or through the skin covering the skull bone. The stimulation propagates to the ipsilateral and contralateral cochlea, mainly via the skull bone and possibly via other skull contents. This study aims to investigate the wave propagation on the surface of the skull bone during BC stimulation at the forehead and at ipsilateral mastoid. Methods: Measurements were performed in five human cadaveric whole heads. The electro-magnetic transducer from a BCHA (bone conducting hearing aid), a Baha (R) Cordelle II transducer in particular, was attached to a percutaneously implanted screw or positioned with a 5-Newton steel headband at the mastoid and forehead. The Baha transducer was driven directly with single tone signals in the frequency range of 0.25-8 kHz, while skull bone vibrations were measured at multiple points on the skull using a scanning laser Doppler vibrometer (SLDV) system and a 3D LDV system. The 3D velocity components, defined by the 3D LDV measurement coordinate system, have been transformed into tangent (in-plane) and normal (out-of-plane) components in a local intrinsic coordinate system at each measurement point, which is based on the cadaver heads shape, estimated by the spatial locations of all measurement points. Results: Rigid-body-like motion was dominant at low frequencies below 1 kHz, and clear transverse traveling waves were observed at high frequencies above 2 kHz for both measurement systems. The surface waves propagation speeds were approximately 450 m/s at 8 kHz, corresponding trans-cranial time interval of 0.4 ms. The 3D velocity measurements confirmed the complex space and frequency dependent response of the cadaver heads indicated by the ID data from the SLDV system. Comparison between the tangent and normal motion components, extracted by transforming the 3D velocity components into a local coordinate system, indicates that the normal component, with spatially varying phase, is dominant above 2 kHz, consistent with local bending vibration modes and traveling surface waves. Conclusion: Both SLDV and 3D LDV data indicate that sound transmission in the skull bone causes rigid body-like motion at low frequencies whereas transverse deformations and travelling waves were observed above 2 kHz, with propagation speeds of approximately of 450 m/s at 8 kHz. (C) 2017 Elsevier B.V. All rights reserved.

Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer’s disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.

Background: Sven Wedin, who was particularly interested in voice production and voice treatment, may be considered Sweden’s first speech-language pathologist. His remnants were donated to the university of Linköping after his passing. These remnants constitute the foundation for this study. This study aims to describe in what way Sven Wedin has contributed to the development of speech-language pathology in Sweden, both at large and regarding voice treatment. This can, in turn, contribute to the overview of the professionalization of speechlanguage pathologists from a historical perspective.

Objective: To describe and analyze historical remnants of speech-language pathologist Sven Wedin. The research questions were: What has the professionalization of speech-language pathologists in Sweden looked like? In what way has voice treatment developed in Sweden?

Methods: A qualitative method was used to sort out, categorize, describe and analyze the remnants of Sven Wedin.

Results: During the first half of the 20th century several professions practiced voice and speech training. Phoniatricians often trained their own therapists for these tasks due to the lack of a formal education of speech-language pathologists. Sven Wedin received a degree in speech-language pathology in the United States in the 1950’s. He later spent his professional life operating in the northern part of Sweden where he established a speech clinic, organized training courses on the subject of voice and speech training and did research.

Conclusion: Sven Wedin has contributed to the professionalization of speech-language pathologists by both educating and carrying out research on the subject. It is reasonable to assume that Sven Wedin was the first Swedish speech-language pathologist, however voice and speech training as such had been practiced in Sweden since the beginning of the 20th century. Sven Wedin also contributed to the efficiency of voice treatment by creating new methods of treatment.

The auditory system helps regulate phonation. A speakers perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems. Purpose: The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids. Method: This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room. Results: The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry amp; Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving ones own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of ones own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of ones voice could be influenced by alterations caused by hearing aid processing. Conclusions: The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.

Objective: To analyze patients with a confirmed voice disorder in order to identify patterns regarding age, gender, and occupation compared to the general public. To explore effects of voice therapy according to the Voice Handicap Index (VHI) score pre- and post-therapy in relation to the number of sessions, age, and gender. Design: Prospective cohort study. Materials and methods: This study was conducted as a collaborative project between Linkoping University and hospitals in the south-east health care region in Sweden. Six voice clinics participated by asking their patients voluntarily to complete the Swedish version of the VHI at the beginning and end of therapy. Results and conclusions: The two most prevalent diagnoses were dysphonia (43%) and phonasthenia (25%). Among the working population, the three most common occupational fields were education, health care, and child-care. The majority of the patients were women (74.3%), and the mean age of all patients was 55 years. A significant improvement in VHI scores was found after therapy, with an average decrease of 19 median points in total score and a substantial effect size (0.55). The number of sessions did not significantly correlate with the mean VHI score difference but had a weak correlation to the start and end scores. Increasing age correlated with a higher median VHI score both at the start and end of therapy but did not affect the average decrease between the two measurements.

In some conversations involving persons with Alzheimers disease, the participants may have to deal with the difficulty that they do not share a common ground in terms of not only who is alive or dead, but even more, who could possibly be alive. It is as if the participants face a reality disjunction. There are very few empirical studies of this difficulty in conversations involving persons with Alzheimers disease or other kinds of dementia diagnoses. Often studies of confabulation have a focus on the behavior and experience of the healthy participants, but rarely on the interaction and the collaborative contributions made by the person with dementia. In the present article, we discuss various strategies used by all participants in an everyday conversation. The material consists of an hour long everyday conversation between a woman with Alzheimers disease and two healthy participants (relatives). This conversation is analyzed by looking at the organization of the interaction with an emphasis on how the participants deal with instances of reality disjunctions. The result from the analysis demonstrates that both the healthy participants as well as the person with dementia together skillfully avoid the face threats posed by reality disjunctive contributions by not pursuing argumentative lines that in the end might jeopardize both the collaborative and the personal relations.

In this article, we explore the organization of assistance in multilingual interaction in Swedish residential care. The data that form the basis for the study cover care encounters involving three residents with a language background other than Swedish, totalling 13 hours and 14 minutes of video documentation. The empirical data consists of a collection of 134 instances where residents seek assistance with the realization of a practical action. For this article, three examples that involve the manipulation of an object have been selected for analysis. We use the concept of recruitment to encompass the various methods by which assistance is sought in the care encounter. In the first example, the need for assistance concerns the transfer of an object that is recognizable and physically available for both participants. This, in combination with the residents gestural work that pinpoints the description of the action, facilitates its realization. In the second and third examples, the realization of the action becomes more difficult because the object involved is not recognizable for the caregiver. The article highlights the collaborative ways in which residents manage to support their talk through bodily practices, and the strong and empathetic engagement with which caregivers become involved in interpreting the meaning of these practices. Finally, we discuss the implications of our findings for care provision in multilingual circumstances.

Previous studies have shown that individuals exhibiting mild intellectual disability show a lower reading ability than individuals with typical development. The reasons behind these differences are unclear. However, research shows that specific language abilities affect reading ability. The present study aims to investigate any possible correlations between language ability and reading ability in young people with mild intellectual disability, aged 12 to 25 years. The examined linguistic abilities were phonological awareness, rapid automatized naming (RAN), vocabulary, grammatical comprehension and language comprehension. Testing was held at the participants’ schools in various parts of central and southern Sweden. The raw scores were used in correlation and regression analyses to map out any correlations.

A total of 27 participants with ages ranging between 13;06 years and 25;09 years were included in the study. The results showed that RAN and phonological awareness had strong significant correlations to decoding and that they together can account for 72.3 % of its variance. Reading comprehension showed strong significant correlations to phonological awareness, grammatical comprehension, decoding, and language comprehension. Language comprehension and vocabulary explained 62.4 % of the variance in reading comprehension. Word decoding showed a stronger correlation to reading comprehension than phonological decoding.

The results of the present study are in large parts compatible with previous research, which supports the findings that phonological awareness and RAN are of importance to decoding ability, and that decoding in turn has an impact on reading comprehension in individuals with both typical development and intellectual disability. However, the results in the present study are at odds with previous research, which has not found significant correlations between vocabulary and reading comprehension in individuals with mild intellectual disability.

In summation, results of the present study show that a number of linguistic abilities can explain the variance of both decoding and reading comprehension. Hopes are that the results from the present study can contribute to furthering knowledge of the underlying factors which explain why individuals with mild intellectual disabilities generally are poor readers. More research is needed to confirm which other factors can explain the remaining variance and to strengthen the results of the present study.

Objective: To compare recordings of bone conduction (BC) stimulated auditory brainstem response (ABR) obtained using the newer BC transducer Radioear B81 and the conventional BC transducer Radioear B71. Balanced electromagnetic separation transducer (BEST) design found in the B81 may influence the ABR magnitudes and latencies, as well as electrical artefacts. Design: ABRs to tone burst stimuli of 500 Hz, 2000 Hz, 4000 Hz, click stimulation, and broad-band chirp stimulation at 20 and 50dB nHL were recorded. For each device, stimulus and intensity level, the ABR Jewett wave V amplitude and latency were obtained. The device-related electrical stimulus artefacts on the ABR recordings were also analysed by calculating the Hilbert envelope of the peri-stimulus recording segments. Study sample: Twenty-three healthy adults with normal hearing were included in the study. Results: The ABRs obtained by the B81 were similar to that of the B71 in terms of ABR wave V amplitude and latency. However, the B81 produced smaller electrical artefacts than B71 and this difference was statistically significant. Conclusions: The BC transducer Radioear B81 provides ABRs comparable to Radioear B71 while causing smaller artefacts.

This article analyzes the tacit norms of embodied turn-taking in a specific dance activity, Lindy Hop jam circles. Building on an extensive tradition of scrutinizing turn-taking in conversation, it shows how dancing couples negotiate the right to a next turn by visual means. Using multimodal interaction analysis, the article dissects the behavior of the exiting couple, the next dancing couple, and the spectators. The analysis shows that music is but one factor in turn-taking, and that maximally three publicly visible steps are necessary for a successful entrance: displaying “couplehood,” displaying imminent entrance, and occupying the exclusive central space. In a case of competition the dancers’ speed and determination are decisive.

Identifying speech in adverse listening conditions requires both native and non-native listeners to cope with decreased intelligibility. The current study examined in four speech reception threshold (SRT) conditions how speech maskers (two-talker babble Swedish, two-talker babble English) and noise maskers (stationary and fluctuating noise) interfered with target speech in Swedish (native language) and English (non-native language). Listening disturbance for each condition was rated on a continuous scale. The participants also performed standardized tests in English proficiency, nonverbal reasoning and working memory capacity; the latter in both Swedish and English. Normal-hearing (n = 23) and hearing-impaired (n = 23) native Swedish listeners participated, age-range between 28 and 65 years.

The SRTs were better for native as compared to non-native speech. In both groups, speech perception performance was lower for the speech than the noise maskers, especially for non-native target speech. The level of English proficiency is important for non-native speech intelligibility in noise. A three-way interaction effect on the subjective rating scores indicated that the hearing loss affects the subjective disturbance of Swedish babble in native and non-native language perception.

Conclusion: Speech perception and subjective disturbance is influenced by a complex interaction between masker types and individual abilities.

Chemoresistant cancer cells express high levels of aldehyde dehydrogenases (ALDHs), particularly in head and neck squamous cell carcinoma (HNSCC). The ALDH family of enzymes detoxify both exogenous and endogenous aldehydes. Since many chemotherapeutic agents, such as cisplatin, result in the generation of cytotoxic aldehydes and oxidative stress, we hypothesized that cells expressing high levels of ALDH may be more chemoresistant due to their increased detoxifying capacity and that inhibitors of ALDHs may sensitize them to these drugs. Here, we show that overall ALDH activity is increased with cisplatin treatment of HNSCC and that ALDH3A1 protein expression is particularly enriched in cells treated with cisplatin. Activation of ALDH3A1 by a small molecule activator (Alda-89) increased survival of HNSCC cells treated with cisplatin. Conversely, treatment with a novel small molecule ALDH inhibitor (Aldi-6) resulted in a marked decrease in cell viability, and the combination of Aldi-6 and cisplatin resulted in a more pronounced reduction of cell viability and a greater reduction in tumor burden in vivo than what was observed with cisplatin alone. These data indicate that ALDH3A1 contributes to cisplatin resistance in HNSCC and that the targeting of ALDH, specifically, ALDH3A1, appears to be a promising strategy in this disease.

Nickel-yttria-stabilized zirconia (Ni-YSZ) cermet is widely used as an anode material in solid oxide fuel cells (SOFCs); however, Ni re-oxidation causes critical problems due to volume expansion, which causes high thermal stress. We fabricated a Ni-YSZ anode functional layer (AFL), which is an essential component in high-performance SOFCs, and re-oxidized it to investigate the related three-dimensional (3D) microstructural and thermo-mechanical effects. A 3D model of the re-oxidized AFL was generated using focused ion beam-scanning electron microscope (FIB-SEM) tomography. Re-oxidation of the Ni phase caused significant volumetric expansion, which was confirmed via image analysis and calculation of the volume fraction, connectivity, and two-phase boundary density. Finite element analysis (FEA) with simulated heating to 500-900 degrees C confirmed that the thermal stress in re-oxidized Ni-YSZ is concentrated at the boundaries between YSZ and re-oxidized NiO (nickel oxide). NiO is subjected to more stress than YSZ. Stress exceeding the fracture stress of 8 mol% YSZ appears primarily at 800 degrees C or higher. The stress is also more severe near the electrolyte-anode boundary than in the Ni-YSZ cermet and the YSZ regions. This may be responsible for the electrolyte membrane delamination and fracture that are observed during high-temperature operation. (C) 2018 Elsevier B.V. All rights reserved.

It would be favorable, during the clinical assessment of language in multilingual children, if the speech-language-pathologist (SLP)spoke all the languages of the child. This is, however, not always possible, hence the need for interpreter-mediation. Furthermore, it would be desirable if the interpreters used in clinical assessments of language are specifically trained. There are only a few studies concerning interpreter-mediated clinical assessment of language and cognition using Conversation Analysis as a method, and no studies of interpreter-mediated clinical assessment of language in multilingual children. The purpose of this study was therefore to investigate the interaction between the SLP, interpreter and child, in interpreter-mediated clinical assessments of language in multilingual children, with a specific focus on the SLP and the interpreter.

Participants of the study were two licensed S LPs, three interpreters and two multilingual children and their caregivers. The study was based on three video recordings of clinical encounters and four semi-structured interviews. The video recordings were translated, transcribed and analyzed using the theory and method of Conversation Analysis, and the interviews were transcribed and analyzed. Analysis of the video recordings resulted in the discovery of three phenomena; the importance of preunderstanding of the working process of SLP, the importance of responsibility during interpreter-mediated clinical assessment of language, and finally communication and language approach. Analysis of the semi-structured interviews resulted in the discovery of four phenomena, which, in addition to the ones already discovered during the video recordings, also included the importance of dialects. Strategies and challenges that the SLP and interpreter faced could be revealed from the phenomena discovered in the video recordings and the semi-structured interviews. It was suggested in the conclusion that challenges were caused by expectations on the interpreter, a lack of preunderstanding of the working process of the SLP, uncertainty regarding the responsibilities of the interpreter versus the SLP, and finally, the demands of a high level of language competence. Strategies that were used within the discovered phenomena were partially consciously applied by the SLP and interpreter. However, there is a great need for further knowledge and awareness of the processes involved in this clinical context, in order to obtain reliable and satisfactory interpreter-mediated clinical assessments of language. Lastly, it was discussed that the patient safety might be compromised if no consideration is taken regarding the investigated challenges and strategies.

Listening to speech in noise can be effortful but when motivated people seem to be more persevering. Previous research showed effects of monetary reward on autonomic responses like cardiovascular reactivity and pupil dilation while participants processed auditory information. The current study examined the effects of monetary reward on the processing of speech in noise and related listening effort as reflected by the pupil dilation response. Twenty-four participants (median age 21 yrs) performed two speech reception threshold (SRT) tasks, one tracking 50% correct (hard) and one tracking 85% correct (easy), both of which they listened to and repeated sentences uttered by a female talker. The sentences were presented with a single male talker or, in a control condition, in quiet. Participants were told that they could earn a high (5 euros) or low (0.20 euro) reward when repeating 70% or more of the sentences correctly. Conditions were presented in a blocked fashion and during each trial, pupil diameter was recorded. At the end of each block, participants rated the effort they had experienced, their performance, and their tendency to quit listening. Additionally, participants performed a working memory capacity task and filled in a need-for-recovery questionnaire as these tap into factors that influence the pupil dilation response. The results showed no effect of reward on speech perception performance as reflected by the SRT. The peak pupil dilation showed a significantly larger response for high than for low reward, for the easy and hard conditions, but not the control condition. Higher need for recovery was associated with a higher subjective tendency to quit listening. Consistent with the Framework for Understanding Effortful Listening, we conclude that listening effort as reflected by the peak pupil dilation is sensitive to the amount of monetary reward. (C) 2018 The Authors. Published by Elsevier B.V.

Wolfram syndrome (WS) is caused by recessive mutations in the Wolfram syndrome 1 (WFS1) gene. Sensorineural hearing impairment (HI) is a frequent feature in WS and, furthermore, certain mutations in WFS1 cause nonsyndromic dominantly inherited low-frequency sensorineural HI. These two phenotypes are clinically distinct indicating that WFS1 is a reasonable candidate for genetic studies in patients with other phenotypes of HI. Here we have investigated, whether the variation in WFS1 has a pathogenic role in age-related hearing impairment (ARHI). WFS1 gene was investigated in a population sample of 518 Finnish adults born in 1938-1949 and representing variable hearing phenotypes. Identified variants were evaluated with respect to pathogenic potential. A rare mutation predicted to be pathogenic was found in a family with many members with impaired hearing. Twenty members were recruited to a segregation study and a detailed clinical examination. Heterozygous p.Tyr528His variant segregated completely with late-onset HI in which hearing deteriorated first at high frequencies and progressed to mid and low frequencies later in life. We report the first mutation in the WFS1 gene causing late-onset HI with audiogram configurations typical for ARHI. Monogenic forms of ARHI are rare and our results add WFS1 to the short list of such genes. (C) 2017 Elsevier B.V. All rights reserved.

This presentation focuses on recycling of stories in conversations involving people with dementia. In dementia, communicative ability gradually deteriorates as the disease progresses typically leading to profound decline of communicative skills in the late stage. Of all of the domains affected by dementia diseases, communication is one of the areas where people with dementia and their caregivers experience most challenges. A significant characteristic for persons with dementia is a tendency to tell the same stories over and over (e.g. Hydén et al., 2013). While the significance conversational partners have on the organization of stories told by people with dementia are highly recognized (e.g. Hydén, et al., 2013; Hydén, 2011), how conversational partners to people with dementia orient toward recycling of stories are still in need of further investigation. In previous research, the phenomenon of recycling stories is mainly credited to the person with dementia. In our present study, we would like to propose another parallel point of view in which caregivers also tend to recycle stories repetitively in conversation with persons with dementia. We argue that recycling of stories in interaction involving people with dementia is a highly collaborative activity, and sometimes even initiated by conversational partners to people with dementia. In this presentation, we focus on how recycling of stories are sequentially organized is ordinary interaction between people with dementia and professional caregivers. The data consist of video recordings of 4 dyads (one person diagnosed with dementia and a professional caregiver in each dyad) totaling approximately 2,5 hours of recordings. In the analyses, we have focused specifically on how the telling of recycled stories is initiated in conversation, and what kind of feedback such stories receive. Our analyses show that recycled stories told by persons with dementia receive strong interactional support from conversational partners by, for example, the use of responses signaling newness and surprise (cf. Hydén et al., 2013). Conversational partners are also actively involved in the telling of recycled stories by, for example, asking guiding questions expanding the stories and use prompting techniques in cases where the person with dementia seem to have difficulties telling the whole story. In our analyses, we have also seen examples where conversational partners to people with dementia not only support the telling of recycled stories, but actually initiate such stories by instructing the person with dementia to talk about a specific topic.

When an individual is diagnosed with a brain tumour, intervention by neurosurgery might be needed. In case of neurosurgery, a preoperative assessment of the individual’s language functions is carried out, if possible, in order to identify sensitive language areas in cortical structures. Today, nTMS, navigated transcranial magnetic stimulation, is being used, which temporarily shuts down functions in specific cortical areas and thus is a useful method to fulfill this aim. The patient is asked to name a series of pictures representing nouns while focal parts of the brain is stimulated with magnetic stimulation.

The purpose of the present study was to examine whether the naming ability of nouns changed during nTMS in individuals with brain tumour and in what way, as well as whether the location of the tumour affected the participants naming abilities during nTMS.

All participants in the present study were patients with brain tumour, previously examined with nTMS in a neurophysiological clinic at a hospital in the South East of Sweden. The examinations were video recorded and have subsequently formed the material for data analysis in the present study. Analysis was made on group and population level. The groups were created based on the participants tumour localisation.

The result shows that the naming ability changes as a number of language related phenomenon aroused in the preoperative examination using nTMS. The five most common phenomena on population level were hesitation sound, latency, sound interjection, no response and inaccurate articulation. Comparison on group level revealed no significant difference regarding tumour location.

The result might indicate that the neurophysiology of language consists of collaborating complex networks. The result can also support theories regarding tumour induced plasticity.

The phonological system can be described and analyzed on three levels; word, syllable and segment. The non-linear nature of the system enables an analysis from different viewpoints on phonology. LINköpingsUnderSökningen (LINUS) is a phonological test for children between the ages of 3 to 6 years which enables a non-linear analysis. Previous studies at  Linköping University have shown that children with phonological language impairment have phonological deviations on all three levels. Even though there is research involving Swedish-speaking children with expressive phonological impairment, further research is needed due to lacking in sample size and age span of participants. The purpose of this thesis is to compare the expressive phonological ability of children between the ages of 3 to 5 years who have been referred to a speech and language pathologist (SLP) for suspected phonological difficulties with a control group consisting of peers without known difficulties.

In the study 10 children participated who were recruited from a speech and language pathologist clinic in a big city in Sweden, and raw data was also used from a previous study on an additional 11 children. Children with language impairment were matched with a control group with children of the same age. The age interval of participating children was between 3 years and 2 months and 4 years and 11 months.  The LINUS test was issued at a speech and language pathologist clinic together with a SLP. 

The results showed similar deviations on word, syllable and segment level for both the study group and the control group. However the results of the study group contained a higher amount of deviations. The word and syllable level caused the greatest challenge for both groups. Additionally, both the study group and the control group exhibited deviations in terms of word structure where the most frequent shortcoming was reduction of consonant clusters.

To conclude, similar types of deviations occurred in both groups, although the study group had a higher amount of deviations on all levels. For stronger conclusions, a larger sample size and younger participants are needed.

Overall weighted or composite variables for perceptual auditory estimation of velopharyngeal closure or competence have been used in several studies for evaluation of velopharyngeal function during speech. The aim of the present study was to investigate the validity of a composite score (VPC-Sum) and of auditory perceptual ratings of velopharyngeal competence (VPC-Rate). Available VPC-Sum scores and judgments of associated variables (hypernasality, audible nasal air leakage, weak pressure consonants, and non-oral articulation) from 391 5-year olds with repaired cleft palate (the Scandcleft project) were used to investigate content validity, and 339 of these were compared with an overall judgment of velopharyngeal competence (VPC-Rate) on the same patients by the same listeners. Significant positive correlations were found between the VPC-Sum and each of the associated variables (Cronbachs alpha 0.55-0.87, P amp;lt; 0.001), and a moderately significant positive correlation between VPC-Sum and VPC-Rate (Rho 0.698, P amp;lt; 0.01). The latter classified cases well when VPC-Sum was dichotomized with 67% predicted velopharyngeal competence and 90% velopharyngeal incompetence. The validity of the VPC-Sum was good and the VPC-Rate a good predictor, suggesting possible use of both measures depending on the objective.

Normative language-based data are important for comparing speech performances of clinical groups. The Swedish Articulation and Nasality Test (SVANTE) was developed to enable a detailed speech assessment. This studys aim was to present normative data on articulation and nasality in Swedish speakers. Single word production, sentence repetition and connected speech were collected using SVANTE in 443 individuals. Mean (SD) and prevalences in the groups of 3-, 5-, 7-, 10-, 16- and 19-year-olds were calculated from phonetic transcriptions or ordinal rating. For the 3- and 5-year-olds, a consonant inventory was also determined. The mean percent of oral consonants correct ranged from 77% at age 3 to 99% at age 19. At age 5, a mean of 96% was already reached, and the consonant inventory was established except for /s/, /r/, /?/. The norms on the SVANTE, also including a short version, will be useful in the interpretation of speech outcomes.

Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children (136 girls, 255 boys) were available and perceptually analysed. The main outcome measures were VPC and hypernasality from blinded assessments. Results: There were no statistically significant differences between the prevalences in the arms in any of the trials. VPC: Trial 1, A: 58%, B: 61%; Trial 2, A: 57%, C: 54%; Trial 3, A: 35%, D: 51%. No hypernasality: Trial 1, A: 54%, B: 44%; Trial 2, A: 47%, C: 51%; Trial 3, A: 34%, D: 49%. Conclusions: No differences were found regarding VPC and hypernasality at age 5 years after different methods for primary palatal repair. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed.

När ett barn med misstänkta tal- och språkavvikelser kommer till logoped för bedömning är det viktigt att samtliga aspekter av tal och språk beaktas. Under de år som svensk logopedi har vuxit fram, har ett flertal instrument för bedömning av barns tal- och språk tagits fram. Ett av dessa, Stora fonemtestet, som skapades i mitten av 1980-talet, har länge varit det enda vitt spridda testet av barns fonologi i landet. Testet fanns under flera år inte att beställa på förlag, vilket var ett av motiven till arbetet med att ta fram ett nytt fonologiskt bedömningsmaterial. Ett annat var att Enheten för logopedi vid Linköpings universitet sedan 2010 ingår i en större multicenterstudie med syftet att jämföra fonologiska avvikelser hos barn i olika länder. Inom ramen för detta projekt och genom några magisterarbeten i logopedi färdigställdes LINUS 2014. Som en direkt följd av det fortsatta internationella forskningssamarbetet och av feed-back från kollegor som använt materialet i sin kliniska vardag, kommer nu en ny version av materialet, LINUS 2.0. och finns för gratis nedladdning på http://phonodevelopment.sites.olt.ubc.ca/practice-units/swedish/. Vi hoppas att det även fortsatt skall komma till användning vid utredning av tal- och språkförmåga hos barn.

Linköpings universitet, 2019

Inger Lundeborg Hammarström

The present study investigated word-initial (WI) /r/-clusters in Central Swedish-speaking children with and without protracted phonological development (PPD). Data for WI singleton /r/ and singleton and cluster /l/ served as comparisons. Participants were twelve 4-year-olds with PPD and twelve age- and gender-matched typically developing (TD) controls. Native speakers audio-recorded and transcribed 109 target single words using a Swedish phonology test with 12 WI C+/r/-clusters and three WI CC+/r/-clusters. The results showed significantly higher match scores for the TD children, a lower match proportion for the /r/ targets and for singletons compared with clusters, and differences in mismatch patterns between the groups. There were no matches for /r/-cluster targets in the PPD group, with all children except two in that group showing deletions for both /r/-cluster types. The differences in mismatch proportions and types between the PPD group and controls suggests new directions for future clinical practice.

Even though there are documented benefits of direct intensive intervention for children with speech sound disorders (SSDs), the intensity given at Swedish Speech Language Pathology services rarely exceeds once a week. Also, indirect therapy approaches are commonly employed. The purpose of the present case study was to investigate the effects of an intensive specialist therapy, based on non-linear phonological analysis and motor learning principles. The participant was a boy aged 4:10 years with severe SSD, who previously had received indirect therapy from age 3 with, very limited results. A single subject ABA design was used. At baseline, whole word match was 0%, Word shape CV match was 39% and PCC was 22, 7%. He had no multisyllabic words, no consonant clusters and no established coronals. Intervention was given 4 days weekly for 3 weeks in two periods with a 7-week intervening break and a post therapy assessments. Therapy was focused on establishing multisyllabic words, iambic stress pattern, clusters and coronals with the principle of using already established elements for targeting new elements. At post therapy assessment, whole word match was 39%, word shape CV match was 71% and PCC 69.1%. Multisyllabic words (86%), coronals (82%) and word initial clusters (80%) were established. Without being targeted, back vowels were also present and segment timing improved. The strong treatment effects of this study demonstrate that at least severe cases of SSD require the clinical knowledge and skills that only a SLP can provide and that frequent direct therapy is both beneficial and needed.

Purpose: This study shows how the spatial organization of objects and their use may impact locally produced order of activities and how that can affect the accomplishment of everyday activities by people with dementia. Methods: The study is based on ethnomethodological conversation analysis of eight and a half hours of video recordings in three different settings. Eighteen sequences of activities identified were multimodally transcribed and analyzed. Results: The availability or non-availability of objects, their arrangements and manipulations play a crucial role in the management of the order of activities and may present both challenges and facilitations for people with dementia. The organizations of objects directly influence the order of the activity, and the objects potential use may afford actions that deviate from the trajectory and the order of the main activity. Conclusions: One of the significant uses of objects is how they contribute to the perceptual field where attention is organized for building actions. Participants in activities modify the perceptual field by manipulating objects in the material surrounds in response to the relevancies resulting from the unfolding activities. Therefore, spatial contingency is significant in the accomplishment of activities by people with dementia. As it is not self-evident that verbal instructions may result in the instructed actions accordingly, the rearrangement of objects and making them timely available to people with dementia may increase the possibilities of keeping the order of the activities intact.

n/a

Background: When it comes to aphasia assessments, many speech and language pathologists (SLPs) rely heavily on norm-referenced language tests, even though they are aware that certain important language skills can only be evaluated by analysis of conversational discourse. The formalized aphasia test situation is a typical example of institutional interaction, which differs in systematic ways from everyday conversations. This article examines conversations between persons with aphasia (PWAs) and SLPs in the two different contexts, a topic where previous research is limited. Aims: The aim is to compare the interactions between PWAs and SLPs in test conversations and in more everyday-like conversations and to relate the interactional data to the participants performance on the aphasia test battery. Methods amp; Procedures: Ten PWAs and three SLPs participated in the study. Each PWA participated in two conversations with an SLP, a test conversation, while performing tasks targeting the ability to produce sentences and narratives from an aphasia test battery, and a more everyday-like conversation. The conversations were audio and video recorded and thereafter transcribed. Three main observations considered to be important mechanisms for interaction organization were identified and calculated in the transcriptions. The test results were summarized and analyzed. Outcomes amp; results: The results demonstrated that there were a larger number of turns produced by the PWAs in the everyday conversations compared to the test conversations. Furthermore, there were more communicative initiatives and nonverbal contributions in the everyday conversations. The number of repairs initiated by the PWAs were equivalent, but looking at repair characteristics, it was found that repairs resolved within the same turn were found in the test conversations while repairs stretching over several turns were more frequent in the everyday conversations. Conclusions: The results of the present study demonstrated differences of the interaction between PWAs and SLPs in test conversations and in more everyday-like conversations. Furthermore, there seemed to be no obvious relationship between the participants actual test scores on the aphasia test battery and aspects of conversation that can be related to being a competent speaker.

This study analyses sequences where people with dementia are positioned as third parties in stories about their own lives. Previous research emphasises how people with dementia are frequently excluded from social encounters, and how others tend to speak for or about them in their co-presence. Drawing on conversation analytic methods when analysing 15 video recorded interviews with Swedish couples living with dementia, we argue that telling stories in which a spouse with dementia is positioned as a third party in his or her co-presence does not have to be an activity of exclusion. Rather, among couples, third-party positioning is a multifaceted activity where couples employ different practices to organise participation frameworks and manage both inclusion and exclusion in talk-in-interaction. Furthermore, we show how participants display joint speakership and counteract actions of exclusion by making use of various communicative resources such as gaze, touch and bodily orientation.

We longitudinally investigated the development of deictic and general accompanying gestures in one 5-year-old boy with autism spectrum condition (ASC) and intellectual disability. The investigation was performed during an intervention focusing on phonological segments. The purpose was to see whether gestures developed in conjunction with language. We found that deictic and general accompanying gestures increased during the study, despite not being trained. There was also a positive temporal correlation between deictic gestures and speech. Contrary to the expectations in this case, declarative gestures were frequent and increased, while imperative decreased during the period of intervention. Furthermore, we detected a specific kind of general accompanying non-context-sensitive gestures that may be involved in the retrieval of phonemes and syllables. Speech prosody was also analysed in relation to these gestures.

To understand speech, the slowly varying outline, or envelope, of the acoustic stimulus is used to distinguish words. A small amount of information about the envelope is sufficient for speech recognition, but the mechanism used by the auditory system to extract the envelope is not known. Several different theories have been proposed, including envelope detection by auditory nerve dendrites as well as various mechanisms involving the sensory hair cells. We used recordings from human and animal inner ears to show that the dominant mechanism for envelope detection is distortion introduced by mechanoelectrical transduction channels. This electrical distortion, which is not apparent in the sound-evoked vibrations of the basilar membrane, tracks the envelope, excites the auditory nerve, and transmits information about the shape of the envelope to the brain.

Objectives/Hypothesis To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil-related upper airway obstruction. Study Design Retrospective population-based cohort study based on data from the Swedish National Patient Register (NPR). Methods All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (+/- adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity. Results In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20-4.77). Conclusions This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil-related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason. Level of Evidence 2b Laryngoscope, 129:2619-2626, 2019

The aim of the present study was to examine receptive and expressive lexicon, as well as gesture production among children with and without developmental language disorder (DLD), Using the Swedish translation of the Picture Naming Game (PiNG). The parental evaluation Swedish Communicative Development Inventory III (SCDI III) was used to determine whether the results from PiNG and SCDI III were consistent. In this study, 10 children with DLD (study group) and 11 age-matched children with typical language development (control group) between 52 and 70 months of age participated. The participants were tested with PiNG, which is a test that examines reception and production of single nouns, verbs, adjectives, adverbs and prepositions. The guardians then completed SCDI III, which contains questions about the language abilities of the child. Gesture production in the form of deictic, iconic and conventional gestures was examined in conjunction with the use of PiNG.

The results showed lower results for the study group on PiNG and SCDI III in comparison with the control group. The study group displayed a higher number of gestures than the control group, and in the former group, the use of gestures was positively correlated with the results from PiNG. In the study group, iconic gestures were used to compensate for language difficulties. The results from PiNG and SCDI III were not consistent. The age of the participants problably did not affect any results. The results from the present study indicate that PiNG may be useful when examining lexicon and gesture production among children with DLD. Both groups achieved high results on PiNG which may have affected the use of gestures and also possible correlations. For future studies, it is therefore recommended to apply PiNG on a group of younger children with DLD.

Objective To assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.

Design Retrospective cohort study.

Setting Data were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.

Participants 1044 children (<15 years) and 2244 adults.

Intervention Tonsillectomy/adenotonsillectomy compared with no surgical treatment.

Main outcome measures Changes in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.

Results In children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.

Conclusion In this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

This study assessed the effect of an easily perceived real-time visual feedback method on touchscreen typing accuracy. Thirty subjects were asked to hold a smartphone with a capacitive touchscreen in one hand and enter a text using the thumb of the same hand via a custom designed virtual keyboard. There were two types of text entry sessions: with or without visual feedback. The visual feedback consisted of a full-screen crosshair, representing the accurate coordinate of touch in real time. In each session, touch-down time on the virtual keyboard and touch coordinates were recorded for every touch action. Two types of typing errors were defined: 1) centering error (CE), which was calculated as the mm distance between the coordinate of the touch and the center of the key, and 2) incorrect entry (IE), which was the number of missed keys. Student t-tests and Wilcoxon tests were used for mean and mean-rank comparisons of CE and IE, respectively. The results showed that visual feedback decreased CE (mean SD) significantly from 1.34 +/- 0.38 mm to 0.85 +/- 0.24 mm (P amp;lt; 0.0005), and decreased IE (median and range, # of incorrect entries) significantly from 5.50 and 32.00 to 1.00 and 7.00 (P amp;lt; 0.005). In conclusion, the accurate, easily perceived, and 2D real-time feedback decreases touch-typing error rates markedly and therefore can be of practical importance for increasing the productivity of smartphone users.

Background: People with dementia frequently suffer from communication disabilities, which usually influence their quality of life. The communication disabilities may affect a persons possibility to participate in interaction as a result of reduced ability to initiate new topics and difficulties in contributing new information to maintain the conversational topic. Technical aids have been proved useful to facilitate communicative activities by supporting memory and stimulating communicative initiatives. Purpose: The aim of the present study is to further understandings of how digital communication support may be used in interaction involving people with dementia. A further aim is to investigate how participants experience communication with and without the use of communication aids. Methods: The study is carried out in a Swedish context, and three dyads of older women with dementia and professional carers participated in the study. The dyads interact in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (Computer Interactive Reminiscence and Communication Aid, CIRCA) and personalised pictures and films (Computer Interactive Reminiscence and Communication University of Sheffield, CIRCUS). The data include twenty-one video recorded activities. Results and Conclusion: The applications appear to provide support for the dyads in finding things to talk about. The participants talk both about the material and memories associated with the material. The participants experience the use of communication aids as positive.