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Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item Interpreting for deaf children in healthcare settings: An exploration of challenges and strategies(SAGE Publications, 2025-10-02) Cherubin, Naomi; Mapson, RachelGood health literacy enables individuals to look after their health and well-being. However, deaf adults are seven times more likely to experience poor health literacy then their hearing counterparts, leading to poorer health outcomes. To improve health literacy levels in the deaf community, researchers emphasise the need for deaf children to access health-related information. When a child attends healthcare appointments, a qualified sign language interpreter is therefore essential. However, interpreting in this environment is a complex phenomenon. This qualitative study adopts an emic perspective to explore the challenges encountered by interpreters and some of the strategies adopted. Ten registered sign language interpreters with experience of working with deaf children in healthcare settings were selected to be involved in the research. Semi-structured interviews were carried out with each participant and reflexive thematic analysis was used to identify themes in the data. This study illustrates that, in addition to linguistic skills, an interpreter needs to possess interpersonal skills to conduct themselves in a professional manner and work in collaboration with the healthcare practitioner, child and parents. Additionally, the research shows that in this environment, interpreters may experience intrapersonal demands, highlighting the need for them to manage their emotions and look after their own well-being.Item ALLIANCE report for the CPG on Deafness - Dementia Assessments for people with Deafness, Deafblindness or Visual Impairment(Health and Social Care Alliance Scotland, 2025-04-07) Johnson, ChristineA working group of the Cross-party Group on Deafness aims to improve care pathways and support for people with dementia who also experience Deafness, Deafblindness or Visual Impairment, including BSL users. This working group, also supported by the Cross-party Group on Visual Impairment, is developing the first framework of sensory care standards for Scotland. The framework of sensory care standards will centre around several core areas, one of which will be sensory assessment. Identifying Deafness, Deafblindness or Visual Impairment before people are assessment for dementia is important, because it enables tailored communication which meets people’s needs. This fosters informed decision making and independence. It also enables GPs and other health and medical professionals to select different memory/dementia assessment tools – rather than using standard tools that require people to see and hear. Not identifying or considering Deafness, Deafblindness or Visual Impairment means that assessments and support planning are unlikely to be appropriately tailored to the needs and rights of individuals. The working group wanted to know if or how sensory assessments feature as part of any dementia assessment pathway in Scotland, or during post-diagnostic support. We explored the practices of health and medical professionals who carry out memory/dementia assessments for people who are Deaf, Deafblind or who have a Visual Impairment, including BSL users, and the eye and hearing care specialists who assess sight and hearing. From August to October 2024 the ALLIANCE collected responses to four online surveys, each one targeted at a specific group of health and medical professionals in Scotland. The major findings from this research are that there are large variations in practice in the assessment of dementia for people with Deafness, Deafblindness and Visual Impairment, including BSL users. There is also a lack of integrated care pathways between dementia assessments performed by GPs and other health and medical professionals, and sensory assessments from eye and hearing care services. Our findings include: Only 6% of GPs and 12% of other health and medical professionals specified that they would assess both sight and hearing as an integrated part of assessing memory/dementia. Methods used to assess dementia risked missing Deafness, Deafblindness or Visual Impairment. GPs and other Health and Medical Professionals were largely unaware of memory/dementia assessments specifically design for people who are Deaf, Deafblind or have a Visual Impairment, and this included assessments for BSL users. A respondent who is also a professional with lived experience of supporting a relative with Deafness and now advanced dementia through diagnosis and post-diagnostic support, stated that if appropriate assessment tools had been used much earlier in the process, poor outcomes could have been avoided: “Provision is drastically lacking for deaf/blind dementia patients […] deafblind manual [users] are not considered – the hearing community typically thinks that it’s all the same language.” Based on the research findings, the ALLIANCE has published a report for the Cross-party Group on Deafness containing 26 recommendations to improve care pathways and support for people with dementia who also experience Deafness, Deafblindness or Visual Impairment, including BSL users. These recommendations will inform future work by the sensory care and dementia working group on developing the first framework of sensory care standards for Scotland.Item Is the Past a Different Culture? Tracking Changes in Prosodic Features of Child-Directed Broadcasting Across Six Decades(University of California, 2025) Kempe, Vera; Gravelle, C. Donnan; Perschke, Stina; Williams, Glenn; Schaeffler, SonjaWhile research has explored cross-cultural variation in childdirected speech (CDS), little is known about if and how it may have changed over time. We explore whether CDS has undergone historical change by analyzing prosodic features in child-directed (CD) broadcasts from a German children’s bedtime program (1959–present) and comparing them to adultdirected (AD) weather forecasts from the same period. The program originated in East Germany and continued after German reunification in 1990, potentially reflecting a sociocultural shift toward more child-centric attitudes characteristic of Western liberal democracies. Pitch variation in CD broadcasts, although higher than in AD broadcasts, remained stable over time. In contrast, articulation rates showed no register difference pre-1990; only after 1990 did CD broadcasts exhibit the slower articulation rates typical of CDS. This suggests that some features of CDS may be subject to cultural evolution over historical time, which can be accelerated by major historical events.Item Foster carers in Scotland’s knowledge and awareness of speech, language, and communication needs(CELCIS, 2025-05) Pellegrinelli, Grace; Hodson, AnnUp to 90% of children experiencing care have speech, language and communication Needs (SLCN) (Clegg et al., 2021). Despite this, there has been no research into foster carers in Scotland’s knowledge and awareness of SLCN, their experience of supporting children with SLCN, or training they receive in this area. Thirty-nine foster carers in Scotland responded to an online questionnaire exploring their experiences. Findings suggested that foster carers are experienced in caring for children with SLCN, with or without a neurodevelopmental condition, and can identify many communication difficulties. They are confident in using strategies to support SLCN. Very few participants had received training specifically for SLCN; those who had found it useful, and the majority of those who hadn’t stated they would value training in SLCN. To uphold Article 12 (the right of a child to express their views and have these listened to and taken seriously in all matters affecting them) of the United Nations Convention on the Rights of the Child (1989), recently incorporated into domestic law in Scotland (2024), we recommend the development and delivery of a national SLCN training programme for foster carers, with speech and language therapists being best placed to enact this.Item The application of Ultrasound Evaluation of Swallowing (USES) to the analysis of hyoid kinematics in healthy swallows(American Speech-Language-Hearing Association, 2025-04-07) Ma, Joan K-Y; Wrench, Alan A.Purpose: Using ultrasound as an adjunct tool for swallowing assessment has gained significant momentum in recent years, with research gaps in areas such as speech and language therapist–driven protocol and measurement methods. This study outlines the recording protocol of Ultrasound Evaluation of Swallowing (USES). Additionally, a set of multidimensional measurements capturing the hyoid kinematics in typical swallows was compared with previous studies to evaluate the current protocol and to develop an ultrasound database of healthy swallows to further the clinical implementation of USES. Method: Swallowing data were acquired from 41 healthy participants. Both discrete swallows (5- and 10-ml) and continuous swallows (100-ml) were analyzed. Automatic tracking of the hyoid and mandible positions using a deep neural net was applied. Six swallowing events of interest were identified for each swallow (beginning hyoid position, maximal hyoid position, hyoid advancement, hyoid retraction, peak forward velocity, and peak backward velocity), and a series of hyoid parameters characterizing the amplitude, velocity, and timing of the movement were calculated and compared across different types of swallows. Results: Results showed significant differences between continuous and discrete swallows. Continuous swallows were characterized by shorter maximal hyoid displacement, a shorter duration between the start of the swallow and the maximal displacement, a shorter total swallow duration, and lower peak velocity in both forward and backward hyoid movement. No significant difference was observed between the 5- and 10-ml swallows in hyoid movement amplitude, velocity, or duration. Conclusions: The quantification of hyoid kinematics in swallowing through the current USES recording protocol, combined with the semi-automatic extraction of hyoid function by applying a deep neural net and feature-finding algorithms, provides initial evidence to support its clinical utility in swallowing assessment. Further studies, including those of different clinical populations, to evaluate the sensitivity of the hyoid metrics in detecting changes to swallowing would support the clinical translation.Item Exploring hearing people’s experiences of working with sign language interpreters in the workplace(SAGE Publications, 2024-12-19) Hockaday, TamsynThis study explored hearing (non-deaf) people’s experiences of working with sign language interpreters in the workplace. Qualitative data were collected through one-to-one interviews with managers, colleagues, or subordinates of deaf people. Transcripts of the interviews were then analysed using a reflexive thematic approach to identify themes that capture the hearing person’s perspective on working with interpreters. These themes included the positive and negative aspects of working with interpreters, the workplace norms and etiquette that affect both their understanding of the interpretation and their relationship with deaf colleagues, the way the interpreter presents both the deaf and hearing people, and finally the professional boundaries of the interpreter. In addition, the research revealed the reasons for hearing people creating their own lists of preferred interpreters and how this intersects with the preferences of deaf persons. Finally, the study explored the concept of trust and the effect this has on all individuals in the workplace.Item A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank(Oxford University Press, 2024-12-16) Mur, J; Klee, M; Wright, H R; Solomon, A; Johnson, Christine; Littlejohns, T J; Muniz-Terrera, G; Leist, A KObservational studies have reported that hearing aid (HA) use is associated with a reduced risk of dementia diagnosis, suggesting a possible protective effect. However, extant observational studies do not explicitly model causal effects, while randomised controlled trials on the effect of HA on dementia exhibit short follow-up. Here we used self-report, hearing tests, and healthcare records in UK Biobank to design a hypothetical intervention for the effect of HA use on the risk of dementia diagnosis in people with incident hearing loss (HL). HA users exhibited a higher risk of dementia diagnosis than non-users (RR=1.43, 95%CI=1.08-1.88). Associations between HA use and dementia diagnosis were robust across sensitivity analyses (RRs: 1.34-1.59) but adjustment for primary healthcare utilisation (0.77, 0.44-1.33) or primary and secondary care utilisation (0.68, 0.39-1.18) substantially decreased the observed effect. The decrease in effect estimates upon adjustment for primary (1.30, 0.95-1.78) and primary and secondary healthcare utilisation (1.30, 0.94-1.78) was smaller when participants with relatively early diagnoses of HL were included in the sample compared to when they were not. While the findings are not conclusive, they suggest residual confounding by healthcare utilisation and dating of HL diagnosis in participants without primary care data in UK Biobank.Item Impact of COVID-19 Pandemic-Related Restrictions for Inpatients with Aphasia and Associated Cognitive Dysfunction: Lessons Learned from Patient Detention(MDPI, 2024-12-04) Eshun, Edwin; Welch, Killian; Britton, Hannah; Mayer, Victoria; Morrice, Fay; Ogilvie, Charlotte; Page, Helen; Pridmore, Jessie; FitzGerald, AlasdairWe describe two patients with a recent stroke or traumatic brain injury associated with aphasia and cognitive impairment who required detention (under the Mental Health Act) as well as some form of restraint during their inpatient rehabilitation. Each of these episodes of care occurred early into the COVID-19 pandemic and we speculate that the detention (and restraint) was attributable, at least in part, to the difficulty in comprehending COVID-19-related changes in patterns of staff interaction and the mandated social and visiting restrictions. We reflect on the impact of these restrictions on the need for detention and how these factors could have been mitigated through speech and language therapist (SLT) and broader multidisciplinary team (MDT) intervention.Item Global assessment of swallow function (GASF) following VMAT radiotherapy for head and neck squamous cell carcinoma(Elsevier, 2024-08-30) Toft, Kate; McLachlan, Kirsty; Winton, Mark; Mactier, Karen; Hare, Nadine; Nugent, Claire; Wincott, Lucie; Srinivasan, Devraj; Mackenzie, Joanna; Nailon, Bill; Noble, DavidAim This study aimed to conduct a global assessment of swallow function (GASF) using a range of swallow outcome tools, in a cohort of patients pre- and post-treatment with image-guided volumetric modulated arc therapy (VMAT) radiotherapy. Materials and methods All patients receiving radical (chemo)radiation for SCC of the larynx, oro-, hypo- or nasopharynx between October 2016 – 2021 were eligible for inclusion. Patients were treated with VMAT radiotherapy according to institutional and national protocols. Patients underwent GASF pre- and 6 months post-treatment. Data were collated from the MD Anderson Dysphagia Inventory (MDADI), the Functional Oral Intake Scale (FOIS), the Performance Status Scale-Head and Neck: Normalcy of Diet scale (PSS-NoD), the 100 ml water swallow test (WST) for capacity and maximal interincisal opening (MIO). Results One hundred and seventy-five patients were included. 55.2 % of patients experienced a fall in MDADI-Composite score greater than the published meaningful clinical important difference (MCID).A trend for a decrease in FOIS score reflects a decrease in range of diet textures and increase in reliance on enteral feeding at 6 months post-treatment. Mean PSS-NoD score decreased reflecting increased restriction in diet textures.20 patients’ WST capacity improved by the minimal clinically important difference of > 4mls whilst 37 % of patients experienced a decrease in WST capacity of 4mls or more. 12.6 % of patients developed trismus following radiotherapy. Conclusions This paper adds new detail to the understanding of the decline in measured eating, drinking and swallowing function that patients treated with VMAT radiotherapy experience at 6 months post treatment. However, gaps are highlighted in the evidence base in terms of interpretation of swallow outcomes tool scores; future research in HNC should include ongoing discussion and development around robust outcomes tools and data collection.Item Personalised 3D printed respirators for healthcare workers during the COVID-19 pandemic(Frontiers Media, 2022-08-01) Roche, Aidan D.; McConnell, Alistair C,; Donaldson, Karen; Lawson, Angus; Tan, Spring; Toft, Kate; Cairns, Gillian; Colle, Alexandre; Coleman, Andrew A.; Stewart, Ken; Digard, Paul; Norrie, John; Stokes, Adam A.Widespread issues in respirator availability and fit have been rendered acutely apparent by the COVID-19 pandemic. This study sought to determine whether personalized 3D printed respirators provide adequate filtration and function for healthcare workers through a Randomized Controlled Trial (RCT). Fifty healthcare workers recruited within NHS Lothian, Scotland, underwent 3D facial scanning or 3D photographic reconstruction to produce 3D printed personalized respirators. The primary outcome measure was quantitative fit-testing to FFP3 standard. Secondary measures included respirator comfort, wearing experience, and function instrument (R-COMFI) for tolerability, Modified Rhyme Test (MRT) for intelligibility, and viral decontamination on respirator material. Of the 50 participants, 44 passed the fit test with the customized respirator, not significantly different from the 38 with the control (p = 0.21). The customized respirator had significantly improved comfort over the control respirator in both simulated clinical conditions (p < 0.0001) and during longer wear (p < 0.0001). For speech intelligibility, both respirators performed equally. Standard NHS decontamination agents were able to eradicate 99.9% of viral infectivity from the 3D printed plastics tested. Personalized 3D printed respirators performed to the same level as control disposable FFP3 respirators, with clear communication and with increased comfort, wearing experience, and function. The materials used were easily decontaminated of viral infectivity and would be applicable for sustainable and reusable respirators.