PURPOSE: The Nasality Severity Index 2.0 (NSI 2.0) forms a new, multiparametric approach in the assessment of hypernasality. To enable clinical implementation of this index, the short- and long-term test-retest reliability of this index was explored. METHODS: In 40 normal-speaking adults (mean age 32y, SD 11, 18-56y) and 29 normal-speaking children (mean age 8y, SD 2, 4-12y), the acoustic parameters included in the NSI 2.0 (i.e. nasalance of the vowel /u/ and an oral text, and the voice low tone to high tone ratio (VLHR) of the vowel /i/) were obtained twice at the same test moment and during a second assessment two weeks later. After determination of the NSI 2.0, a comprehensive set of statistical measures was applied to determine its reliability. RESULTS: Long-term variability of the NSI 2.0 and its parameters was slightly higher compared to the short-term variability, both in adults and in children. Overall, a difference of 2.82 for adults and 2.68 for children between the results of two consecutive measurements can be interpreted as a genuine change. With an ICC of 0.84 in adults and 0.77 in children, the NSI 2.0 additionally shows an excellent relative consistency. No statistically significant difference was withheld in the reliability of test-retest measurements between adults and children. CONCLUSION: Reliable test-retest measurements of the NSI 2.0 can be performed. Consequently, the NSI 2.0 can be applied in clinical practice, in which successive NSI 2.0 scores can be reliably compared and interpreted. LEARNING OUTCOMES: The reader will be able to describe and discuss both the short-term and long-term test-retest reliability of the Nasality Severity Index 2.0, a new multiparametric approach to hypernasality, and its parameters. Based on this information, the NSI 2.0 can be applied in clinical practice, in which successive NSI 2.0 scores, e.g. before and after surgery or speech therapy, can be compared and interpreted.
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Objectives: The purpose of the current study was to assess the short-term effectiveness of short and intensive speech therapy provided to patients with cleft (lip and) palate (C(L)P) in terms of articulation and resonance. Methods: Five Ugandan patients (age: 7.3-19.6 years) with non-syndromic C(L)P received six hours of individualized speech therapy in three to four days. Speech therapy focused on correct phonetic placement and contrasts between oral and nasal airflow and resonance. Speech evaluations performed before and immediately after speech therapy, including perceptual and instrumental assessment techniques, were compared. Results: Post-therapy, improvement of speech was noted for most of the patients, although to varying degrees. Clinically relevant progress of objective nasalance values and/or articulation was obtained in four patients. Overall, two patients showed normal speech intelligibility, while three patients required additional speech therapy. Conclusion: These preliminary short-term results demonstrate that short and intensive speech therapy can be effective for patients with C(L)P in countries with limited access to speech-language therapy. However, further research is needed on the long-term effectiveness and the advantages of applying this treatment protocol in countries with good access to speech therapy. Learning outcomes: The reader will be able to (1) list the challenges in resource poorcountries to achieve access to speech-language therapy services, (2) describe when the application of speech therapy is appropriate in patients with C(L)P, (3) describe the speech therapy that can be applied to reduce compensatory articulation and resonance disorders in patients with C(L)P, and (4) list the (possible) advantages of short, intensive speech therapy for both resource-poor and developed countries.
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Background: Globalisation trends such as increased migration to andwithin European countries have led to even greater cultural diversityin European societies. Cultural diversity increases the demand ofcultural competency amongst professionals entering their workfield. In particular, healthcare professionals need knowledge and skillsto equip them to work with clients from different cultural backgrounds.Within higher education (HE), the professional developmentof cultural competency should ideally feature in undergraduate educationand is often promoted as a by-product of a study abroadperiod. However, recognising that logistical and financial barriersoften exist for extended study abroad, one alternative approachcould be participation, at home or abroad, in a short-term internationalprogramme set within students’ own HE institutions.Purpose: The aim of this study was to explore HE students’ experiencesof participating in international ‘short-term mobility week’programmes at three European universities.Methods: Each university involved in the research offered short termprogrammes for healthcare professions students at their owninstitution, where both local students and students from abroadcould participate. Participants were healthcare students in theprogramme at one of the three universities. Data were collectedthrough focus group interviews (4–8 students per group; n = 25).The data were transcribed and then analysed qualitatively, usinga content comparison method.Results: The analysis identified six categories, which reflectedstudents’ journeys within the short-term international experiences.Conclusions: The analysis suggested that, for these students,engagement in a short-term mobility week programme providedvaluable opportunities for encounters with others, which contributedto personal and professional development, greater confidencein the students’ own professional identities, as well as anincreasing sense of cultural awareness.
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Physical rehabilitation programs revolve around the repetitive execution of exercises since it has been proven to lead to better rehabilitation results. Although beginning the motor (re)learning process early is paramount to obtain good recovery outcomes, patients do not normally see/experience any short-term improvement, which has a toll on their motivation. Therefore, patients find it difficult to stay engaged in seemingly mundane exercises, not only in terms of adhering to the rehabilitation program, but also in terms of proper execution of the movements. One way in which this motivation problem has been tackled is to employ games in the rehabilitation process. These games are designed to reward patients for performing the exercises correctly or regularly. The rewards can take many forms, for instance providing an experience that is engaging (fun), one that is aesthetically pleasing (appealing visual and aural feedback), or one that employs gamification elements such as points, badges, or achievements. However, even though some of these serious game systems are designed together with physiotherapists and with the patients’ needs in mind, many of them end up not being used consistently during physical rehabilitation past the first few sessions (i.e. novelty effect). Thus, in this project, we aim to 1) Identify, by means of literature reviews, focus groups, and interviews with the involved stakeholders, why this is happening, 2) Develop a set of guidelines for the successful deployment of serious games for rehabilitation, and 3) Develop an initial implementation process and ideas for potential serious games. In a follow-up application, we intend to build on this knowledge and apply it in the design of a (set of) serious game for rehabilitation to be deployed at one of the partners centers and conduct a longitudinal evaluation to measure the success of the application of the deployment guidelines.
Due to their diverse funding sources, theatres are under increasing pressure to demonstrate impact on society. The Raad voor Cultuur (2023) for example advised the secretary of state to include societal impact as an additional evaluation measure next to artistic value. Many theaters, such as the Chassé Theater and Parkstad Limburg Theaters, have reformulated their missions to focus on impact of performances on visitors. This is a profound transformation from merely selling tickets and filling seats, and requires new measurement instruments to monitor, manage, and improve impact. Currently available instruments are insufficient, and effective monitoring is crucial to larger future projects that theaters are currently planning to systematically broaden impacts of performances on their communities. The specific goal of this project is to empower theaters to monitor and improve impact by developing a brief experience impact questionnaire, taking existing data from student projects conducted at the Chassé Theater about performing arts experiences on one hand, and experience impact theory innovations on the other, as starting points. We will develop potential items to measure and benchmark against established measures of valued societal outcomes, such as subjective well-being and quality of life. These will be measured in questionnaires developed with project partners Chassé Theater and Parkstad Limburg Theaters and administered before and after performances across a wide range of genres. The resulting data will enable comparison of new questionnaire items with benchmarked measures of valued societal outcomes. The final product of the project will be a brief impact questionnaire, which within several brief self-report instruments and just a few minutes can effectively be used to quantify the impact of a performing arts experience. A workshop and practice-oriented article will make this questionnaire implementable, thereby mobilizing the key enabling methodology of monitoring and impact measurement in the performing arts sector.
Nederland kent ongeveer 220.000 bedrijfsongevallen per jaar (met 60 mensen die overlijden). Vandaar dat elke werkgever verplicht is om bedrijfshulpverlening (BHV) te organiseren, waaronder BHV-trainingen. Desondanks brengt slechts een-derde van alle bedrijven de arbeidsrisico’s in kaart via een Risico-Inventarisatie & Evaluatie (RI&E) en blijft het aandeel werknemers met een arbeidsongeval hoog. Daarom wordt er continu geïnnoveerd om BHV-trainingen te optimaliseren, o.a. door middel van Virtual Reality (VR). VR is niet nieuw, maar is wel doorontwikkeld en betaalbaarder geworden. VR biedt de mogelijkheid om veilige realistische BHV-noodsimulaties te ontwikkelen waarbij de cursist het gevoel heeft daar echt te zijn. Ondanks de toename in VR-BHV-trainingen, is er weinig onderzoek gedaan naar het effect van VR in BHV-trainingen en zijn resultaten tegenstrijdig. Daarnaast zijn er nieuwe technologische ontwikkelingen die het mogelijk maken om kijkgedrag te meten in VR m.b.v. Eye-Tracking. Tijdens een BHV-training kan met Eye-Tracking gemeten worden hoe een instructie wordt opgevolgd, of cursisten worden afgeleid en belangrijke elementen (gevaar en oplossingen) waarnemen tijdens de simulatie. Echter, een BHV-training met VR en Eye-Tracking (interacties) bestaat niet. In dit project wordt een prototype ontwikkeld waarin Eye-Tracking wordt verwerkt in een 2021 ontwikkelde VR-BHV-training, waarin noodsituaties zoals een kantoorbrand worden gesimuleerd (de BHVR-toepassing). Door middel van een experiment zal het prototype getest worden om zo voor een deel de vraag te beantwoorden in hoeverre en op welke manier Eye-Tracking in VR een meerwaarde biedt voor (RI&E) BHV-trainingen. Dit project sluit daarmee aan op het missie-gedreven innovatiebeleid ‘De Veiligheidsprofessional’ en helpt het MKB dat vaak middelen en kennis ontbreekt voor onderzoek naar effectiviteit rondom innovatieve-technologieën in educatie/training. Het project levert onder meer een prototype op, een productie-rapport en onderzoeks-artikel, en staat open voor nieuwe deelnemers bij het schrijven van een grotere aanvraag rondom de toepassing en effect van VR en Eye-Tracking in BHV-trainingen.
