Fluent English Speakers Research Articles

Cultural Considerations in Intelligence Test Adaptations: a Critical Review of the WAIS-IV India and Its U.K. and U.S. Counterparts.

This study critically examined the adaptation and normative processes of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)India. WAIS-IV U.K. Edition Administration and Scoring Manual, WAIS-IVIndia Administration and Scoring Manual, and WAIS-IV Administration and Scoring Manual and Technical and Interpretive Manuals were used to extract test development and adaptation process data. The analyses were descriptive and qualitative. A review of the manuals showed that the normative sample were fluent English speakers with high education levels, which is not representative of India's multilingual and educational diversity. The study identified minimal cultural and linguistic adaptations in subtests, which raised concern about potential biases in the test adaptation process across cultures. The lack of clarity in item selection, demographic data, sample selection, and psychometric properties raised questions about the test's reliability and validity. Issues related to education, age, gender, and regional distribution are discussed, emphasizing the test's limitations in capturing the diverse characteristics of the heterogeneous Indian population. WAIS-IV India may not adequately represent India's population. More careful consideration of socioecological and psychometric factors when adapting intelligence (IQ) tests and use of advanced data harmonization methods can provide robust cross-national statistical harmonization in the future along with more ecologically valid local test development efforts. This can allow consideration of social determinants of health and other factors that can inform a more nuanced approach to IQ test development in non-western contexts.

"Alexa, Cycle The Blood Pressure": A Voice Control Interface Method for Anesthesia Monitoring.

Anesthesia monitors and devices are usually controlled with some combination of dials, keypads, a keyboard, or a touch screen. Thus, anesthesiologists can operate their monitors only when they are physically close to them, and not otherwise task-loaded with sterile procedures such as line or block placement. Voice recognition technology has become commonplace and may offer advantages in anesthesia practice such as reducing surface contamination rates and allowing anesthesiologists to effect changes in monitoring and therapy when they would otherwise presently be unable to do so. We hypothesized that this technology is practicable and that anesthesiologists would consider it useful. A novel voice-driven prototype controller was designed for the GE Solar 8000M anesthesia patient monitor. The apparatus was implemented using a Raspberry Pi 4 single-board computer, an external conference audio device, a Google Cloud Speech-to-Text platform, and a modified Solar controller to effect commands. Fifty anesthesia providers tested the prototype. Evaluations and surveys were completed in a nonclinical environment to avoid any ethical or safety concerns regarding the use of the device in direct patient care. All anesthesiologists sampled were fluent English speakers; many with inflections from their first language or national origin, reflecting diversity in the population of practicing anesthesiologists. The prototype was uniformly well-received by anesthesiologists. Ease-of-use, usefulness, and effectiveness were assessed on a Likert scale with means of 9.96, 7.22, and 8.48 of 10, respectively. No population cofactors were associated with these results. Advancing level of training (eg, nonattending versus attending) was not correlated with any preference. Accent of country or region was not correlated with any preference. Vocal pitch register did not correlate with any preference. Statistical analyses were performed with analysis of variance and the unpaired t -test. The use of voice recognition to control operating room monitors was well-received anesthesia providers. Additional commands are easily implemented on the prototype controller. No adverse relationship was found between acceptability and level of anesthesia experience, pitch of voice, or presence of accent. Voice recognition is a promising method of controlling anesthesia monitors and devices that could potentially increase usability and situational awareness in circumstances where the anesthesiologist is otherwise out-of-position or task-loaded.

Proneness to false memory generation predicts pseudoscientific belief endorsement

Among cognitive factors that can influence the endorsement of pseudoscientific beliefs, our study focuses on proneness to false memory generation. In this preregistered study, we presented 170 fluent English speakers residing in the USA with a misinformation task aimed at generating false memories. In this task, they first completed an event encoding stage, in which two events were narrated through sequentially presented pictures. One day later, they read a series of sentences relating the same events but which included several inaccurate descriptions aimed at producing a misinformation effect. Finally, we measured the influence of the misinformation manipulation over false memory generation. After completing the misinformation task, participants responded to a questionnaire measuring pseudoscientific beliefs. Our results showed a positive correlation between pseudoscience endorsement and false memory rates, which indicates that the latter might be a key factor influencing susceptibility to pseudoscience. To our knowledge, this is the first study showing a link between the tendency to believe in pseudoscience and variability regarding proneness to develop false memories. Practical implications for the design of new interventions to effectively reduce pseudoscientific beliefs and their negative impact on our society are discussed.

Self-administered mindfulness interventions reduce stress in a large, randomized controlled multi-site study

Mindfulness witnessed a substantial popularity surge in the past decade, especially as digitally self-administered interventions became available at relatively low costs. Yet, it is uncertain whether they effectively help reduce stress. In a preregistered (OSF https://doi.org/10.17605/OSF.IO/UF4JZ; retrospective registration at ClinicalTrials.gov NCT06308744) multi-site study (nsites = 37, nparticipants = 2,239, 70.4% women, Mage = 22.4, s.d.age = 10.1, all fluent English speakers), we experimentally tested whether four single, standalone mindfulness exercises effectively reduced stress, using Bayesian mixed-effects models. All exercises proved to be more efficacious than the active control. We observed a mean difference of 0.27 (d = −0.56; 95% confidence interval, −0.43 to −0.69) between the control condition (M = 1.95, s.d. = 0.50) and the condition with the largest stress reduction (body scan: M = 1.68, s.d. = 0.46). Our findings suggest that mindfulness may be beneficial for reducing self-reported short-term stress for English speakers from higher-income countries.

The utility of ChatGPT as a generative medical translator.

Large language models continue to dramatically change the medical landscape. We aimed to explore the utility of ChatGPT in providing accurate, actionable, and understandable generative medical translations in English, Spanish, and Mandarin pertaining to Otolaryngology. Responses of GPT-4 to commonly asked patient questions listed on official otolaryngology clinical practice guidelines (CPG) were evaluated with the Patient Education materials Assessment Tool-printable (PEMAT-P.) Additional critical elements were identified a priori to evaluate ChatGPT's accuracy and thoroughness in its responses. Multiple fluent speakers of English, Mandarin, and Spanish evaluated each response generated by ChatGPT. Total PEMAT-P scores differed between English, Mandarin, and Spanish GPT-4 generated responses depicting a moderate effect size of language, Eta-Square 0.07 with scores ranging from 73 to 77 (P-value = 0.03). Overall understandability scores did not differ between English, Mandarin, and Spanish depicting a small effect size of language, Eta-Square 0.02 scores ranging from 76 to 79 (P-value = 0.17), nor did overall actionability scores Eta-Square 0 score ranging 66-73 (P-value = 0.44). Overall a priori procedure-specific responses similarly did not differ between English, Spanish, and Mandarin Eta-Square 0.02 scores ranging 61-78 (P-value = 0.22). GPT-4 produces accurate, understandable, and actionable outputs in English, Spanish, and Mandarin. Responses generated by GPT-4 in Spanish and Mandarin are comparable to English counterparts indicating a novel use for these models within Otolaryngology, and implications for bridging healthcare access and literacy gaps. IV.

The Attitude of Pakistani Undergraduates towards Speaking English

The fluency in speaking skills is one of the important skills that determines professional and academic success. Students in Pakistan are eager to learn how to speak better English for many social benefits. To become fluent speakers of English, it is mandatory for the teachers to provide a good number of opportunities to students for improving their English-speaking skills. This study aims to explore the reasons with which students prefer to speak English in different contexts. The factors that encourage or discourage students for adopting English to communicate are also examined. For this purpose, interviews of undergraduate students at a public sector university were conducted. The findings that emerge from this study are that students are motivated to learn English and speak English because it promises several social gains. Additionally, students receive its advantages during studies as it provides them better grades and improved impression in front of teachers and peers. It was concluded that while keeping, strong hold to one’s culture, speaking English for better understanding of the world is necessary.

New Picture Stimuli for the NIH Stroke Scale: A Validation Study.

The National Institutes of Health Stroke Scale is a widely accepted tool for structured graded neurological examination of stroke or suspected stroke in the hyperacute setting. Concerns have arisen about the use of its picture stimuli in a contemporary and global health context. Here, we present new stimuli prepared to serve the needs of stroke providers worldwide: the precarious painter image description and updated objects for naming. This was a validation study of 101 healthy fluent English speakers. Participants were reached by the Johns Hopkins Outpatient Center, the University of South Carolina, and Prisma Health from 2022 to 2023 and included residents of the United States, Germany, Canada, the United Kingdom, Australia, and Zambia. Participants were recorded in person or via video conferencing when asked to describe the new picture, while a subset named seven illustrations. Multivariate analyses of variance were used for primary analyses. In a complementary investigation, 299 attendees of the 2023 International Stroke Conference were asked about their preference for the existing or new stimuli and why. Each of the 44 content units from the picture description was included by at least 5% of respondents in the demographically representative subsample. Performance was similar across healthy participants irrespective of age, sex, race, ethnicity, or education. Typical descriptions were characterized by an average of 23 content units (SD=5) conveyed with 167 syllables (SD=79). The new naming stimuli were recognized by 100% of participants from many countries as being familiar and identifiable, and names provided in response to the task were highly convergent. The majority of stroke health care providers preferred both the precarious painter and naming stimuli. The description of the new National Institutes of Health Stroke Scale picture, the precarious painter, results in rich samples among healthy speakers that will provide an appropriate basis for the detection of language deficits.

Exploring static and dynamic functional brain networks in adolescent depression using a co-produced novel irritability paradigm

Background Irritability is a core symptom of depression in adolescence and a risk factor for emotion regulation problems. However, its neural correlates are not well understood. Existing functional magnetic resonance imaging (fMRI) research on irritability typically overlooks its social context. Methods Here, we pilot a novel naturalistic fMRI paradigm targeting the social nature of irritability that was co-produced with young people (N = 88) and apply it in an independent sample of youth (N = 29, mean age 18.9 years, 77% female) with self-reported low mood that were aged 16 to 20 years. Participants were also fluent English speakers, free from MRI contraindications, and did not report a diagnosis of a neurological or neurodevelopmental condition. Our aim was to investigate whether graph theoretic and dynamical properties of functional brain networks differed between a resting state scan and our irritability paradigm. We also examined whether these brain features were associated with depressive symptoms and trait irritability. Results Using Leading Eigenvector Dynamics Analysis (LEiDA), we found that the dynamic properties of brain networks comprising default-mode and fronto-parietal regions differed significantly during the irritability paradigm compared to the rest condition. While no gross static topological differences were found between these two conditions, we found that some dynamic and topological features of emotion-related brain networks were related to trait irritability and depressive symptoms in our sample. Conclusions Although the current findings are preliminary due to the pilot nature of this study, this work showcases the feasibility of co-produced research in neuroimaging and lays a strong foundation for further study.

48 Longitudinal Language Outcomes in Pediatric Brain Tumor Patients Diagnosed in Early Childhood

Objective:Pediatric brain tumor (PBT) survivors are at risk for speech (e.g., articulation, prosody, fluency) and language (e.g., vocabulary, grammar, narratives, pragmatics) difficulties (Hodges et al., 2020). It is important to understand what treatment and/or demographic factors are associated with language functioning soon after diagnosis, and what factors are associated with language functioning years after treatment completion. This study characterizes longitudinal language functioning for clinically referred PBT survivors diagnosed in early childhood.Participants and Methods:Participants were 48 PBT patients (54% supratentorial, 6% disseminated), 21% with NF-1, who were diagnosed by age 6 (M = 43.2 months, SD 24.5) and received tumor-directed intervention including surgery (85%), chemotherapy (69%), and/or radiation therapy (50%). Hearing concerns existed for 29% of the patients. Age at first neuropsychological evaluation was 2-15 years (M=7.6, SD=3.63), age at second neuropsychological evaluation was 5-19 years (M=12.04, SD=3.86), with an average of 4.42 years (SD=2.37) between evaluations. Patients were 63% male, 77% White, 94% non-Hispanic, and fluent English speakers. Verbal IQ, working memory, fluencies, comprehension, memory, and parent-reported functional communication outcomes were assessed as part of comprehensive batteries. Rates of weak performance (1 SD<Mean) were compared to the expected base rate of 16%.Results:Group means significantly diverged from age-expected performance by the second evaluation in all domains except semantic fluency. Weakness was identified on at least 1 verbal subtest for 79% of the sample at the first evaluation, and for 85% of the sample at the second evaluation. As a group, patients showed a significant increase in the number of weaknesses identified on performance-based measures from the first to second evaluation [t(47) = -3.60, p <.001]. Over half of the sample showed an increase in the rate of verbal weaknesses identified (56.3%). Those with more weaknesses over time had lower IQ at the initial evaluation [t(36) =-2.61, p=.013]. An increase in the number of weaknesses from first to second evaluation was not associated with tumor type/location, treatment modality, or demographic variables.Conclusions:Brain tumor diagnosis in early childhood during rapid language development is associated with language impairments soon after diagnosis, and years after treatment completion. Causes for continued and increased impairment are multifactorial and risk cannot clearly be identified by demographic and treatment variables alone. Any early language weakness identification should signal need for intervention as the causes for difficulty are complex and these weaknesses are likely to persist and increase over time.

Searching for the “native” speaker: A preregistered conceptual replication and extension of Reid, Trofimovich, and O’Brien (2019)

AbstractThis study conceptually replicated and extended Reid, Trofimovich, and O’Brien (2019), who found that native English speakers could be biased positively (or negatively) relative to a control condition in terms of how they rate non-native English speech. Our internet-based study failed to replicate Reid et al. across a wider population sample of “native” speakers (n = 189). Listeners did not change how they rated non-native English speech after social bias orientations and performed similarly across all five measures of speech and across age and race (Asian, Black, and Caucasian). We attribute our results to differences in the methods (in-person vs. online) and/or participants. Of note, roughly one-third of our “native” participants indicated proficiency in languages other than English and residency in 12 different English-speaking countries, despite identifying as a) fluent English speakers who b) used English primarily and c) acquired English before any other language from birth. These screening items taken together qualified “native” participants in line with traditional psycholinguistics research. We conclude that the concept of “nativeness” is tied to culture-specific perspectives surrounding language use. As such, the native/non-native categorical variable simultaneously serves and limits the advancement of psycholinguistics research.

Cognitive and Sociopsychological Individual Differences, Experience, and Naturalistic Second Language Speech Learning: A Longitudinal Study

AbstractThis study longitudinally examined the effects of cognitive and sociopsychological individual differences (aptitude, motivation, personality) and the quantity and quality of second language (L2) experience on L2 speech gains in naturalistic settings. We elicited L2 spontaneous speech from 50 Chinese learners of English at the beginning and the end of their first 4 months of study abroad. Then, we linked the participants’ gains in comprehensibility (ease of understanding) and accentedness (linguistic nativelikeness) to their individual difference and experience profiles. The participants’ gains in comprehensibility were associated mainly with the amount of their interaction with fluent English speakers during immersion and secondarily with certain cognitive (grammatical inferencing) and sociopsychological (extraversion) individual differences. Furthermore, the amount of interactive L2 use mediated the effect of sociopsychological individual differences (extraversion and potentially ideal L2 self). In contrast, gains in accentedness tended to be less subject to experience effects but could be affected by certain pronunciation‐related cognitive individual differences (phonemic coding).

Participation of Patients With Limited English Proficiency in Gynecologic Oncology Clinical Trials.

Significant disparities exist in recruitment of minorities to clinical trials, with much of the prior literature focused on race/ethnicity only. Limited English proficiency (LEP) is a known barrier in healthcare that may also drive disparities in trial enrollment. We sought to determine participation rates in gynecologic oncology trials among patients with LEP and to explore barriers to their participation. In a retrospective cohort study, electronic health record data from >2,700 patients treated over 2 years at one academic gynecologic oncology practice were abstracted and the primary exposure of having LEP was identified. The primary outcome was enrollment in a clinical trial. Demographic, financial, clinical, and healthcare access-related covariates were also abstracted and considered as potential confounders in a multivariable logistic regression model. Age, race, ethnicity, and insurance status were further examined for evidence of effect modification. In addition, a survey was administered to all gynecologic oncology research staff and gynecologic oncology providers (n=25) to assess barriers to research participation among patients with LEP. Clinical trial enrollment was 7.5% among fluent English speakers and 2.2% among patients with LEP (risk ratio, 0.29; 95% CI, 0.11-0.78; P=.007), and remained significantly lower in patients with LEP after adjusting for the identified confounders of Hispanic ethnicity and insurance payer (odds ratio, 0.34; 95% CI, 0.12-0.97; P=.043). There was a trend toward race and LEP interaction: Asian patients were equally likely to participate in research regardless of language fluency, whereas White and Black patients with LEP were less likely to participate than non-LEP patients in both groups (P=.07). Providers reported that the most significant barriers to enrollment of patients with LEP in research were unavailability of translated consent forms and increased time needed to enroll patients. Patients with LEP were 3.4 times less likely to participate in gynecologic oncology trials than fluent English speakers. De-aggregation of race, ethnicity, and language proficiency yielded important information about enrollment disparities. These findings offer avenues for future interventions to correct disparities.

Promoting EFL Learners’ Proficiency and Motivation via Google Jamboard-based Autonomous Knowledge Sharing

This study examined how Google Jamboard-based autonomous knowledge-sharing advanced language proficiency and motivation in an online intermediate–high EFL communication course. For one semester, 30 Korean first-year college students shared their learning experiences beyond the classroom, enhancing their English communication competence via a weekly Jamboard. The students speaking and perceived proficiencies and motivation changes were examined. Overall speaking proficiency increased, except for pronunciation. Students acquired the ability to selfstudy, but this was insufficient for oral practice because distance learning limited direct interactions. Perceived current proficiency increased, but imaginary proficiency and English importance did not. Their ease in using English in their daily life improved, and they felt the gap between the current and imaginary proficiencies decreased. The ideal L2 self increased, based on instrumentality and integrativeness. This finding indicates that students understood that they were undergoing the process of becoming fluent English speakers. Hence, well-organized self-directed activities can promote autonomous learning behavior to improve language proficiency and motivation.

Gratitude in Foreign Language Learning

Studies on positive emotions in language learning have increased over the years. However, gratitude, a moral virtue, which may have a novel effect in learning a foreign language, remains underexplored in applied linguistics. This paper aims to know the antecedents of gratitude and its constructs in English as a foreign language context. Nineteen antecedents of gratitude were generated to create a survey questionnaire called Foreign Language Gratitude Scale, a 4-point Likert rating scale. An open-ended question was also added to gain qualitative data. Convenience sampling was used to collect data from 240 undergraduate students. Descriptive statistics results showed that the participants were very grateful in all situations in the survey, specifically for their improved outputs and the corrections initiated by their teachers. Further, principal component analysis was used to explore the underlying dimensions of gratitude. Two factors were elicited – positive reinforcement and language practice. The first factor includes the following grateful situations: encouraging students to do better, appreciating students’ output, correcting students’ mistakes, using media resources in learning, sharing practical knowledge, providing examples and practices, treating students equally, encouraging language activities, and managing classroom effectively. The grateful situations in the second factor are having fluent English speakers, doing productive activities, providing opportunities, sharing ideas, and having a better output. Other factors coded from the qualitative data include promoting collaborative work, gaining comprehension and knowledge, language success, encouraging productive activities, the teacher acts, and designing out-of-class activities. Finally, implications of results and suggestions for future studies were presented.

Validationof the Spanish version of the Sunnybrook facial grading system.

The Sunnybrook facial grading system (SFGS) is one of the most widely employed tools to assess facial function. The present study aimed to determine the validity and reliability of the Spanish language version of the SFGS. Forward-backward translation from the original English version was performed by fluent speakers of English and Spanish. Videos from 65 patients with facial paralysis (FP) were evaluated twice by five otolaryngologists with experience in FP evaluation. Internal consistency and intra- and inter-rater reliability were assessed. The House-Brackmann scale was used to display concurrent validity which was established by Spearman's rho correlation. The Cronbach's α score exceeded 0.70. The intra-rater intraclass correlation coefficient (ICC) was nearly perfect for the composite score (0.96-0.99), voluntary movements (0.97-0.99), and synkinesis (0.91-0.98), and important to almost perfect for symmetry at rest (0.79-0.97). In both evaluations, the inter-rater ICC was higher than 0.90 for the composite score (0.92-0.96) and voluntary movements (0.91-0.96) and slightly lower for symmetry at rest (0.66-0.85) and synkinesis (0.72-0.87). A strong negative correlation was found between the H-B scale and SFGS (Spearman's rho coefficient = -0.92, p < 0.001) in both evaluations. The Spanish version of the SFGS is a reliable and valuable instrument for the assessment of facial function in the diagnosis and treatment of patients with FP.

QOL-21. Language development and outcomes in pediatric brain tumor

Abstract RATIONALE: Pediatric brain tumor (PBT) survivors are at risk for speech (e.g., articulation, prosody, fluency) and language (e.g., vocabulary, grammar, narratives, pragmatics) difficulties, though group outcomes vary with study design and individual risk factors (Hodges et al 2020). This study characterizes language functioning for clinically referred PBT survivors diagnosed in early childhood, a time of rapid language development and vulnerability. METHODS: Participants were 98 PBT patients (56 supratentorial) diagnosed by age 6 (M = 43.8 months, SD 24.4) who received tumor-directed intervention (surgery, chemotherapy, and/or radiation). Age at neuropsychological evaluation (2019 – 2022) was 2-19 years (M = 9.1, SD 4.1). Patients were 56% male, 73.5% White, and fluent English speakers. Verbal IQ, naming, working memory, fluency, comprehension, syntactic and phonological processing, and parent-reported functional communication outcomes were assessed. Rates of weak performance (1 SD&amp;lt;Mean) were compared to the expected base rate of 16%. RESULTS: Group means significantly diverged from age-expected performance in all domains except fluency. IQ correlated with most language measures, age at diagnosis (r .280, p .010), and time from diagnosis (r -.276, p .012). Weakness was identified on at least 1 verbal subtests for 71.4% of the full sample and most (57%) patients with IQ&amp;gt;84. Patients with NF1 (n=15) or treatment-related hearing concerns had lower reported functional communication. Naming difficulty was associated with supratentorial tumors; there were no other significant differences by tumor type or location. While functional communication correlated with several measures, weaknesses on performance-based and parent-report measures only corresponded for 44.6% of the sample. CONCLUSIONS: Language weaknesses are prevalent following early childhood PBT diagnosis. IQ and functional communication measures are useful indicators of risk, but more detailed and higher-level language measures are needed, particularly for cognitively intact patients. Additional implications and research needs will be discussed.

Academic English Program Evaluation of the Foundation Year at Saudi Petroleum Services Polytechnic College: Trainees and EFL Instructors’ Perceptions

The main reason of conducting this study is grounded on my rational to provide further guidance to curriculum staff in my professional context, College of Saudi Petroleum Services Polytechnic (SPSP), to develop the current English program taught to vocational trainees to prepare them to their future jobs at petroleum services industry in Saudi Arabia. Unfortunately, the graduates’ spoken language is inadequate at their worksites and therefore their employers are relatively dissatisfied with the language quality of their manpower. Accordingly, I have decided to explore the speaking skill aspects in the existing English curriculum to value its effectiveness in improving and helping the academic staff to produce fluent speakers of English at oil industry workplaces. Based on my study findings, I have found that it is relatively difficult to assign a language course book which meets all the needs of trainees at vocational training institutions because their working environment needs specific learning objectives for learning job-related language. In my research and professional experience, as a researcher in language curriculum development as well as being a language instructor at a vocational training college, I can conclude that the solution to solve language learning and its implication at workplace is to develop EAP/ESP language program based on specific instructional objectives driven from the actual needs assessment at the target workplaces and their intended learning outcomes could be aligned with both learning and teaching activities and assessment tasks using the constructive alignment principles as the constructive alignment framework could be effective in structuring and designing aligned curriculum to meet the intended goals of these contexts, especially vocational training centers and higher education institutions.

Effects of background noise and extraversion on reading comprehension performance

This study was concerned with the effects of acoustic distraction at work. Using a within-subject study we aimed to investigate the effect of background distraction on cognitive performance. In the presence of silence, white noise, and sirens, 55 fluent English speakers completed three equivalent variations of a reading comprehension task. As predicted, there was a significant main effect of background sound, with poorer performance in the presence of distraction (particularly sirens), but no interaction was found between distraction and extraversion. Thus, the findings partially replicated previous research in terms of distraction but were inconsistent with regard to the Eysenckian theory of arousal differences between introverts and extraverts. Implications of the effect of sirens on those they are not designed to alert are considered. Limitations of this study are also considered. Practitioner Summary: This study was concerned with whether white noise and the sound of sirens affects reading comprehension. We found that compared to doing a highly involving and demanding cognitive task in silence, siren noise has the most significant negative effect on performance. Compared to working silence, white noise also reduced the efficiency of text comprehension. There were no introvert–extravert effects.

Assessment of Speech Understanding After Cochlear Implantation in Adult Hearing Aid Users

Cochlear implants were approved for use in adults in the 1980s, but use remains low owing to a lack of awareness regarding cochlear implantation candidacy criteria and expected outcomes. There have been limited, small series examining the safety and effectiveness of cochlear implantation in adult hearing aid (HA) users with and without mild cognitive impairment (MCI). To investigate the safety and effectiveness of a single-ear cochlear implant in a group of optimized adult HA users with and without MCI across a variety of domains. In this nonrandomized controlled trial, a multicenter, prospective, repeated-measures investigation was conducted at 13 US institutions. The setting was academic and community-based cochlear implant programs. Eligible participants were 100 adults (aged >18 years) with postlinguistic onset of bilateral moderate sloping to profound or worse sensorineural hearing loss (≤20 years' duration). Fluent English speakers underwent an optimized bilateral HA trial for at least 30 days. Individuals with aided Consonant-Vowel Nucleus-Consonant (CNC) word score in quiet of 40% or less correct in the ear to be implanted and 50% or less correct in the contralateral ear were offered cochlear implants. The first participant was enrolled on February 20, 2017, and the last participant was enrolled on May 3, 2018. The final follow-up was on December 21, 2018. Participants received the same cochlear implant system and contralateral HA. The primary outcome measure was speech understanding in quiet (CNC word score) using both the cochlear implant and opposite ear HA. Secondary outcome measures included the following: adverse events; speech understanding in noise (AzBio signal-to-noise ratio of +10 db [+10 SNR]) Health Utilities Index Mark 3 (HUI3); Speech, Spatial, and Qualities of Hearing Questionnaire 49 (SSQ49); and Montreal Cognitive Assessment (MoCA). The median age at cochlear implantation of the 96 patients included in the trial was 71 years (range, 23-91 years), and 62 patients (65%) were male. Three serious adverse events requiring revision surgery occurred, and all resolved without sequelae. By 6 months after activation, the absolute marginal mean change in CNC word score and AzBio +10 SNR was 40.5% (95% CI, 35.9%-45.0%) and 24.1% (95% CI, 18.9%-29.4%), respectively. Ninety-one percent (87 of 96) of participants had a clinically important improvement (>15%) in the CNC word score in the implant ear. Mild cognitive impairment (MoCA total score ≤25) was observed in 48 of 81 study participants (59%) at baseline. Speech perception marginal mean improvements were similar between individuals with and without baseline MCI, with values of 40.9% (95% CI, 35.2%-46.6%) and 39.6% (95% CI, 31.8%-47.4%), respectively, for CNC word score and 27.5% (95% CI, 21.0%-33.9%) and 17.8% (95% CI, 9.0%-26.6%), respectively, for AzBio +10 SNR. Statistically significant and clinically important improvements in the HUI3 and SSQ49 were evident at 6 months. The findings of this nonrandomized controlled trial seem to indicate that cochlear implants are safe and effective in restoring speech understanding in both quiet and noise and improve quality of life in individuals with and without MCI. ClinicalTrials.gov Identifier: NCT03007472.

New Form of Social Capital: Language Advice Networks in Multilingual Organizations

We present a new form of social capital, the Language Advice Network (LAN)- an informal network in which individuals with low and high levels of English fluency seek and offer language-related advice at work in multilingual organization that adopt English as lingua franca. Extant research on language and international business highlights the generally negative impact of lingua franca on social integration in multinational organizations. We present a case study of how lingua franca positively contributes to forming ties between fluent and less-fluent English speakers, drawing on data from a Qatari multinational organization, a context where migrant- and expatriate workers outnumber (local) nationals at their headquarters and their home language is Arabic. Adopting a mixed-methods approach including participant observations, focus groups, individual interviews and social networks analyses, we find that the individuals who actively engage in LAN foster social capital (bridging and bonding) and achieve positive career outcomes - enhanced status, empowerment, and tangible rewards.