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1.
Trends Hear ; 26: 23312165221134378, 2022.
Article in English | MEDLINE | ID: covidwho-2139084

ABSTRACT

Unhindered auditory and visual signals are essential for a sufficient speech understanding of cochlear implant (CI) users. Face masks are an important hygiene measurement against the COVID-19 virus but disrupt these signals. This study determinates the extent and the mechanisms of speech intelligibility alteration in CI users caused by different face masks. The audiovisual German matrix sentence test was used to determine speech reception thresholds (SRT) in noise in different conditions (audiovisual, audio-only, speechreading and masked audiovisual using two different face masks). Thirty-seven CI users and ten normal-hearing listeners (NH) were included. CI users showed a reduction in speech reception threshold of 5.0 dB due to surgical mask and 6.5 dB due to FFP2 mask compared to the audiovisual condition without mask. The greater proportion of reduction in SRT by mask could be accounted for by the loss of the visual signal (up to 4.5 dB). The effect of each mask was significantly larger in CI users who exclusively hear with their CI (surgical: 7.8 dB, p = 0.005 and FFP2: 8.7 dB, p = 0.01) compared to NH (surgical: 3.8 dB and FFP2: 5.1 dB). This study confirms that CI users who exclusively rely on their CI for hearing are particularly susceptible. Therefore, visual signals should be made accessible for communication whenever possible, especially when communicating with CI users.


Subject(s)
COVID-19 , Cochlear Implants , Speech Perception , Humans , Masks/adverse effects , Pandemics , Speech Intelligibility
2.
Cogn Res Princ Implic ; 7(1): 73, 2022 07 30.
Article in English | MEDLINE | ID: covidwho-2109073

ABSTRACT

Mask-wearing during the COVID-19 pandemic has prompted a growing interest in the functional impact of masks on speech and communication. Prior work has shown that masks dampen sound, impede visual communication cues, and reduce intelligibility. However, more work is needed to understand how speakers change their speech while wearing a mask and to identify strategies to overcome the impact of wearing a mask. Data were collected from 19 healthy adults during a single in-person session. We investigated the effects of wearing a KN95 mask on speech intelligibility, as judged by two speech-language pathologists, examined speech kinematics and acoustics associated with mask-wearing, and explored KN95 acoustic filtering. We then considered the efficacy of three speaking strategies to improve speech intelligibility: Loud, Clear, and Slow speech. To inform speaker strategy recommendations, we related findings to self-reported speaker effort. Results indicated that healthy speakers could compensate for the presence of a mask and achieve normal speech intelligibility. Additionally, we showed that speaking loudly or clearly-and, to a lesser extent, slowly-improved speech intelligibility. However, using these strategies may require increased physical and cognitive effort and should be used only when necessary. These results can inform recommendations for speakers wearing masks, particularly those with communication disorders (e.g., dysarthria) who may struggle to adapt to a mask but can respond to explicit instructions. Such recommendations may further help non-native speakers and those communicating in a noisy environment or with listeners with hearing loss.


Subject(s)
COVID-19 , Communication Disorders , Adult , COVID-19/prevention & control , Cognition , Humans , Masks , N95 Respirators , Pandemics , Speech Intelligibility
3.
J Acoust Soc Am ; 151(4): 2276, 2022 04.
Article in English | MEDLINE | ID: covidwho-1807295

ABSTRACT

In March 2020 with the advent of COVID, emergency plans were put in place to deliver the Master's Course in Environmental and Architectural Acoustics entirely on-line. This was necessary as although the acoustics laboratory is large, it was deemed to be unsafe for face-to-face teaching due to a complete lack of ventilation in the anechoic and reverberation chambers. Hence, it was necessary to create an alternative for the 2020/21 delivery. In September 2020, it was decided that a "Lab in a Box" supported by on-line demonstrations and pre-recorded films would create the best alternative experience for the postgraduate students. The "Lab in a Box" allowed demonstrations to be replicated at home or in the garden using a Windows based calibrated measurement platform based on audio components. Examples of such laboratories included Fast and Slow Measurements, Noise Exposure, Noise Survey, Loudness, Reverberation Time, and Speech Intelligibility. The results showed that the students gained from more independence and increased flexibility in delivery, achieving very similar marks. This has opened up the possibility of increasing student numbers by reusing these alternative teaching strategies in the future.


Subject(s)
COVID-19 , Speech Perception , Acoustics , COVID-19/epidemiology , Humans , Laboratories , Pandemics , Speech Intelligibility , Teaching
4.
Trends Hear ; 26: 23312165221087011, 2022.
Article in English | MEDLINE | ID: covidwho-1799133

ABSTRACT

Following the outbreak of the COVID-19 pandemic, public-health measures introduced to stem the spread of the disease caused profound changes to patterns of daily-life communication. This paper presents the results of an online survey conducted to document adult cochlear-implant (CI) users' perceived listening difficulties under four communication scenarios commonly experienced during the pandemic, specifically when talking: with someone wearing a facemask, under social/physical distancing guidelines, via telephone, and via video call. Results from ninety-four respondents indicated that people considered their in-person listening experiences in some common everyday scenarios to have been significantly worsened by the introduction of mask-wearing and physical distancing. Participants reported experiencing an array of listening difficulties, including reduced speech intelligibility and increased listening effort, which resulted in many people actively avoiding certain communication scenarios at least some of the time. Participants also found listening effortful during remote communication, which became rapidly more prevalent following the outbreak of the pandemic. Potential solutions identified by participants to ease the burden of everyday listening with a CI may have applicability beyond the context of the COVID-19 pandemic. Specifically, the results emphasized the importance of visual cues, including lipreading and live speech-to-text transcriptions, to improve in-person and remote communication for people with a CI.


Subject(s)
COVID-19 , Cochlear Implantation , Cochlear Implants , Speech Perception , Adult , Humans , Pandemics , Speech Intelligibility
5.
Otol Neurotol ; 43(3): 282-288, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1722677

ABSTRACT

OBJECTIVE: To investigate the effects of wearing a simulated mask on speech perception of normal-hearing subjects. STUDY DESIGN: Prospective cohort study. SETTING: University hospital. PATIENTS: Fifteen normal-hearing, native German speakers (8 female, 7 male). INTERVENTION: Different experimental conditions with and without simulated face masks using the audiovisual version of the female German Matrix test (Oldenburger Satztest, OLSA). MAIN OUTCOME MEASURES: Signal-to-noise ratio (SNR) at speech intelligibility of 80%. RESULTS: The SNR at which 80% speech intelligibility was achieved deteriorated by a mean of 4.1 dB SNR when simulating a medical mask and by 5.1 dB SNR when simulating a cloth mask in comparison to the audiovisual condition without mask. Interestingly, the contribution of the visual component alone was 2.6 dB SNR and thus had a larger effect than the acoustic component in the medical mask condition. CONCLUSIONS: As expected, speech understanding with face masks was significantly worse than under control conditions. Thus, the speaker's use of face masks leads to a significant deterioration of speech understanding by the normal-hearing listener. The data suggest that these effects may play a role in many everyday situations that typically involve noise.


Subject(s)
Masks , Speech Perception , Female , Hearing , Humans , Male , Prospective Studies , Speech Intelligibility
6.
J Acoust Soc Am ; 150(3): 1674, 2021 09.
Article in English | MEDLINE | ID: covidwho-1583240

ABSTRACT

With the Covid-19 pandemic, face masks have become part of our daily lives. While face masks are effective in slowing down the spread of the virus, they also make face-to-face communication more challenging. The present study sought to examine the impact of face masks on listeners' intelligibility and recall of sentences produced by one German native adult and one child talker. In the intelligibility task, German native adult listeners watched video clips of either an adult or a child talker producing sentences with and without a face mask. In a cued-recall experiment, another group of German native listeners watched the same video clips and then completed a cued-recall task. The results showed that face masks significantly affected listeners' intelligibility and recall performance, and this effect was equally true for both talkers. The findings here contribute to the fast growing and urgent research regarding the impact of face masks on communication.


Subject(s)
COVID-19 , Speech Perception , Adult , Child , Humans , Masks , Pandemics , SARS-CoV-2 , Speech Intelligibility
7.
Int J Environ Res Public Health ; 18(23)2021 12 03.
Article in English | MEDLINE | ID: covidwho-1559485

ABSTRACT

This review aims to examine the discrimination and prejudices toward the accent of non-native English speakers and cyberbullying as the ripple effect of these negative consequences. Following Arksey and O'Malley's framework of conducting a scoping review, 60 studies from 2012 to 2021 were retrieved from the ERIC and Google Scholar databases. The studies were reviewed from two aspects: (1) psychological impact on speakers with a non-native English accent, (2) attitudes toward non-native English accents from the victim's and perpetrator's perspectives. The findings suggested that speaking with a non-native English accent drew negative cognitive, affective, and behavioral experiences. Biases toward non-native English accents were due to the general derogatory perception of an accent and the comprehensibility of speakers' accent and pronunciation. "Accent acceptability" can be inculcated at all levels of education, not only through multicultural education but also through the concerted effort of policy makers and practitioners to seriously address this social issue. Accent awareness can dispel unwarranted and undesirable judgements of non-native English accent speakers. Future studies should be conducted on the effects of social and mental health experiences, particularly of non-native ESL and EFL teachers, given that this may be the only profession required to teach "live" during the pandemic and thus be subjected to public praise or ridicule.


Subject(s)
Multilingualism , Speech Perception , Cultural Diversity , Language , Speech Intelligibility
8.
Am J Speech Lang Pathol ; 30(2): 503-516, 2021 03 26.
Article in English | MEDLINE | ID: covidwho-1545665

ABSTRACT

Purpose COVID-19 has shifted models of health care delivery, requiring the rapid adoption of telehealth, despite limited evidence and few resources to guide speech-language pathologists. Management of dysarthria presents specific challenges in the telehealth modality. Evaluations of dysarthria typically rely heavily on perceptual judgments, which are difficult to obtain via telehealth given a variety of technological factors such as inconsistencies in mouth-to-microphone distance, changes to acoustic properties based on device settings, and possible interruptions in connection that may cause video freezing. These factors limit the validity, reliability, and clinicians' certainty of perceptual speech ratings via telehealth. Thus, objective measures to supplement the assessment of dysarthria are essential. Method This tutorial outlines how to obtain objective measures in real time and from recordings of motor speech evaluations to support traditional perceptual ratings in telehealth evaluations of dysarthria. Objective measures include pause patterns, utterance length, speech rate, diadochokinetic rates, and overall speech severity. We demonstrate, through clinical case vignettes, how these measures were completed following three clinical telehealth evaluations of dysarthria conducted via Zoom during the COVID-19 pandemic. This tutorial describes how each of these objective measures were utilized, in combination with subjective perceptual analysis, to determine deviant speech characteristics and their etiology, develop a patient-specific treatment plan, and track change over time. Conclusion Utilizing objective measures as an adjunct to perceptual ratings for telehealth dysarthria evaluations is feasible under real-world pandemic conditions and can be used to enhance the quality and utility of these evaluations.


Subject(s)
Dysarthria/therapy , Speech-Language Pathology/methods , Telemedicine/methods , COVID-19/epidemiology , Humans , Pandemics , SARS-CoV-2 , Speech Intelligibility , Telemedicine/standards
9.
J Acoust Soc Am ; 150(3): 2030, 2021 09.
Article in English | MEDLINE | ID: covidwho-1438063

ABSTRACT

Both the scarcity and environmental impact of disposable face masks, as in the COVID-19 pandemic, have instigated the recent development of reusable masks. Such face masks reduce transmission of infectious agents and particulates, but often impact a user's ability to be understood when materials, such as silicone or hard polymers, are used. In this work, we present a numerical optimisation approach to optimise waveguide topology, where a waveguide is used to transmit and direct sound from the interior of the mask volume to the outside air. This approach allows acoustic energy to be maximised according to specific frequency bands, including those most relevant to human speech. We employ this method to convert a resuscitator mask, made of silicone, into respiration personal protective equipment (PPE) that maximises the speech intelligibility index (SII). We validate this approach experimentally as well, showing improved SII when using the fabricated device. Together, this design represents a unique and effective approach to utilize and adapt available apparatus to filter air while improving the ability to communicate effectively, including in healthcare settings.


Subject(s)
COVID-19 , Speech Intelligibility , Humans , Masks , Pandemics , Respiration , SARS-CoV-2
10.
Eur Arch Otorhinolaryngol ; 278(9): 3565-3570, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1384414

ABSTRACT

OBJECTIVE: To predict the impact of face personal protective equipment on verbal communication during the SARS-CoV-2 pandemic. DESIGN: We assessed the effect of common types and combinations of face personal protective equipment on speech intelligibility in quiet and in a simulated noisy environment. RESULTS: Wearing face personal protective equipment impairs transmission of middle-to-high voice frequencies and affects speech intelligibility. Surgical masks are responsible for up to 23.3% loss of speech intelligibility in noisy environments. The effects are larger in the condition of advanced face personal protective equipment, accounting for up to 69.0% reduction of speech intelligibility. CONCLUSION: The use of face personal protective equipment causes significant verbal communication issues. Healthcare workers, school-aged children, and people affected by voice and hearing disorders may represent specific at-risk groups for impaired speech intelligibility.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Communication , Humans , Masks , Personal Protective Equipment , Speech Intelligibility
12.
Int J Audiol ; 61(5): 365-370, 2022 05.
Article in English | MEDLINE | ID: covidwho-1328904

ABSTRACT

OBJECTIVE: The aim of the study was to investigate the effect of surgical masks and face shields on speech intelligibility of adults with moderate to severe hearing loss. DESIGN: This study measured speech tracking scores in quiet for life speech in three different conditions: without a mask, with a surgical mask and with a face shield. Acoustic effects of the masks and face shields on the speech signal were also investigated. Study sample: The study sample consists of 42 patients with moderate to severe hearing loss, 23 cochlear implant users and 19 hearing aid users. RESULTS: A significant average difference in speech perception scores was found for the use of a surgical mask compared to the listening situation "without mask". The worse the speech understanding in quiet, the larger the impact of the surgical mask. For the worse performers even the face shield had a negative impact on speech perception. The sound distortion for the face shield compared to the surgical mask was greater. CONCLUSION: This study shows that even for speech perception in quiet, surgical face masks, and face shields to a lesser extent, have a negative effect for patients with moderate to severe hearing loss.


Subject(s)
COVID-19 , Cochlear Implants , Deafness , Hearing Aids , Hearing Loss , Speech Perception , Adult , Hearing Loss/diagnosis , Humans , Masks , Speech Intelligibility
13.
Orthopedics ; 44(4): 208-214, 2021.
Article in English | MEDLINE | ID: covidwho-1320605

ABSTRACT

Surgical suits provide protection to orthopedic surgeons, but the suits and fan noise may interfere with communication between operative team members. The goal of this study was to quantify the fan sound and effect of the suit, fan, and N95 mask. Sound levels were measured using a specialized manikin and evaluated using preferred speech interference levels (PSILs), noise criterion (NC) ratings, and comparison with speech sound levels from the literature. Additionally, sound blocking due to the surgical suit was measured and combined effects of the fan and suit were described using a signal to noise ratio (SNR). The noise with the fan at medium and high speed was louder than average speech and the PSILs at these speeds were significantly higher than with the fan off. The fan NC rating of 50 to 60 exceeded the recommended range of 25 to 30 for operating rooms. The N95 mask, space suit, and distance between speaker and receiver all reduced the sound signal at the receiver's ear, with the worst case being full personal protective equipment on both and speaker distanced from receiver. The estimated SNR for the suit and fan system was negative for many frequency bands used in speech, indicating more noise than signal. Multiple measures indicated that the fan noises were at levels associated with speech interference. This noise combined with sound blocking provided by the suit produced SNRs commonly associated with noisy to very noisy environments. This study suggests the combined effects of the suit, fan, and distance may negatively impact operating room communication. [Orthopedics. 2021;44(4):208-214.].


Subject(s)
Orthopedics , Speech Intelligibility , Head Protective Devices , Humans , Noise/adverse effects , Personal Protective Equipment
14.
J Acoust Soc Am ; 149(6): 4013, 2021 06.
Article in English | MEDLINE | ID: covidwho-1276871

ABSTRACT

Though necessary, protective mask wearing in response to the COVID-19 pandemic presents communication challenges. The present study examines how signal degradation and loss of visual information due to masks affects intelligibility and memory for native and non-native speech. We also test whether clear speech can alleviate perceptual difficulty for masked speech. One native and one non-native speaker of English recorded video clips in conversational speech without a mask and conversational and clear speech with a mask. Native English listeners watched video clips presented in quiet or mixed with competing speech. The results showed that word recognition and recall of speech produced with a mask can be as accurate as without a mask in optimal listening conditions. Masks affected non-native speech processing at easier noise levels than native speech. Clear speech with a mask significantly improved accuracy in all listening conditions. Speaking clearly, reducing noise, and using surgical masks as well as good signal amplification can help compensate for the loss of intelligibility due to background noise, lack of visual cues, physical distancing, or non-native speech. The findings have implications for communication in classrooms and hospitals where listeners interact with teachers and healthcare providers, oftentimes non-native speakers, through their protective barriers.


Subject(s)
COVID-19 , Speech Perception , Humans , Masks , Pandemics , SARS-CoV-2 , Speech Intelligibility
15.
Aerosp Med Hum Perform ; 92(4): 274-280, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1146055

ABSTRACT

INTRODUCTION: In response to the urgent need for safe aircrew respiratory protection due to the COVID-19 pandemic, three small descriptive evaluations were conducted with aircrew and air traffic controllers (ATC) that assessed the impact of mask use on safety and performance onboard rotary wing aircraft.METHODS: A series of evaluations assessed aircrew performance using the 3MTM Model 1860 N95 respiratory protection mask, two aviation-specific cloth mask prototypes, and a commercial off-the-shelf aviation-specific cloth mask. The series of evaluations included different sets of subjects consisting of up to five Black Hawk helicopter aircrew members, air traffic control (ATC), and 12 CH-47 aircrew members. The Modified Rhyme Test was used to measure speech intelligibility and was administered in the UH-60 among crewmembers of the same aircraft, between pilots of different aircraft, and between the pilots and ATC. Measures of workload, usability, comfort, and pulse oximetry were also administered.RESULTS: Results from the Modified Rhyme Test indicated that all subjects scored greater than 80% accuracy given the proper microphone positioning relative to the mask. With respect to workload, NASA-TLX total scores for the perform radio communications task was 50.83.DISCUSSION: Despite an elevated perceived degree of workload on the communications flight task, results from the speech intelligibility test indicated that performance was maintained within the acceptable range as defined by MIL-STD-1474E, Design Criteria Standard Noise Limit. This abbreviated evaluation suggests that the face masks tested are safe for use by helicopter aircrew under the conditions tested.Cave KM, Kelley AM, Feltman KA, Gerstner JA, Stewart JL, Crowley JS. Aircrew performance and safety while using protective masks in response to coronavirus disease. Aerosp Med Hum Perform. 2021; 92(4):274280.


Subject(s)
Aircraft , Masks , Speech Discrimination Tests , Speech Intelligibility , Humans , Radio , Safety , Workload
16.
J Acoust Soc Am ; 148(6): 3562, 2020 12.
Article in English | MEDLINE | ID: covidwho-1004074

ABSTRACT

Wearing face masks (alongside physical distancing) provides some protection against infection from COVID-19. Face masks can also change how people communicate and subsequently affect speech signal quality. This study investigated how three common face mask types (N95, surgical, and cloth) affected acoustic analysis of speech and perceived intelligibility in healthy subjects. Acoustic measures of timing, frequency, perturbation, and power spectral density were measured. Speech intelligibility and word and sentence accuracy were also examined using the Assessment of Intelligibility of Dysarthric Speech. Mask type impacted the power distribution in frequencies above 3 kHz for the N95 mask, and above 5 kHz in surgical and cloth masks. Measures of timing and spectral tilt mainly differed with N95 mask use. Cepstral and harmonics to noise ratios remained unchanged across mask type. No differences were observed across conditions for word or sentence intelligibility measures; however, accuracy of word and sentence translations were affected by all masks. Data presented in this study show that face masks change the speech signal, but some specific acoustic features remain largely unaffected (e.g., measures of voice quality) irrespective of mask type. Outcomes have bearing on how future speech studies are run when personal protective equipment is worn.


Subject(s)
COVID-19/prevention & control , Masks/adverse effects , Speech Acoustics , Speech Intelligibility , Adult , Female , Humans , Male , SARS-CoV-2 , Voice Quality , Young Adult
17.
J Acoust Soc Am ; 148(6): 3663, 2020 12.
Article in English | MEDLINE | ID: covidwho-1004073

ABSTRACT

With the COVID-19 pandemic, the wearing of face masks covering mouth and nose has become ubiquitous all around the world. This study investigates the impact of typical face masks on voice radiation. To analyze the transmission loss caused by masks and the influence of masks on directivity, this study measured the full-spherical voice directivity of a dummy head with a mouth simulator covered with six masks of different types, i.e., medical masks, filtering facepiece respirator masks, and cloth face coverings. The results show a significant frequency-dependent transmission loss, which varies depending on the mask, especially above 2 kHz. Furthermore, the two facepiece respirator masks also significantly affect speech directivity, as determined by the directivity index (DI). Compared to the measurements without a mask, the DI deviates by up to 7 dB at frequencies above 3 kHz. For all other masks, the deviations are below 2 dB in all third-octave frequency bands.


Subject(s)
COVID-19/prevention & control , Masks , Speech Acoustics , Speech Intelligibility , Voice , Humans , SARS-CoV-2
18.
J Speech Lang Hear Res ; 63(12): 3982-3990, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-927154

ABSTRACT

Purpose There has been increased interest in using telepractice for involving more diverse children in research and clinical services, as well as when in-person assessment is challenging, such as during COVID-19. Little is known, however, about the feasibility, reliability, and validity of language samples when conducted via telepractice. Method Child language samples from parent-child play were recorded either in person in the laboratory or via video chat at home, using parents' preferred commercially available software on their own device. Samples were transcribed and analyzed using Systematic Analysis of Language Transcripts software. Analyses compared measures between-subjects for 46 dyads who completed video chat language samples versus 16 who completed in-person samples; within-subjects analyses were conducted for a subset of 13 dyads who completed both types. Groups did not differ significantly on child age, sex, or socioeconomic status. Results The number of usable samples and percent of utterances with intelligible audio signal did not differ significantly for in-person versus video chat language samples. Child speech and language characteristics (including mean length of utterance, type-token ratio, number of different words, grammatical errors/omissions, and child speech intelligibility) did not differ significantly between in-person and video chat methods. This was the case for between-group analyses and within-child comparisons. Furthermore, transcription reliability (conducted on a subset of samples) was high and did not differ between in-person and video chat methods. Conclusions This study demonstrates that child language samples collected via video chat are largely comparable to in-person samples in terms of key speech and language measures. Best practices for maximizing data quality for using video chat language samples are provided.


Subject(s)
COVID-19 , Language Disorders/diagnosis , Language Tests/standards , Speech Production Measurement/standards , Telemedicine/standards , Child Language , Child, Preschool , Feasibility Studies , Female , Humans , Infant , Longitudinal Studies , Male , Non-Randomized Controlled Trials as Topic , Reproducibility of Results , SARS-CoV-2 , Speech Intelligibility , Speech Production Measurement/methods , Telemedicine/methods
19.
J Laryngol Otol ; 134(7): 577-581, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-639738

ABSTRACT

BACKGROUND: Coronavirus disease 2019 personal protective equipment has been reported to affect communication in healthcare settings. This study sought to identify those challenges experimentally. METHOD: Bamford-Kowal-Bench speech discrimination in noise performance of healthcare workers was tested under simulated background noise conditions from a variety of hospital environments. Candidates were assessed for ability to interpret speech with and without personal protective equipment, with both normal speech and raised voice. RESULTS: There was a significant difference in speech discrimination scores between normal and personal protective equipment wearing subjects in operating theatre simulated background noise levels (70 dB). CONCLUSION: Wearing personal protective equipment can impact communication in healthcare environments. Efforts should be made to remind staff about this burden and to seek alternative communication paradigms, particularly in operating theatre environments.


Subject(s)
Communication , Coronavirus Infections/therapy , Personal Protective Equipment/adverse effects , Pneumonia, Viral/therapy , Adult , COVID-19 , Female , Humans , Intensive Care Units , Male , Middle Aged , Operating Rooms , Pandemics , Personnel, Hospital/psychology , Speech , Speech Intelligibility
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