Assessing the Specificity and Accuracy of Accent Judgments by Lay Listeners.

Historically, there has been less research carried out on earwitness than eyewitness testimony. However, in some cases, earwitness evidence might play an important role in securing a conviction. This paper focuses on accent which is a central characteristic of voices in a forensic linguistic context. The paper focuses on two experiments (Experiment 1, n = 41; Experiment 2, n = 57) carried out with participants from a wide range of various locations around the United Kingdom to rate the accuracy and confidence in recognizing accents from voices from England, Scotland, Wales, Northern Ireland, and Ireland as well as looking at specificity of answers given and how this varies for these regions. Our findings show that accuracy is variable and that participants are more likely to be accurate when using vaguer descriptions (such as "Scottish") than being more specific. Furthermore, although participants lack the meta-linguistic ability to describe the features of accents, they are able to name particular words and pronunciations which helped them make their decision.

Evaluating earwitness identification procedures: adapting pre-parade instructions and parade procedure.

Voice identification parades can be unreliable, as earwitness responses are error-prone. In this paper we tested performance across serial and sequential procedures, and varied pre-parade instructions, with the aim of reducing errors. The participants heard a target voice and later attempted to identify it from a parade. In Experiment 1 they were either warned that the target may or may not be present (standard warning) or encouraged to consider responding "not present" because of the associated risk of a wrongful conviction (strong warning). Strong warnings prompted a conservative criterion shift, with participants less likely to make a positive identification regardless of whether the target was present. In contrast to previous findings, we found no statistically reliable difference in accuracy between serial and sequential parades. Experiment 2 ruled out a potential confound in Experiment 1. Taken together, our results suggest that adapting pre-parade instructions provides a simple way of reducing the risk of false identifications.

Get Parkinson's medications on time: the Leeds QI project.

Parkinson's disease (PD) is a common neurodegenerative disease. Delayed administration of PD medications is associated with increased risk of life-threatening complications including choking, aspiration pneumonia and neuroleptic malignant syndrome. In 2016, the spouse of a patient with PD wrote to Leeds Teaching Hospitals Trust (LTHT) to highlight that multiple medication delays and omissions had occurred during his recent admission. In response, LTHT formed a PD quality improvement (QI) Collaborative of multidisciplinary members committed to ensuring timely PD medication administration. The faculty used Institute for Healthcare Improvement Model for Improvement QI methodology. Interventions were tested on pilot wards and the most successful were scaled up and spread across all 90 adult inpatient wards as an 'intervention bundle'. Between January 2016 and June 2020 mean delays in the time from admission to first dose of medication dropped from over 7 to under 1 h. The mean percentage of omitted PD medications reduced from 15.1 to 0.6%. Project success was multifactorial but due to: Simplicity of interventions.Multiprofessional ownership by frontline teams to make changes and take prompt action.The spouse of the patient taking a leading role in the Collaborative, bringing her unique personal insight and experience, which facilitated behavioural change.

Voice parade procedures: optimising witness performance.

Unfamiliar voice identification is error-prone. Whilst the investigation of system variables may indicate ways of boosting earwitness performance, this is an under-researched area. Two experiments were conducted to investigate how methods of presenting voices during a parade affect accuracy and self-rated confidence. In each experiment participants listened to a target voice, and were later asked to identify that voice from a nine-person target present or target absent parade. In Experiment 1, accuracy did not vary across parades comprising 15 or 30 s sample durations. Overall, when the target was present, participants correctly identified the target voice with 39% accuracy. However, when the target was absent, participants correctly rejected the parade 6% of the time. There was no relationship between accuracy and confidence. In Experiment 2, performance with a serial procedure, in which participants responded after hearing all nine voices, was compared with a sequential procedure, in which participants made a decision after listening to each voice. Overall accuracy was higher with the sequential procedure. These results highlight the importance of system variable research in voice identification. Different methods of presenting voices have the potential to support higher levels of accuracy than the procedure currently recommended in England and Wales.

What to do when people with Parkinson's disease cannot take their usual oral medications.

People with Parkinson's disease have limited brain reserves of endogenous dopamine; thus, their medications must not be omitted or delayed as this may lead to a significant drop in brain dopamine levels. This has two main clinical consequences: first, a deterioration in disease control, with distressing symptoms such as tremor, pain, rigidity, dysphagia and immobility, and second, an increased risk of developing the life-threatening complication of neuroleptic malignant-like syndrome. Common reasons for people with Parkinson's disease being unable to take their oral medications are neurogenic dysphagia from progressive disease or concurrent illness, gastroenteritis, iatrogenic 'nil by mouth' status especially perioperatively, and impaired consciousness level. Here we outline alternative methods to give dopaminergic drugs in the acute setting to people with Parkinson's disease who cannot take their usual oral treatment, namely using dispersible preparations in thickened fluids, an enteral tube, a transdermal patch or subcutaneous injections.

Impact of prescribed medications on patient safety in older people.

Appropriate prescribing for older adults presents unique challenges to the prescriber. An understanding of the scale of the problems and contributing factors is essential when designing interventions to improve patient safety. The altered pharmacology of ageing, the existence of multiple medical conditions and the exclusion of elderly patients from many trials render this subgroup of the population particularly vulnerable to underprescribing and overprescribing. Adverse drug events are common, causing significant morbidity and mortality as well as having economic implications. 'High-risk' medications such as opioids, anticoagulants and antipsychotics can have benefits in this group of patients but strategies to optimize their safety are required. Tools exist that help to identify those at risk of adverse drug reactions and to screen for inappropriate prescribing. Developments in information technology are ongoing, and it is hoped that these may enhance the process of medication reconciliation across healthcare transitions and alert the prescriber to potential adverse drug events. This review addresses commonly encountered issues when prescribing for older people, considers strategies to improve medication safety and offers a list of 'top tips' to aid the clinician.