To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
The use of electronic cigarettes (e-cigarettes) in smokers with mental health conditions (MHC) is not well understood.
This study aims to compare e-cigarette users and non-users among veteran smokers with MHC to characterize differences in smoking behavior, motivation to quit, psychological distress, primary psychiatric diagnosis, and other factors.
Baseline survey data were used from a randomized smoking cessation trial enrolling smokers with MHC from four Veterans Health Administration hospitals. Participants were categorized as current, former (having ever tried an e-cigarette), or never e-cigarette users. Pearson's χ2 and ANOVA Type-3 F-tests were used to test the bivariate associations between e-cigarette use and variables measured.
Among 1,836 participants, mean age was 58 years (STD ± 12.5), 87% were male, 15% were current e-cigarette users (n = 275), and 27% were former users (n = 503). Sixty-five percent of e-cigarette users reported ‘wanting to quit smoking’ as a primary reason. Mean readiness to quit smoking (1–10) was 7.2, 6.8, and 6.4 for current, former, and never e-cigarette users, respectively (P = 0.0002). Sixty-three percent of current and former users and 55% of never-users reported some mental distress on Kessler-6 scale (P = 0.0003, OR = 1.4, 95% CI 1.1–1.7). A primary psychiatric diagnosis of alcohol or substance use disorder was recorded for 50% of current or former users and 60% of never-users (P = 0.0003, OR = 0.69, 95% CI 0.56–0.84).
E-cigarette users were more ready to quit and most often reported using e-cigarettes to assist with quitting. E-cigarette users had more psychological distress and were less likely to have substance use disorders as their primary psychiatric diagnosis.
This is a copy of the slides presented at the meeting but not formally written up for the volume.
To address the needs of a wide variety of potential application domains, the sophistication and structural complexity of engineered nanoparticle systems has been steadily increasing. Often the unique functionality of these systems depends on the 3-dimensional distribution of multiple phases, ranging from simple coatings to core-shell morphologies to multifunctionalizations for drug delivery. This need for controlled 3-dimensional chemical heterogeneity at the nanoscale presents significant challenges both for the nanomanufacturing of these materials and their metrology and characterization. Even when the nanoparticles have relatively simple structures, the demands of modern process control methodologies and the specifications of end users frequently require increased metrology precision and decreased measurement bias for critical measurands such as coating thicknesses or particle size distributions. Recent advances in electron microscopy and focused ion beam (FIB) technology provide powerful tools for the 3-dimensional structural and elemental characterization of nanomaterials. Dimensional metrology using phase contrast high-resolution transmission electron microscopy (HRTEM) and scanning transmission electron microscopy (STEM) can measure the physical dimensions of nanostructures at the single nanometer level. Elemental mapping using energy-filtered TEM (EFTEM) can be used to map the spatial distribution of different stoichiometries, while electron tomography can reconstruct the 3-dimensional morphology of nanoparticle assemblies. Examples of the above techniques will be presented along with recent NIST efforts to fuse these techniques into a methodology for 3-dimensional chemical imaging of engineered nanostructures.
Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total score correlations and the diagnostic accuracy to detect major depression of the PHQ-8 and PHQ-9.
We conducted an individual patient data meta-analysis. We fit bivariate random-effects models to assess diagnostic accuracy.
16 742 participants (2097 major depression cases) from 54 studies were included. The correlation between PHQ-8 and PHQ-9 scores was 0.996 (95% confidence interval 0.996 to 0.996). The standard cutoff score of 10 for the PHQ-9 maximized sensitivity + specificity for the PHQ-8 among studies that used a semi-structured diagnostic interview reference standard (N = 27). At cutoff 10, the PHQ-8 was less sensitive by 0.02 (−0.06 to 0.00) and more specific by 0.01 (0.00 to 0.01) among those studies (N = 27), with similar results for studies that used other types of interviews (N = 27). For all 54 primary studies combined, across all cutoffs, the PHQ-8 was less sensitive than the PHQ-9 by 0.00 to 0.05 (0.03 at cutoff 10), and specificity was within 0.01 for all cutoffs (0.00 to 0.01).
PHQ-8 and PHQ-9 total scores were similar. Sensitivity may be minimally reduced with the PHQ-8, but specificity is similar.
The first description of voice quality production in forty years, this book provides a new framework for its study: The Laryngeal Articulator Model. Informed by instrumental examinations of the laryngeal articulatory mechanism, it revises our understanding of articulatory postures to explain the actions, vibrations and resonances generated in the epilarynx and pharynx. It focuses on the long-term auditory-articulatory component of accent in the languages of the world, explaining how voice quality relates to segmental and syllabic sounds. Phonetic illustrations of phonation types and of laryngeal and oral vocal tract articulatory postures are provided. Extensive video and audio material is available on a companion website. The book presents computational simulations, the laryngeal and voice quality foundations of infant speech acquisition, speech/voice disorders and surgeries that entail compensatory laryngeal articulator adjustment, and an exploration of the role of voice quality in sound change and of the larynx in the evolution of speech.
Chapter 4 contains extensive references to exemplifications of the voice quality categories described in Chapters 1 and 2. Distinctive voice quality settings of actors, singers, media announcers, politicians, and other personalities are cited with specific references to be used as search terms to locate video and audio material online. A separate ‘Multimedia References’ section is included at the end of the text to facilitate searching. Long-term voice qualities are essentially extralinguistic, but they can also alternate among phrases of speech as paralinguistic ‘registers’. Many laryngeal postures, and their auditory output, are employed linguistically as syllabic registers or segmental units to signal contrastive lexical meaning. This is a result of the positioning of the laryngeal articulator at the beginning of the shaping of the sound stream, where background elements are easily patterned behind oral articulations. Extensive references to linguistic examples of lower-vocal-tract consonantal strictures and tonal register effects are presented within the text notes and are included among the video and audio materials online.
Terminology for voice quality is revised, particularly for the lower vocal tract. The concepts of ‘voice quality’ as the long-term, habitual postural settings in an accent and ‘voice quality’ as the vibratory, phonatory portion of speech are reconciled through the laryngeal articulator mechanism that explains how multiple configurational adjustments and vibratory elements are achieved in the lower vocal tract. The origins of voice quality theory are reviewed, and articulatory settings of the laryngeal mechanism, velopharyngeal opening, the tongue, the jaw, and the lips are reviewed. The descriptions from Laver (1980) are reinforced, connections to laryngeal articulation are made explicit, and the musculature responsible for each setting is outlined. New drawings of the mechanisms of the vocal tract provide a fresh perspective on articulatory movements and resulting auditory qualities. Pharyngeal/epiglottal articulations are remapped, and their status as laryngeal configurations is made explicit.
Chapter 8 summarizes the ramifications of the Laryngeal Articular Model for the phonetic description of voice quality and investigates its place in phonetic theory. Predispositions for background voice qualities to underlie different vowel qualities are identified. It is argued that there is a parallel between the coarticulatory path that infants follow in their earliest speech development and elements in the process of phonetic sound change. The laryngeal articulator as an enabler of sound change is explored. Theories of ontogenetic speech development are reviewed (concepts of ‘speechlikeness,’ autogeneration, frame/content, cyclicity, reduplication, variegation) and reinterpreted to reflect the scope of laryngeal behaviour outlined in this volume. The discussion evaluates the implications of the revised view of laryngeal phonetic behaviour for the phylogeny of human speech. The physiology of the larynx is shown to permit a wider range of speech production than formerly assumed and to accommodate, on phonetic grounds, an earlier time period for the appearance of speech in human ancestors, as hypothesized in recent anthropological and genetic research.
Chapter 5 explores the implications of the Laryngeal Articulator Model for phonology and the place of voice quality in phonological analysis. The Phonological Potentials Model (PPM) is explained, and synergistic and anti-synergistic relations are mapped in diagrams. Earlier phonological approaches that do not consider the laryngeal articulator are reviewed, while the PPM demonstrates how cooperative lingual-laryngeal activity can be accommodated in phonological analysis. Case studies of languages having lower-vocal-tract contrasts (vocal register, pharyngealization in click languages) give an idea of the network of articulatory relationships that form the grounding of phonological representations. We highlight vocalic-harmony (so-called [ATR]), syllabic, and tense–lax registers in West African, Northeast African and Southeast Asian languages. The case of Southern Wakashan pharyngeal genesis illustrates the role of voice quality in sound change.
Three of Thomas Pynchon’s novels – The Crying of Lot 49 (1966), Vineland (1990), and Inherent Vice (2009) – are set primarily in California in the 1960s, 1970s, and 1980s. These “California novels” are shorter and less structurally complex than the longer, encyclopedic, globe-trotting, and quasi-historical works that have established his literary reputation (though The Crying of Lot 49 is undoubtedly the most widely read and taught of his novels). Two of the longer novels, Gravity’s Rainbow (1973) and Against the Day (2006), also conclude with episodes set in Southern California, in the 1970s and 1920s respectively. Despite their formal differences, the California novels deal with many of the same concerns that animate the longer works, including perhaps most centrally, the struggles of individual human subjects to understand and liberate themselves from the varied but often obscured agents of determinacy – economic, political, psychological, and existential – arrayed against them. In order to situate the California fiction within the body of Pynchon’s work, it is worth exploring some of the meanings attached to the common setting that Pynchon chose for them.
Instrumental phonetic techniques illustrate the analyses behind the interpretation of laryngeal articulator function and laryngeal sounds. High-speed laryngoscopy demonstrates aryepiglottic trilling. Cineradiography demonstrates where and how epiglottal stop and voiceless and voiced aryepiglottic trilling are generated. Simultaneous laryngoscopy and laryngeal ultrasound gauge the vertical displacement of the larynx during laryngeally constricted articulations compared to opening manoeuvres. MRI provides insight into the effects of lower-vocal-tract configurations on changes in vowel quality. Computational modelling shows how algorithms that account for voicing can be adapted to explain the mechanics of complex laryngeal vibrations. Vocal-ventricular fold coupling (VVFC) occurs as a vertical compression effect in stopping airflow and in constricted phonation types (creaky voice, harsh voice) and is modelled to illustrate the relationships and actions among laryngeal structures. Analyses, data capture, explanations of the algorithms, and videos of the working models are incorporated in the online companion materials, including articulatory simulations by the laryngeal component of the ‘ArtiSynth’ model.
Chapter 6 investigates the earliest steps of how infants acquire the phonetic capacity to speak. It is relevant to voice quality that infants begin life with laryngeally constricted qualities, based on which they develop elaborated oral articulations with laryngeal quality as background. Ontogenetically, speech begins with the laryngeal articulator. New drawings illustrate the infant vocal tract (vs. the adult vocal tract). The companion website contains over 100 audio files of phonetic stages during the first year of life, comparing articulatory development in English with Tibeto-Burman Bái. The LAM provides the basis for understanding the distribution of non-syllabic and syllabic utterances, focusing on intermediate ‘mixed’ utterances. During the first several months of life, infants parse phonetic possibilities, refining the identity of potential individual sounds against the emerging backgrounds of long-term laryngeal qualities. Laryngeal voice quality reflects a complex interaction between the developing physiology of the infant vocal tract and the innate disposition to engage in vocal exploration, playing a crucial role in speech development.
Chapter 7 explores laryngeal speech disorders, voice pathologies that depart from normal function, and the consequences of laryngeal surgery on voice quality from the perspective of the Laryngeal Articulator Model. Clinical cases involve the laryngeal mechanism as a whole, and many voice quality outcomes resemble the registers of linguistic systems. New drawings diagram surgical excisions of laryngeal structures. Post-surgery compensatory behaviours demonstrate innovative adaptation of the aryepiglottic sphincter mechanism to generate ‘substitution voice’. Numerous videos/audio of clinical cases illustrate the effect of pathologies on voice quality. Pre- and post-operative speech production show how altered structures create altered voice quality. Epilaryngeal tube control is shown to be the cornerstone of our ability to adapt. Mongolian long song and human beatboxing illustrate the use of the professional voice. Clinicians as well as linguists will benefit from the detailed new exploration of the laryngeal articulator and its adaptability.