All of the following cues EXCEPT ______________________ would be provided to the patient to promote “clear speech.”

Mr. Sheridan, a 68-year-old male, presented with a 4-year history of progressive difficulty getting into and out of chairs and a 2-3 year history of speech difficulty. Walking was slow with shuffling steps. His handwriting had deteriorated and was hard to read. During the oral mechanism exam, lingual tremulousness on protrusion and during lateral movements was noted. No other deficits were noted. Conversational speech, reading, and repetition displayed a remarkable degree of dysfluency; characterized by rapid repetition of initial sounds, syllables, and occasional words and phrases. Articulation was moderately imprecise and overall pitch and loudness variability were reduced. Speech AMRs were rapid and accelerated. Prolonged “ah” was hoarse. What speaker-oriented treatment strategies might you recommend? (Select all that apply)

Ms. McCrea, a 35-year-old woman, with a history of a chronic progressive condition presented for consideration of thalamotomy to control severe bilateral upper limb tremor. Neurologic examination revealed hyperreflexia, pathologic reflexes, bilateral weakness, spasticity, impaired coordination, nystagmus, and severe resting postural and movement tremor. Neuropsychological assessment noted severe impairment of new learning and memory and generalized loss of intellectual abilities.  During the speech evaluation, she reported a 1-year history of progressive speech difficulty. She had reduced facial and lingual strength. Her speech was characterized by slow rate, irregular articulatory breakdowns, breathy-hoarse voice quality, and hypernasality with nasal emission. Speech intelligibility was significantly reduced. What type of dysarthria do you suspect?

The movement disorders underlying hyperkinetic dysarthrias are categorized by: (Select all that apply)

Mr. Scott, a 40-year-old millwright, presented with an 8-month history of voice difficulty. His dysphonia began after anterior-approach cervical disk surgery. He could not return to work because his co-workers could not hear him in the noisy work environment. The SLP observed he occasionally coughed and choked after swallowing and had to clear his throat frequently. Speech and oral mechanism examination were normal except for markedly breathy-hoarse voice, moderately decreased loudness, and short phrases. He could sustain “ah” and “z” for only 2 seconds but sustained “s” for 12 seconds. His cough and glottal coup were markedly weak. There was no palatal asymmetry, the palate was mobile, and the gag was normal. What type of dysarthria do you suspect?

You are an Organization Design Strategist at Hardcastle Cement Company, Inc.  Over the last 18 months, the company has experienced a spike in work-related accidents. Despite communication and training efforts, people seem to be circumventing safety protocols, and it is resulting in some serious accidents.  Mr. Hardcastle has asked for your advice on how to evolve the company culture to one that values safety above everything else.  Drawing from the four culture maintenance levers discussed in class (and the textbook), describe two specific actions Hardcastle Cement could take to help evolve the company to a “Safety First” culture.  For each action, name the lever you are using and describe the action consistent with that lever that you believe will help shape the new culture.

Write the chemical formulas for the following compounds or ions. (a) hypochlorite ion; (b) tetraphosphorus hexasulfide; (c) strontium cyanide; (d) hydrobromic acid.

Use the standard enthalpies of formation from your handout to calculate ΔH for the reaction: CH4(g) + 4 Cl2(g) → CCl4(g) + 4 HCl(g).

A 6.35 L sample of carbon monoxide is at 55 °C and 0.892 atm. What volume will the gas occupy at 1.05 atm and 20 °C?

A 15.0 g sample of nickel metal is heated to 100.0 °C and dropped into 55.0 g of water initially at 23.0 °C. Assuming all heat lost by nickel is absorbed by water, calculate the final temperature of the nickel and water. (c_Ni = 0.444 J g^−1 °C^−1).