1
|
Kondaurova MV, Zheng Q, Donaldson CW, Smith AF. Effect of telepractice on pediatric cochlear implant users and provider vowel space: A preliminary report. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:467. [PMID: 36732236 DOI: 10.1121/10.0016866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/27/2022] [Indexed: 06/18/2023]
Abstract
Clear speaking styles are goal-oriented modifications in which talkers adapt acoustic-phonetic characteristics of speech to compensate for communication challenges. Do children with hearing loss and a clinical provider modify speech characteristics during telepractice to adjust for remote communication? The study examined the effect of telepractice (tele-) on vowel production in seven (mean age 4:11 years, SD 1:2 years) children with cochlear implants (CIs) and a provider. The first (F1) and second (F2) formant frequencies of /i/, /ɑ/, and /u/ vowels were measured in child and provider speech during one in-person and one tele-speech-language intervention, order counterbalanced. Child and provider vowel space areas (VSA) were calculated. The results demonstrated an increase in F2 formant frequency for /i/ vowel in child and provider speech and an increase in F1 formant frequency for /ɑ/ vowel in the provider speech during tele- compared to in-person intervention. An expansion of VSA was found in child and provider speech in tele- compared to in-person intervention. In children, the earlier age of CI activation was associated with larger VSA in both tele- and in-person intervention. The results suggest that the children and the provider adjust vowel articulation in response to remote communication during telepractice.
Collapse
Affiliation(s)
- Maria V Kondaurova
- Department of Psychological and Brain Sciences, University of Louisville, 301 Life Sciences Building, Louisville, Kentucky 40292, USA
| | - Qi Zheng
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky 40202, USA
| | - Cheryl W Donaldson
- The Heuser Hearing Institute and Language Academy, Louisville, Kentucky 40203, USA
| | - Alan F Smith
- Department of Otolaryngology-Head/Neck Surgery and Communicative Disorders, Speech-Language Pathology Program, University of Louisville, Louisville, Kentucky 40202, USA
| |
Collapse
|
2
|
Rezaei M, Rashedi V, Borhaninejad V, Nurian ZS. Pragmatic Skills in Children with Hearing Loss: Comparison Between Cochlear Implants and Hearing Aids Users. Indian J Otolaryngol Head Neck Surg 2022; 74:434-438. [PMID: 36213476 PMCID: PMC9535044 DOI: 10.1007/s12070-021-02529-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/22/2021] [Indexed: 11/26/2022] Open
Abstract
Pragmatic language ability denotes the ability to use language in a social context. There is a lack of research that has compared children's pragmatic skills with hearing loss with those of hearing peers. This study questioned whether children with a cochlear implant would show better pragmatic skills than children with hearing aids. 52 children were included in three groups: cochlear implant (n = 16), hearing aid (n = 16), and normal hearing (n = 20). The participants' pragmatic skills were evaluated using the Persian version of the children's communication checklist. Of the 52 participants recruited, 22 (42.3%) were males, and 30 (57.7%) were females. The mean age of the CI, HA, and NH group participants was 75.19 ± 10.80, 72.19 ± 8.68, and 68.90 ± 6.78 months, respectively (P > 0.05). There was a significant difference between the mean scores of Speech Output and Syntax between the groups (CI, HA and NH) (P < 0.001). The hearing-impaired children show acceptable pragmatic skills in comparison with NH children. Specialists, such as teachers and clinicians, should be alert of the abilities and difficulties that the hearing-impaired children might be facing in the regular classroom.
Collapse
Affiliation(s)
- Mohammad Rezaei
- Autism Spectrum Disorder Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Vahidreza Borhaninejad
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Zohreh Sadat Nurian
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
3
|
Ghayedlou L, Ahmadi A, Ghorbani A, Torabinezhad F, Keyhani MR, Hashemi SB. Vowel duration measurement in school-age children with cochlear implant. Int J Pediatr Otorhinolaryngol 2020; 136:110142. [PMID: 32544641 DOI: 10.1016/j.ijporl.2020.110142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/23/2020] [Accepted: 05/23/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Normal hearing system is an essential factor for accurate production of speech segments. It seems that cochlear implant prosthesis helps children with hearing impairment to speak more accurately than before receiving prosthesis. The current research aimed to compare the vowel duration in school-aged children with cochlear implants and that in children with normal hearing. Additionally, the performance of girls and boys in two groups were investigated. METHODS A cross-sectional and descriptive-analytical study was carried out to compare the vowel duration in 9- to 12-year-old children with cochlear implant and those with normal hearing. Participants were 52 children who were matched by age and sex. We asked the children to read the target words with each word including one vowel and then participants' voice samples were recorded. Then, vowel duration was measured using Praat software. Finally, the vowel duration was compared between the two groups running independent sample t-test. The level of significance was (P < 0.05). RESULTS There was no statistically significant difference observed between the two groups in the mean values of the vowel duration for the six Persian vowels (P > 0.05). Also, no significant difference was found between boys and girls in the mean value of the vowel duration between the two groups (P > 0.05). CONCLUSION Persian vowels in school-aged children with cochlear implant and with typical hearing are produced with similar durations. This finding is probably related to the increased duration of using prosthesis in this age range and speech mode used to measure vowel duration in the present study.
Collapse
Affiliation(s)
- Leila Ghayedlou
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Akram Ahmadi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, I.R, Iran.
| | - Ali Ghorbani
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Farhad Torabinezhad
- Department of Speech and Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Keyhani
- Department of Basic Rehabilitation Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Basir Hashemi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Khalili St., Khalili Hospital, Shiraz, Iran
| |
Collapse
|
4
|
Khoramian S, Soleymani Z, Keramati N, Motasaddi Zarandy M. Effect of cochlear implantation on language development and assessment of the quality of studies in this field: A systematic review. Med J Islam Repub Iran 2020; 33:107. [PMID: 31934567 PMCID: PMC6946925 DOI: 10.34171/mjiri.33.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Indexed: 11/05/2022] Open
Abstract
Background: Cochlear implantation (CI) is an achievement that facilitates the acquisition of language skills in deaf children throughout the world. The use of this technology has a positive effect on all components of language acquisition (syntax, semantic, pragmatic, etc.). However, this positive impact is influenced by various factors. Understanding the strengths and weaknesses of studies on the development of language abilities can help improve these studies. Consequently, in the future, it will lead to the improvement of language rehabilitation in these children. Limited studies on children with CI in have been done so far. This article summarized the outcomes of scientific articles on the clinical efficacy of CI on Persian speaking children. This study also provided a clear picture of these studies by examining the quality of their methodologies and tools. Methods: Articles indexed in Google Scholar, Web of Science, Medline, Scopus and Iranian databases (Danesh Gostar, Magiran, and SID) were searched using keywords "language," "Cochlear implant", "Persian/ Farsi" in English and Persian languages with "and/or". Original articles investigated on children younger than 13 years old with hearing impairment and CI were included. Results: Five hundred and twenty-three articles were found based on the keywords. Among all of these, 485 were excluded due to the title and the abstract; we selected 38, of which 24 were repeated. Finally, 14 articles remained. We reviewed the articles based on the preferred reporting items for systematic review and meta-analysis (PRISMA) and checklist and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Conclusion: Similar to international studies, Persian speaking children with CI have slower language development than their peers with normal hearing, but they are better than their peers who use hearing aids. The results of reviewing on quality of the articles showed that the studies could not meet reasonable quality because of the lack of a standard test in different aspects of Persian language and the absence of patients’ databanks. These results also can be used by other nationalities that recently have started surveys on children with CIs.
Collapse
Affiliation(s)
- Soodeh Khoramian
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Soleymani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Keramati
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Motasaddi Zarandy
- Department of Cochlear Implant, Otorhinolaryngology Research Center, Amir Aalam Hospital, Tehran, Iran
| |
Collapse
|
5
|
Gautam A, Naples JG, Eliades SJ. Control of speech and voice in cochlear implant patients. Laryngoscope 2019; 129:2158-2163. [DOI: 10.1002/lary.27787] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 11/10/2018] [Accepted: 12/11/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Anirudh Gautam
- Royal College of Surgeons in Ireland School of Medicine Dublin Ireland
| | - James G. Naples
- Department of Otorhinolaryngology: Head and Neck SurgeryHospital of the University of Pennsylvania Philadelphia Pennsylvania U.S.A
| | - Steven J. Eliades
- Department of Otorhinolaryngology: Head and Neck SurgeryHospital of the University of Pennsylvania Philadelphia Pennsylvania U.S.A
- Auditory and Communication Systems Laboratory, Department of Otorhinolaryngology: Head and Neck SurgeryUniversity of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania U.S.A
| |
Collapse
|
6
|
Zamani P, Soleymani Z, Jalaie S, Zarandy MM. The effects of narrative-based language intervention (NBLI) on spoken narrative structures in Persian-speaking cochlear implanted children: A prospective randomized control trial. Int J Pediatr Otorhinolaryngol 2018; 112:141-150. [PMID: 30055723 DOI: 10.1016/j.ijporl.2018.06.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous research has shown that narrative-based language intervention (NBLI) is a feasible approach increasing the narrative skills of hearing-impaired children. OBJECTIVE In the present study, the efficacy of NBLI on the macrostructure and microstructure components of the spoken narrative of children with cochlear implants (CI) was evaluated in an experimental study. MATERIALS AND METHODS Thirty-six CI children between the ages of 5.5 and 7 years were randomly divided in three groups of equal size. Group 1 attended 24 1-h sessions of NBLI group therapy. Group 2 participants each attended 24 1-h private sessions of NBLI instruction. Group 3 attended 24 1-h conventional speech therapy (CST) sessions. The subjects' storytelling skills were prompted using pictures from the Persian version of the Language Sample Analysis test. The results were assessed before treatment (T0), after treatment (T1) and two months after treatment (T2) as follow-up. RESULTS Groups 1 and 2 showed significantly better results over Group 3 on all microstructure components of spoken narrative at the T1 (p ≤ 0.04) and T2 (p ≤ 0.04) levels in comparison with T0, but no differences were observed between the NBLI approaches (p > 0.05). All three intervention programs significantly improved the macrostructure of the spoken narrative in CI children. CONCLUSION Improvements in spoken narrative structures were observed in CI children that support the efficacy of NBLI over CST for the hearing-impaired population.
Collapse
Affiliation(s)
- Peyman Zamani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Hearing and Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Soleymani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
| | - Shohreh Jalaie
- Departments of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Motasaddi Zarandy
- Cochlear Implant Center and Department of Otorhinolaryngology, Amir Aalam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
7
|
Zamani P, Soleymani Z, Rashedi V, Farahani F, Lotf G, Rezaei M. Spoken and Written Narrative in Persian-Speaking Students Who Received Cochlear Implant and/or Hearing Aid. Clin Exp Otorhinolaryngol 2018; 11:250-258. [PMID: 29909611 PMCID: PMC6222186 DOI: 10.21053/ceo.2017.01011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 03/26/2018] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To compare narrative skills between fourth and fifth grades of Persian-speaking students with hearing impairments and typical hearing students of the same grade and also to evaluate the effects of group, sex, hearing age, and educational grade of the students on their spoken/written narrative performance. METHODS The subjects were 174 students aged 10-13 years, 54 of whom wore cochlear implants, 60 suffered from moderate to severe hearing losses and wore hearing aids, with the remaining 60 students being typical hearing in terms of the sense of hearing. The micro- and macrostructure components of spoken and written narrative were elicited from a pictorial story (The Playful Little Elephant) and then scored by raters. RESULTS Compared to the typical hearing, the students with hearing impairments had significantly lower scores in all of the microstructure components of narratives. However, the findings showed no significant difference among different groups in macrostructure components of narratives. It was also revealed that the students had equal performance in spoken and written narrative. Finally, factor analysis manifested that group, sex, hearing age, and educational level of children might alter the outcome measures in various interactions. CONCLUSION Although cochlear implantation was more effective than hearing aid on spoken and written narrative skills, the Persian-speaking students with hearing impairments were seen to need additional trainings on microstructure components of spoken/written narrative.
Collapse
Affiliation(s)
- Peyman Zamani
- Hearing and Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Soleymani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhad Farahani
- Hearing Disorders Research Center, Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gohar Lotf
- Hearing Disorders Research Center, Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Speech Therapy, Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Rezaei
- Hearing Disorders Research Center, Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Speech Therapy, Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
8
|
Zamani P, Soleymani Z, Mousavi SM, Akbari N. Assessment of narrative writing by Persian-speaking students with hearing impairments. Clin Otolaryngol 2018; 43:904-911. [PMID: 29451359 DOI: 10.1111/coa.13087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Previous studies have highlighted that narrative skill is critical to the development of the literacy skills by children. Children with cochlear implants (CI) and hearing aids (HA) may have problems in narrative development compared to peers with healthy hearing (HH). There is no exact data about the narrative writing ability of Persian-speaking students who are hearing-impaired. This study was undertaken to compare the microstructure and macrostructure scores for narrative writing of Persian-speaking students who are hearing-impaired and peers with HH. DESIGN This was a cross-sectional descriptive-analytical study. SETTING The subjects were recruited from elementary schools in the city of Tehran. PARTICIPANTS A total of 144 elementary school students were participated. OUTCOME MEASURES The written narratives were elicited using a wordless pictorial storybook story. Three-way ANOVA with post hoc adjusted Bonferroni test was applied to determine the main effects and interactions of grounded variables on the microstructure and macrostructure components of narrative writing. RESULTS No significant differences were observed in the macrostructure components of narrative writing between hearing-impaired and HH students. Factors analysis showed that the 4th grade HH students had significantly the highest scores, and the 3rd grade HA students had significantly the lowest scores in microstructure components of narrative writing. CONCLUSION The findings revealed that hearing-impaired students similarly to their HH peers can transmit the main idea (macrostructure) of narrative writing, but show critical difficulties when using complete grammatical elements (microstructures) to form sentences to convey the idea in the narrative.
Collapse
Affiliation(s)
- P Zamani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.,Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Z Soleymani
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - S M Mousavi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - N Akbari
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Rezaei M, Emadi M, Zamani P, Farahani F, Lotfi G. Speech Intelligibility in Persian Hearing Impaired Children with Cochlear Implants and Hearing Aids. J Audiol Otol 2017; 21:57-60. [PMID: 28417111 PMCID: PMC5392002 DOI: 10.7874/jao.2017.21.1.57] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/03/2016] [Accepted: 01/08/2017] [Indexed: 11/29/2022] Open
Abstract
The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.
Collapse
Affiliation(s)
- Mohammad Rezaei
- Department of Speech Therapy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Emadi
- Department of Audiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Peyman Zamani
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farhad Farahani
- Hearing Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gohar Lotfi
- Department of Speech Therapy, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
10
|
Rezaei M, Rashedi V, Morasae EK. Reading skills in Persian deaf children with cochlear implants and hearing aids. Int J Pediatr Otorhinolaryngol 2016; 89:1-5. [PMID: 27619019 DOI: 10.1016/j.ijporl.2016.07.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/06/2016] [Accepted: 07/08/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Reading skills are necessary for educational development in children. Many studies have shown that children with hearing loss often experience delays in reading. This study aimed to examine reading skills of Persian deaf children with cochlear implant and hearing aid and compare them with normal hearing counterparts. METHOD The sample consisted of 72 s and third grade Persian-speaking children aged 8-12 years. They were divided into three equal groups including 24 children with cochlear implant (CI), 24 children with hearing aid (HA), and 24 children with normal hearing (NH). Reading performance of participants was evaluated by the "Nama" reading test. "Nama" provides normative data for hearing and deaf children and consists of 10 subtests and the sum of the scores is regarded as reading performance score. RESULTS Results of ANOVA on reading test showed that NH children had significantly better reading performance than deaf children with CI and HA in both grades (P < 0.001). Post-hoc analysis, using Tukey test, indicated that there was no significant difference between HA and CI groups in terms of non-word reading, word reading, and word comprehension skills (respectively, P = 0.976, P = 0.988, P = 0.998). CONCLUSION Considering the findings, cochlear implantation is not significantly more effective than hearing aid for improvement of reading abilities. It is clear that even with considerable advances in hearing aid technology, many deaf children continue to find literacy a challenging struggle.
Collapse
Affiliation(s)
- Mohammad Rezaei
- Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences & Health Services, Hamadan, Iran.
| | - Vahid Rashedi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Esmaeil Khedmati Morasae
- Qom University of Medical Sciences & Health Services, Qom, Iran; Center for Systems Studies, Hull University Business School, Hull University, Hull, UK
| |
Collapse
|