Editing links, such as 'editing_show' have a title e.g. "Show" which is shown on hover, and read by screen readers.
The images (class="iconsmall") within these links also have alt text and titles e.g. "Show" - which is also shown on hover (some browsers) and also read by screen readers.
The title attribute should only be applied to the link element. The alt text and title on the icon are unnecessary.
When users of screen readers encounter this they hear "Show show", "Delete delete", "Move move", etc...
A better pattern would be :
<a href='foo' class='editing_delete' title='Delete'>
<img src='path/delete.gif' alt='' />
<span class='accesshide'>Delete</span>
</a>
I put this into the tracker - http://tracker.moodle.org/browse/MDL-31976