Effectiveness of a Voice Training Program for Student Teachers on Vocal Health.

PubMed

Richter, Bernhard; Nusseck, Manfred; Spahn, Claudia; Echternach, Matthias

2016-07-01

The effectiveness of a preventive training program on vocal health for German student teachers was investigated on specific vocal parameters. The voice quality as described by the Dysphonia Severity Index of 204 student teachers (training group: n = 123; control group: n = 81) was measured at the beginning and at the end of the student teachers training period (duration 1.5 years). Additionally, for investigating the voice-carrying capacity, a vocal loading test (VLT) was performed. Finally, participants had to provide a subjective judgment of a possible Voice Handicap Index. The training program improved the voice quality of the trained group compared with that of the control group, whose voice quality declined. The trained group was also able to better sustain their voice quality across the VLT than the control group. Both groups, however, reported a similar increase in subjective vocal strain. The presented training program clearly showed a positive impact on the voice quality and the vocal capacity. The results maintain the importance of such a training program to be integrated in the education and occupational routine of teachers. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Identifying a Comparison for Matching Rough Voice Quality

ERIC Educational Resources Information Center

Patel, Sona; Shrivastav, Rahul; Eddins, David A.

2012-01-01

Purpose: Perceptual estimates of voice quality obtained using rating scales are subject to contextual biases that influence how individuals assign numbers to estimate the magnitude of vocal quality. Because rating scales are commonly used in clinical settings, assessments of voice quality are also subject to the limitations of these scales.…

The effects of indwelling voice prosthesis on the quality of life, depressive symptoms, and self-esteem in patients with total laryngectomy.

PubMed

Polat, Beldan; Orhan, Kadir Serkan; Kesimli, Mustafa Caner; Gorgulu, Yasemin; Ulusan, Murat; Deger, Kemal

2015-11-01

This study aims to evaluate the effects of voice rehabilitation with indwelling voice prosthesis on quality of life, depression, anxiety, self-esteem, and sexual functions in laryngectomy patients. Provox-1 was applied to 30 patients who underwent total laryngectomy by opening a tracheoesophageal fistula. WHO Quality of Life-BREF, Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg Self-Esteem Scale, Arizona Sexual Experience Scale forms were asked to be filled out by the patients before voice prosthesis application. These tests were asked to be filled out again 3 months later after the voice prosthesis application. Paired samples and Wilcoxon tests were used to compare before and after operation values. Indwelling voice prosthesis was found to improve quality of life, self-esteem, and sexual function (p < 0.05). Additionally, symptoms of depression and anxiety were regressed (p < 0.05). Indwelling voice prosthesis was found to especially increase the quality of life and decrease depression (p < 0.05). This study is an uncontrolled single-arm study comparing patients' psychosocial statuses pre- and post-voice prosthesis.

A Comparative Study of the VHI-10 and the V-RQOL for Quality of Life Among Chinese Teachers With and Without Voice Disorders.

PubMed

Lu, Dan; Wen, Bei; Yang, Hui; Chen, Fei; Liu, Jun; Xu, Yanan; Zheng, Yitao; Zhao, Yu; Zou, Jian; Wang, Haiyang

2017-07-01

To investigate the differences and correlation between the Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) in teachers in China with and without voice disorders. This is a cross-sectional descriptive analytical study. The participants were 864 teachers (569 women, 295 men) whose vocal cords were examined using a flexible nasofibrolaryngoscope. Questionnaire results were obtained for both the VHI-10 and the V-RQOL. Of the 864 participants, 409 teachers had no voice disorders and 455 teachers had voice disorders. The most common voice complaint was hoarseness (n = 298) and the most common throat complaint was globus pharyngis (n = 79) in teachers with voice disorders. Chronic laryngitis (n = 218) and polyps and nodules (n = 182) were the most frequent diagnoses in teachers with voice disorders. Significant differences were seen on the VHI-10 between teachers with and those without voice disorders (P < 0.05) and in function between female and male teachers with voice disorders (P < 0.05) and between those with different voice disorders (P < 0.05). Moderate to strong correlations were observed between VHI-10 total score and those for the three domains of the VHI-10 and the V-RQOL (P < 0.0001). There is a high prevalence of voice disorders in teachers. Teachers with voice disorders have poor voice-related quality of life, with more impairment seen among female than male teachers. Different groups of voice disorders have different effects on voice-related quality of life. A moderate correlation was found between the results of the VHI-10 and the V-RQOL. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice, stress, work and quality of life of soccer coaches and physical trainers.

PubMed

Penteado, Regina Zanella; Silva, Noelle Bernardi da; Montebello, Maria Imaculada de Lima

2015-01-01

To assess aspects related to work, stress and quality of life related to voice in soccer coaches (C) and physical trainers (T), comparing the categories. Qualitative and quantitative studies with 13 C and 13 T of teams competing in Phase One of the highest level (Série A ) of the 2012 Campeonato Paulista (São Paulo State Soccer Championship). The questions were open ended and related to complaints, difficulties, and/or problems regarding voice use during work and to the relations between voice, work, stress, and quality of life. Stress at work was analyzed by the Job Stress Scale (JSS) questionnaire. The perception of the impact of the voice on quality of life was evaluated by the Voice-Related Quality of Life (V-RQOL) protocol. The answers to the questions were transcribed and submitted to content analysis, and regarding the questionnaire, descriptive data and analytical statistics were used. Content analysis showed lack of preparation for voice care; voice complaints; and intense vocal use demand under stressful work, in addition to the absence of healthy habits and social/family support. The JSS dimensions showed that the Active Work situation and the high V-RQOL scores are compatible with vocal health without complaints. There were no statistical differences between the categories. Both categories reported complaints/problems linked to professional voice use and stressful workload. However, the perception of vocal impact on the quality of life was positive, and the analysis of stress at work resulted in "good" and favorable conditions. The relationship between voice, work, stress, and quality of life in both the categories require further investigations.

Validation of the Acoustic Voice Quality Index in the Japanese Language.

PubMed

Hosokawa, Kiyohito; Barsties, Ben; Iwahashi, Toshihiko; Iwahashi, Mio; Kato, Chieri; Iwaki, Shinobu; Sasai, Hisanori; Miyauchi, Akira; Matsushiro, Naoki; Inohara, Hidenori; Ogawa, Makoto; Maryn, Youri

2017-03-01

The Acoustic Voice Quality Index (AVQI) is a multivariate construct for quantification of overall voice quality based on the analysis of continuous speech and sustained vowel. The stability and validity of the AVQI is well established in several language families. However, the Japanese language has distinct characteristics with respect to several parameters of articulatory and phonatory physiology. The aim of the study was to confirm the criterion-related concurrent validity of AVQI, as well as its responsiveness to change and diagnostic accuracy for voice assessment in the Japanese-speaking population. This is a retrospective study. A total of 336 voice recordings, which included 69 pairs of voice recordings (before and after therapeutic interventions), were eligible for the study. The auditory-perceptual judgment of overall voice quality was evaluated by five experienced raters. The concurrent validity, responsiveness to change, and diagnostic accuracy of the AVQI were estimated. The concurrent validity and responsiveness to change based on the overall voice quality was indicated by high correlation coefficients 0.828 and 0.767, respectively. Receiver operating characteristic analysis revealed an excellent diagnostic accuracy for discrimination between dysphonic and normophonic voices (area under the curve: 0.905). The best threshold level for the AVQI of 3.15 corresponded with a sensitivity of 72.5% and specificity of 95.2%, with the positive and negative likelihood ratios of 15.1 and 0.29, respectively. We demonstrated the validity of the AVQI as a tool for assessment of overall voice quality and that of voice therapy outcomes in the Japanese-speaking population. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects of Radioactive Iodine Ablation Therapy on Voice Quality.

PubMed

Aydoğdu, İmran; Atar, Yavuz; Saltürk, Ziya; Sarı, Hüseyin; Ataç, Enes; Aydoğdu, Zeynep; İnan, Muzaffer; Mersinlioğlu, Gökhan; Uyar, Yavuz

2017-01-01

The goal of this study was to evaluate the effects of radioactive iodine ablation therapy on voice quality of patients diagnosed with well-differentiated thyroid carcinoma. We enrolled 36 patients who underwent total or subtotal thyroidectomy due to well-differentiated thyroid carcinoma. Voice recordings from patients were analyzed for acoustic and aerodynamic voice. The Voice Handicap Index-10 was used for subjective analysis. The control group consisted of 36 healthy participants. Results taken before and after therapy were compared statistically. There were no differences in the results taken before and after therapy for the radioactive iodine ablation group. The Voice Handicap Index-10 results did not differ between groups before and after therapy. Radioactive iodine ablation therapy has no effect on voice quality objectively or subjectively. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Voice assessment and demographic data of applicants for a school of speech therapists].

PubMed

Reiter, R; Brosch, S

2008-05-01

Demographic data, subjective und objective voice analysis as well as self-assessment of voice quality from applicants for a school of speech therapists were investigated. Demographic data from 116 applicants were collected and their voice quality assessed by three independent judges. An objective evaluation was done by maximum phonation time, average fundamental frequency, dynamic range and percent of jitter and shimmer by means of Goettinger Hoarseness diagram. Self-assessment of voice quality was done by "voice handicap index questionnaire". The twenty successful applicants had a physiological voice in 95 %, they were all musical and had university entrance qualifications. Subjective voice assessment showed in 16 % of the applicants a hoarse voice. In this subgroup an unphysiological vocal use was observed in 72 % and a reduced articulation in 45 %. The objective voice parameters did not show a significant difference between the 3 groups. Self-assessment of the voice was inconspicuous in all applicants. Applicants with general qualification for university entrance, musicality and a physiological voice were more likely to be successful. There were main differences between self assessment of voice and quantitative analysis or subjective assessment by three independent judges.

The Effect of Hydration on the Voice Quality of Future Professional Vocal Performers.

PubMed

van Wyk, Liezl; Cloete, Mariaan; Hattingh, Danel; van der Linde, Jeannie; Geertsema, Salome

2017-01-01

The application of systemic hydration as an instrument for optimal voice quality has been a common practice by several professional voice users over the years. Although the physiological action has been determined, the benefits on acoustic and perceptual characteristics are relatively unknown. The present study aimed to determine whether systemic hydration has beneficial outcomes on the voice quality of future professional voice users. A within-subject, pretest posttest design is applied to determine quantitative research results of female singing students between 18 and 32 years of age without a history of voice pathology. Acoustic and perceptual data were collected before and after a 2-hour singing rehearsal. The difference between the hypohydrated condition (controlled) and the hydrated condition (experimental) and the relationship between adequate hydration and acoustic and perceptual parameters of voice was then investigated. A statistical significant (P = 0.041) increase in jitter values were obtained for the hypohydrated condition. Increased maximum phonation time (MPT/z/) and higher maximum frequency for hydration indicated further statistical significant changes in voice quality (P = 0.028 and P = 0.015, respectively). Systemic hydration has positive outcomes on perceptual and acoustic parameters of voice quality for future professional singers. The singer's ability to sustain notes for longer and reach higher frequencies may reflect well in performances. Any positive change in voice quality may benefit the singer's occupational success and subsequently their social, emotional, and vocational well-being. More research evidence is needed to determine the parameters for implementing adequate hydration in vocal hygiene programs. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice quality after treatment of early vocal cord cancer: a randomized trial comparing laser surgery with radiation therapy.

PubMed

Aaltonen, Leena-Maija; Rautiainen, Noora; Sellman, Jaana; Saarilahti, Kauko; Mäkitie, Antti; Rihkanen, Heikki; Laranne, Jussi; Kleemola, Leenamaija; Wigren, Tuija; Sala, Eeva; Lindholm, Paula; Grenman, Reidar; Joensuu, Heikki

2014-10-01

Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO2 laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality was assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option. Copyright © 2014 Elsevier Inc. All rights reserved.

Voice Quality After Treatment of Early Vocal Cord Cancer: A Randomized Trial Comparing Laser Surgery With Radiation Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aaltonen, Leena-Maija, E-mail: leena-maija.aaltonen@hus.fi; Rautiainen, Noora; Sellman, Jaana

Objective: Early laryngeal cancer is usually treated with either transoral laser surgery or radiation therapy. The quality of voice achieved with these treatments has not been compared in a randomized trial. Methods and Materials: Male patients with carcinoma limited to 1 mobile vocal cord (T1aN0M0) were randomly assigned to receive either laser surgery (n=32) or external beam radiation therapy (n=28). Surgery consisted of tumor excision with a CO{sub 2} laser with the patient under general anaesthesia. External beam radiation therapy to the larynx was delivered to a cumulative dose of 66 Gy in 2-Gy daily fractions over 6.5 weeks. Voice quality wasmore » assessed at baseline and 6 and 24 months after treatment. The main outcome measures were expert-rated voice quality on a grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, videolaryngostroboscopic findings, and the patients' self-rated voice quality and its impact on activities of daily living. Results: Overall voice quality between the groups was rated similar, but voice was more breathy and the glottal gap was wider in patients treated with laser surgery than in those who received radiation therapy. Patients treated with radiation therapy reported less hoarseness-related inconvenience in daily living 2 years after treatment. Three patients in each group had local cancer recurrence within 2 years from randomization. Conclusions: Radiation therapy may be the treatment of choice for patients whose requirements for voice quality are demanding. Overall voice quality was similar in both treatment groups, however, indicating a need for careful consideration of patient-related factors in the choice of a treatment option.« less

Contemporary Commercial Music Singing Students-Voice Quality and Vocal Function at the Beginning of Singing Training.

PubMed

Sielska-Badurek, Ewelina M; Sobol, Maria; Olszowska, Katarzyna; Niemczyk, Kazimierz

2017-10-03

The purpose of this study was to assess the voice quality and the vocal tract function in popular singing students at the beginning of their singing training at the High School of Music. This is a retrospective cross-sectional study. The study consisted of 45 popular singing students (35 females and 10 males, mean age: 19.9 ± 2.8 years). They were assessed in the first 2 months of their 4-year singing training at the High School of Music, between 2013 and 2016. Voice quality and vocal tract function were evaluated using videolaryngostroboscopy, palpation of the vocal tract structures, the perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, the Voice Handicap Index, and the Singing Voice Handicap Index (SVHI). Twenty-two percent of Contemporary Commercial Music singing students began their education in the High School, with vocal nodules. Palpation of the vocal tract structure showed in 50% correct motions and tension in speaking and in 39.3% in singing. Perceptual voice assessment showed in 80% proper speaking voice quality and in 82.4% proper singing voice quality. The mean vocal fundamental frequency while speaking in females was 214 Hz and in males was 116 Hz. Dysphonia Severity Index was at the level of 2, and maximum phonation time was 17.7 seconds. The Voice Handicap Index and the SVHI remained within the normal range: 7.5 and 19, respectively. Perceptual singing voice assessment correlated with the SVHI (P = 0.006). Twenty-two percent of the Contemporary Commercial Music singing students began their education in the High School, with organic vocal fold lesions. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Prevalence of hoarseness in school-aged children.

PubMed

Kallvik, Emma; Lindström, Elisabeth; Holmqvist, Sofia; Lindman, Jenny; Simberg, Susanna

2015-03-01

The purpose of this cross-sectional study was to determine the prevalence of hoarseness in children attending the first or second grade of primary school and to explore possible background factors for hoarseness in children. The participants were 217 children, aged 6-10 years, from 10 different schools. Questionnaires were filled in by the parents and the teachers of the children and voice samples were recorded. The voice samples from the children were perceptually evaluated by eight trained listeners and intra- and inter-rater reliability was calculated. Additionally, the parents and teachers were in the questionnaires asked to rate the children's voices. Connections between background factors and voice quality were explored. Both the intra- and inter-rater reliability for the trained listeners were relatively high and significant. The prevalence of hoarseness for the whole group was 12.0% as judged by the trained listeners. For girls, the prevalence of hoarseness was 7.8% and for boys 15.8%. A lower teacher rating of degree of maturity correlated significantly with the voice quality. Additionally, there was a significant negative correlation between the amount of talking at home and voice quality. For girls, heavy voice use as an infant correlated significantly with voice quality. For boys, being the youngest sibling correlated significantly with voice quality. The results from the present study indicate that more attention should be paid to hoarseness in children and that background factors should be further explored. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Pre- and posttreatment voice and speech outcomes in patients with advanced head and neck cancer treated with chemoradiotherapy: expert listeners' and patient's perception.

PubMed

van der Molen, Lisette; van Rossum, Maya A; Jacobi, Irene; van Son, Rob J J H; Smeele, Ludi E; Rasch, Coen R N; Hilgers, Frans J M

2012-09-01

Perceptual judgments and patients' perception of voice and speech after concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer. Prospective clinical trial. A standard Dutch text and a diadochokinetic task were recorded. Expert listeners rated voice and speech quality (based on Grade, Roughness, Breathiness, Asthenia, and Strain), articulation (overall, [p], [t], [k]), and comparative mean opinion scores of voice and speech at three assessment points calculated. A structured study-specific questionnaire evaluated patients' perception pretreatment (N=55), at 10-week (N=49) and 1-year posttreatment (N=37). At 10 weeks, perceptual voice quality is significantly affected. The parameters overall voice quality (mean, -0.24; P=0.008), strain (mean, -0.12; P=0.012), nasality (mean, -0.08; P=0.009), roughness (mean, -0.22; P=0.001), and pitch (mean, -0.03; P=0.041) improved over time but not beyond baseline levels, except for asthenia at 1-year posttreatment (voice is less asthenic than at baseline; mean, +0.20; P=0.03). Perceptual analyses of articulation showed no significant differences. Patients judge their voice quality as good (score, 18/20) at all assessment points, but at 1-year posttreatment, most of them (70%) judge their "voice not as it used to be." In the 1-year versus 10-week posttreatment comparison, the larynx-hypopharynx tumor group was more strained, whereas nonlarynx tumor voices were judged less strained (mean, -0.33 and +0.07, respectively; P=0.031). Patients' perceived changes in voice and speech quality at 10-week post- versus pretreatment correlate weakly with expert judgments. Overall, perceptual CCRT effects on voice and speech seem to peak at 10-week posttreatment but level off at 1-year posttreatment. However, at that assessment point, most patients still perceive their voice as different from baseline. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The Relationship Between Acoustic Signal Typing and Perceptual Evaluation of Tracheoesophageal Voice Quality for Sustained Vowels.

PubMed

Clapham, Renee P; van As-Brooks, Corina J; van Son, Rob J J H; Hilgers, Frans J M; van den Brekel, Michiel W M

2015-07-01

To investigate the relationship between acoustic signal typing and perceptual evaluation of sustained vowels produced by tracheoesophageal (TE) speakers and the use of signal typing in the clinical setting. Two evaluators independently categorized 1.75-second segments of narrow-band spectrograms according to acoustic signal typing and independently evaluated the recording of the same segments on a visual analog scale according to overall perceptual acoustic voice quality. The relationship between acoustic signal typing and overall voice quality (as a continuous scale and as a four-point ordinal scale) was investigated and the proportion of inter-rater agreement as well as the reliability between the two measures is reported. The agreement between signal type (I-IV) and ordinal voice quality (four-point scale) was low but significant, and there was a significant linear relationship between the variables. Signal type correctly predicted less than half of the voice quality data. There was a significant main effect of signal type on continuous voice quality scores with significant differences in median quality scores between signal types I-IV, I-III, and I-II. Signal typing can be used as an adjunct to perceptual and acoustic evaluation of the same stimuli for TE speech as part of a multidimensional evaluation protocol. Signal typing in its current form provides limited predictive information on voice quality, and there is significant overlap between signal types II and III and perceptual categories. Future work should consider whether the current four signal types could be refined. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Application of Psychometric Theory to the Measurement of Voice Quality Using Rating Scales

ERIC Educational Resources Information Center

Shrivastav, Rahul; Sapienza, Christine M.; Nandur, Vuday

2005-01-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the midrange of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have…

Voice activity and participation profile: assessing the impact of voice disorders on daily activities.

PubMed

Ma, E P; Yiu, E M

2001-06-01

Traditional clinical voice evaluation focuses primarily on the severity of voice impairment, with little emphasis on the impact of voice disorders on the individual's quality of life. This study reports the development of a 28-item assessment tool that evaluates the perception of voice problem, activity limitation, and participation restriction using the International Classification of Impairments, Disabilities and Handicaps-2 Beta-1 concept (World Health Organization, 1997). The questionnaire was administered to 40 subjects with dysphonia and 40 control subjects with normal voices. Results showed that the dysphonic group reported significantly more severe voice problems, limitation in daily voice activities, and restricted participation in these activities than the control group. The study also showed that the perception of a voice problem by the dysphonic subjects correlated positively with the perception of limitation in voice activities and restricted participation. However, the self-perceived voice problem had little correlation with the degree of voice-quality impairment measured acoustically and perceptually by speech pathologists. The data also showed that the aggregate scores of activity limitation and participation restriction were positively correlated, and the extent of activity limitation and participation restriction was similar in all except the job area. These findings highlight the importance of identifying and quantifying the impact of dysphonia on the individual's quality of life in the clinical management of voice disorders.

Comparison of Pitch Strength With Perceptual and Other Acoustic Metric Outcome Measures Following Medialization Laryngoplasty.

PubMed

Rubin, Adam D; Jackson-Menaldi, Cristina; Kopf, Lisa M; Marks, Katherine; Skeffington, Jean; Skowronski, Mark D; Shrivastav, Rahul; Hunter, Eric J

2018-05-14

The diagnoses of voice disorders, as well as treatment outcomes, are often tracked using visual (eg, stroboscopic images), auditory (eg, perceptual ratings), objective (eg, from acoustic or aerodynamic signals), and patient report (eg, Voice Handicap Index and Voice-Related Quality of Life) measures. However, many of these measures are known to have low to moderate sensitivity and specificity for detecting changes in vocal characteristics, including vocal quality. The objective of this study was to compare changes in estimated pitch strength (PS) with other conventionally used acoustic measures based on the cepstral peak prominence (smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and clinical judgments of voice quality (GRBAS [grade, roughness, breathiness, asthenia, strain] scale) following laryngeal framework surgery. This study involved post hoc analysis of recordings from 22 patients pretreatment and post treatment (thyroplasty and behavioral therapy). Sustained vowels and connected speech were analyzed using objective measures (PS, smoothed cepstral peak prominence, cepstral spectral index of dysphonia, and acoustic voice quality index), and these results were compared with mean auditory-perceptual ratings by expert clinicians using the GRBAS scale. All four acoustic measures changed significantly in the direction that usually indicates improved voice quality following treatment (P < 0.005). Grade and breathiness correlated the strongest with the acoustic measures (|r| ~0.7) with strain being the least correlated. Acoustic analysis on running speech highly correlates with judged ratings. PS is a robust, easily obtained acoustic measure of voice quality that could be useful in the clinical environment to follow treatment of voice disorders. Copyright © 2018. Published by Elsevier Inc.

Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study.

PubMed

Pizolato, Raquel Aparecida; Rehder, Maria Inês Beltrati Cornacchioni; Meneghim, Marcelo de Castro; Ambrosano, Glaucia Maria Bovi; Mialhe, Fábio Luiz; Pereira, Antonio Carlos

2013-02-27

Voice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects' lives. To investigate the impact of educational voice interventions for teachers on quality of life and voice. A longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α < 0.05. Teachers showed significantly higher domain and overall V-RQOL scores after preventive intervention, in both control and experimental groups. Nevertheless, there was no statistical difference in scores between the groups. Educational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested.

Impact on quality of life in teachers after educational actions for prevention of voice disorders: a longitudinal study

PubMed Central

2013-01-01

Background Voice problems are more common in teachers due to intensive voice use during routine at work. There is evidence that occupational disphonia prevention programs are important in improving the quality voice and consequently the quality of subjects’ lives. Aim To investigate the impact of educational voice interventions for teachers on quality of life and voice. Methods A longitudinal interventional study involving 70 teachers randomly selected from 11 public schools, 30 to receive educational intervention with vocal training exercises and vocal hygiene habits (experimental group) and 40 to receive guidance on vocal hygiene habits (control group control). Before the process of educational activities, the Voice-Related Quality of Life instrument (V-RQOL) was applied, and 3 months after conclusion of the activities, the subjects were interviewed again, using the same instrument. For data analysis, Prox MIXED were applied, with a level of significance α < 0.05. Results: Teachers showed significantly higher domain and overall V-RQOL scores after preventive intervention, in both control and experimental groups. Nevertheless, there was no statistical difference in scores between the groups. Conclusion Educational actions for vocal health had a positive impact on the quality of life of the participants, and the incorporation of permanent educational actions at institutional level is suggested. PMID:23445566

Transmasculine People's Voice Function: A Review of the Currently Available Evidence.

PubMed

Azul, David; Nygren, Ulrika; Södersten, Maria; Neuschaefer-Rube, Christiane

2017-03-01

This study aims to evaluate the currently available discursive and empirical data relating to those aspects of transmasculine people's vocal situations that are not primarily gender-related, to identify restrictions to voice function that have been observed in this population, and to make suggestions for future voice research and clinical practice. We conducted a comprehensive review of the voice literature. Publications were identified by searching six electronic databases and bibliographies of relevant articles. Twenty-two publications met inclusion criteria. Discourses and empirical data were analyzed for factors and practices that impact on voice function and for indications of voice function-related problems in transmasculine people. The quality of the evidence was appraised. The extent and quality of studies investigating transmasculine people's voice function was found to be limited. There was mixed evidence to suggest that transmasculine people might experience restrictions to a range of domains of voice function, including vocal power, vocal control/stability, glottal function, pitch range/variability, vocal endurance, and voice quality. More research into the different factors and practices affecting transmasculine people's voice function that takes account of a range of parameters of voice function and considers participants' self-evaluations is needed to establish how functional voice production can be best supported in this population. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Perceptual and Acoustic Analyses of Good Voice Quality in Male Radio Performers.

PubMed

Warhurst, Samantha; Madill, Catherine; McCabe, Patricia; Ternström, Sten; Yiu, Edwin; Heard, Robert

2017-03-01

Good voice quality is an asset to professional voice users, including radio performers. We examined whether (1) voices could be reliably categorized as good for the radio and (2) these categories could be predicted using acoustic measures. Male radio performers (n = 24) and age-matched male controls performed "The Rainbow Passage" as if presenting on the radio. Voice samples were rated using a three-stage paired-comparison paradigm by 51 naive listeners and perceptual categories were identified (Study 1), and then analyzed for fundamental frequency, long-term average spectrum, cepstral peak prominence, and pause or spoken-phrase duration (Study 2). Study 1: Good inter-judge reliability was found for perceptual judgments of the best 15 voices (good for radio category, 14/15 = radio performers), but agreement on the remaining 33 voices (unranked category) was poor. Study 2: Discriminant function analyses showed that the SD standard deviation of sounded portion duration, equivalent sound level, and smoothed cepstral peak prominence predicted membership of categories with moderate accuracy (R 2  = 0.328). Radio performers are heterogeneous for voice quality; good voice quality was judged reliably in only 14 out of 24 radio performers. Current acoustic analyses detected some of the relevant signal properties that were salient in these judgments. More refined perceptual analysis and the use of other perceptual methods might provide more information on the complex nature of judging good voices. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Effect of Anchors and Training on the Reliability of Voice Quality Ratings for Different Types of Speech Stimuli.

PubMed

Brinca, Lilia; Batista, Ana Paula; Tavares, Ana Inês; Pinto, Patrícia N; Araújo, Lara

2015-11-01

The main objective of the present study was to investigate if the type of voice stimuli-sustained vowel, oral reading, and connected speech-results in good intrarater and interrater agreement/reliability. A short-term panel study was performed. Voice samples from 30 native European Portuguese speakers were used in the present study. The speech materials used were (1) the sustained vowel /a/, (2) oral reading of the European Portuguese version of "The Story of Arthur the Rat," and (3) connected speech. After an extensive training with textual and auditory anchors, the judges were asked to rate the severity of dysphonic voice stimuli using the phonation dimensions G, R, and B from the GRBAS scale. The voice samples were judged 6 months and 1 year after the training. Intrarater agreement and reliability were generally very good for all the phonation dimensions and voice stimuli. The highest interrater reliability was obtained using the oral reading stimulus, particularly for phonation dimensions grade (G) and breathiness (B). Roughness (R) was the voice quality that was the most difficult to evaluate, leading to interrater unreliability in all voice quality ratings. Extensive training using textual and auditory anchors and the use of anchors during the voice evaluations appear to be good methods for auditory-perceptual evaluation of dysphonic voices. The best results of interrater reliability were obtained when the oral reading stimulus was used. Breathiness appears to be a voice quality that is easier to evaluate than roughness. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Connections between voice ergonomic risk factors and voice symptoms, voice handicap, and respiratory tract diseases.

PubMed

Rantala, Leena M; Hakala, Suvi J; Holmqvist, Sofia; Sala, Eeva

2012-11-01

The aim of the study was to investigate the connections between voice ergonomic risk factors found in classrooms and voice-related problems in teachers. Voice ergonomic assessment was performed in 39 classrooms in 14 elementary schools by means of a Voice Ergonomic Assessment in Work Environment--Handbook and Checklist. The voice ergonomic risk factors assessed included working culture, noise, indoor air quality, working posture, stress, and access to a sound amplifier. Teachers from the above-mentioned classrooms reported their voice symptoms, respiratory tract diseases, and completed a Voice Handicap Index (VHI). The more voice ergonomic risk factors found in the classroom the higher were the teachers' total scores on voice symptoms and VHI. Stress was the factor that correlated most strongly with voice symptoms. Poor indoor air quality increased the occurrence of laryngitis. Voice ergonomics were poor in the classrooms studied and voice ergonomic risk factors affected the voice. It is important to convey information on voice ergonomics to education administrators and those responsible for school planning and taking care of school buildings. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

The persuasiveness of synthetic speech versus human speech.

PubMed

Stern, S E; Mullennix, J W; Dyson, C; Wilson, S J

1999-12-01

Is computer-synthesized speech as persuasive as the human voice when presenting an argument? After completing an attitude pretest, 193 participants were randomly assigned to listen to a persuasive appeal under three conditions: a high-quality synthesized speech system (DECtalk Express), a low-quality synthesized speech system (Monologue), and a tape recording of a human voice. Following the appeal, participants completed a posttest attitude survey and a series of questionnaires designed to assess perceptions of speech qualities, perceptions of the speaker, and perceptions of the message. The human voice was generally perceived more favorably than the computer-synthesized voice, and the speaker was perceived more favorably when the voice was a human voice than when it was computer synthesized. There was, however, no evidence that computerized speech, as compared with the human voice, affected persuasion or perceptions of the message. Actual or potential applications of this research include issues that should be considered when designing synthetic speech systems.

Automatic assessment of voice quality according to the GRBAS scale.

PubMed

Sáenz-Lechón, Nicolás; Godino-Llorente, Juan I; Osma-Ruiz, Víctor; Blanco-Velasco, Manuel; Cruz-Roldán, Fernando

2006-01-01

Nowadays, the most extended techniques to measure the voice quality are based on perceptual evaluation by well trained professionals. The GRBAS scale is a widely used method for perceptual evaluation of voice quality. The GRBAS scale is widely used in Japan and there is increasing interest in both Europe and the United States. However, this technique needs well-trained experts, and is based on the evaluator's expertise, depending a lot on his own psycho-physical state. Furthermore, a great variability in the assessments performed from one evaluator to another is observed. Therefore, an objective method to provide such measurement of voice quality would be very valuable. In this paper, the automatic assessment of voice quality is addressed by means of short-term Mel cepstral parameters (MFCC), and learning vector quantization (LVQ) in a pattern recognition stage. Results show that this approach provides acceptable results for this purpose, with accuracy around 65% at the best.

Analysis of the Auditory Feedback and Phonation in Normal Voices.

PubMed

Arbeiter, Mareike; Petermann, Simon; Hoppe, Ulrich; Bohr, Christopher; Doellinger, Michael; Ziethe, Anke

2018-02-01

The aim of this study was to investigate the auditory feedback mechanisms and voice quality during phonation in response to a spontaneous pitch change in the auditory feedback. Does the pitch shift reflex (PSR) change voice pitch and voice quality? Quantitative and qualitative voice characteristics were analyzed during the PSR. Twenty-eight healthy subjects underwent transnasal high-speed video endoscopy (HSV) at 8000 fps during sustained phonation [a]. While phonating, the subjects heard their sound pitched up for 700 cents (interval of a fifth), lasting 300 milliseconds in their auditory feedback. The electroencephalography (EEG), acoustic voice signal, electroglottography (EGG), and high-speed-videoendoscopy (HSV) were analyzed to compare feedback mechanisms for the pitched and unpitched condition of the phonation paradigm statistically. Furthermore, quantitative and qualitative voice characteristics were analyzed. The PSR was successfully detected within all signals of the experimental tools (EEG, EGG, acoustic voice signal, HSV). A significant increase of the perturbation measures and an increase of the values of the acoustic parameters during the PSR were observed, especially for the audio signal. The auditory feedback mechanism seems not only to control for voice pitch but also for voice quality aspects.

Quality of Life and Voice Changes After a Single Injection in Patients With ADSD Over Time.

PubMed

Faham, Maryam; Torabinezhad, Farhad; Murry, Thomas; Dabirmoghaddam, Payman; Abolghasemi, Jamileh; Kamali, Mohammad; Asgari, Meysam

2018-06-05

Adductor spasmodic dysphonia (ADSD) is one of the most disabling voice disorders with no permanent cure. Patients with ADSD suffer from poor voice quality and repeated interruption of phonation that leads to limitations in daily communication. Botox (BT) injection, considered the gold standard treatment for ADSD, reduces the amount of voice breaks and improves voice quality for a limited period. In this study, patients with ADSD were followed after a single BT injection to track the changes in QOL and perceptual voice quality over a 6-month period. This is a prospective and longitudinal study. Fifteen patients with ADSD were evaluated preinjection and 1, 3, and 6 months postinjection. They completed the Voice Activity and Participation Profile-Persian Version (VAPPP) and read a passage at each recording period. Perceptual assessment was done by three expert speech-language pathologists with knowledge of ADSD using the grade, roughness, breathiness, asthenia, strain (GRBAS) scale. The data were analyzed using Friedman, Wilcoxon, and McNemar tests. The significance level was set at P < 0.05. The VAPPP total score and each of the domain scores reached their peak scores at 3 months postinjection. At 6 months postinjection, the VAPPP scores increased significantly in comparison with the 3-month scores and but were lower than preinjection scores. GRBAS results also indicated that patients' voices at 1 and 3 months postinjection were significantly less severe in terms of strain and roughness (P = 0.01; P < 0.001, respectively). BT injection resulted in improvement of subjects' QOL. The improvement was greatest at 3 months postinjection but remained above the preinjection values at 6 months after injection. The voice quality also improved but was not judged as normal. Copyright © 2018 The Voice Foundation. All rights reserved.

Impact of voice- and knowledge-enabled clinical reporting--US example.

PubMed

Bushko, Renata G; Havlicek, Penny L; Deppert, Edward; Epner, Stephen

2002-01-01

This study shows qualitative and quantitative estimates of the national and the clinic level impact of utilizing voice and knowledge enabled clinical reporting systems. Using common sense estimation methodology, we show that the delivery of health care can experience a dramatic improvement in four areas as a result of the broad use of voice and knowledge enabled clinical reporting: (1) Process Quality as measured by cost savings, (2) Organizational Quality as measured by compliance, (3) Clinical Quality as measured by clinical outcomes and (4) Service Quality as measured by patient satisfaction. If only 15 percent of US physicians replaced transcription with modem clinical reporting voice-based methodology, about one half billion dollars could be saved. $6.7 Billion could be saved annually if all medical reporting currently transcribed was handled with voice-and knowledge-enabled dictation and reporting systems.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" Versus "Straw Phonation".

PubMed

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-09-18

The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. A multigroup pretest-posttest randomized control group design was used. Thirty healthy speech-language pathology students with a mean age of 19 years (range: 17-22 years) were randomly assigned into a resonant voice training group (practicing resonant exercises across 6 weeks, n = 10), a straw phonation group (practicing straw phonation across 6 weeks, n = 10), or a control group (receiving no voice training, n = 10). A voice assessment protocol consisting of both subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, aerodynamic assessment, voice range profile, acoustic analysis, acoustic voice quality index, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and posttraining. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post hoc pairwise comparisons. No significant time × group interactions were found for any of the outcome measures, indicating no differences in evolution over time among the 3 groups. Within-group effects of time showed a significant improvement in dysphonia severity index in the resonant voice training group, and a significant improvement in the intensity range in the straw phonation group. Results suggest that the semi-occluded vocal tract training programs using resonant voice training and straw phonation may have a positive impact on the vocal quality and vocal capacities of future occupational voice users. The resonant voice training caused an improved dysphonia severity index, and the straw phonation training caused an expansion of the intensity range in this population.

Application of the acoustic voice quality index for objective measurement of dysphonia severity.

PubMed

Núñez-Batalla, Faustino; Díaz-Fresno, Estefanía; Álvarez-Fernández, Andrea; Muñoz Cordero, Gabriela; Llorente Pendás, José Luis

Over the past several decades, many acoustic parameters have been studied as sensitive to and to measure dysphonia. However, current acoustic measures might not be sensitive measures of perceived voice quality. A meta-analysis which evaluated the relationship between perceived overall voice quality and several acoustic-phonetic correlates, identified measures that do not rely on the extraction of the fundamental period, such the measures derived from the cepstrum, and that can be used in sustained vowel as well as continuous speech samples. A specific and recently developed method to quantify the severity of overall dysphonia is the acoustic voice quality index (AVQI) that is a multivariate construct that combines multiple acoustic markers to yield a single number that correlates reasonably with overall vocal quality. This research is based on one pool of voice recordings collected in two sets of subjects: 60 vocally normal and 58 voice disordered participants. A sustained vowel and a sample of connected speech were recorded and analyzed to obtain the six parameters included in the AVQI using the program Praat. Statistical analysis was completed using SPSS for Windows, version 12.0. Correlation between perception of overall voice quality and AVQI: A significant difference exists (t(95) = 9.5; p<.000) between normal and dysphonic voices. The findings of this study demonstrate the clinical feasibility of the AVQI as a measure of dysphonia severity. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Short-Term Effect of Two Semi-Occluded Vocal Tract Training Programs on the Vocal Quality of Future Occupational Voice Users: "Resonant Voice Training Using Nasal Consonants" versus "Straw Phonation"

ERIC Educational Resources Information Center

Meerschman, Iris; Van Lierde, Kristiane; Peeters, Karen; Meersman, Eline; Claeys, Sofie; D'haeseleer, Evelien

2017-01-01

Purpose: The purpose of this study was to determine the short-term effect of 2 semi-occluded vocal tract training programs, "resonant voice training using nasal consonants" versus "straw phonation," on the vocal quality of vocally healthy future occupational voice users. Method: A multigroup pretest--posttest randomized control…

Patient-reported voice and speech outcomes after whole-neck intensity modulated radiation therapy and chemotherapy for oropharyngeal cancer: prospective longitudinal study.

PubMed

Vainshtein, Jeffrey M; Griffith, Kent A; Feng, Felix Y; Vineberg, Karen A; Chepeha, Douglas B; Eisbruch, Avraham

2014-08-01

To describe voice and speech quality changes and their predictors in patients with locally advanced oropharyngeal cancer treated on prospective clinical studies of organ-preserving chemotherapy-intensity modulated radiation therapy (chemo-IMRT). Ninety-one patients with stage III/IV oropharyngeal cancer were treated on 2 consecutive prospective studies of definitive chemoradiation using whole-field IMRT from 2003 to 2011. Patient-reported voice and speech quality were longitudinally assessed from before treatment through 24 months using the Communication Domain of the Head and Neck Quality of Life (HNQOL-C) instrument and the Speech question of the University of Washington Quality of Life (UWQOL-S) instrument, respectively. Factors associated with patient-reported voice quality worsening from baseline and speech impairment were assessed. Voice quality decreased maximally at 1 month, with 68% and 41% of patients reporting worse HNQOL-C and UWQOL-S scores compared with before treatment, and improved thereafter, recovering to baseline by 12-18 months on average. In contrast, observer-rated larynx toxicity was rare (7% at 3 months; 5% at 6 months). Among patients with mean glottic larynx (GL) dose ≤20 Gy, >20-30 Gy, >30-40 Gy, >40-50 Gy, and >50 Gy, 10%, 32%, 25%, 30%, and 63%, respectively, reported worse voice quality at 12 months compared with before treatment (P=.011). Results for speech impairment were similar. Glottic larynx dose, N stage, neck dissection, oral cavity dose, and time since chemo-IMRT were univariately associated with either voice worsening or speech impairment. On multivariate analysis, mean GL dose remained independently predictive for both voice quality worsening (8.1%/Gy) and speech impairment (4.3%/Gy). Voice quality worsening and speech impairment after chemo-IMRT for locally advanced oropharyngeal cancer were frequently reported by patients, underrecognized by clinicians, and independently associated with GL dose. These findings support reducing mean GL dose to as low as reasonably achievable, aiming at ≤20 Gy when the larynx is not a target. Copyright © 2014 Elsevier Inc. All rights reserved.

Patient-Reported Voice and Speech Outcomes After Whole-Neck Intensity Modulated Radiation Therapy and Chemotherapy for Oropharyngeal Cancer: Prospective Longitudinal Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vainshtein, Jeffrey M.; Griffith, Kent A.; Feng, Felix Y.

Purpose: To describe voice and speech quality changes and their predictors in patients with locally advanced oropharyngeal cancer treated on prospective clinical studies of organ-preserving chemotherapy–intensity modulated radiation therapy (chemo-IMRT). Methods and Materials: Ninety-one patients with stage III/IV oropharyngeal cancer were treated on 2 consecutive prospective studies of definitive chemoradiation using whole-field IMRT from 2003 to 2011. Patient-reported voice and speech quality were longitudinally assessed from before treatment through 24 months using the Communication Domain of the Head and Neck Quality of Life (HNQOL-C) instrument and the Speech question of the University of Washington Quality of Life (UWQOL-S) instrument, respectively.more » Factors associated with patient-reported voice quality worsening from baseline and speech impairment were assessed. Results: Voice quality decreased maximally at 1 month, with 68% and 41% of patients reporting worse HNQOL-C and UWQOL-S scores compared with before treatment, and improved thereafter, recovering to baseline by 12-18 months on average. In contrast, observer-rated larynx toxicity was rare (7% at 3 months; 5% at 6 months). Among patients with mean glottic larynx (GL) dose ≤20 Gy, >20-30 Gy, >30-40 Gy, >40-50 Gy, and >50 Gy, 10%, 32%, 25%, 30%, and 63%, respectively, reported worse voice quality at 12 months compared with before treatment (P=.011). Results for speech impairment were similar. Glottic larynx dose, N stage, neck dissection, oral cavity dose, and time since chemo-IMRT were univariately associated with either voice worsening or speech impairment. On multivariate analysis, mean GL dose remained independently predictive for both voice quality worsening (8.1%/Gy) and speech impairment (4.3%/Gy). Conclusions: Voice quality worsening and speech impairment after chemo-IMRT for locally advanced oropharyngeal cancer were frequently reported by patients, underrecognized by clinicians, and independently associated with GL dose. These findings support reducing mean GL dose to as low as reasonably achievable, aiming at ≤20 Gy when the larynx is not a target.« less

NWR (National Weather Service) voice synthesis project, phase 1

NASA Astrophysics Data System (ADS)

Sampson, G. W.

1986-01-01

The purpose of the NOAA Weather Radio (NWR) Voice Synthesis Project is to provide a demonstration of the current voice synthesis technology. Phase 1 of this project is presented, providing a complete automation of an hourly surface aviation observation for broadcast over NWR. In examining the products currently available on the market, the decision was made that synthetic voice technology does not have the high quality speech required for broadcast over the NWR. Therefore the system presented uses the phrase concatenation type of technology for a very high quality, versatile, voice synthesis system.

Interventions for preventing voice disorders in adults.

PubMed

Ruotsalainen, J H; Sellman, J; Lehto, L; Jauhiainen, M; Verbeek, J H

2007-10-17

Poor voice quality due to a voice disorder can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to periods of absence from work. To evaluate the effectiveness of interventions to prevent voice disorders in adults. We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 05/04/06. Randomised controlled clinical trials (RCTs) of interventions evaluating the effectiveness of treatments to prevent voice disorders in adults. For work-directed interventions interrupted time series and prospective cohort studies were also eligible. Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate. We identified two randomised controlled trials including a total of 53 participants in intervention groups and 43 controls. One study was conducted with teachers and the other with student teachers. Both trials were poor quality. Interventions were grouped into 1) direct voice training, 2) indirect voice training and 3) direct and indirect voice training combined.1) Direct voice training: One study did not find a significant decrease of the Voice Handicap Index for direct voice training compared to no intervention.2) Indirect voice training: One study did not find a significant decrease of the Voice Handicap Index for indirect voice training when compared to no intervention.3) Direct and indirect voice training combined: One study did not find a decrease of the Voice Handicap Index for direct and indirect voice training combined when compared to no intervention. The same study did however find an improvement in maximum phonation time (Mean Difference -3.18 sec; 95 % CI -4.43 to -1.93) for direct and indirect voice training combined when compared to no intervention. No work-directed studies were found. None of the studies found evaluated the effectiveness of prevention in terms of sick leave or number of diagnosed voice disorders. We found no evidence that either direct or indirect voice training or the two combined are effective in improving self-reported vocal functioning when compared to no intervention. The current practice of giving training to at-risk populations for preventing the development of voice disorders is therefore not supported by definitive evidence of effectiveness. Larger and methodologically better trials are needed with outcome measures that better reflect the aims of interventions.

A Comparative Study of Iranian Female Primary School Teachers' Quality of Life With and Without Voice Complaints.

PubMed

Aghadoost, Ozra; Moradi, Negin; Aghadoost, Alireza; Montazeri, Ali; Soltani, Majid; Saffari, Ali

2016-11-01

As the largest group of professional voice users, teachers are more likely to face voice disorders because of their specific job conditions. This study aimed to compare the quality of life in female teachers with and without voice complaints. This is a cross-sectional descriptive-analytical study. This was a cross-sectional study of samples of primary school female teachers with (n = 60) and without (n = 60) voice disorders. All teachers were serving in Tehran, Iran. Professional background information was obtained through interviews, and quality of life was measured using the 36-item Short Form Health Survey questionnaire. A comparison was made between the study groups to analyze the data. The mean age of teachers was 44 (standard deviation = 3.95) years. There were no significant differences between the two groups regarding their professional background. However, significant differences were observed between the two groups in all subscales of the 36-item Short Form Health Survey, including physical and social functioning, role limitations because of either physical or emotional problems, bodily pain, general health, vitality, and mental health (P < 0.05). Findings of this study point to the effect of voice complaint on quality of life and showed that teachers with voice complaints suffer from poor health-related quality of life. Therefore, both voice-specific and unspecific assessment methods are required for clinical diagnostics. Copyright © 2016. Published by Elsevier Inc.

The relation of vocal fold lesions and voice quality to voice handicap and psychosomatic well-being.

PubMed

Smits, R; Marres, H; de Jong, Felix

2012-07-01

Voice disorders have a multifactorial genesis and may be present in various ways. They can cause a significant communication handicap and impaired quality of life. To assess the effect of vocal fold lesions and voice quality on voice handicap and psychosomatic well-being. Female patients, aged 18-65 years, who were referred to the outpatient clinic with voice problems were subsequently assessed. Laryngostroboscopic examination and acoustic voice analysis were carried out, and the patients were asked to fill in the Voice Handicap Index (VHI) and Symptom Check List-90 questionnaires. Eighty-two patients were included. In 43 patients (52.4%), a vocal fold lesion was observed. The VHI and psychosomatic well-being did not differ significantly between patients with and without a vocal fold lesion. The patients with a vocal fold lesion showed lower scores on the Dysphonia Severity Index (DSI) compared with those without a vocal fold lesion. However, the DSI was not correlated with voice handicap and psychosomatic well-being, except for the VHI physical subscale. Objective measurement does not necessarily correlate with the subjective appraisal of the patient's voice handicap and psychosomatic well-being. Furthermore, the criterion of the presence of a vocal fold lesion as the base of indemnity that is applied by health insurance institutions should be questioned. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Quality and Readability of English-Language Internet Information for Voice Disorders.

PubMed

Dueppen, Abigail J; Bellon-Harn, Monica L; Radhakrishnan, Nandhakumar; Manchaiah, Vinaya

2017-12-15

The purpose of this study is to evaluate the readability and quality of English-language Internet information related to vocal hygiene, vocal health, and prevention of voice disorders. This study extends recent work because it evaluates readability, content quality, and website origin across broader search criteria than previous studies evaluating online voice material. Eighty-five websites were aggregated using five different country-specific search engines. Websites were then analyzed using quality and readability assessments. The entire web page was evaluated; however, no information or links beyond the first page was reviewed. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. Websites exhibited acceptable quality as measured by the DISCERN. However, only one website obtained the Health On the Net certification. Significant differences in quality were found among website origin, with government websites receiving higher quality ratings. Approximate educational levels required to comprehend information on the websites ranged from 8 to 9 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of nonprofit organizations. Current vocal hygiene, vocal health, and prevention of voice disorders websites were found to exhibit acceptable levels of quality and readability. However, highly rated Internet information related to voice care should be made more accessible to voice clients through Health On the Net certification. Published by Elsevier Inc.

Acoustical analysis of trained and untrained singers onsite before and after prolonged voice use

NASA Astrophysics Data System (ADS)

Jackson, Christophe E.

Controlled acoustic environments are important in voice research. Recording environment affects the quality of voice recordings. While sound booths and anechoic chambers are examples of controlled acoustic environments widely used in research, they are both costly and not portable. The long-term goal of this project is to compare the voice usage and efficiency of trained and untrained singers onsite immediately before and after vocal performance. The specific goal of this project is the further of development a Portable Sound Booth (PSB) and standardization of onsite voice recording procedures under controlled conditions. We hypothesized that the simple and controlled acoustic environment provided by the PSB would enable consistent reliable onsite voice recordings and the immediate differences as a consequence of voice usage were measurable. Research has suggested that it would be possible to conduct onsite voice recordings. Proof of concept research titled "Construction and Characterization of a Portable Sound Booth for Onsite Measurement" was conducted before initiating the full research effort. Preliminary findings revealed that: (1) it was possible to make high-quality voice recordings onsite, (2) the use of a Portable Sound Booth (PSB) required further acoustic characterization of its inherent acoustic properties, and (3) testable differences before and after performance were evident. The specific aims were to (1) develop and refine onsite objective voice measurements in the PSB and (2) evaluate use of the PSB to measure voice quality changes before and after voice usage.

The singing power ratio as an objective measure of singing voice quality in untrained talented and nontalented singers.

PubMed

Watts, Christopher; Barnes-Burroughs, Kathryn; Estis, Julie; Blanton, Debra

2006-03-01

A growing body of contemporary research has investigated differences between trained and untrained singing voices. However, few studies have separated untrained singers into those who do and do not express abilities related to singing talent, including accurate pitch control and production of a pleasant timbre (voice quality). This investigation studied measures of the singing power ratio (SPR), which is a quantitative measure of the resonant quality of the singing voice. SPR reflects the amplification or suppression in the vocal tract of the harmonics produced by the sound source. This measure was acquired from the voices of untrained talented and nontalented singers as a means to objectively investigate voice quality differences. Measures of SPR were acquired from vocal samples with fast Fourier transform (FFT) power spectra to analyze the amplitude level of the partials in the acoustic spectrum. Long-term average spectra (LTAS) were also analyzed. Results indicated significant differences in SPR between groups, which suggest that vocal tract resonance, and its effect on perceived vocal timbre or quality, may be an important variable related to the perception of singing talent. LTAS confirmed group differences in the tuning of vocal tract harmonics.

Perceptual connections between prepubertal children's voices in their speaking behavior and their singing behavior.

PubMed

Rinta, Tiija Elisabet; Welch, Graham F

2009-11-01

Traditionally, children's speaking and singing behaviors have been regarded as two separate sets of behaviors. Nevertheless, according to the voice-scientific view, all vocal functioning is interconnected due to the fact that we exploit the same voice and the same physiological mechanisms in generating all vocalization. The intention of the study was to investigate whether prepubertal children's speaking and singing behaviors are connected perceptually. Voice recordings were conducted with 60 10-year-old children. Each child performed a set of speaking and singing tasks in the voice experiments. Each voice sample was analyzed perceptually with a specially designed perceptual voice assessment protocol. The main finding was that the children's vocal functioning and voice quality in their speaking behavior correlated statistically significantly with those in their singing behavior. The findings imply that children's speaking and singing behaviors are perceptually connected through their vocal functioning and voice quality. Thus, it can be argued that children possess one voice that is used for generating their speaking and singing behaviors.

A high quality voice coder with integrated echo canceller and voice activity detector for mobile satellite applications

NASA Technical Reports Server (NTRS)

Kondoz, A. M.; Evans, B. G.

1993-01-01

In the last decade, low bit rate speech coding research has received much attention resulting in newly developed, good quality, speech coders operating at as low as 4.8 Kb/s. Although speech quality at around 8 Kb/s is acceptable for a wide variety of applications, at 4.8 Kb/s more improvements in quality are necessary to make it acceptable to the majority of applications and users. In addition to the required low bit rate with acceptable speech quality, other facilities such as integrated digital echo cancellation and voice activity detection are now becoming necessary to provide a cost effective and compact solution. In this paper we describe a CELP speech coder with integrated echo canceller and a voice activity detector all of which have been implemented on a single DSP32C with 32 KBytes of SRAM. The quality of CELP coded speech has been improved significantly by a new codebook implementation which also simplifies the encoder/decoder complexity making room for the integration of a 64-tap echo canceller together with a voice activity detector.

Assessing the effectiveness of botulinum toxin injections for adductor spasmodic dysphonia: clinician and patient perception.

PubMed

Braden, Maia N; Johns, Michael M; Klein, Adam M; Delgaudio, John M; Gilman, Marina; Hapner, Edie R

2010-03-01

To determine the effectiveness of Botox treatment for adductor spasmodic dysphonia (ADSD), the clinician and patient judge changes in voice symptoms and the effect on quality of life. Currently, there is no standard protocol for determining the effectiveness of Botox injections in treating ADSD. Therefore, clinicians use a variety of perceptual scales and patient-based self-assessments to determine patients' impressions of severity and changes after treatments. The purpose of this study was to assess clinician-patient agreement of the effects of Botox on voice quality and quality of life in ADSD. Retrospective chart review of 199 randomly selected patients since 2004. Results indicated a weak correlation between the patient's assessment of voice impairment (EIS) and patient's quality of life impairment (Voice-Related Quality of Life [V-RQOL]) in the mild-moderate dysphonia severity group and the moderate-to-severe dysphonia group. There was a weak correlation between the patient's assessment of voice impairment EIS and the clinician's perceptual judgment of voice impairment (Consensus Auditory Perceptual Evaluation of Voice [CAPE-V]) only in the moderate to severe dysphonia group. There was a weak correlation between the patient's quality of life impairment (V-RQOL) and the clinician's perceptual judgment of voice impairment (CAPE-V) only in the severe to profound dysphonia group. The poor relationship among commonly used outcome measures leads us to question how best to assess the effectiveness of Botox in ADSD. Clinicians are required to document treatment outcomes, making it important to use scales that are valid, reliable, and sensitive to change. Future research directions include examining relationships between measures both before and after Botox injections, examining the specific factors that determine quality of life changes, and further research on specific parameters of the CAPE-V as well as comparing perceptual and quality of life scales with acoustic and aerodynamic measures in this population would be beneficial in the move toward more effective ways of measuring change. Copyright (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Connections between voice ergonomic risk factors in classrooms and teachers' voice production.

PubMed

Rantala, Leena M; Hakala, Suvi; Holmqvist, Sofia; Sala, Eeva

2012-01-01

The aim of the study was to investigate if voice ergonomic risk factors in classrooms correlated with acoustic parameters of teachers' voice production. The voice ergonomic risk factors in the fields of working culture, working postures and indoor air quality were assessed in 40 classrooms using the Voice Ergonomic Assessment in Work Environment - Handbook and Checklist. Teachers (32 females, 8 males) from the above-mentioned classrooms recorded text readings before and after a working day. Fundamental frequency, sound pressure level (SPL) and the slope of the spectrum (alpha ratio) were analyzed. The higher the number of the risk factors in the classrooms, the higher SPL the teachers used and the more strained the males' voices (increased alpha ratio) were. The SPL was already higher before the working day in the teachers with higher risk than in those with lower risk. In the working environment with many voice ergonomic risk factors, speakers increase voice loudness and use more strained voice quality (males). A practical implication of the results is that voice ergonomic assessments are needed in schools. Copyright © 2013 S. Karger AG, Basel.

Effects of voice training and voice hygiene education on acoustic and perceptual speech parameters and self-reported vocal well-being in female teachers.

PubMed

Ilomaki, Irma; Laukkanen, Anne-Maria; Leppanen, Kirsti; Vilkman, Erkki

2008-01-01

Voice education programs may help in optimizing teachers' voice use. This study compared effects of voice training (VT) and voice hygiene lecture (VHL) in 60 randomly assigned female teachers. All 60 attended the lecture, and 30 completed a short training course in addition. Text reading was recorded in working environments and analyzed for fundamental frequency (F0), equivalent sound level (Leq), alpha ratio, jitter, shimmer, and perceptual quality. Self-reports of vocal well-being were registered. In the VHL group, increased F0 and difficulty of phonation and in the VT group decreased perturbation, increased alpha ratio, easier phonation, and improved perceptual and self-reported voice quality were found. Both groups equally self-reported increase of voice care knowledge. Results seem to indicate improved vocal well-being after training.

Voice Quality in Native and Foreign Languages Investigated by Inverse Filtering and Perceptual Analyses.

PubMed

Järvinen, Kati; Laukkanen, Anne-Maria; Geneid, Ahmed

2017-03-01

Language shift from native (L1) to foreign language (L2) may affect speaker's voice production and induce vocal fatigue. This study investigates the effects of language shift on voice source and perceptual voice quality. This is a comparative experimental study. Twenty-four subjects were recorded in L1 and L2. Twelve of the subjects were native Finnish speakers and 12 were native English speakers, and the foreign languages were English and Finnish. Two groups were created based on reports of fatigability. Group 1 had the subjects who did not report more vocal fatigue in L2 than in L1, and in group 2 those who reported more vocal fatigue in L2 than in L1. Acoustic analyses by inverse filtering were conducted in L1 and L2. Also, the subjects' voices were perceptually evaluated in both languages. Results show that language shift from L1 to L2 increased perceived pressedness of voice. Acoustic analyses correlated with the perceptual evaluations. Also, the subjects who reported more vocal loading had poorer voice quality, more strenuous voice production, more pressed phonation, and a higher pitch. Voice production was less optimal in L2 than in L1. Speech training given in L2 could be beneficial for people who need to use L2 extensively. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of singing training on total laryngectomees wearing a tracheoesophageal voice prosthesis.

PubMed

Onofre, Fernanda; Ricz, Hilton Marcos Alves; Takeshita-Monaretti, Telma Kioko; Prado, Maria Yuka de Almeida; Aguiar-Ricz, Lílian Neto

2013-02-01

To assess the effect of a program of singing training on the voice of total laryngectomees wearing tracheoesophageal voice prosthesis, considering the quality of alaryngeal phonation, vocal extension and the musical elements of tunning and legato. Five laryngectomees wearing tracheoesophageal voice prosthesis completed the singing training program over a period of three months, with exploration of the strengthening of the respiratory muscles and vocalization and with evaluation of perceptive-auditory and singing voice being performed before and after 12 sessions of singing therapy. After the program of singing voice training, the quality of tracheoesophageal voice showed improvement or the persistence of the general degree of dysphonia for the emitted vowels and for the parameters of roughness and breathiness. For the vowel "a", the pitch was displaced to grave in two participants and to acute in one, and remained adequate in the others. A similar situation was observed also for the vowel "i". After the singing program, all participants presented tunning and most of them showed a greater presence of legato. The vocal extension improved in all participants. Singing training seems to have a favorable effect on the quality of tracheoesophageal phonation and on singing voice.

Does the speaker's voice quality influence children's performance on a language comprehension test?

PubMed

Lyberg-Åhlander, Viveka; Haake, Magnus; Brännström, Jonas; Schötz, Susanne; Sahlén, Birgitta

2015-02-01

A small number of studies have explored children's perception of speakers' voice quality and its possible influence on language comprehension. The aim of this explorative study was to investigate the relationship between the examiner's voice quality, the child's performance on a digital version of a language comprehension test, the Test for Reception of Grammar (TROG-2), and two measures of cognitive functioning. The participants were (n = 86) mainstreamed 8-year old children with typical language development. Two groups of children (n = 41/45) were presented with the TROG-2 through recordings of one female speaker: one group was presented with a typical voice and the other with a simulated dysphonic voice. Significant associations were found between executive functioning and language comprehension. The results also showed that children listening to the dysphonic voice achieved significantly lower scores for more difficult sentences ("the man but not the horse jumps") and used more self-corrections on simpler sentences ("the girl is sitting"). Findings suggest that a dysphonic speaker's voice may force the child to allocate capacity to the processing of the voice signal at the expense of comprehension. The findings have implications for clinical and research settings where standardized language tests are used.

Vocal warm-up and breathing training for teachers: randomized clinical trial

PubMed Central

Pereira, Lílian Paternostro de Pina; Masson, Maria Lúcia Vaz; Carvalho, Fernando Martins

2015-01-01

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality. METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists. RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group. CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up. PMID:26465664

Influence of Left-Right Asymmetries on Voice Quality in Simulated Paramedian Vocal Fold Paralysis

ERIC Educational Resources Information Center

Samlan, Robin A.; Story, Brad H.

2017-01-01

Purpose: The purpose of this study was to determine the vocal fold structural and vibratory symmetries that are important to vocal function and voice quality in a simulated paramedian vocal fold paralysis. Method: A computational kinematic speech production model was used to simulate an exemplar "voice" on the basis of asymmetric…

Surgery or Rehabilitation: A Randomized Clinical Trial Comparing the Treatment of Vocal Fold Polyps via Phonosurgery and Traditional Voice Therapy with "Voice Therapy Expulsion" Training.

PubMed

Barillari, Maria Rosaria; Volpe, Umberto; Mirra, Giuseppina; Giugliano, Francesco; Barillari, Umberto

2017-05-01

Phonomicrosurgery is generally considered to be the treatment of choice for removing vocal fold polyps. However, specific techniques of voice therapy may represent, in selected cases and under certain conditions, a noninvasive therapeutic option for the treatment of such laryngeal lesions. The aim of the present study is to longitudinally assess, in terms of clinical outcomes and quality of life, two groups of patients with cordal polyps, treated either with standard surgery plus standard voice therapy or with a specific training of voice therapy alone, which we have called "Voice Therapy Expulsion." This study is a randomized controlled trial. A total of 150 patients with vocal fold polyps were randomly assigned to either standard surgery or "voice therapy expulsion" protocol. The trial was carried out at the Division of Phoniatrics and Audiology of the Second University of Naples and at the Division of Communication Disorders of Local Health Unit (3 Naples South) from January 2010 to December 2013. A thorough phoniatric evaluation, including laryngostroboscopy, acoustic voice analysis, global grade of dysphonia, instability, roughness, breathiness, asthenia, and strain scale, Voice Handicap Index, and Voice-Related Quality of Life, was performed by using standardized tools, at baseline, at the end of the treatment, and up to 1 year after treatment. We found no significant differences between the two experimental groups in terms of clinical outcomes and personal satisfaction. However, "Voice Therapy Expulsion" was associated with higher scores for quality of life at endpoint evaluation. Besides phonosurgery, this specific "Voice Therapy Expulsion" technique should be considered as a valid, noninvasive, and well-tolerated therapeutic option for the treatment of selected patients with vocal fold polyps. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Effect of Hydration on Voice Quality in Adults: A Systematic Review.

PubMed

Alves, Maxine; Krüger, Esedra; Pillay, Bhavani; van Lierde, Kristiane; van der Linde, Jeannie

2017-11-06

We aimed to critically appraise scientific, peer-reviewed articles, published in the past 10 years on the effects of hydration on voice quality in adults. This is a systematic review. Five databases were searched using the key words "vocal fold hydration", "voice quality", "vocal fold dehydration", and "hygienic voice therapy". The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. The included studies were scored based on American Speech-Language-Hearing Association's levels of evidence and quality indicators, as well as the Cochrane Collaboration's risk of bias tool. Systemic dehydration as a result of fasting and not ingesting fluids significantly negatively affected the parameters of noise-to-harmonics ratio (NHR), shimmer, jitter, frequency, and the s/z ratio. Water ingestion led to significant improvements in shimmer, jitter, frequency, and maximum phonation time values. Caffeine intake does not appear to negatively affect voice production. Laryngeal desiccation challenges by oral breathing led to surface dehydration which negatively affected jitter, shimmer, NHR, phonation threshold pressure, and perceived phonatory effort. Steam inhalation significantly improved NHR, shimmer, and jitter. Only nebulization of isotonic solution decreased phonation threshold pressure and showed some indication of a potential positive effect of nebulization substances. Treatments in high humidity environments prove to be effective and adaptations of low humidity environments should be encouraged. Recent literature regarding vocal hydration is high quality evidence. Systemic hydration is the easiest and most cost-effective solution to improve voice quality. Recent evidence therefore supports the inclusion of hydration in a vocal hygiene program. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal parameters and voice-related quality of life in adult women with and without ovarian function.

PubMed

Ferraz, Pablo Rodrigo Rocha; Bertoldo, Simão Veras; Costa, Luanne Gabrielle Morais; Serra, Emmeliny Cristini Nogueira; Silva, Eduardo Magalhães; Brito, Luciane Maria Oliveira; Chein, Maria Bethânia da Costa

2013-05-01

To identify the perceptual and acoustic parameters of voice in adult women with and without ovarian function and its impact on quality of life related to voice. Cross-sectional and analytical study with 106 women divided into, two groups: G1, with ovarian function (n=43) and G2, without physiological ovarian function (n=63). The women were instructed to sustain the vowel "a" and the sounds of /s/ and /z/ in habitual pitch and loudness. They were also asked to classify their voices and answer the voice-related quality of life (V-RQOL) questionnaire. The perceptual analysis of the vocal samples was performed by three speech-language pathologists using the GRBASI (G: grade; R: roughness; B: breathness; A: asthenia; S: strain; I: instability) scale. The acoustic analysis was carried out with the software VoxMetria 2.7h (CTS Informatica). The data were analyzed using descriptive statistics. In the perceptual analysis, both groups showed a mild deviation for the parameters roughness, strain, and instability, but only G2 showed a mild impact for the overall degree of dysphonia. The mean of fundamental frequency was significantly lower for the G2, with a difference of 17.41Hz between the two groups. There was no impact on V-RQOL in any of the V-RQOL domains for this group. With the menopause, there is a change in women's voices, impacting on some voice parameters. However, there is no direct impact on their quality of life related to voice. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

External Validation of the Acoustic Voice Quality Index Version 03.01 With Extended Representativity.

PubMed

Barsties, Ben; Maryn, Youri

2016-07-01

The Acoustic Voice Quality Index (AVQI) is an objective method to quantify the severity of overall voice quality in concatenated continuous speech and sustained phonation segments. Recently, AVQI was successfully modified to be more representative and ecologically valid because the internal consistency of AVQI was balanced out through equal proportion of the 2 speech types. The present investigation aims to explore its external validation in a large data set. An expert panel of 12 speech-language therapists rated the voice quality of 1058 concatenated voice samples varying from normophonia to severe dysphonia. The Spearman rank-order correlation coefficients (r) were used to measure concurrent validity. The AVQI's diagnostic accuracy was evaluated with several estimates of its receiver operating characteristics (ROC). Finally, 8 of the 12 experts were chosen because of reliability criteria. A strong correlation was identified between AVQI and auditoryperceptual rating (r = 0.815, P = .000). It indicated that 66.4% of the auditory-perceptual rating's variation was explained by AVQI. Additionally, the ROC results showed again the best diagnostic outcome at a threshold of AVQI = 2.43. This study highlights external validation and diagnostic precision of the AVQI version 03.01 as a robust and ecologically valid measurement to objectify voice quality. © The Author(s) 2016.

Restoration of voice function by using biological feedback in laryngeal and hypopharyngeal carcinoma patients

NASA Astrophysics Data System (ADS)

Choinzonov, E. L.; Balatskaya, L. N.; Chizhevskaya, S. Yu.; Meshcheryakov, R. V.; Kostyuchenko, E. Yu.; Ivanova, T. A.

2016-08-01

The aim of the research is to develop and introduce a new technique of post-laryngectomy voice rehabilitation of laryngeal and hypopharyngeal carcinoma patients. The study involves comparing and analyzing 82 cases of voice function restoration by using biological feedback based on mathematical modeling of voice production. The advantage of the modern technology-based method in comparison with the conventional one is proved. Restoration of voice function using biofeedback allows taking into account patient's abilities, adjusting parameters of voice trainings, and controlling their efficiency in real-time mode. The data obtained indicate that the new method contributes to the rapid inclusion of self-regulation mechanisms of the body and results in the overall success rate of voice rehabilitation in totally laryngectomized patients reaching 92%, which reduces the rehabilitation period to 18 days, compared to 86% and 38 days in the control group, respectively. Restoration of disturbed functions after successful treatment is an important task of rehabilitation and is crucial in terms of the quality of cancer patients' lives. To assess life quality of laryngeal cancer patients, the EORTC Quality of Life Core Questionnaire (QLQ-C30), and head and neck module (QLQ-H&N35) were used. The analyzed results proved that the technique of biofeedback voice restoration significantly improves the quality of life of laryngectomized patients. It allows reducing the number of disabled people, restoring patients' ability to work-related activities, and significantly improving social adaptation of these patients.

Respiratory Tract Infections and Voice Quality in 4-Year-old Children in the STEPS Study.

PubMed

Kallvik, Emma; Toivonen, Laura; Peltola, Ville; Kaljonen, Anne; Simberg, Susanna

2018-03-02

Health-related factors are part of the multifactorial background of dysphonia in children. Respiratory tract infections affect the same systems and structures that are used for voice production. The purpose of this study was to investigate if the number of respiratory tract infections or the viral etiology were significant predictors for a more hoarse voice quality. The participants were 4-year-old children who participated in the multidisciplinary STEPS study (Steps to the Healthy Development and Well-being of Children) where they were followed up from pregnancy or birth to 4 years of age. Data were collected through questionnaires and a health diary filled in by the parents. Some of the children were followed up more intensively for respiratory tract infections during the first 2 years of life, and nasal swab samples were taken at the onset of respiratory symptoms. Our participants were 489 of these children who had participated in the follow-up for at least 1 year and for whom data on respiratory tract infections and data on voice quality were available. The number of hospitalizations due to respiratory tract infections was a significant predictor for a more hoarse voice quality. Neither the number of rhinovirus infections nor the number of respiratory syncytial virus infections was statistically significant predictors for a more hoarse voice quality. Based on our results, we would suggest including questions on the presence of respiratory tract infections that have led to hospitalization in the pediatric voice anamnesis. Whether the viral etiology of respiratory tract infections is of importance or not requires further research. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Lax Vox as a Voice Training Program for Teachers: A Pilot Study.

PubMed

Mailänder, Eva; Mühre, Lea; Barsties, Ben

2017-03-01

The objective of this study was to explore the effectiveness of a 3-week training program with the voice therapy "Lax Vox" for teachers. Four healthy female teachers participated as volunteers for the study. Several voice measurements of perception, acoustics, aerodynamics, and self-evaluation were investigated. Furthermore, a survey to rate the applicability of Lax Vox was also part of the study. To assess the treatment effects of the Lax Vox training, an effect size analysis (d unb ) was conducted. After 3 weeks of training, medium and large improvements were found in some parameters of perceptual and acoustic voice quality assessments (d unb >0.50 and d unb >0.80, respectively). Furthermore, medium improvements were revealed in some parameters of self-evaluation (ie, physical and total scale of the Voice Handicap Index) and aerodynamic (ie, maximum phonation time) assessments (all d unb >0.50). Additionally, acoustic measures of vocal function showed an expansion in the upper contour of voice range profiles after training. Particularly, the main improvements in the voice range profile was found in the modal and the beginning of the falsetto voice registers. There was an increase of the intensity levels of about 4.6 dB. No changes were revealed in some acoustic measures of the voice range profile, self-evaluation measurements, and the perception of breathy voice quality (all d unb <0.20). Finally, the applicability of Lax Vox perceptually showed clear support in training success, learning process, and transfer to the daily routine. Lax Vox training for teachers appears to improve select measures of voice quality, maximum phonation time, vocal function, self-evaluation, and perceived applicability. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Soprano and source: A laryngographic analysis

NASA Astrophysics Data System (ADS)

Bateman, Laura Anne

2005-04-01

Popular music in the 21st century uses a particular singing quality for female voice that is quite different from the trained classical singing quality. Classical quality has been the subject of a vast body of research, whereas research that deals with non-classical qualities is limited. In order to learn more about these issues, the author chose to do research on singing qualities using a variety of standard voice quality tests. This paper looks at voice qualities found in various different styles of singing: Classical, Belt, Legit, R&B, Jazz, Country, and Pop. The data was elicited from a professional soprano and the voice qualities reflect industry standards. The data set for this paper is limited to samples using the vowel [i]. Laryngographic (LGG) data was generated simultaneously with the audio samples. This paper will focus on the results of the LGG analysis; however, an audio analysis was also performed using Spectrogram, LPC, and FFT. Data from the LGG is used to calculate the contact quotient, speed quotient, and ascending slope. The LGG waveform is also visually assessed. The LGG analysis gives insights into the source vibration for the different singing styles.

Interactive Augmentation of Voice Quality and Reduction of Breath Airflow in the Soprano Voice.

PubMed

Rothenberg, Martin; Schutte, Harm K

2016-11-01

In 1985, at a conference sponsored by the National Institutes of Health, Martin Rothenberg first described a form of nonlinear source-tract acoustic interaction mechanism by which some sopranos, singing in their high range, can use to reduce the total airflow, to allow holding the note longer, and simultaneously enrich the quality of the voice, without straining the voice. (M. Rothenberg, "Source-Tract Acoustic Interaction in the Soprano Voice and Implications for Vocal Efficiency," Fourth International Conference on Vocal Fold Physiology, New Haven, Connecticut, June 3-6, 1985.) In this paper, we describe additional evidence for this type of nonlinear source-tract interaction in some soprano singing and describe an analogous interaction phenomenon in communication engineering. We also present some implications for voice research and pedagogy. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Application of psychometric theory to the measurement of voice quality using rating scales.

PubMed

Shrivastav, Rahul; Sapienza, Christine M; Nandur, Vuday

2005-04-01

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the mid-range of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.

The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease--a feasibility study.

PubMed

Elefant, Cochavit; Baker, Felicity A; Lotan, Meir; Lagesen, Simen Krogstie; Skeie, Geir Olve

2012-01-01

Parkinson's disease (PD) is a progressive neurodegenerative disorder where patients exhibit impairments in speech production. Few studies have investigated the influence of music interventions on vocal abilities of individuals with PD. To evaluate the influence of a group voice and singing intervention on speech, singing, and depressive symptoms in individuals with PD. Ten patients diagnosed with PD participated in this one-group, repeated measures design study. Participants received the sixty-minute intervention, in a small group setting once a week for 20 consecutive weeks. Speech and singing quality were acoustically analyzed using a KayPentax Multi-Dimensional Voice Program, voice ability using the Voice Handicap Index (VHI), and depressive symptoms using the Montgomery and Asberg Depression rating scale (MADRS). Measures were taken at baseline (Time 1), after 10 weeks of weekly sessions (Time 2), and after 20 weeks of weekly sessions (Time 3). Significant changes were observed for five of the six singing quality outcomes at Time 2 and 3, as well as voice range and the VHI physical subscale at Time 3. No significant changes were found for speaking quality or depressive symptom outcomes; however, there was an absence of decline on speaking quality outcomes over the intervention period. Significant improvements in singing quality and voice range, coupled with the absence of decline in speaking quality support group singing as a promising intervention for persons with PD. A two-group randomized control study is needed to determine whether the intervention contributes to maintenance of speaking quality in persons with PD.

A pneumatic Bionic Voice prosthesis-Pre-clinical trials of controlling the voice onset and offset.

PubMed

Ahmadi, Farzaneh; Noorian, Farzad; Novakovic, Daniel; van Schaik, André

2018-01-01

Despite emergent progress in many fields of bionics, a functional Bionic Voice prosthesis for laryngectomy patients (larynx amputees) has not yet been achieved, leading to a lifetime of vocal disability for these patients. This study introduces a novel framework of Pneumatic Bionic Voice Prostheses as an electronic adaptation of the Pneumatic Artificial Larynx (PAL) device. The PAL is a non-invasive mechanical voice source, driven exclusively by respiration with an exceptionally high voice quality, comparable to the existing gold standard of Tracheoesophageal (TE) voice prosthesis. Following PAL design closely as the reference, Pneumatic Bionic Voice Prostheses seem to have a strong potential to substitute the existing gold standard by generating a similar voice quality while remaining non-invasive and non-surgical. This paper designs the first Pneumatic Bionic Voice prosthesis and evaluates its onset and offset control against the PAL device through pre-clinical trials on one laryngectomy patient. The evaluation on a database of more than five hours of continuous/isolated speech recordings shows a close match between the onset/offset control of the Pneumatic Bionic Voice and the PAL with an accuracy of 98.45 ±0.54%. When implemented in real-time, the Pneumatic Bionic Voice prosthesis controller has an average onset/offset delay of 10 milliseconds compared to the PAL. Hence it addresses a major disadvantage of previous electronic voice prostheses, including myoelectric Bionic Voice, in meeting the short time-frames of controlling the onset/offset of the voice in continuous speech.

A pneumatic Bionic Voice prosthesis—Pre-clinical trials of controlling the voice onset and offset

PubMed Central

Noorian, Farzad; Novakovic, Daniel; van Schaik, André

2018-01-01

Despite emergent progress in many fields of bionics, a functional Bionic Voice prosthesis for laryngectomy patients (larynx amputees) has not yet been achieved, leading to a lifetime of vocal disability for these patients. This study introduces a novel framework of Pneumatic Bionic Voice Prostheses as an electronic adaptation of the Pneumatic Artificial Larynx (PAL) device. The PAL is a non-invasive mechanical voice source, driven exclusively by respiration with an exceptionally high voice quality, comparable to the existing gold standard of Tracheoesophageal (TE) voice prosthesis. Following PAL design closely as the reference, Pneumatic Bionic Voice Prostheses seem to have a strong potential to substitute the existing gold standard by generating a similar voice quality while remaining non-invasive and non-surgical. This paper designs the first Pneumatic Bionic Voice prosthesis and evaluates its onset and offset control against the PAL device through pre-clinical trials on one laryngectomy patient. The evaluation on a database of more than five hours of continuous/isolated speech recordings shows a close match between the onset/offset control of the Pneumatic Bionic Voice and the PAL with an accuracy of 98.45 ±0.54%. When implemented in real-time, the Pneumatic Bionic Voice prosthesis controller has an average onset/offset delay of 10 milliseconds compared to the PAL. Hence it addresses a major disadvantage of previous electronic voice prostheses, including myoelectric Bionic Voice, in meeting the short time-frames of controlling the onset/offset of the voice in continuous speech. PMID:29466455

Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: a pilot study on long-term outcome on voice quality.

PubMed

Tsuji, Domingos Hiroshi; Takahashi, Marystella Tomoe; Imamura, Rui; Hachiya, Adriana; Sennes, Luiz Ubirajara

2012-09-01

Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Prospective study. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). A significant improvement in VHI was observed after surgery, as compared with baseline values (P=0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Quality of life and voice assessment in patients with early-stage glottic cancer.

PubMed

Arias, Fernando; Arraras, Juan Ignacio; Asin, Gemma; Uzcanga, María Itziar; Maraví, Enrique; Chicata, Volker; Eito, Clara; Zarandona, Uxue; Mora, Itxaso; Vila, Meritxell; Domínguez, Miguel Angel

2015-03-01

The purpose of this study was to assess the quality of life (QOL) and voice handicap in a sample of disease-free patients who had been treated at our center with radiotherapy (RT) or surgery for early glottic cancer. QOL and voice handicap were assessed using the European Organisation for Research and Treatment of Cancer (EORTC) questionnaires Quality of Life Questionnaire-Core 30-questions (QLQ-C30) and Quality of Life Questionnaire-Head and Neck 35-questions (QLQ-H&N35) and the Voice Handicap Index (VHI). Ninety-one patients completed the questionnaires. Fifty-nine patients (65%) were treated with RT and 32 (35%) with surgery. QOL scores for the sample recorded, moderate limitations in 6 areas, and more than moderate limitations (>30 of 100) in 2 areas. Significant differences were found in emotional functioning (88.5 vs 76.6) and social contact (4.6 vs 12.1) on the EORTC questionnaires and on the VHI (6.1 vs 12.8), which favored the RT group. In this cross-sectional study, voice quality, emotional functioning, and social contact were better in the RT group. © 2014 Wiley Periodicals, Inc.

Comparing Measures of Voice Quality From Sustained Phonation and Continuous Speech.

PubMed

Gerratt, Bruce R; Kreiman, Jody; Garellek, Marc

2016-10-01

The question of what type of utterance-a sustained vowel or continuous speech-is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation. Speakers with voice disorders sustained vowels and read sentences. Vowel samples were excerpted from the steadiest portion of each vowel in the sentences. In addition to sustained and excerpted vowels, a 3rd set of stimuli was created by shortening sustained vowel productions to match the duration of vowels excerpted from continuous speech. Acoustic measures were made on the stimuli, and listeners judged the severity of vocal quality deviation. Sustained vowels and those extracted from continuous speech contain essentially the same acoustic and perceptual information about vocal quality deviation. Perceived and/or measured differences between continuous speech and sustained vowels derive largely from voice source variability across segmental and prosodic contexts and not from variations in vocal fold vibration in the quasisteady portion of the vowels. Approaches to voice quality assessment by using continuous speech samples average across utterances and may not adequately quantify the variability they are intended to assess.

Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course.

PubMed

Fabron, Eliana Maria Gradim; Regaçone, Simone Fiuza; Marino, Viviane Cristina de Castro; Mastria, Marina Ludovico; Motonaga, Suely Mayumi; Sebastião, Luciana Tavares

2015-01-01

To compare the vocal self-perception and vocal complaints reported by two groups of students of the pedagogy course (freshmen and graduates); to relate the vocal self-perception to the vocal complaints for these groups; and to compare the voice quality of the students from these groups through perceptual auditory assessment and acoustic analysis. Initially, 89 students from the pedagogy course answered a questionnaire about self-perceived voice quality and vocal complaints. In a second phase, auditory-perceptual evaluation and acoustic analyses of 48 participants were made through voice recordings of sustained vowel emission and poem reading. The most reported vocal complaints were fatigue while using the voice, sore throat, effort to speak, irritation or burning in the throat, hoarseness, tightness in the neck, and variations of voice throughout the day. There was a higher occurrence of complaints from graduates than from freshmen, with significant differences for four of the nine complaints. It was also possible to observe the relationship between vocal self-perception and complaints reported by these students. No significant differences were observed in the results of auditory-perceptual evaluation; however, some graduates had their voices evaluated with higher severity of deviation of normalcy. During acoustic analysis no difference was observed between groups. The increase in vocal demand by the graduates may have caused the greatest number and diversity of vocal complaints, and several of them are related to the self-assessment of voice quality. The auditory-perceptual evaluation and acoustic analysis showed no deviations in their voice.

Is children's listening effort in background noise influenced by the speaker's voice quality?

PubMed

Sahlén, Birgitta; Haake, Magnus; von Lochow, Heike; Holm, Lucas; Kastberg, Tobias; Brännström, K Jonas; Lyberg-Åhlander, Viveka

2018-07-01

The present study aims at exploring the influence of voice quality on listening effort in children performing a language comprehension test with sentences of increasing difficulty. Listening effort is explored in relation to gender ( = cisgender). The study has a between-groups design. Ninety-three mainstreamed children aged 8;2 to 9;3 with typical language development participated. The children were randomly assigned to two groups (n = 46/47) with equal allocation of boys and girls and for the analysis to four groups depending of gender and voice condition. Working memory capacity and executive functions were tested in quiet. A digital version of a language comprehension test (the TROG-2) was used to measure the effect of voice quality on listening effort, measured as response time in a forced-choice paradigm. The groups listened to sentences through recordings of the same female voice, one group with a typical voice and one with a dysphonic voice, both in competing multi-talker babble noise. Response times were logged after a time buffer between the sentence-ending and indication of response. There was a significant increase in response times with increased task difficulty and response times between the two voice conditions differed significantly. The girls in the dysphonic condition were slower with increasing task difficulty. A dysphonic voice clearly adds to the noise burden and listening effort is greater in girls than in boys when the teacher speaks with dysphonic voice in a noisy background. These findings might mirror gender differences as for coping strategies in challenging contexts and have important implications for education.

Voice hearing within the context of hearers' social worlds: an interpretative phenomenological analysis.

PubMed

Mawson, Amy; Berry, Katherine; Murray, Craig; Hayward, Mark

2011-09-01

Research has found relational qualities of power and intimacy to exist within hearer-voice interactions. The present study aimed to provide a deeper understanding of the interpersonal context of voice hearing by exploring participants' relationships with their voices and other people in their lives. This research was designed in consultation with service users and employed a qualitative, phenomenological, and idiographic design using semi-structured interviews. Ten participants, recruited via mental health services, and who reported hearing voices in the previous week, completed the interviews. These were transcribed verbatim and analysed using interpretative phenomenological analysis. Five themes resulted from the analysis. Theme 1: 'person and voice' demonstrated that participants' voices often reflected the identity, but not always the quality of social acquaintances. Theme 2: 'voices changing and confirming relationship with the self' explored the impact of voice hearing in producing an inferior sense-of-self in comparison to others. Theme 3: 'a battle for control' centred on issues of control and a dilemma of independence within voice relationships. Theme 4: 'friendships facilitating the ability to cope' and theme 5: 'voices creating distance in social relationships' explored experiences of social relationships within the context of voice hearing, and highlighted the impact of social isolation for voice hearers. The study demonstrated the potential role of qualitative research in developing theories of voice hearing. It extended previous research by highlighting the interface between voices and the social world of the hearer, including reciprocal influences of social relationships on voices and coping. Improving voice hearers' sense-of-self may be a key factor in reducing the distress caused by voices. ©2010 The British Psychological Society.

A Randomized Controlled Trial of Two Semi-Occluded Vocal Tract Voice Therapy Protocols

PubMed Central

Hunter, Eric J.; Kirkham, Kimberly; Cox, Karin; Titze, Ingo R.

2015-01-01

Purpose Although there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions. Method Twenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group. Results Voice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings. Conclusions VFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study. PMID:25675335

Voice- and swallow-related quality of life in idiopathic Parkinson's disease.

PubMed

van Hooren, Michel R A; Baijens, Laura W J; Vos, Rein; Pilz, Walmari; Kuijpers, Laura M F; Kremer, Bernd; Michou, Emilia

2016-02-01

This study explores whether changes in voice- and swallow-related QoL are associated with progression of idiopathic Parkinson's disease (IPD). Furthermore, it examines the relationship between patients' perception of both voice and swallowing disorders in IPD. Prospective clinical study, quality of life (QoL). One-hundred mentally competent IPD patients with voice and swallowing complaints were asked to answer four QoL questionnaires (Voice Handicap Index, MD Anderson Dysphagia Inventory, Visual Analog Scale [VAS] voice, and Dysphagia Severity Scale [DSS]). Differences in means for the QoL questionnaires and their subscales within Hoehn and Yahr stage groups were calculated using one-way analysis of variance. The relationship between voice- and swallow-related QoL questionnaires was determined with the Spearman correlation coefficient. Scores on both voice and swallow questionnaires suggest an overall decrease in QoL with progression of IPD. A plateau in QoL for VAS voice and the DSS was seen in the early Hoehn and Yahr stages. Finally, scores on voice-related QoL questionnaires were significantly correlated with swallow-related QoL outcomes. Voice- and swallow-related QoL decreases with progression of IPD. A significant association was found between voice- and swallow-related QoL questionnaires. Healthcare professionals can benefit from voice- and swallow-related QoL questionnaires in a multidimensional voice- or swallow-assessment protocol. The patient's perception of his/her voice and swallowing disorders and its impact on QoL in IPD should not be disregarded. 2b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Establishing Validity of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)

ERIC Educational Resources Information Center

Zraick, Richard I.; Kempster, Gail B.; Connor, Nadine P.; Thibeault, Susan; Klaben, Bernice K.; Bursac, Zoran; Thrush, Carol R.; Glaze, Leslie E.

2011-01-01

Purpose: The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) was developed to provide a protocol and form for clinicians to use when assessing the voice quality of adults with voice disorders (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kramer, & Hillman, 2009). This study examined the reliability and the empirical validity of the…

Personal Genres, Public Voices

ERIC Educational Resources Information Center

Danielewicz, Jane

2008-01-01

Writing in personal genres, like autobiography, leads writers to public voices. Public voice is a discursive quality of a text that conveys the writer's authority and position relative to others. To show how voice and authority depend on genre, I analyze the autobiographies of two writers who take opposing positions on the same topic. By producing…

Reliability in perceptual analysis of voice quality.

PubMed

Bele, Irene Velsvik

2005-12-01

This study focuses on speaking voice quality in male teachers (n = 35) and male actors (n = 36), who represent untrained and trained voice users, because we wanted to investigate normal and supranormal voices. In this study, both substantial and methodologic aspects were considered. It includes a method for perceptual voice evaluation, and a basic issue was rater reliability. A listening group of 10 listeners, 7 experienced speech-language therapists, and 3 speech-language therapist students evaluated the voices by 15 vocal characteristics using VA scales. Two sets of voice signals were investigated: text reading (2 loudness levels) and sustained vowel (3 levels). The results indicated a high interrater reliability for most perceptual characteristics. Connected speech was evaluated more reliably, especially at the normal level, but both types of voice signals were evaluated reliably, although the reliability for connected speech was somewhat higher than for vowels. Experienced listeners tended to be more consistent in their ratings than did the student raters. Some vocal characteristics achieved acceptable reliability even with a smaller panel of listeners. The perceptual characteristics grouped in 4 factors reflected perceptual dimensions.

Measuring voice outcomes: state of the science review.

PubMed

Carding, Pau N; Wilson, J A; MacKenzie, K; Deary, I J

2009-08-01

Researchers evaluating voice disorder interventions currently have a plethora of voice outcome measurement tools from which to choose. Faced with such a wide choice, it would be beneficial to establish a clear rationale to guide selection. This article reviews the published literature on the three main areas of voice outcome assessment: (1) perceptual rating of voice quality, (2) acoustic measurement of the speech signal and (3) patient self-reporting of voice problems. We analysed the published reliability, validity, sensitivity to change and utility of the common outcome measurement tools in each area. From the data, we suggest that routine voice outcome measurement should include (1) an expert rating of voice quality (using the Grade-Roughness-Breathiness-Asthenia-Strain rating scale) and (2) a short self-reporting tool (either the Vocal Performance Questionnaire or the Vocal Handicap Index 10). These measures have high validity, the best reported reliability to date, good sensitivity to change data and excellent utility ratings. However, their application and administration require attention to detail. Acoustic measurement has arguable validity and poor reliability data at the present time. Other areas of voice outcome measurement (e.g. stroboscopy and aerodynamic phonatory measurements) require similarly detailed research and analysis.

Does CPAP treatment affect the voice?

PubMed

Saylam, Güleser; Şahin, Mustafa; Demiral, Dilek; Bayır, Ömer; Yüceege, Melike Bağnu; Çadallı Tatar, Emel; Korkmaz, Mehmet Hakan

2016-12-20

The aim of this study was to investigate alterations in voice parameters among patients using continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea syndrome. Patients with an indication for CPAP treatment without any voice problems and with normal laryngeal findings were included and voice parameters were evaluated before and 1 and 6 months after CPAP. Videolaryngostroboscopic findings, a self-rated scale (Voice Handicap Index-10, VHI-10), perceptual voice quality assessment (GRBAS: grade, roughness, breathiness, asthenia, strain), and acoustic parameters were compared. Data from 70 subjects (48 men and 22 women) with a mean age of 44.2 ± 6.0 years were evaluated. When compared with the pre-CPAP treatment period, there was a significant increase in the VHI-10 score after 1 month of treatment and in VHI- 10 and total GRBAS scores, jitter percent (P = 0.01), shimmer percent, noise-to-harmonic ratio, and voice turbulence index after 6 months of treatment. Vague negative effects on voice parameters after the first month of CPAP treatment became more evident after 6 months. We demonstrated nonsevere alterations in the voice quality of patients under CPAP treatment. Given that CPAP is a long-term treatment it is important to keep these alterations in mind.

Singing in groups for Parkinson's disease (SING-PD): a pilot study of group singing therapy for PD-related voice/speech disorders.

PubMed

Shih, Ludy C; Piel, Jordan; Warren, Amanda; Kraics, Lauren; Silver, Althea; Vanderhorst, Veronique; Simon, David K; Tarsy, Daniel

2012-06-01

Parkinson's disease related speech and voice impairment have significant impact on quality of life measures. LSVT(®)LOUD voice and speech therapy (Lee Silverman Voice Therapy) has demonstrated scientific efficacy and clinical effectiveness, but musically based voice and speech therapy has been underexplored as a potentially useful method of rehabilitation. We undertook a pilot, open-label study of a group-based singing intervention, consisting of twelve 90-min weekly sessions led by a voice and speech therapist/singing instructor. The primary outcome measure of vocal loudness as measured by sound pressure level (SPL) at 50 cm during connected speech was not significantly different one week after the intervention or at 13 weeks after the intervention. A number of secondary measures reflecting pitch range, phonation time and maximum loudness also were unchanged. Voice related quality of life (VRQOL) and voice handicap index (VHI) also were unchanged. This study suggests that a group singing therapy intervention at this intensity and frequency does not result in significant improvement in objective and subject-rated measures of voice and speech impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Using Hyaluronic Acid for Improving Vocal Function in a Prepubescent Boy With an Atrophied Right Vocal Fold.

PubMed

Cohen, Wendy; Wynne, David McGregor

2015-07-01

A single case study is reported of a child who underwent several surgical procedures as result of congenital grade III subglottic stenosis. The anterior aspect of the right vocal cord was damaged and underwent atrophy during one of these procedures. Now, an active 10-year-old, the patient has become increasingly aware of his vocal limitations on functional activities. Injection of hyaluronic acid into the vocal folds has been known to provide improved voice quality in adults although there are no known cases reported of this procedure in children. This article reports voice outcomes after injection of hyaluronic acid into the Reinke's space in a single case study. Voice recordings were made before, after, and 1 month after injection. The voice recordings were subject to acoustic and perceptual analysis. Post and follow-up voice recordings demonstrate decreased jitter, shimmer, and harmonics-to-noise ratio. Perceptual evaluation indicates improved voice quality. Injection of hyaluronic acid in children who require voice augmentation is possible and may contribute to increased vocal function and improved voice outcomes. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Impact of a Teaching or Singing Career on the Female Vocal Quality at the Mean Age of 67 Years: A Pilot Study.

PubMed

D'haeseleer, Evelien; Claeys, Sofie; Bettens, Kim; Leemans, Laura; Van Calster, Ann-Sophie; Van Damme, Nina; Thijs, Zoë; Daelman, Julie; Leyns, Clara; Van Lierde, Kristiane

2017-07-01

The purpose of this study was to measure the objective and subjective vocal quality in women aged between 60 and 75 years. Secondly, the impact of a teaching or singing career on the vocal quality was investigated by comparing the vocal quality of retired women with different careers. This is a case-control study. Seventy-three retired women between 60 and 75 years (mean age: 67 years, standard deviation: 4.49) participated in the study and were divided into three groups: women with a teaching career (n = 21), choir singers with a singing career (n = 12), and women with a non-vocal career (n = 40). All subjects underwent the same assessment protocol consisting of objective (aerodynamic, maximum performance, vocal range, acoustic measurements, and the Dysphonia Severity Index) and subjective (the Voice Handicap Index, auditory-perceptual evaluations by three listeners) voice measurements. In all three groups, objective and perceptual voice analysis showed a mild dysphonia. No differences in the Dysphonia Severity Index were found between the three groups. The voices of choir singers with a singing career were perceived significantly less rough than voices of the women with a non-vocal career. Additionally, the lowest frequency of the frequency range was significantly lower in the retired teachers and choir singers than in the controls. The results of this study prudently suggest that a singing or a teaching career compared with a non-vocal career has a positive impact on the vocal frequency range, and that singing has a positive impact on the perceptual vocal quality of the older female voice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Massed versus Spaced Practice in Vocology: Effect of a Short-Term Intensive Voice Training versus a Longer-Term Traditional Voice Training

ERIC Educational Resources Information Center

Meerschman, Iris; Van Lierde, Kristiane; Van Puyvelde, Caro; Bostyn, Astrid; Claeys, Sofie; D'haeseleer, Evelien

2018-01-01

Background: In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. Aims: The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy…

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses

PubMed Central

Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia

2018-01-01

OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses. PMID:29538494

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses.

PubMed

Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia

2018-03-12

To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses.

Voice Quality After a Semi-Occluded Vocal Tract Exercise With a Ventilation Mask in Contemporary Commercial Singers: Acoustic Analysis and Self-Assessments.

PubMed

Fantini, Marco; Succo, Giovanni; Crosetti, Erika; Borragán Torre, Alfonso; Demo, Roberto; Fussi, Franco

2017-05-01

The current study aimed at investigating the immediate effects of a semi-occluded vocal tract exercise with a ventilation mask in a group of contemporary commercial singers. A randomized controlled study was carried out. Thirty professional or semi-professional singers with no voice complaints were randomly divided into two groups on recruitment: an experimental group and a control group. The same warm-up exercise was performed by the experimental group with an occluded ventilation mask placed over the nose and the mouth and by the control group without the ventilation mask. Voice was recorded before and after the exercise. Acoustic and self-assessment analysis were accomplished. The acoustic parameters of the voice samples recorded before and after training were compared, as well as the parameters' variations between the experimental and the control group. Self-assessment results of the experimental and the control group were compared too. Significant changes after the warm-up exercise included jitter, shimmer, and singing power ratio (SPR) in the experimental group. No significant changes were recorded in the control group. Significant differences between the experimental and the control group were found for ΔShimmer and ΔSPR. Self-assessment analysis confirmed a significantly higher phonatory comfort and voice quality perception for the experimental group. The results of the present study support the immediate advantageous effects on singing voice of a semi-occluded vocal tract exercise with a ventilation mask in terms of acoustic quality, phonatory comfort, and voice quality perception in contemporary commercial singers. Long-term effects still remain to be studied. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice Quality and Gender Stereotypes: A Study of Lebanese Women With Reinke's Edema.

PubMed

Matar, Nayla; Portes, Cristel; Lancia, Leonardo; Legou, Thierry; Baider, Fabienne

2016-12-01

Women with Reinke's edema (RW) report being mistaken for men during telephone conversations. For this reason, their masculine-sounding voices are interesting for the study of gender stereotypes. The study's objective is to verify their complaint and to understand the cues used in gender identification. Using a self-evaluation study, we verified RW's perception of their own voices. We compared the acoustic parameters of vowels produced by 10 RW to those produced by 10 men and 10 women with healthy voices (hereafter referred to as NW) in Lebanese Arabic. We conducted a perception study for the evaluation of RW, healthy men's, and NW voices by naïve listeners. RW self-evaluated their voices as masculine and their gender identities as feminine. The acoustic parameters that distinguish RW from NW voices concern fundamental frequency, spectral slope, harmonicity of the voicing signal, and complexity of the spectral envelope. Naïve listeners very often rate RW as surely masculine. Listeners may rate RW's gender incorrectly. These incorrect gender ratings are correlated with acoustic measures of fundamental frequency and voice quality. Further investigations will reveal the contribution of each of these parameters to gender perception and guide the treatment plan of patients complaining of a gender ambiguous voice.

Is there an effect of dysphonic teachers' voices on children's processing of spoken language?

PubMed

Rogerson, Jemma; Dodd, Barbara

2005-03-01

There is a vast body of literature on the causes, prevalence, implications, and issues of vocal dysfunction in teachers. However, the educational effect of teacher vocal impairment is largely unknown. The purpose of this study was to investigate the effect of impaired voice quality on children's processing of spoken language. One hundred and seven children (age range, 9.2 to 10.6, mean 9.8, SD 3.76 months) listened to three video passages, one read in a control voice, one in a mild dysphonic voice, and one in a severe dysphonic voice. After each video passage, children were asked to answer six questions, with multiple-choice answers. The results indicated that children's perceptions of speech across the three voice qualities differed, regardless of gender, IQ, and school attended. Performance in the control voice passages was better than performance in the mild and severe dysphonic voice passages. No difference was found between performance in the mild and severe dysphonic voice passages, highlighting that any form of vocal impairment is detrimental to children's speech processing and is therefore likely to have a negative educational effect. These findings, in light of the high rate of vocal dysfunction in teachers, further support the implementation of specific voice care education for those in the teaching profession.

The objective vocal quality, vocal risk factors, vocal complaints, and corporal pain in Dutch female students training to be speech-language pathologists during the 4 years of study.

PubMed

Van Lierde, Kristiane M; D'haeseleer, Evelien; Wuyts, Floris L; De Ley, Sophia; Geldof, Ruben; De Vuyst, Julie; Sofie, Claeys

2010-09-01

The purpose of the present cross-sectional study was to determine the objective vocal quality and the vocal characteristics (vocal risk factors, vocal and corporal complaints) in 197 female students in speech-language pathology during the 4 years of study. The objective vocal quality was measured by means of the Dysphonia Severity Index (DSI). Perceptual voice assessment, the Voice Handicap Index (VHI), questionnaires addressing vocal risks, and vocal and corporal complaints during and/or after voice usage were performed. Speech-language pathology (SLP) students have a borderline vocal quality corresponding to a DSI% of 68. The analysis of variance revealed no significant change of the objective vocal quality between the first bachelor year and the master year. No psychosocial handicapping effect of the voice was observed by means of the VHI total, though there was an effect at the functional VHI level in addition to some vocal complaints. Ninety-three percent of the student SLPs reported the presence of corporal pain during and/or after speaking. In particular, sore throat and headache were mentioned as the prevalent corporal pain symptoms. A longitudinal study of the objective vocal quality of the same subjects during their career as an SLP might provide new insights. 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Correlation between the Voice Handicap and Swallowing Quality of Life in patients with laryngeal cancer submitted to chemoradiotherapy.

PubMed

Rosa, Maria Eduarda da; Mituuti, Cláudia Tiemi; Ghirardi, Ana Carolina de Assis Moura

2018-01-01

Purpose To verify the correlation between the voice handicap and swallowing quality of life in individuals submitted to chemoradiotherapy for laryngeal cancer treatment. Methods Cross-sectional, observational and quantitative study. Fourteen male individuals diagnosed with laryngeal cancer were submitted to exclusive chemoradiotherapy treatment. The individuals completed the Voice Handicap Index (VHI) and the Swallowing Quality of Life (SWAL-QOL) questionnaires. Data were submitted to descriptive and inferential analysis using Spearman's Correlation Test to verify possible correlations among the scores of these instruments. Values of p ≤ 0.05 were considered statistically significant. Results No significant correlation was found between the total VHI and overall SWAL-QOL scores. However, there was significant correlation between the domain Functional of the VHI and the domains Fatigue and Social of the SWAL-QOL, between the domain Organic in the VHI and the SWAL-QOL domain Social, and total VHI score and SWAL-QOL domain Swallowing as a burden. Furthermore, chemoradiotherapy treatment had a greater impact on the voice than on the swallowing for the studied individuals. Conclusion The data showed a significant correlation between voice handicap and the impact of quality of life involving swallowing in individuals with laryngeal cancer submitted to chemoradiotherapy. This may affect individuals' emotional and social aspects, impacting their overall quality of life.

Assessment of voice related quality of life and its correlation with socioeconomic status after total laryngectomy.

PubMed

Agarwal, Sangeet Kumar; Gogia, Shweta; Agarwal, Alok; Agarwal, Rajiv; Mathur, Ajay Swaroop

2015-10-01

After total laryngectomy for laryngeal cancer, the major determinants of QOL is the patient's voice related quality of life (V-RQOL). The primary aim of this study was to assess the V-RQOL and impact of socioeconomic status over it in Indian population by using two validated scales [voice handicap index (VHI) and V-RQOL questionnaires]. Total 104 patients underwent total laryngectomy but 71 were eligible for study. Patients filled the VHI and V-RQOL questionnaires after completion of 1 year of usage of the TEP voice. The socioeconomic status of the patients was calculated according to various domains related to their life and were divided into lower and higher status. A total of 76.1% patients had VHI score between 0 to 30 (minimal voice handicap), 19.7% had score between 31 to 60 (moderate voice handicap) and only 4.2% patients had VHI score more than 61 (serious voice handicap). On V-RQOL scores, 16.9% patients had score between 10 to 15 (excellent), 40.8% patients, between 16 to 20 (very good), 22.5% patients, between 21 and 25 (good voice), 15.5% patients, between 26 and 30 (fair) and only 4.2% patients scored more than 30 with poor quality of voice. Patients with lower socioeconomic group had better V-RQOL than with high socioeconomic group. VHI and V-RQOL scores in our series were superior to other studies due to major population with lower socioeconomic status and better social support which exists in our society.

Vocal characteristics of congenital anterior glottic webs in children: A case report.

PubMed

Shah, Jay; White, Katherine; Dohar, Joseph

2015-06-01

This case report describes a 5-year-old girl with chronic dysphonia and high-pitched voice since birth. Vocal quality was noted to be harsh. Videostroboscopy revealed significant hyperfunction and a Type II congenital anterior glottic web. Endoscopic division of the anterior glottic web was performed with significant improvement in vocal quality and quality of life. This paper describes methods of analyzing, diagnosing, and treating anterior glottic web with a focus on quality of life. Also, unique acoustic and aerodynamic voice features are identified. No other descriptions of a voice characteristic for anterior glottic web currently exist in the literature. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Study of Risk Factors for Development of Voice Disorders and its Impact on the Quality of Life of School Teachers in Mangalore, India.

PubMed

Alva, Arati; Machado, Megna; Bhojwani, Kiran; Sreedharan, Suja

2017-01-01

School teachers are most prone to the development and detrimental effects of voice disorders as a consequence of their work. The risk factors for development of dysphonia in teachers are multifactorial. The primary aim of our study was to investigate the various risk factors that influence the onset and progression of voice disorders in school teachers in the Indian context. We wanted to assess the effect of voice problems on the physical, psychosocial and functional aspect of a teacher's life. It was a cross-sectional study conducted across three English medium institutions. A total of 105 teachers consented to participate in the study and they had to answer a semi-structured, pre-tested questionnaire, which included demographic details, living habits (drug intake, smoking and alcohol intake) health condition [any Deviated Nasal Septum (DNS), Gastroesophageal Reflux Disease (GERD), stress, etc., or any history of surgery], teaching characteristics, voice symptoms and physical discomforts and quality of life assessment. The completed questionnaires were collected and analyzed based on the responses obtained. It was found that 81% of the study population had voice problems at some point of their career. A total of 26% of them fell into the voice disorder category. The association of upper respiratory infections DNS and GERD with voice disorders was found to be statistically significant. We also found that a significant number of teachers with voice disorders had changed their teaching styles and were planning to opt for an early retirement. Most importantly, it was also seen that teachers with voice disorders were more likely to have a poorer quality of life as compared to those without a voice disorder (p<0.001). Voice disorders had a significant bearing on all the spheres of a school teacher's life. The affected teachers were more likely to take sick leaves, change overall job opinions, retire early, reduce overall communiations, repeat statements and avoid talking to people in person as well as over the telephone. It reduced their overall social abilities and made them avoid social activities. They got easily upset and were dissatisfied with their job performance. All these in turn deteriorate the quality of life in these individuals.

Study of Risk Factors for Development of Voice Disorders and its Impact on the Quality of Life of School Teachers in Mangalore, India

PubMed Central

Machado, Megna; Bhojwani, Kiran; Sreedharan, Suja

2017-01-01

Introduction School teachers are most prone to the development and detrimental effects of voice disorders as a consequence of their work. The risk factors for development of dysphonia in teachers are multifactorial. Aim The primary aim of our study was to investigate the various risk factors that influence the onset and progression of voice disorders in school teachers in the Indian context. We wanted to assess the effect of voice problems on the physical, psychosocial and functional aspect of a teacher’s life. Materials and Methods It was a cross-sectional study conducted across three English medium institutions. A total of 105 teachers consented to participate in the study and they had to answer a semi-structured, pre-tested questionnaire, which included demographic details, living habits (drug intake, smoking and alcohol intake) health condition [any Deviated Nasal Septum (DNS), Gastroesophageal Reflux Disease (GERD), stress, etc., or any history of surgery], teaching characteristics, voice symptoms and physical discomforts and quality of life assessment. The completed questionnaires were collected and analyzed based on the responses obtained. Results It was found that 81% of the study population had voice problems at some point of their career. A total of 26% of them fell into the voice disorder category. The association of upper respiratory infections DNS and GERD with voice disorders was found to be statistically significant. We also found that a significant number of teachers with voice disorders had changed their teaching styles and were planning to opt for an early retirement. Most importantly, it was also seen that teachers with voice disorders were more likely to have a poorer quality of life as compared to those without a voice disorder (p<0.001). Conclusion Voice disorders had a significant bearing on all the spheres of a school teacher’s life. The affected teachers were more likely to take sick leaves, change overall job opinions, retire early, reduce overall communiations, repeat statements and avoid talking to people in person as well as over the telephone. It reduced their overall social abilities and made them avoid social activities. They got easily upset and were dissatisfied with their job performance. All these in turn deteriorate the quality of life in these individuals. PMID:28273984

Teacher Voice in Global Conversations around Education Access, Equity, and Quality

ERIC Educational Resources Information Center

Gozali, Charlina; Claassen Thrush, Elizabeth; Soto-Peña, Michelle; Whang, Christine; Luschei, Thomas F.

2017-01-01

Despite public commitments internationally and nationally to include the voices of all stakeholders, the voices of teachers have continued to be marginalized in the literature and in policy-making related to global educational development. The purpose of the current study is to examine the process of invoking teacher voice using a sample of…

Assessment of voice, speech, and related quality of life in advanced head and neck cancer patients 10-years+ after chemoradiotherapy.

PubMed

Kraaijenga, S A C; Oskam, I M; van Son, R J J H; Hamming-Vrieze, O; Hilgers, F J M; van den Brekel, M W M; van der Molen, L

2016-04-01

Assessment of long-term objective and subjective voice, speech, articulation, and quality of life in patients with head and neck cancer (HNC) treated with concurrent chemoradiotherapy (CRT) for advanced, stage IV disease. Twenty-two disease-free survivors, treated with cisplatin-based CRT for inoperable HNC (1999-2004), were evaluated at 10-years post-treatment. A standard Dutch text was recorded. Perceptual analysis of voice, speech, and articulation was conducted by two expert listeners (SLPs). Also an experimental expert system based on automatic speech recognition was used. Patients' perception of voice and speech and related quality of life was assessed with the Voice Handicap Index (VHI) and Speech Handicap Index (SHI) questionnaires. At a median follow-up of 11-years, perceptual evaluation showed abnormal scores in up to 64% of cases, depending on the outcome parameter analyzed. Automatic assessment of voice and speech parameters correlated moderate to strong with perceptual outcome scores. Patient-reported problems with voice (VHI>15) and speech (SHI>6) in daily life were present in 68% and 77% of patients, respectively. Patients treated with IMRT showed significantly less impairment compared to those treated with conventional radiotherapy. More than 10-years after organ-preservation treatment, voice and speech problems are common in this patient cohort, as assessed with perceptual evaluation, automatic speech recognition, and with validated structured questionnaires. There were fewer complaints in patients treated with IMRT than with conventional radiotherapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients.

PubMed

van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2017-02-01

Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

Voice Use Among Music Theory Teachers: A Voice Dosimetry and Self-Assessment Study.

PubMed

Schiller, Isabel S; Morsomme, Dominique; Remacle, Angélique

2017-07-25

This study aimed (1) to investigate music theory teachers' professional and extra-professional vocal loading and background noise exposure, (2) to determine the correlation between vocal loading and background noise, and (3) to determine the correlation between vocal loading and self-evaluation data. Using voice dosimetry, 13 music theory teachers were monitored for one workweek. The parameters analyzed were voice sound pressure level (SPL), fundamental frequency (F0), phonation time, vocal loading index (VLI), and noise SPL. Spearman correlation was used to correlate vocal loading parameters (voice SPL, F0, and phonation time) and noise SPL. Each day, the subjects self-assessed their voice using visual analog scales. VLI and self-evaluation data were correlated using Spearman correlation. Vocal loading parameters and noise SPL were significantly higher in the professional than in the extra-professional environment. Voice SPL, phonation time, and female subjects' F0 correlated positively with noise SPL. VLI correlated with self-assessed voice quality, vocal fatigue, and amount of singing and speaking voice produced. Teaching music theory is a profession with high vocal demands. More background noise is associated with increased vocal loading and may indirectly increase the risk for voice disorders. Correlations between VLI and self-assessments suggest that these teachers are well aware of their vocal demands and feel their effect on voice quality and vocal fatigue. Visual analog scales seem to represent a useful tool for subjective vocal loading assessment and associated symptoms in these professional voice users. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

PubMed Central

SCHINDLER, A.; MOZZANICA, F.; GINOCCHIO, D.; MARUZZI, P.; ATAC, M.; OTTAVIANI, F.

2012-01-01

SUMMARY Benign vocal fold lesions are common in the general population, and have important public health implications and impact on patient quality of life. Nowadays, phonomicrosurgery is the most common treatment of these lesions. Voice therapy is generally associated in order to minimize detrimental vocal behaviours that increase the stress at the mid-membranous vocal folds. Nonetheless, the most appropriate standard of care for treating benign vocal fold lesion has not been established. The aim of this study was to analyze voice changes in a group of dysphonic patients affected by benign vocal fold lesions, evaluated with a multidimensional protocol before and after voice therapy. Sixteen consecutive patients, 12 females and 4 males, with a mean age of 49.7 years were enrolled. Each subject had 10 voice therapy sessions with an experienced speech/language pathologist for a period of 1-2 months, and was evaluated before and at the end of voice therapy with a multidimensional protocol that included self-assessment measures and videostroboscopic, perceptual, aerodynamic and acoustic ratings. Videostroboscopic examination did not reveal resolution of the initial pathology in any case. No improvement was observed in aerodynamic and perceptual ratings. A clear and significant improvement was visible on Wilcoxon signed-rank test for the mean values of Jitt%, Noise to Harmonic Ratio (NHR) and Voice Handicap Index (VHI) scores. Even if it is possible that, for benign vocal fold lesions, only a minor improvement of voice quality can be achieved after voice therapy, rehabilitation treatment still seems useful as demonstrated by improvement in self-assessment measures. If voice therapy is provided as an initial treatment to the patients with benign vocal fold lesions, this may lead to an improvement in the perceived voice quality, making surgical intervention unnecessary. This is one of the first reports on the efficacy of voice therapy in the management of benign vocal fold lesions; further studies are needed to confirm these preliminary data. PMID:23326009

Vibrato in Singing Voice: The Link between Source-Filter and Sinusoidal Models

NASA Astrophysics Data System (ADS)

Arroabarren, Ixone; Carlosena, Alfonso

2004-12-01

The application of inverse filtering techniques for high-quality singing voice analysis/synthesis is discussed. In the context of source-filter models, inverse filtering provides a noninvasive method to extract the voice source, and thus to study voice quality. Although this approach is widely used in speech synthesis, this is not the case in singing voice. Several studies have proved that inverse filtering techniques fail in the case of singing voice, the reasons being unclear. In order to shed light on this problem, we will consider here an additional feature of singing voice, not present in speech: the vibrato. Vibrato has been traditionally studied by sinusoidal modeling. As an alternative, we will introduce here a novel noninteractive source filter model that incorporates the mechanisms of vibrato generation. This model will also allow the comparison of the results produced by inverse filtering techniques and by sinusoidal modeling, as they apply to singing voice and not to speech. In this way, the limitations of these conventional techniques, described in previous literature, will be explained. Both synthetic signals and singer recordings are used to validate and compare the techniques presented in the paper.

[Estimation of quality of voice after removal of neoplasms T1 and T2 of glottis with simultaneous reconstruction of vocal fold with pedunculated sterno-thyroid muscle flap].

PubMed

Ratajczak, Jan; Wójtowicz, Piotr; Krzeski, Antoni

2014-01-01

In recent years there has been an increasing number of cases of cancer, including cancer of the larynx. The choice of treatment should be primarily dictated by the complete elimination of cancer, but from the point of view of the patient, an important factor to keep in mind, is the quality of the voice that will be created at the end of the therapeutic process. The aim of this study was to evaluate the voice quality of patients after partial surgery of the larynx with vocal fold reconstruction pedunculated sterno-thyroid muscle flap. The study included 30 men aged 53-72 years who were treated at the Clinic of Otorhinolaryngology Department of Medical-Dental Medical University of Warsaw on account of cancer of the larynx, qualified according to the TNM classification T1 or T2. The radical removal of cancer was associated with resection of one vocal fold, laryngeal pouches and ventricular fold. In 15 patients, included to the group I at the end of phase oncology surgery, a reconstruction of "vocal fold" pedunculated sterno-thyroid muscle flap were performed simultaneously. The group II consisted of 15 patients who underwent surgery that removed only the cancerous lesions. Impact assessments arising after surgery of voice disorders on quality of life were made using the self-test failure of the voice (Voice Handicap Index in the Pruszewicz modification). The nature of the created voice was studied using GRBAS scale. All patients performed the laryngostroboscope examination. With "IRIS" program, prepared by a team at Wrocław University of Technology, the voice was recorded, and then was subjected to acoustic analysis. In addition, noise level and the maximum phonation time was measured. The results indicate that the patients of group I gained a better voice confirming the values of objective acoustic analysis. The assessment made by the scale GRBAS patients who supplemented the resulting loss after tumour removal, with much less hoarseness of voice, did not have the hyperkinesis and there was no puff character. They had the better flow of voice and phonation time of vowels "a" was much longer. The assessment of quality of life of patients in group I made in a test of the VHI was higher than in group II. The laryngostroboscope examination confirmed a good phonatory occlusion and a nearly regular, healthy vocal fold vibration in patients who had received flap of muscle. Evaluation of the quality of voice after removing the tumor multiplicity in the glottis with simultaneous reconstruction "vocal fold" has confirmed that this is a very good surgical technique, which allows radically curing cancer for the simultaneous preservation of a good voice. The operation has limited indications for radiotherapy because of the desire to preserve the phonatory function of the larynx, and thus avoids the negative effects of radiation. Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

Perceptual, auditory and acoustic vocal analysis of speech and singing in choir conductors.

PubMed

Rehder, Maria Inês Beltrati Cornacchioni; Behlau, Mara

2008-01-01

the voice of choir conductors. to evaluate the vocal quality of choir conductors based on the production of a sustained vowel during singing and when speaking in order to observe auditory and acoustic differences. participants of this study were 100 choir conductors, with an equal distribution between genders. Participants were asked to produce the sustained vowel "é" using a singing and speaking voice. Speech samples were analyzed based on auditory-perceptive and acoustic parameters. The auditory-perceptive analysis was carried out by two speech-language pathologist, specialists in this field of knowledge. The acoustic analysis was carried out with the support of the computer software Doctor Speech (Tiger Electronics, SRD, USA, version 4.0), using the Real Analysis module. the auditory-perceptive analysis of the vocal quality indicated that most conductors have adapted voices, presenting more alterations in their speaking voice. The acoustic analysis indicated different values between genders and between the different production modalities. The fundamental frequency was higher in the singing voice, as well as the values for the first formant; the second formant presented lower values in the singing voice, with statistically significant results only for women. the voice of choir conductors is adapted, presenting fewer deviations in the singing voice when compared to the speaking voice. Productions differ based the voice modality, singing or speaking.

I like my voice better: self-enhancement bias in perceptions of voice attractiveness.

PubMed

Hughes, Susan M; Harrison, Marissa A

2013-01-01

Previous research shows that the human voice can communicate a wealth of nonsemantic information; preferences for voices can predict health, fertility, and genetic quality of the speaker, and people often use voice attractiveness, in particular, to make these assessments of others. But it is not known what we think of the attractiveness of our own voices as others hear them. In this study eighty men and women rated the attractiveness of an array of voice recordings of different individuals and were not told that their own recorded voices were included in the presentation. Results showed that participants rated their own voices as sounding more attractive than others had rated their voices, and participants also rated their own voices as sounding more attractive than they had rated the voices of others. These findings suggest that people may engage in vocal implicit egotism, a form of self-enhancement.

Neuromuscular electrical stimulation of the cricothyroid muscle in patients with suspected superior laryngeal nerve weakness.

PubMed

Guzman, Marco; Rubin, Adam; Cox, Paul; Landini, Fernando; Jackson-Menaldi, Cristina

2014-03-01

In this retrospective case study, we report the apparent clinical effectiveness of neuromuscular electrical stimulation (NMES) in combination with voice therapy (VT) for rehabilitating dysphonia secondary to suspected superior laryngeal nerve (SLN) weakness in two female patients. Both patients failed or plateaued with traditional VT but had significant improvement with the addition of NMES of the cricothyroid muscle and SLN using a VitalStim unit. Stimulation was provided simultaneously with voice exercises based on musical phonatory tasks. Both acoustic analysis and endoscopic evaluation demonstrated important improvements after treatment. In the first patient, the major change was obtained within the primo passaggio region; specifically, a decrease in voice breaks was demonstrated. In the second patient, an improvement in voice quality (less breathiness) and vocal range were the most important findings. Additionally, each patient reported a significant improvement in their voice complaints. Neuromuscular laryngeal electrical stimulation in combination with vocal exercises might be a useful tool to improve voice quality in patients with SLN injury. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Mechanics of human voice production and control

PubMed Central

Zhang, Zhaoyan

2016-01-01

As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed. PMID:27794319

Mechanics of human voice production and control.

PubMed

Zhang, Zhaoyan

2016-10-01

As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed.

Changes After Voice Therapy in Acoustic Voice Analysis of Chinese Patients With Voice Disorders.

PubMed

Lu, Dan; Chen, Fei; Yang, Hui; Yu, Rong; Zhou, Qi; Zhang, Xinyuan; Ren, Jia; Zheng, Yitao; Zhang, Xiaoyan; Zou, Jian; Wang, Haiyang; Liu, Jun

2018-05-01

This study aimed to evaluate the effects of voice therapy on patients with voice disorders by comparing the acoustic parameter changes before and after treatment. This is a retrospective study. Forty-five female patients with early-stage vocal nodules or polyps, postoperative patients, and patients with chronic laryngitis were divided into three subgroups. Videostroboscopic, acoustic analysis (fundamental frequency, jitter, shimmer, mean harmonics-to-noise ratio), and maximum phonation time (MPT) were measured before and after treatment. Fifty healthy female volunteers were the control group. After treatment, 24.4% of nodules or polyps had decreased in size, 11.1% of patients with chronic laryngitis and postoperative patients had reduced edema, and the mucosal wave of vocal folds had different degrees of recovery in postoperative patients. All acoustic analysis values and MPT in the patient group were statistically worse than in the control group, except for fundamental frequency before treatment (P > 0.05). After treatment, the acoustic analysis and MPT values were improved. However, the jitter, mean harmonics-to-noise ratio, and MPT values in the patient group were still worse after voice therapy than in the control group (P < 0.05). Most of acoustic analysis values can be useful as a complementary tool in diagnosis and assessment of voice disorders; however, it is not recommended to use a single parameter to assess voice quality. Voice therapy can improve voice quality in patients with voice disorders, but a period longer than 8 weeks is recommended for these patients. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The point-touch technique for botulinum toxin injection in adductor spasmodic dysphonia: quality of life assessment.

PubMed

Morzaria, S; Damrose, E J

2011-07-01

Botulinum toxin injection under electromyographic guidance is the 'gold standard' for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction. To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients. Stanford University Voice and Swallowing Center. Prospective case series (evidence level four). Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose-response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively. Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total). The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

Analog voicing detector responds to pitch

NASA Technical Reports Server (NTRS)

Abel, R. S.; Watkins, H. E.

1967-01-01

Modified electronic voice encoder /Vocoder/ includes an independent analog mode of operation in addition to the conventional digital mode. The Vocoder is a bandwidth compression equipment that permits voice transmission over channels, having only a fraction of the bandwidth required for conventional telephone-quality speech transmission.

Influence of Security Mechanisms on the Quality of Service of VoIP

NASA Astrophysics Data System (ADS)

Backs, Peter; Pohlmann, Norbert

While Voice over IP (VoIP) is advancing rapidly in the telecommunications market, the interest to protect the data transmitted by this new service is also rising. However, in contrast to other internet services such as email or HTTP, VoIP is real-time media, and therefore must meet a special requirement referred to as Quality-of-Service to provide a comfortable flow of speech. Speech quality is worsened when transmitted over the network due to delays in transmission or loss of packets. Often, voice quality is at a level that even prevents comprehensive dialog. Therefore, an administrator who is to setup a VoIP infrastructure might consider avoiding additional decreases in voice quality resulting from security mechanisms, and might leave internet telephony unprotected as a result. The inspiration for this paper is to illustrate that security mechanisms have negligible impact on speech quality and should in fact be encouraged.

Telephony-based voice pathology assessment using automated speech analysis.

PubMed

Moran, Rosalyn J; Reilly, Richard B; de Chazal, Philip; Lacy, Peter D

2006-03-01

A system for remotely detecting vocal fold pathologies using telephone-quality speech is presented. The system uses a linear classifier, processing measurements of pitch perturbation, amplitude perturbation and harmonic-to-noise ratio derived from digitized speech recordings. Voice recordings from the Disordered Voice Database Model 4337 system were used to develop and validate the system. Results show that while a sustained phonation, recorded in a controlled environment, can be classified as normal or pathologic with accuracy of 89.1%, telephone-quality speech can be classified as normal or pathologic with an accuracy of 74.2%, using the same scheme. Amplitude perturbation features prove most robust for telephone-quality speech. The pathologic recordings were then subcategorized into four groups, comprising normal, neuromuscular pathologic, physical pathologic and mixed (neuromuscular with physical) pathologic. A separate classifier was developed for classifying the normal group from each pathologic subcategory. Results show that neuromuscular disorders could be detected remotely with an accuracy of 87%, physical abnormalities with an accuracy of 78% and mixed pathology voice with an accuracy of 61%. This study highlights the real possibility for remote detection and diagnosis of voice pathology.

Relationship between quality of life instruments and phonatory function in tracheoesophageal speech with voice prosthesis.

PubMed

Miyoshi, Masayuki; Fukuhara, Takahiro; Kataoka, Hideyuki; Hagino, Hiroshi

2016-04-01

The use of tracheoesophageal speech with voice prosthesis (T-E speech) after total laryngectomy has increased recently as a method of vocalization following laryngeal cancer. Previous research has not investigated the relationship between quality of life (QOL) and phonatory function in those using T-E speech. This study aimed to demonstrate the relationship between phonatory function and both comprehensive health-related QOL and QOL related to speech in people using T-E speech. The subjects of the study were 20 male patients using T-E speech after total laryngectomy. At a visit to our clinic, the subjects underwent a phonatory function test and completed three questionnaires: the MOS 8-Item Short-Form Health Survey (SF-8), the Voice Handicap Index-10 (VHI-10), and the Voice-Related Quality of Life (V-RQOL) Measure. A significant correlation was observed between the physical component summary (PCS), a summary score of SF-8, and VHI-10. Additionally, a significant correlation was observed between the SF-8 mental component summary (MCS) and both VHI-10 and VRQOL. Significant correlations were also observed between voice intensity in the phonatory function test and both VHI-10 and V-RQOL. Finally, voice intensity was significantly correlated with the SF-8 PCS. QOL questionnaires and phonatory function tests showed that, in people using T-E speech after total laryngectomy, voice intensity was correlated with comprehensive QOL, including physical and mental health. This finding suggests that voice intensity can be used as a performance index for speech rehabilitation.

Injection laryngoplasty as miniinvasive office-based surgery in patients with unilateral vocal fold paralysis - voice quality outcomes.

PubMed

Sielska-Badurek, Ewelina M; Sobol, Maria; Jędra, Katarzyna; Rzepakowska, Anna; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

2017-09-01

Injection laryngoplasty (glottis augmentation) is the preferred method in surgical management of unilateral vocal fold paralysis (UVFP). Traditionally, these procedures are performed in the operating room. Nowadays, however, these procedures have moved into the office. To evaluate the voice quality after transoral injection laryngoplasty under local anaesthesia in patients with unilateral vocal fold paralysis. Fourteen subjects (5 women and 9 men) with unilateral vocal fold paresis (9 with right vocal fold paresis and 5 with left vocal fold paresis) were included in the study. The mean age of the group was 57.8 ±19.0 years (32-83 years). All of the injection laryngoplasties were performed transorally, under local anaesthesia. The injection material was calcium hydroxylapatite. Before and 1, 3 and 6 months after the procedure the following variables were evaluated: voice perception, videostroboscopy, acoustic analysis, aerodynamic evaluation, and the subjective rating of the voice quality by the patient. After injection laryngoplasty, complete glottal closure was achieved or there was a significant improvement in the glottal closure of each subject. We noted great improvement in the post-injection objective and subjective voice outcomes and patients reported improvement in the voice-related quality of life. The transoral approach for injection laryngoplasty under local anaesthesia is an effective and safe way to treat incomplete glottal closure in patients with UVFP. The transoral approach is an efficient alternative to other surgical techniques used for vocal fold injection.

Injection laryngoplasty as miniinvasive office-based surgery in patients with unilateral vocal fold paralysis – voice quality outcomes

PubMed Central

Sielska-Badurek, Ewelina M.; Jędra, Katarzyna; Rzepakowska, Anna; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

2017-01-01

Introduction Injection laryngoplasty (glottis augmentation) is the preferred method in surgical management of unilateral vocal fold paralysis (UVFP). Traditionally, these procedures are performed in the operating room. Nowadays, however, these procedures have moved into the office. Aim To evaluate the voice quality after transoral injection laryngoplasty under local anaesthesia in patients with unilateral vocal fold paralysis. Material and methods Fourteen subjects (5 women and 9 men) with unilateral vocal fold paresis (9 with right vocal fold paresis and 5 with left vocal fold paresis) were included in the study. The mean age of the group was 57.8 ±19.0 years (32–83 years). All of the injection laryngoplasties were performed transorally, under local anaesthesia. The injection material was calcium hydroxylapatite. Before and 1, 3 and 6 months after the procedure the following variables were evaluated: voice perception, videostroboscopy, acoustic analysis, aerodynamic evaluation, and the subjective rating of the voice quality by the patient. Results After injection laryngoplasty, complete glottal closure was achieved or there was a significant improvement in the glottal closure of each subject. We noted great improvement in the post-injection objective and subjective voice outcomes and patients reported improvement in the voice-related quality of life. Conclusions The transoral approach for injection laryngoplasty under local anaesthesia is an effective and safe way to treat incomplete glottal closure in patients with UVFP. The transoral approach is an efficient alternative to other surgical techniques used for vocal fold injection. PMID:29062449

Network Quality of Service Monitoring for IP Telephony.

ERIC Educational Resources Information Center

Ghita, B. V.; Furnell, S. M.; Lines, B. M.; Le-Foll, D.; Ifeachor, E. C.

2001-01-01

Discusses the development of real-time applications on the Internet for telecommunications and presents a non-intrusive way of determining network performance parameters for voice packet flows within a voice over IP (Internet Protocol), or Internet telephony call. Considers measurement of quality of service and describes results of a preliminary…

Effects of HearFones on speaking and singing voice quality.

PubMed

Laukkanen, Anne-Maria; Mickelson, Nils Peter; Laitala, Marja; Syrjä, Tiina; Salo, Arla; Sihvo, Marketta

2004-12-01

HearFones (HF) have been designed to enhance auditory feedback during phonation. This study investigated the effects of HF (1) on sound perceivable by the subject, (2) on voice quality in reading and singing, and (3) on voice production in speech and singing at the same pitch and sound level. Test 1: Text reading was recorded with two identical microphones in the ears of a subject. One ear was covered with HF, and the other was free. Four subjects attended this test. Tests 2 and 3: A reading sample was recorded from 13 subjects and a song from 12 subjects without and with HF on. Test 4: Six females repeated [pa:p:a] in speaking and singing modes without and with HF on same pitch and sound level. Long-term average spectra were made (Tests 1-3), and formant frequencies, fundamental frequency, and sound level were measured (Tests 2 and 3). Subglottic pressure was estimated from oral pressure in [p], and simultaneously electroglottography (EGG) was registered during voicing on [a:] (Test 4). Voice quality in speech and singing was evaluated by three professional voice trainers (Tests 2-4). HF seemed to enhance sound perceivable at the whole range studied (0-8 kHz), with the greatest enhancement (up to ca 25 dB) being at 1-3 kHz and at 4-7 kHz. The subjects tended to decrease loudness with HF (when sound level was not being monitored). In more than half of the cases, voice quality was evaluated "less strained" and "better controlled" with HF. When pitch and loudness were constant, no clear differences were heard but closed quotient of the EGG signal was higher and the signal more skewed, suggesting a better glottal closure and/or diminished activity of the thyroarytenoid muscle.

Adaptation and Validation of the Voice-Related Quality of Life Measure Into Polish.

PubMed

Sielska-Badurek, Ewelina; Rzepakowska, Anna; Sobol, Maria; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

2016-11-01

The purpose of the study was to translate and adapt the original V-RQOL (Voice-Related Quality of Life) instrument into Polish and to evaluate the psychometric properties of the Polish version of the V-RQOL Measure such as internal consistency, reliability, and construct validity in different groups of dysphonic patients. A total of 214 patients with voice disorders were assessed using the V-RQOL Measure, the Voice Handicap Index, and the World Health Organization Quality of Life, short version. The Polish version of the V-RQOL Measure showed strong internal consistency with the Cronbach alpha coefficient: 0.92 for the total score, 0.90 for the social-emotional domain, and 0.86 for the physical functioning domain, and a good test-retest reliability (r-Spearman correlation coefficient: r = 0.8852 for the total score of the V-RQOL Measure). Construct validity was demonstrated with a strong correlation to the Voice Handicap Index (r = -0.843, P = 0.000*) and a weak positive, statistically significant correlation between the V-RQOL-physical functioning domain, V-RQOL-social-emotional domain, and the Q1, Q2, and Domain 1-Domain 4 of the World Health Organization Quality of Life, short version (0.2 < r < 0.4). The Polish version of the V-RQOL Measure is a valid and reliable instrument to evaluate the patient's perception of his or her own voice disorders and the impact it can have on the patient's life. The V-RQOL Measure is easy to perform in clinical practice. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of Training and Level of External Auditory Feedback on the Singing Voice: Volume and Quality.

PubMed

Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J

2016-07-01

Previous research suggests that classically trained professional singers rely not only on external auditory feedback but also on proprioceptive feedback associated with internal voice sensitivities. The Lombard effect and the relationship between sound pressure level (SPL) and external auditory feedback were evaluated for professional and nonprofessional singers. Additionally, the relationship between voice quality, evaluated in terms of singing power ratio (SPR), and external auditory feedback, level of accompaniment, voice register, and singer gender was analyzed. The subjects were 10 amateur or beginner singers and 10 classically trained professional or semiprofessional singers (10 men and 10 women). Subjects sang an excerpt from the Star-Spangled Banner with three different levels of the accompaniment, 70, 80, and 90 dBA and with three different levels of external auditory feedback. SPL and SPR were analyzed. The Lombard effect was stronger for nonprofessional singers than professional singers. Higher levels of external auditory feedback were associated with a reduction in SPL. As predicted, the mean SPR was higher for professional singers than nonprofessional singers. Better voice quality was detected in the presence of higher levels of external auditory feedback. With an increase in training, the singer's reliance on external auditory feedback decreases. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Radiotherapy for T1-2N0 glottic cancer: a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients.

PubMed

Al-Mamgani, A; van Rooij, P H; Woutersen, D P; Mehilal, R; Tans, L; Monserez, D; Baatenburg de Jong, R J

2013-08-01

To evaluate the outcomes of patients with early stage glottic cancer (GC) treated with radiotherapy (RT). The current study report on a retrospective analysis of oncologic outcome of 1050 patients with T1-2N0 glottic cancer treated with radiotherapy. Prospective assessment of quality of life (QoL) and voice handicap index (VHI) was performed in all patients treated from 2006 onwards (n = 233). Local control (LC), regional control (RC), disease-free survival (DFS), overall survival (OS), quality of life and voice handicap index. After a median follow-up of 90 months (range 3-309), the actuarial rates of local control, regional control, disease-free survival and overall survival were 85%, 99%, 84% and 81% at 5 years and 82%, 98%, 80% and 61% at 10 years, respectively. On multivariate analysis, T2 tumours, smoking after radiotherapy and conventional radiation scheme correlated significantly with poor local control. Patients who continued smoking after radiotherapy had also significantly lower overall survival rates (OR 4.3, P < 0.001). Hypothyroidism was reported in 18% of patients. Slight and temporary deterioration of quality of life scores was reported. Patient-reported xerostomia and dysphagia at 48 months were -7.1 and -6.5, compared with baseline, respectively. Voice handicap index improved significantly from 37 at baseline to 18 at 48 months. Patients with T2b and those who continued smoking had significantly worse voice handicap index. In the current study, excellent outcome with good quality of life and voice handicap index scores were reported. T2 tumours, in particular T2b, and continuing smoking after radiotherapy correlated significantly with poor local control and worse voice handicap index. © 2013 John Wiley & Sons Ltd.

Vocal Tract Discomfort and Voice-Related Quality of Life in Wind Instrumentalists.

PubMed

Cappellaro, Juliane; Beber, Bárbara Costa

2018-05-01

This study aimed to investigate vocal tract discomfort and quality of life in the voice of wind instrumentalists. It is a cross-sectional study. The sample was composed of 37 musicians of the orchestra of Caxias do Sul city, RS, Brazil. The participants answered a nonstandard questionnaire about demographic and professional information, the Voice-Related Quality of Life (V-RQOL), the Vocal Tract Discomfort (VTD) scale, and additional items about fatigue after playing the instrument and pain in the cervical muscles. Correlation analyses were performed using Spearman correlation test. The most frequent symptoms mentioned by musicians in the VTD, for both frequency and intensity of occurrence, were dryness, ache, irritability, and cervical muscle pain, in addition to the frequency of occurrence of fatigue after playing. The musicians showed high scores in the V-RQOL survey. Several symptoms evaluated by the VTD had a negative correlation with the musicians' years of orchestra membership and with V-RQOL scores. Symptoms of vocal tract discomfort are present in wind instrumentalists in low frequency and intensity of occurrence. However, these symptoms affect the musicians' voice-related quality of life, and they occur more in musicians with fewer years of orchestra membership. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Evaluation of Phonatory Behavior and Voice Quality in Patients with Multiple Sclerosis Treated with Deep Brain Stimulation.

PubMed

Pützer, Manfred; Wokurek, Wolfgang; Moringlane, Jean Richard

2017-07-01

The effect of deep brain stimulation (DBS) on phonatory behavior and voice quality in eight patients with multiple sclerosis (MS) was examined instrumentally and perceptually. The acoustic signals of vowel productions obtained from patients (produced with and without stimulation) and from a group of 16 healthy control speakers were analyzed to prove statistically the changes of phonatory behavior and voice quality. This is a randomized study. Firstly, a new parametrization was used to determine phonatory behavior. Secondly, a perceptual evaluation of voice quality of the same speech material was performed. With stimulation, phonation has a greater tendency to be strained. The results of perceptual evaluation support this strained phonation behavior under stimulation, resulting in a smaller degree of breathiness ratings of all raters. Without stimulation, an impaired and partly disturbed adduction of the vocal folds can be shown. These findings are also supported in the perceptual experiment providing a higher degree of hoarseness ratings of all raters for these signals. High-frequency electrical impulses to the thalamus in patients with MS influence the phonatory behavior of their vocal folds. The results suggest the need for long-term monitoring of phonatory behavior during DBS to initiate adequate treatments without delay. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects of chemoradiotherapy on voice and swallowing

PubMed Central

Lazarus, Cathy L.

2009-01-01

Purpose of review Chemotherapy has been found to result in comparable survival rates to surgery for head and neck cancer. However, toxicity can often be worse after chemoradiotherapy, with impairment in voice, swallowing, nutrition, and quality of life. Investigators are attempting to modify radiotherapy treatment regimens to spare organs that have an impact on swallowing. This review will highlight voice and swallowing impairment seen after chemoradiotherapy, as well as treatment for voice and swallowing disorders in this population. Results of newer radiotherapy regimens will also be highlighted. Recent findings Specific oropharyngeal swallowing motility disorders after chemoradiotherapy have been identified. Damage to specific structures has been correlated with specific pharyngeal phase swallow impairment. Swallowing function and quality of life have been examined over time, with improvement seen in both. Preventive/prophylactic swallow exercise programs have been encouraging. Chemoradiotherapy effects on voice have been identified in terms of acoustic, aerodynamic, and patient and clinician-rated perception of function. Improvement in voice has also been observed over time after chemoradiotherapy. Voice therapy has been found to have a positive impact on voice and perceptual measures in this population. Summary Current studies show some improvement in swallow function after swallow and voice therapy in patients treated with chemoradiotherapy. Further, there is a suggestion of improved swallow function with sparing of organs with specific radiotherapy protocols. Future research needs to focus on specific voice and swallow treatment regimens in the head and neck cancer patient treated with chemoradiotherapy, specifically, timing, frequency, duration, and specific treatment types. PMID:19337126

Voice and Speech after Laryngectomy

ERIC Educational Resources Information Center

Stajner-Katusic, Smiljka; Horga, Damir; Musura, Maja; Globlek, Dubravka

2006-01-01

The aim of the investigation is to compare voice and speech quality in alaryngeal patients using esophageal speech (ESOP, eight subjects), electroacoustical speech aid (EACA, six subjects) and tracheoesophageal voice prosthesis (TEVP, three subjects). The subjects reading a short story were recorded in the sound-proof booth and the speech samples…

The Moderating Effect of Frequent Singing on Voice Aging.

PubMed

Lortie, Catherine L; Rivard, Julie; Thibeault, Mélanie; Tremblay, Pascale

2017-01-01

The effects of aging on voice production are well documented, including changes in loudness, pitch, and voice quality. However, one important and clinically relevant question that remains concerns the possibility that the aging of voice can be prevented or at least delayed through noninvasive methods. Indeed, discovering natural means to preserve the integrity of the human voice throughout aging could have a major impact on the quality of life of elderly adults. The objective of this study was therefore to examine the potentially positive effect of singing on voice production. To this aim, a group of 72 healthy nonsmoking adults (20-93 years old) was recruited and separated into three groups based on their singing habits. Several voice parameters were assessed (fundamental frequency [f0] mean, f0 standard deviation [SD], f0 minimum and f0 maximum, mean amplitude and amplitude SD, jitter, shimmer, and harmonic-to-noise ratio) during the sustained production of vowel /a/. Other parameters were assessed during standardized reading passage (speaking f0, speaking f0 SD). As was expected, age effects were found on most acoustic parameters with significant sex differences. Importantly, moderation analyses revealed that frequent singing moderates the effect of aging on most acoustic parameters. Specifically, in frequent singers, there was no decrease in the stability of pitch and amplitude with age, suggesting that the voice of frequent singers remains more stable in aging than the voice of non-singers, and more generally, providing empirical evidence for a positive effect of singing on voice in aging. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The Impact of Dysphonic Voices on Healthy Listeners: Listener Reaction Times, Speech Intelligibility, and Listener Comprehension.

PubMed

Evitts, Paul M; Starmer, Heather; Teets, Kristine; Montgomery, Christen; Calhoun, Lauren; Schulze, Allison; MacKenzie, Jenna; Adams, Lauren

2016-11-01

There is currently minimal information on the impact of dysphonia secondary to phonotrauma on listeners. Considering the high incidence of voice disorders with professional voice users, it is important to understand the impact of a dysphonic voice on their audiences. Ninety-one healthy listeners (39 men, 52 women; mean age = 23.62 years) were presented with speech stimuli from 5 healthy speakers and 5 speakers diagnosed with dysphonia secondary to phonotrauma. Dependent variables included processing speed (reaction time [RT] ratio), speech intelligibility, and listener comprehension. Voice quality ratings were also obtained for all speakers by 3 expert listeners. Statistical results showed significant differences between RT ratio and number of speech intelligibility errors between healthy and dysphonic voices. There was not a significant difference in listener comprehension errors. Multiple regression analyses showed that voice quality ratings from the Consensus Assessment Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were able to predict RT ratio and speech intelligibility but not listener comprehension. Results of the study suggest that although listeners require more time to process and have more intelligibility errors when presented with speech stimuli from speakers with dysphonia secondary to phonotrauma, listener comprehension may not be affected.

Compliance and quality of life in patients on prescribed voice rest.

PubMed

Rousseau, Bernard; Cohen, Seth M; Zeller, Amy S; Scearce, Leda; Tritter, Andrew G; Garrett, C Gaelyn

2011-01-01

To determine patient compliance with voice rest and the impact of voice rest on quality of life (QOL). Prospective. University hospital. Demographics, self-reported compliance, QOL impact on a 100-mm visual analog scale (VAS), and communication methods were collected from 84 participants from 2 academic voice centers. Of 84 participants, 36.9% were men, 63.1% were women, and 64.3% were singers. The mean age of participants was 47.2 years. The mean duration of voice rest was 8.8 days (range, 3-28), and the median was 7 days. Overall compliance was 34.5%. Postoperative voice rest patients were more compliant than non-postoperative patients (42.4% vs 16.0%, P = .04, χ(2)). Voice rest had an impact on QOL (mean ± SD, 68.5 ± 27.7). Voice rest also had a greater impact on singers than nonsingers (mean VAS 77.2 vs 63.6, P = .03, t test) and on those age <60 years than those age ≥ 60 years (mean VAS 74.4 vs 46.7, P < .001, t test). More talkative patients and those with longer periods of voice rest had worse QOL scores (Spearman correlation = 0.35, P = .001 and Spearman correlation = 0.24, P = .03, respectively). Restrictions in personal and social life were noted in 36.9% of patients, 46.4% were unable to work, 44.0% felt frustrated, and 38.1% reported feeling handicapped while on voice rest. Given poor patient compliance and the significant impact of voice rest on QOL, further studies are warranted to examine the efficacy of voice rest and factors that may contribute to patient noncompliance with treatment.

Comparing Measures of Voice Quality from Sustained Phonation and Continuous Speech

ERIC Educational Resources Information Center

Gerratt, Bruce R.; Kreiman, Jody; Garellek, Marc

2016-01-01

Purpose: The question of what type of utterance--a sustained vowel or continuous speech--is best for voice quality analysis has been extensively studied but with equivocal results. This study examines whether previously reported differences derive from the articulatory and prosodic factors occurring in continuous speech versus sustained phonation.…

Variability in the relationships among voice quality, harmonic amplitudes, open quotient, and glottal area waveform shape in sustained phonationa

PubMed Central

Kreiman, Jody; Shue, Yen-Liang; Chen, Gang; Iseli, Markus; Gerratt, Bruce R.; Neubauer, Juergen; Alwan, Abeer

2012-01-01

Increases in open quotient are widely assumed to cause changes in the amplitude of the first harmonic relative to the second (H1*–H2*), which in turn correspond to increases in perceived vocal breathiness. Empirical support for these assumptions is rather limited, and reported relationships among these three descriptive levels have been variable. This study examined the empirical relationship among H1*–H2*, the glottal open quotient (OQ), and glottal area waveform skewness, measured synchronously from audio recordings and high-speed video images of the larynges of six phonetically knowledgeable, vocally healthy speakers who varied fundamental frequency and voice qualities quasi-orthogonally. Across speakers and voice qualities, OQ, the asymmetry coefficient, and fundamental frequency accounted for an average of 74% of the variance in H1*–H2*. However, analyses of individual speakers showed large differences in the strategies used to produce the same intended voice qualities. Thus, H1*–H2* can be predicted with good overall accuracy, but its relationship to phonatory characteristics appears to be speaker dependent. PMID:23039455

Changes in teachers' voice quality during a working day with and without electric sound amplification.

PubMed

Jónsdottir, Valdis; Laukkanen, Anne-Maria; Siikki, Ilona

2003-01-01

The present study investigated changes in the voice quality of teachers during a working day (a). in ordinary conditions and (b). when using electrical sound amplification while teaching. Classroom speech of 5 teachers was recorded with a portable DAT recorder and a head-mounted microphone during the first and the last lesson of a hard working day first in ordinary conditions and the following week using amplification. Long-term average spectrum and sound pressure level (SPL) analyses were made. The subjects' comments were gathered by questionnaire. Voice quality was evaluated by 2 speech trainers. With amplification, SPL was lower and the spectrum more tilted. Voice quality was evaluated to be better. The subjects reported less fatigue in the vocal mechanism. Spectral tilt decreased and SPL increased during the day. There was a tendency for perceived asthenia to decrease. No significant changes were observed in ordinary conditions. The acoustic changes seem to reflect a positive adaptation to vocal loading. Their absence may be a sign of vocal fatigue. Copyright 2003 S. Karger AG, Basel

Singer and listener perception of vocal warm-up.

PubMed

Moorcroft, Lynda; Kenny, Dianna T

2013-03-01

This study investigated changes perceived by singers and listeners after the singers had vocally warmed up. The study used a repeated measures within-subject design to assess changes in vibrato quality from pre (nonwarmed-up voice) to post (warmed-up voice) test. Intraclass correlation coefficients were calculated to assess singers' self-ratings pre- and posttest and intra- and interlistener rater reliability. Twelve classically trained female singers recorded and self-rated their performance of an eight bar solo before and after 25 minutes of vocal warm-up exercises. Six experienced listeners assessed the vocal samples for pre- to posttest differences in tone quality and for each singer's warm-up condition. Perceptual judgements were also compared with pre- to posttest changes in vibrato. All singers perceived significant changes in tone quality, psychophysiological factors, proprioceptive feedback and technical command. Significant pre- to posttest differences in tone quality and correct appraisal of the singer's warm-up condition from most of the listeners were only observed for singers who moderated extremely fast or extremely slow vibrato after warming up. The findings reveal the divide between listeners' and singers' perceptions of the warmed-up voice and highlight the importance of enhanced vibrato quality to listener perception of an improvement in vocal quality. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Using quality function deployment to capture the voice of the customer and translate it into the voice of the provider.

PubMed

Chaplin, E; Bailey, M; Crosby, R; Gorman, D; Holland, X; Hippe, C; Hoff, T; Nawrocki, D; Pichette, S; Thota, N

1999-06-01

Health care has a number of historical barriers to capturing the voice of the customer and to incorporating customer wants into health care services, whether the customer is a patient, an insurer, or a community. Quality function deployment (QFD) is a set of tools and practices that can help overcome these barriers to form a process for the planning and design or redesign of products and services. The goal of the project was to increase referral volume and to improve a rehabilitation hospital's capacity to provide comprehensive medical and/or legal evaluations for people with complex and catastrophic injuries or illnesses. HIGH-LEVEL VIEW OF QFD AS A PROCESS: The steps in QFD are as follows: capture of the voice of the customer, quality deployment, functions deployment, failure mode deployment, new process deployment, and task deployment. The output of each step becomes the input to a matrix tool or table of the next step of the process. In 3 1/2 months a nine-person project team at Continental Rehabilitation Hospital (San Diego) used QFD tools to capture the voice of the customer, use these data as the basis for a questionnaire on important qualities of service from the customer's perspective, obtain competitive data on how the organization was perceived to be meeting the demanded qualities, identify measurable dimensions and targets of these qualities, and incorporate the functions and tasks into the delivery of service which are necessary to meet the demanded qualities. The future of providing health care services will belong to organizations that can adapt to a rapidly changing environment and to demands for new products and services that are produced and delivered in new ways.

Factors associated with voice disorders among the elderly: a systematic review.

PubMed

Gois, Amanda Cibelly Brito; Pernambuco, Leandro de Araújo; Lima, Kenio Costa de

2017-12-26

During the aging process, natural modifications occur in the larynx and the structures involved in phonation which explain the specific characteristics found in the voices of elderly persons. When, at any moment, a voice fails and there is interference with communication, a voice disorder has occurred. This can generate disadvantages in communicative efficiency and have a negative impact on quality of life, compromising mechanisms of socialization, the maintenance of autonomy, and the sense of well-being. Nevertheless, there appears to be little clarity about which factors are associated with voice disorders in this population, especially from an epidemiological perspective. The present study is a literature review to identify factors associated with voice disorders among the elderly described in population-based studies. A systematic review of electronic databases was carried out. The methodological quality of the studies was analyzed with the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The research was conducted independently by two researchers. Although two articles met the eligibility criteria, none fulfilled all the criteria for the evaluation of methodological quality. According to the two studies selected for this review, factors associated with voice disorders among the elderly included both physical and psychosocial aspects. However, the methodological discrepancies between the studies, particularly in relation to sample selection and the instruments used indicate great variability and compromise the reliability of the results. Further prevalence studies and investigations of factors associated with voice disorders in the elderly from an epidemiological perspective, and which involve different cultures, should be carried out. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia.

PubMed

Conde, Mariana de Cásisa Macedo; Siqueira, Larissa Thaís Donalonso; Vendramini, José Eduardo; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Silverio, Kelly Cristina Alves

2018-05-01

This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects on vocal range and voice quality of singing voice training: the classically trained female voice.

PubMed

Pabon, Peter; Stallinga, Rob; Södersten, Maria; Ternström, Sten

2014-01-01

A longitudinal study was performed on the acoustical effects of singing voice training under a given study program, using the voice range profile (VRP). Pretraining and posttraining recordings were made of students who participated in a 3-year bachelor singing study program. A questionnaire that included questions on optimal range, register use, classification, vocal health and hygiene, mixing technique, and training goals was used to rate and categorize self-assessed voice changes. Based on the responses, a subgroup of 10 classically trained female voices was selected, which was homogeneous enough for effects of training to be identified. The VRP perimeter contour was analyzed for effects of voice training. Also, a mapping within the VRP of voice quality, as expressed by the crest factor, was used to indicate the register boundaries and to monitor the acoustical consequences of the newly learned vocal technique of "mixed voice." VRPs were averaged across subjects. Findings were compared with the self-assessed vocal changes. Pre/post comparison of the average VRPs showed, in the midrange, (1) a decrease in the VRP area that was associated with the loud chest voice, (2) a reduction of the crest factor values, and (3) a reduction of maximum sound pressure level values. The students' self-evaluations of the voice changes appeared in some cases to contradict the VRP findings. VRPs of individual voices were seen to change over the course of a singing education. These changes were manifest also in the average group. High-resolution computerized recording, complemented with an acoustic register marker, allows a meaningful assessment of some effects of training, on an individual basis and for groups that comprise singers of a specific genre. It is argued that this kind of investigation is possible only within a focused training program, given by a faculty who has agreed on the goals. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Screening value of V-RQOL in the evaluation of occupational voice disorders.

PubMed

Morawska, Joanna; Niebudek-Bogusz, Ewa; Wiktorowicz, Justyna; Śliwińska-Kowalska, Mariola

2018-03-09

Given the growing number of occupational voice users, easy and quick broad-scale screening is necessary to provide prophylaxis of voice disorders. The aim of the study was to assess applicability of the Voice Related Quality of Life questionnaire (V-RQOL) to screening occupational voice disorders. The research comprised 284 subjects divided into 3 groups: 0 - the control group of normophonic subjects, non-professional voice users (N = 60), 1 - occupational voice users with objectively confirmed voice disorders (N = 124), 2 - the non-randomized group of occupational voice users with and without voice problems (N = 100). Self-assessment of voice was performed by means of the V-RQOL in comparison to the Voice Handicap Index (VHI). The relation between the V-RQOL and VHI was determined by means of linear regression. Receiver Operating Characteristic (ROC) curves were constructed and the cut-off point of the VRQOL was determined to discriminate between normophonic and dysphonic subjects. The relationship between the VHI and V-RQOL scores indicated a satisfactory coefficient of determination: R² = 0.7266. High values of Cronbach's α confirmed high reliability of the V-RQOL test (0.867). Voice-Related Quality of Life questionnaire (V-RQOL) results were significantly worse in the study group than for normophonic controls (p < 0.001). The cut-off point for the test was set at 79 points. The determined area under the curve (AUC) = 0.910 (p < 0.001) showed high diagnostic accuracy of the V-RQOL. Results of the VRQOL differed for diagnose-based subgroups of dysphonic patients. The study gives grounds for application of the V-RQOL as a reliable tool for screening occupational voice disorders. Med Pr 2018;69(2):119-128. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Patient-reported symptom questionnaires in laryngeal cancer: voice, speech and swallowing.

PubMed

Rinkel, R N P M; Verdonck-de Leeuw, I M; van den Brakel, N; de Bree, R; Eerenstein, S E J; Aaronson, N; Leemans, C R

2014-08-01

To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress. Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (speech), SWAL-QOL (swallowing), EORTC QLQ-C30, QLQ-HN35, HADS, and study-specific questions on rehabilitation. Eighty-eight patients and 110 healthy controls participated. Cut off scores of 15, 6, and 14 were defined for the VHI, SHI, and SWAL-QOL (sensitivity > 90%; specificity > 80%). Based on these scores, 56% of the patients reported voice, 63% speech, and 54% swallowing problems. VHI, SHI, and SWAL-QOL scores were associated significantly with quality of life (EORTC QLQ-C30 global quality of life scale) (r = .43 (VHI and SHI) and r = .46 (SWAL-QOL)) and distress (r = .50 (VHI and SHI) and r = .58 (SWAL-QOL)). In retrospect, 32% of the patients indicated the need for rehabilitation at time of treatment, and 81% of these patients availed themselves of such services. Post-treatment, 8% of the patients expressed a need for rehabilitation, and 20% of these patients actually made use of such services. Psychometric characteristics of the VHI, SHI, and SWAL-QOL in laryngeal cancer patients are good. The prevalence of voice, speech, and swallowing problems is high, and clearly related to quality of life and distress. Although higher during than after treatment, the perceived need for and use of rehabilitation services is limited. Copyright © 2014 Elsevier Ltd. All rights reserved.

Objective vocal quality in children using cochlear implants: a multiparameter approach.

PubMed

Baudonck, Nele; D'haeseleer, Evelien; Dhooge, Ingeborg; Van Lierde, Kristiane

2011-11-01

The purpose of this study was to determine the objective vocal quality in 36 prelingually deaf children using cochlear implant (CI) with a mean age of 9 years. An additional purpose was to compare the objective vocal quality of these 36 CI users with 25 age-matched children with prelingual severe hearing loss using conventional hearing aids (HAs) and 25 normal hearing (NH) children. The design for this cross-sectional study was a multigroup posttest-only design. The objective vocal quality was measured by means of the dysphonia severity index (DSI). Moreover, perceptual voice assessment using the GRBASI scale was performed. CI children have a vocal quality by means of the DSI of +1.8, corresponding with a DSI% of 68%, indicating a borderline vocal quality situated 2% above the limit of normality. The voice was perceptually characterized by the presence of a very slight grade of hoarseness, roughness, strained phonation, and higher pitch and intensity levels. No significant objective vocal quality differences were measured between the voices of the CI children, HA users, and NH children. According to the results, one aspect of the vocal approach in children with CI and using HAs must be focused on the improvement of the strained vocal characteristic and the use of a lower pitch and intensity level. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Student Voice in Textbook Evaluation: Comparing Open and Restricted Textbooks

ERIC Educational Resources Information Center

Woodward, Scott; Lloyd, Adam; Kimmons, Royce

2017-01-01

Advocates for student voice in higher education believe students should have the right and power to engage in much of the decision-making traditionally dominated by instructors or administrators. This qualitative study examines the role of student voice in the evaluation of textbook quality. Evaluators included two graduate students enrolled in a…

Spectral Analysis of the Voice in Down Syndrome

ERIC Educational Resources Information Center

Albertini, G.; Bonassi, S.; Dall'Armi, V.; Giachetti, I.; Giaquinto, S.; Mignano, M.

2010-01-01

The voice quality of individuals with Down Syndrome (DS) is generally described as husky, monotonous and raucous. On the other hand, the voice of DS children is characterized by breathiness, roughness, and nasality and is typically low pitched. However, research on phonation and intonation in these participants is limited. The present study was…

Voice and respiratory outcomes after permanent transoral surgery of bilateral vocal fold paralysis.

PubMed

Nawka, Tadeus; Sittel, Christian; Arens, Christoph; Lang-Roth, Ruth; Wittekindt, Claus; Hagen, Rudolf; Mueller, Andreas H; Nasr, Ahmed I; Guntinas-Lichius, Orlando; Friedrich, Gerhard; Gugatschka, Markus

2015-12-01

Bilateral vocal fold paralysis (BVFP) is a rare but life-threatening condition mostly caused by iatrogenic damage to the peripheral recurrent laryngeal nerve. Endoscopic enlargement techniques have been the standard treatment for decades. However, prospective studies using internationally accepted phoniatric and respiratory evaluation guidelines are rare. Prospective observational multicenter study. Twelve clinical centers screened 61 patients, of whom 36 were eligible according to the study protocol. Subjects were assessed with specific phoniatric and respiratory tests preoperatively and at 1 and 6 months postoperatively. Important respiratory parameters improved significantly 6 months postoperatively (peak expiratory and expiratory flow), confirming that a glottal enlargement effectively reduced the obstruction. Objective parameters dealing with voice quality worsened significantly (maximum phonation time, voice range profile, hoarseness), whereas subjective voice assessment (VHI-12) did not change significantly. Endoscopic glottal enlargement is an effective method for relieving symptoms of dyspnea due to BVFP. Postoperatively, voice quality objectively worsened; however, this was not perceived by the patients themselves. Laryngostroboscopic findings did not correlate strongly with voice and respiratory outcomes. 2b. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

The effect of voice quality and competing speakers in a passage comprehension task: perceived effort in relation to cognitive functioning and performance in children with normal hearing.

PubMed

von Lochow, Heike; Lyberg-Åhlander, Viveka; Sahlén, Birgitta; Kastberg, Tobias; Brännström, K Jonas

2018-04-01

The study investigates the effect of voice quality and competing speakers on perceived effort in a passage comprehension task in relation to cognitive functioning. In addition, it explores if perceived effort was related to performance. A total of 49 children (aged 7:03 to 12:02 years) with normal hearing participated. The children performed an auditory passage comprehension task presented with six different listening conditions consisting of a typical voice or a dysphonic voice presented in quiet, with one competing speaker, and with four competing speakers. After completing the task, they rated their perceived effort on a five-grade scale. The children also performed tasks measuring working memory capacity (WMC) and executive functioning. The results show that voice quality had no direct effect on perceived effort but the children's ratings of perceived effort were related to their executive functioning. A significant effect was seen for background listening condition indicating higher perceived effort for background listening conditions with competing speakers. The effects of background listening condition were mainly related to the children's WMC but also their executive functioning. It can be concluded that the individual susceptibility to the effect of the dysphonic voice is related to the child's executive functioning. The individual susceptibility to the presence of competing speakers is related to the child's WMC and executive functioning.

Effects of a three-week vocal exercise program using the Finnish Kuukka exercises on the speaking voice of Norwegian broadcast journalism students.

PubMed

Bele, Irene; Laukkanen, Anne-Maria; Sipilä, Laura

2010-12-01

Nine broadcast journalism students attended 10 hours in Kuukka vocal exercises, which aims at producing a ringing vocal quality. Nine control subjects received no training. A text was read at habitual loudness before and after the course. Five speech specialists evaluated the text samples for perceptual voice quality and analyzed mean fundamental frequency (F0), equivalent sound level (Leq), and long-term average spectrum (LTAS). For the Training Group, voice quality improved and correlated negatively with firmness and timbre (less firm and darker qualities being considered more desirable), and F0 increased slightly. Leq increased significantly in both groups. The results show positive and perceivable differences after the course. However, the aimed ring was not reached, may be due to too short time.

Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia.

PubMed

Yeung, Jeffrey C; Fung, Kevin; Davis, Eric; Rai, Sunita K; Day, Adam M B; Dzioba, Agnieszka; Bornbaum, Catherine; Doyle, Philip C

2015-03-01

Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL). Longitudinal, correlational study. Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale. LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD. Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Relationship between perceived politeness and spectral characteristics of voice

NASA Astrophysics Data System (ADS)

Ito, Mika

2005-04-01

This study investigates the role of voice quality in perceiving politeness under conditions of varying relative social status among Japanese male speakers. The work focuses on four important methodological issues: experimental control of sociolinguistic aspects, eliciting natural spontaneous speech, obtaining recording quality suitable for voice quality analysis, and assessment of glottal characteristics through the use of non-invasive direct measurements of the speech spectrum. To obtain natural, unscripted utterances, the speech data were collected with a Map Task. This methodology allowed us to study the effect of manipulating relative social status among participants in the same community. We then computed the relative amplitudes of harmonics and formant peaks in spectra obtained from the Map Task recordings. Finally, an experiment was conducted to observe the alignment between acoustic measures and the perceived politeness of the voice samples. The results suggest that listeners' perceptions of politeness are determined by spectral characteristics of speakers, in particular, spectral tilts obtained by computing the difference in amplitude between the first harmonic and the third formant.

A laryngographic and laryngoscopic study of Northern Vietnamese tones.

PubMed

Brunelle, Marc; Nguyên, Duy Duong; Nguyên, Khac Hùng

2010-01-01

A laryngographic and laryngoscopic study of tone production in Northern Vietnamese, a language whose tones combine both fundamental frequency (f0) modulations and voice qualities (phonation types), was conducted with 5 male and 5 female speakers. Results show that the f0 contours of Northern Vietnamese tones are not only attributable to changes in vocal fold length and tension (partly through changes in larynx height), but that f0 drops are also largely caused by the glottal configurations responsible for the contrastive voice qualities associated with some of the tones. We also find that voice quality contrasts are mostly due to glottal constriction: they occasionally involve additional ventricular fold incursion and epiglottal constriction, but these articulations are usually absent. Copyright © 2010 S. Karger AG, Basel.

Effects of singing on voice, respiratory control and quality of life in persons with Parkinson's disease.

PubMed

Stegemöller, Elizabeth L; Radig, Hollie; Hibbing, Paul; Wingate, Judith; Sapienza, Christine

2017-03-01

Purpose Interventions focused on singing may provide additional benefits to established voice and respiratory therapies, due to their greater emphasis on the respiratory muscle control system in those with Parkinson's disease (PD) progresses. The purpose of this study was to examine if singing can improve voice, respiratory pressure and quality of life (QOL) in persons with PD. Methods This pilot study measured the effects of a singing intervention in 27 participants with PD. Participants were assigned to a high (met twice weekly) or low (met once weekly) dosage group. Voice, respiratory and QOL measures were recorded before and after an 8-week singing intervention. Sessions were led by board-certified music therapists and included a series of vocal and articulation exercises and group singing. Results Both groups demonstrated significant improvements in maximum inspiratory and expiratory pressure, as well as phonation time. While other voice measures improved, they did not reach statistical significance. Voice QOL and whole health QOL also significantly improved. Conclusion These results suggest singing may be a beneficial and engaging treatment choice for improving and maintaining vocal function and respiratory pressure in persons with PD. Implications for Rehabilitation In a small sample, group singing proved beneficial for improving voice and respiratory impairment in persons with Parkinson's disease. Completing group singing one time per week for 8 weeks was as effective as completing group singing two times per week for 8 weeks in persons with Parkinson's disease. Group singing is an effective means of improving overall quality of life in persons with Parkinson's disease.

Acoustic characteristics of voice after severe traumatic brain injury.

PubMed

McHenry, M

2000-07-01

To describe the acoustic characteristics of voice in individuals with motor speech disorders after traumatic brain injury (TBI). Prospective study of 100 individuals with TBI based on consecutive referrals for motor speech evaluations. Subjects were audio tape-recorded while producing sustained vowels and single word and sentence intelligibility tests. Laryngeal airway resistance was estimated, and voice quality was rated perceptually. None of the subjects evidenced vocal parameters within normal limits. The most frequently occurring abnormal parameter across subjects was amplitude perturbation, followed by voice turbulence index. Twenty-three percent of subjects evidenced deviation in all five parameters measured. The perceptual ratings of breathiness were significantly correlated with both the amplitude perturbation quotient and the noise-to-harmonics ratio. Vocal quality deviation is common in motor speech disorders after TBI and may impact intelligibility.

How do teachers with self-reported voice problems differ from their peers with self-reported voice health?

PubMed

Lyberg Åhlander, Viveka; Rydell, Roland; Löfqvist, Anders

2012-07-01

This randomized case-control study compares teachers with self-reported voice problems to age-, gender-, and school-matched colleagues with self-reported voice health. The self-assessed voice function is related to factors known to influence the voice: laryngeal findings, voice quality, personality, psychosocial and coping aspects, searching for causative factors of voice problems in teachers. Subjects and controls, recruited from a teacher group in an earlier questionnaire study, underwent examinations of the larynx by high-speed imaging and kymograms; voice recordings; voice range profile; audiometry; self-assessment of voice handicap and voice function; teaching and environmental aspects; personality; coping; burnout, and work-related issues. The laryngeal and voice recordings were assessed by experienced phoniatricians and speech pathologists. The subjects with self-assessed voice problems differed from their peers with self-assessed voice health by significantly longer recovery time from voice problems and scored higher on all subscales of the Voice Handicap Index-Throat. The results show that the cause of voice dysfunction in this group of teachers with self-reported voice problems is not found in the vocal apparatus or within the individual. The individual's perception of a voice problem seems to be based on a combination of the number of symptoms and of how often the symptoms occur, along with the recovery time. The results also underline the importance of using self-assessed reports of voice dysfunction. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Authentic leadership and nurses' voice behaviour and perceptions of care quality.

PubMed

Wong, Carol A; Spence Laschinger, Heather K; Cummings, Greta G

2010-11-01

The purpose of the present study was to test a theoretical model linking authentic leadership with staff nurses' trust in their manager, work engagement, voice behaviour and perceived unit care quality. Authentic leadership is a guide for effective leadership needed to build trust and healthier work environments because there is special attention given to honesty, integrity and high ethical standards in the development of leader-follower relationships. A non-experimental, predictive survey design was used to test the hypothesized model in a random sample of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario. The final model fitted the data acceptably (χ(2)=17.24, d.f.=11, P=0.10, IFI=0.99, CFI=0.99, RMSEA=0.045). Authentic leadership significantly and positively influenced staff nurses' trust in their manager and work engagement which in turn predicted voice behaviour and perceived unit care quality. These findings suggest that authentic leadership and trust in the manager play a role in fostering trust, work engagement, voice behaviour and perceived quality of care. Nursing leaders can improve care quality and workplace conditions by paying attention to facilitating genuine and positive relationships with their staff. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

A 4.8 kbps code-excited linear predictive coder

NASA Technical Reports Server (NTRS)

Tremain, Thomas E.; Campbell, Joseph P., Jr.; Welch, Vanoy C.

1988-01-01

A secure voice system STU-3 capable of providing end-to-end secure voice communications (1984) was developed. The terminal for the new system will be built around the standard LPC-10 voice processor algorithm. The performance of the present STU-3 processor is considered to be good, its response to nonspeech sounds such as whistles, coughs and impulse-like noises may not be completely acceptable. Speech in noisy environments also causes problems with the LPC-10 voice algorithm. In addition, there is always a demand for something better. It is hoped that LPC-10's 2.4 kbps voice performance will be complemented with a very high quality speech coder operating at a higher data rate. This new coder is one of a number of candidate algorithms being considered for an upgraded version of the STU-3 in late 1989. The problems of designing a code-excited linear predictive (CELP) coder to provide very high quality speech at a 4.8 kbps data rate that can be implemented on today's hardware are considered.

Signal analysis of the female singing voice: Features for perceptual singer identity

NASA Astrophysics Data System (ADS)

Mellody, Maureen

2001-07-01

Individual singing voices tend to be easy for a listener to identify, particularly when compared to the difficulty of identifying the performer of any other musical instrument. What cues does a listener use to identify a particular singing voice? This work seeks to identify a set of features with which one can synthesize notes with the vocal quality of a particular singer. Such analysis and synthesis influences computer music (in the creation of synthetic sounds with different timbre), vocal pedagogy (as a training tool to help singers understand properties of their own voice as well as different professional-quality voices), and vocal health (to identify improper behavior in vocal production). The problem of singer identification is approached in three phases: signal analysis, the development of low- order representations, and perceptual evaluation. To perform the signal analysis, a high-resolution time- frequency distribution is applied to vowel tokens from sopranos and mezzo-sopranos. From these results, low- order representations are created for each singer's notes, which are used to synthesize sounds with the timbral quality of that singer. Finally, these synthesized sounds, along with original recordings, are evaluated by trained listeners in a variety of perceptual experiments to determine the extent to which the vocal quality of the desired singer is captured. Results from the signal analysis show that amplitude and frequency estimates extracted from the time-frequency signal analysis can be used to re-create each signal with little degradation in quality and no loss of perceptual identity. Low-order representations derived from the signal analysis are used in clustering and classification, which successfully clusters signals with corresponding singer identity. Finally, perceptual results indicate that trained listeners are, surprisingly, only modestly successful at correctly identifying the singer of a recording, and find the task to be particularly difficult for certain voices and extremely easy for others. Listeners also indicate that the majority of sounds synthesized with the low-order representations sufficiently capture the desired vocal timbre. Again, the task is easy for certain voices and much more difficult when evaluating other singers, consistent with the results from the original recordings.

A modulatory effect of male voice pitch on long-term memory in women: evidence of adaptation for mate choice?

PubMed

Smith, David S; Jones, Benedict C; Feinberg, David R; Allan, Kevin

2012-01-01

From a functionalist perspective, human memory should be attuned to information of adaptive value for one's survival and reproductive fitness. While evidence of sensitivity to survival-related information is growing, specific links between memory and information that could impact upon reproductive fitness have remained elusive. Here, in two experiments, we showed that memory in women is sensitive to male voice pitch, a sexually dimorphic cue important for mate choice because it not only serves as an indicator of genetic quality, but may also signal behavioural traits undesirable in a long-term partner. In Experiment 1, we report that women's visual object memory is significantly enhanced when an object's name is spoken during encoding in a masculinised (i.e., lower-pitch) versus feminised (i.e., higher-pitch) male voice, but that no analogous effect occurs when women listen to other women's voices. Experiment 2 replicated this pattern of results, additionally showing that lowering and raising male voice pitch enhanced and impaired women's memory, respectively, relative to a baseline (i.e., unmanipulated) voice condition. The modulatory effect of sexual dimorphism cues in the male voice may reveal a mate-choice adaptation within women's memory, sculpted by evolution in response to the dilemma posed by the double-edged qualities of male masculinity.

Health-related quality of life in children with dysphonia and validation of the French Pediatric Voice Handicap Index.

PubMed

Oddon, P A; Boucekine, M; Boyer, L; Triglia, J M; Nicollas, R

2018-01-01

voice disorders are common in the pediatric population and can negatively affect children's quality of life. The pediatric voice handicap Index (pVHI) is a valid instrument to assess parental perception of their children voice but it is not translated into French language. The aim of the present study was to adapt a French version of the pVHI and to evaluate its psychometric properties including construct validity, reliability, and some aspects of external validity. we performed a cross sectional study including 32 dysphonic children and 60 children with no history of voice problems between 3 and 12 years of age. The original pVHI was translated into French language according to forward-backward rules and then administered to parents or caregivers. Construct validity and internal consistency were explored using confirmatory factor analysis and Cronbach's alpha. The questionnaire was filled twice to assess test-retest reliability using the intra-class correlation coefficient. The external validity was explored by comparing the French pVHI total and subscales scores between dysphonic and asymptomatic children. Correlations between the French pVHI and both the perceptual GRBAS scale and the health-related quality of life (HRQOL) survey "Vécu et Santé Perçu de l'Adolescent et de l'Enfant" (VSP-Ap) were also performed. the structure of the French pVHI showed a good fit with excellent reliability (α = 0.929) and high test-retest reliability. Significant differences were found between the group of dysphonic children and the control group (p < 0.001). The French pVHI scores were positively correlated to all parameters of the GRBAS scale (p < 0.05). Significant negative correlations were found between the Functional domain of the pVHI and various domains of the VSP-Ap as Leisure Activities, Schooling and Sentimental Relationship (p < 0.05). the French pVHI is considered to be a valid and reliable instrument to assess voice-related quality of life in children with voice disorder. We recommend its use in the multidimensional protocols for assessing voice disorder in the pediatric population. Copyright © 2017. Published by Elsevier B.V.

Changes of some functional speech disorders after surgical correction of skeletal anterior open bite.

PubMed

Knez Ambrožič, Mojca; Hočevar Boltežar, Irena; Ihan Hren, Nataša

2015-09-01

Skeletal anterior open bite (AOB) or apertognathism is characterized by the absence of contact of the anterior teeth and affects articulation parameters, chewing, biting and voice quality. The treatment of AOB consists of orthognatic surgical procedures. The aim of this study was to evaluate the effects of treatment on voice quality, articulation and nasality in speech with respect to skeletal changes. The study was prospective; 15 patients with AOB were evaluated before and after surgery. Lateral cephalometric x-ray parameters (facial angle, interincisal distance, Wits appraisal) were measured to determine skeletal changes. Before surgery, nine patients still had articulation disorders despite speech therapy during childhood. The voice quality parameters were determined by acoustic analysis of the vowel sound /a/ (fundamental frequency-F0, jitter, shimmer). Spectral analysis of vowels /a/, /e/, /i/, /o/, /u/ was carried out by determining the mean frequency of the first (F1) and second (F2) formants. Nasality in speech was expressed as the ratio between the nasal and the oral sound energies during speech samples. After surgery, normalizations of facial skeletal parameters were observed in all patients, but no statistically significant changes in articulation and voice quality parameters occurred despite subjective observations of easier articulation. Any deterioration in velopharyngeal insufficiency was absent in all of the patients. In conclusion, the surgical treatment of skeletal AOB does not lead to deterioration in voice, resonance and articulation qualities. Despite surgical correction of the unfavourable skeletal situation of the speech apparatus, the pre-existing articulation disorder cannot improve without professional intervention.

Determinants and Effects of Voice Disorders among Secondary School Teachers in Peninsular Malaysia Using a Validated Malay Version of VHI-10

PubMed Central

Moy, Foong Ming; Hoe, Victor Chee Wai; Hairi, Noran Naqiah; Chu, Anne Hin Yee; Bulgiba, Awang; Koh, David

2015-01-01

Objectives To establish the prevalence of voice disorder using the Malay-Voice Handicap Index 10 (Malay-VHI-10) and to study the determinants, quality of life, depression, anxiety and stress associated with voice disorder among secondary school teachers in Peninsular Malaysia. Methods This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance. Results In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p < 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score > 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06). Conclusions The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers. PMID:26540291

Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

PubMed

Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

2015-11-01

Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial.

PubMed

Tamplin, Jeanette; Baker, Felicity A; Grocke, Denise; Brazzale, Danny J; Pretto, Jeffrey J; Ruehland, Warren R; Buttifant, Mary; Brown, Douglas J; Berlowitz, David J

2013-03-01

To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. Randomized controlled trial. Large, university-affiliated public hospital, Victoria, Australia. Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Voice over Internet Protocol (VoIP) Technology as a Global Learning Tool: Information Systems Success and Control Belief Perspectives

ERIC Educational Resources Information Center

Chen, Charlie C.; Vannoy, Sandra

2013-01-01

Voice over Internet Protocol- (VoIP) enabled online learning service providers struggling with high attrition rates and low customer loyalty issues despite VoIP's high degree of system fit for online global learning applications. Effective solutions to this prevalent problem rely on the understanding of system quality, information quality, and…

Effect of Auditory-Perceptual Training With Natural Voice Anchors on Vocal Quality Evaluation.

PubMed

Dos Santos, Priscila Campos Martins; Vieira, Maurílio Nunes; Sansão, João Pedro Hallack; Gama, Ana Cristina Côrtes

2018-01-10

To analyze the effects of auditory-perceptual training with anchor stimuli of natural voices on inter-rater agreement during the assessment of vocal quality. This is a quantitative nature study. An auditory-perceptual training site was developed consisting of Programming Interface A, an auditory training activity, and Programming Interface B, a control activity. Each interface had three stages: pre-training/pre-interval evaluation, training/interval, and post-training/post-interval evaluation. Two experienced evaluators classified 381 voices according to the GRBASI scale (G-grade, R-roughness, B-breathiness, A-asthenia, S-strain, I-instability). Voices were selected that received the same evaluation by both evaluators: 57 voices for evaluation and 56 for training were selected, with varying degrees of deviation across parameters. Fifteen inexperienced evaluators were then selected. In the pre-, post-training, pre-, and postinterval stages, evaluators listened to the voices and classified them via the GRBASI scale. In the stage interval evaluators read a text. In the stage training each parameter was trained separately. Evaluators analyzed the degrees of deviation of the GRBASI parameters based on anchor stimuli, and could only advance after correctly classifying the voices. To quantify inter-rater agreement and provide statistical analyses, the AC1 coefficient, confidence intervals, and percentage variation of agreement were employed. Except for the asthenia parameter, decreased agreement was observed in the control condition. Improved agreement was observed with auditory training, but this improvement did not achieve statistical significance. Training with natural voice anchors suggest an increased inter-rater agreement during perceptual voice analysis, potentially indicating that new internal references were established. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Validation of the Acoustic Voice Quality Index in the Lithuanian Language.

PubMed

Uloza, Virgilijus; Petrauskas, Tadas; Padervinskis, Evaldas; Ulozaitė, Nora; Barsties, Ben; Maryn, Youri

2017-03-01

The aim of the present study was to validate the Acoustic Voice Quality Index in Lithuanian language (AVQI-LT) and investigate the feasibility and robustness of its diagnostic accuracy, differentiating normal and dysphonic voice. A total of 184 native Lithuanian subjects with normal voices (n = 46) and with various voice disorders (n = 138) were asked to read aloud the Lithuanian text and to sustain the vowel /a/. A sentence with 13 syllables and a 3-second midvowel portion of the sustained vowel were edited. Both speech tasks were concatenated, and perceptually rated for dysphonia severity by five voice clinicians. They rated the Grade (G) from the Grade Roughness Breathiness Asthenia Strain (GRBAS) protocol and the overall severity from the Consensus Auditory-perceptual Evaluation of Voice protocol with a visual analog scale (VAS). The average scores (G mean and VAS mean ) were taken as the perceptual dysphonia severity level for every voice sample. All concatenated voice samples were acoustically analyzed to receive an AVQI-LT score. Both auditory-perceptual judgment procedures showed sufficient strength of agreement between five raters. The results achieved significant and marked concurrent validity between both auditory-perceptual judgment procedures and AVQI-LT. The diagnostic accuracy of AVQI-LT showed for both auditory-perceptual judgment procedures comparable results with two different AVQI-LT thresholds. The AVQI-LT threshold of 2.97 for the G mean rating obtained reasonable sensitivity = 0.838 and excellent specificity = 0.937. For the VAS rating, an AVQI-LT threshold of 3.48 was determined with sensitivity = 0.840 and specificity = 0.922. The AVQI-LT is considered a valid and reliable tool for assessing the dysphonia severity level in Lithuanian-speaking population. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The influence of vocal training and acting experience on measures of voice quality and emotional genuineness

PubMed Central

Livingstone, Steven R.; Choi, Deanna H.; Russo, Frank A.

2014-01-01

Vocal training through singing and acting lessons is known to modify acoustic parameters of the voice. While the effects of singing training have been well documented, the role of acting experience on the singing voice remains unclear. In two experiments, we used linear mixed models to examine the relationships between the relative amounts of acting and singing experience on the acoustics and perception of the male singing voice. In Experiment 1, 12 male vocalists were recorded while singing with five different emotions, each with two intensities. Acoustic measures of pitch accuracy, jitter, and harmonics-to-noise ratio (HNR) were examined. Decreased pitch accuracy and increased jitter, indicative of a lower “voice quality,” were associated with more years of acting experience, while increased pitch accuracy was associated with more years of singing lessons. We hypothesized that the acoustic deviations exhibited by more experienced actors was an intentional technique to increase the genuineness or truthfulness of their emotional expressions. In Experiment 2, listeners rated vocalists’ emotional genuineness. Vocalists with more years of acting experience were rated as more genuine than vocalists with less acting experience. No relationship was reported for singing training. Increased genuineness was associated with decreased pitch accuracy, increased jitter, and a higher HNR. These effects may represent a shifting of priorities by male vocalists with acting experience to emphasize emotional genuineness over pitch accuracy or voice quality in their singing performances. PMID:24639659

Comparison of Voice Quality Between Patients Who Underwent Inferior Turbinoplasty or Radiofrequency Cauterization.

PubMed

Göker, Ayşe Enise; Aydoğdu, İmran; Saltürk, Ziya; Berkiten, Güler; Atar, Yavuz; Kumral, Tolgar Lütfi; Uyar, Yavuz

2017-01-01

The aim of this study was to analyze and compare the vocal quality in patients who underwent either submucosal turbinectomy or radiofrequency cauterization. In this study, we enrolled 60 patients diagnosed with inferior concha hypertrophy. These patients were divided into two groups by using computer program "Research Randomizer." Of the 60 patients, 30 underwent submucosal inferior turbinoplasty and 30 underwent radiofrequency cauterization. The control group was composed of 30 healthy adults with no nasal or upper aerodigestive system pathology. The patients were checked at weeks 1, 2, and 4. Voice records were taken before the procedure and at week 4 postprocedure. The mean age of patients in the inferior turbinoplasty group was 29.4 years (range: 19-42 years); in the radiofrequency group, it was 30.30 years (range: 18-50 years). There was no statistical difference in age between groups. In the inferior turbinoplasty group, there were 16 male and 14 female patients, and in the radiofrequency group, there were 13 male and 17 female patients. There was no significant difference in the number of males and females between groups. Voice professionals, especially singers, actors, and actresses, should be informed about possible voice changes before undergoing endonasal surgery because these individuals are more sensitive to changes in resonance organs. We believe that voice quality should be regarded as a highly important parameter when measuring the success of endonasal surgery. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy.

PubMed

Ţiple, Cristina; Drugan, Tudor; Dinescu, Florina Veronica; Mureşan, Rodica; Chirilă, Magdalena; Cosgarea, Marcel

2016-01-01

Health-related quality of life (HRQL) and voice handicap index (VHI) of laryngectomies seem to be relevant regarding voice rehabilitation. The aim of this study is to assess the impact on HRQL and VHI of laryngectomies, following voice rehabilitation. A retrospective study done at the Ear, Nose, and Throat Department of the Emergency County Hospital. Sixty-five laryngectomees were included in this study, of which 62 of them underwent voice rehabilitation. Voice handicap and QOL were assessed using the QOL questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC); variables used were functional scales (physical, role, cognitive, emotional, and social), symptom scales (fatigue, pain, and nausea and vomiting), global QOL scale (pain, swallowing, senses, speech, social eating, social contact, and sexuality), and the functional, physical, and emotional aspects of the voice handicap (one-way ANOVA test). The mean age of the patients was 59.22 (standard deviation = 9.00) years. A total of 26 (40%) patients had moderate VHI (between 31 and 60) and 39 (60%) patients had severe VHI (higher than 61). Results of the HRQL questionnaires showed that patients who underwent speech therapy obtained better scores in most scales ( P = 0.000). Patients with esophageal voice had a high score for functional scales compared with or without other voice rehabilitation methods ( P = 0.07), and the VHI score for transesophageal prosthesis was improved after an adjustment period. The global health status and VHI scores showed a statistically significant correlation between speaker groups. The EORTC and the VHI questionnaires offer more information regarding life after laryngectomy.

Behavioral Voice Therapy in School-Age Children with Vocal Fold Nodules. EBP Briefs. Volume 6, Issue 5

ERIC Educational Resources Information Center

Watts, Christopher R.

2012-01-01

Does behavioral voice therapy effectively improve voice quality and eliminate or reduce the size of vocal fold pathology in school-age children who have vocal nodules? An evidence-based practice intervention review was conducted to answer this research question. The following resources were searched: Cumulative Index to Nursing and Allied Health…

Effect of training and level of external auditory feedback on the singing voice: volume and quality

PubMed Central

Bottalico, Pasquale; Graetzer, Simone; Hunter, Eric J.

2015-01-01

Background Previous research suggests that classically trained professional singers rely not only on external auditory feedback but also on proprioceptive feedback associated with internal voice sensitivities. Objectives The Lombard Effect in singers and the relationship between Sound Pressure Level (SPL) and external auditory feedback was evaluated for professional and non-professional singers. Additionally, the relationship between voice quality, evaluated in terms of Singing Power Ratio (SPR), and external auditory feedback, level of accompaniment, voice register and singer gender was analyzed. Methods The subjects were 10 amateur or beginner singers, and 10 classically-trained professional or semi-professional singers (10 males and 10 females). Subjects sang an excerpt from the Star-spangled Banner with three different levels of the accompaniment, 70, 80 and 90 dBA, and with three different levels of external auditory feedback. SPL and the SPR were analyzed. Results The Lombard Effect was stronger for non-professional singers than professional singers. Higher levels of external auditory feedback were associated with a reduction in SPL. As predicted, the mean SPR was higher for professional than non-professional singers. Better voice quality was detected in the presence of higher levels of external auditory feedback. Conclusions With an increase in training, the singer’s reliance on external auditory feedback decreases. PMID:26186810

Analysis and enhancement of country singing

NASA Astrophysics Data System (ADS)

Lee, Matthew; Smith, Mark J. T.

2003-04-01

The study of human singing has focused extensively on the analysis of voice characteristics. At the same time, a substantial body of work has been under study aimed at modeling and synthesizing the human voice. The work on which we report brings together some key analysis and synthesis principles to create a new model for digitally improving the perceived quality of an average singing voice. The model presented employs an analysis-by-synthesis overlap-add (ABS-OLA) sinusoidal model, which in the past has been used for the analysis and synthesis of speech, in combination with a spectral model of the vocal tract. The ABS-OLA sinusoidal model for speech has been shown to be a flexible, accurate, and computationally efficient representation capable of producing a natural-sounding singing voice [E. B. George and M. J. T. Smith, Trans. Speech Audio Processing 5, 389-406 (1997)]. A spectral model infused in the ABS-OLA uses Generalized Gaussian functions to provide a simple framework which enables the precise modification of spectral characteristics while maintaining the quality and naturalness of the original voice. Furthermore, it is shown that the parameters of the new ABS-OLA can accommodate pitch corrections and vocal quality enhancements while preserving naturalness and singer identity. Examples of enhanced country singing will be presented.

Speech and Voice Response to a Levodopa Challenge in Late-Stage Parkinson's Disease.

PubMed

Fabbri, Margherita; Guimarães, Isabel; Cardoso, Rita; Coelho, Miguel; Guedes, Leonor Correia; Rosa, Mario M; Godinho, Catarina; Abreu, Daisy; Gonçalves, Nilza; Antonini, Angelo; Ferreira, Joaquim J

2017-01-01

Parkinson's disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa's (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge. The following was assessed: respiratory support for speech, voice quality, stability and variability, speech rate, and motor performance (MDS-UPDRS-III). All voice samples were recorded and analyzed by a speech and language therapist blinded to patients' therapeutic condition using Praat 5.1 software. 24/27 (14 men) LSPD patients succeeded in performing voice tasks. Median age and disease duration of patients were 79 [IQR: 71.5-81.7] and 14.5 [IQR: 11-15.7] years, respectively. In MED OFF, respiratory breath support and pitch break time of LSPD patients were worse than the normative values of non-parkinsonian. A correlation was found between disease duration and voice quality ( R  = 0.51; p  = 0.013) and speech rate ( R  = -0.55; p  = 0.008). l-Dopa significantly improved MDS-UPDRS-III score (20%), with no effect on speech as assessed by clinical rating scales and automated analysis. Speech is severely affected in LSPD. Although l-dopa had some effect on motor performance, including axial signs, speech and voice did not improve. The applicability and efficacy of non-pharmacological treatment for speech impairment should be considered for speech disorder management in PD.

Impact of the codec and various QoS methods on the final quality of the transferred voice in an IP network

NASA Astrophysics Data System (ADS)

Slavata, Oldřich; Holub, Jan

2015-02-01

This paper deals with an analysis of the relation between the codec that is used, the QoS method, and the final voice transmission quality. The Cisco 2811 router is used for adjusting QoS. VoIP client Linphone is used for adjusting the codec. The criterion for transmission quality is the MOS parameter investigated with the ITU-T P.862 PESQ and P.863 POLQA algorithms.

Involvement of the left insula in the ecological validity of the human voice

PubMed Central

Tamura, Yuri; Kuriki, Shinji; Nakano, Tamami

2015-01-01

A subtle difference between a real human and an artificial object that resembles a human evokes an impression of a large qualitative difference between them. This suggests the existence of a neural mechanism that processes the sense of humanness. To examine the presence of such a mechanism, we compared the behavioral and brain responses of participants who listened to human and artificial singing voices created from vocal fragments of a real human voice. The behavioral experiment showed that the song sung by human voices more often elicited positive feelings and feelings of humanness than the same song sung by artificial voices, although the lyrics, melody, and rhythm were identical. Functional magnetic resonance imaging revealed significantly higher activation in the left posterior insula in response to human voices than in response to artificial voices. Insular activation was not merely evoked by differences in acoustic features between the voices. Therefore, these results suggest that the left insula participates in the neural processing of the ecological quality of the human voice. PMID:25739519

Immediate effects of tongue trills associated with transcutaneous electrical nerve stimulation (TENS).

PubMed

Fabron, Eliana Maria Gradim; Petrini, Andressa Schweitzer; Cardoso, Vanessa de Moraes; Batista, João Carlos Torgal; Motonaga, Suely Mayumi; Marino, Viviane Cristina de Castro

2017-06-08

To investigate vocal quality variability after applying tongue trills associated with transcutaneous electrical nerve stimulation (TENS) on the larynx of women with normal laryngeal function. Additionally, to verify the effect of this technique over time on voice quality. Participants were 40 women (average 23.4 years) without vocal complaints. The procedure involved tongue trills with or without TENS for 3 minutes, rest and repeating the technique for another 2 minutes. The participants' voices were recorded before (Pre), after three minutes (Post 3min) and after two additional minutes (Post 5min) applying the technique. TENS with two electrodes was used on the thyroid cartilage. Self-assessment, acoustic and perceptual analysis were performed. When comparing tongue trills in isolation and associated with TENS, a greater sense of stability in phonation (self-assessment) and improvement in voice quality (perceptual evaluation) was observed in the combination technique. There was no statistical difference in acoustics findings between tongue trills in isolation and associated with TENS. When comparing the time effect of tongue trills with TENS in self-assessment there was a perception of less muscle tension (3min) and greater comfort during phonation (5 min); in the acoustic analysis, there was an increase of F0 (3 and 5 min) and intensity (5 min) when compared to Pre-moment; in the perceptual evaluation, better voice quality (3min). Comparing tongue trills in isolation and associated with TENS, there were changes in the comfort and muscle tension perception, as well as in vocal quality. On the other hand, tongue trills associated with TENS performed in 3 or 5 minutes resulted in beneficial effects on the voice identified in the assessments.

Change of signs, symptoms and voice quality evaluations throughout a 3- to 6-month empirical treatment for laryngopharyngeal reflux disease.

PubMed

Lechien, J R; Finck, C; Khalife, M; Huet, K; Delvaux, V; Picalugga, M; Harmegnies, B; Saussez, S

2018-05-16

To assess the usefulness of voice quality measurements as a treatment outcome in patients with laryngopharyngeal reflux (LPR)-related symptoms. Prospective uncontrolled multi-centre study. A total of 80 clinically diagnosed LPR patients with a reflux finding score (RFS)>7 and a reflux symptom index (RSI)>13 were treated with pantoprazole and diet recommendations during 3 or 6 months, according to their evolution. RSI; RFS; blinded Grade, Roughness, Breathiness, Asthenia, Strain and Instability (GRBASI) and aerodynamic and acoustic measurements were evaluated at baseline, 3 months (n = 80), and 6 months (n = 41) post-treatment. We conducted a correlation analysis between the adherence to the diet, and the evolution of both signs and symptoms and between videolaryngostroboscopic signs and acoustic measurements. Reflux symptom index, RFS, perceptual voice quality evaluations (dysphonia, roughness, strain and instability), and aerodynamic and acoustic measurements (ie, percent jitter and percent shimmer) were significantly improved at 3 months post-treatment but not at 6 months. Percent jitter was the most useful outcome for evaluating the clinical evolution of patients throughout the treatment course. A significant relationship between globus sensation and posterior commissure hypertrophy was documented; both seemed to significantly improve from 3 to 6 months. The correlation analysis revealed correlations between adherence to diet recommendations and the improvement of symptoms and between posterior commissure granulation severity and acoustic measurement impairments. Voice quality improved in a manner similar to both signs and symptoms throughout a 6-month empirical treatment with better improvement the 3 first months. Voice quality assessments can be used as indicators of treatment effectiveness in patients with LPR-related symptoms. © 2018 John Wiley & Sons Ltd.

The effectiveness of a voice treatment approach for teachers with self-reported voice problems.

PubMed

Gillivan-Murphy, Patricia; Drinnan, Michael J; O'Dwyer, Tadhg P; Ridha, Hayder; Carding, Paul

2006-09-01

Teachers are considered the professional group most at risk of developing voice-problems, but limited treatment effectiveness evidence exists. We studied prospectively the effectiveness of a 6-week combined treatment approach using vocal function exercises (VFEs) and vocal hygiene (VH) education with 20 teachers with self-reported voice problems. Twenty subjects were randomly assigned to a no-treatment control (n = 11) and a treatment group (n = 9). Fibreoptic endoscopic evaluation was carried out on all subjects before randomization. Two self-report voice outcome measures were used: the Voice-Related Quality of Life (VRQOL) and the Voice Symptom Severity Scale (VoiSS). A Voice Care Knowledge Visual Analogue Scale (VAS), developed specifically for the study, was also used to evaluate change in selected voice knowledge areas. A Student unpaired t test revealed a statistically significant (P < 0.05) improvement in the treatment group as measured by the VoiSS. There was not a significant improvement in the treatment group as measured by the V-RQOL. The difference in voice care knowledge areas was also significant for the treatment group (P < 0.05). This study suggests that a voice treatment approach of VFEs and VH education improved self-reported voice symptoms and voice care knowledge in a group of teachers.

The phonatory deviation diagram: a novel objective measurement of vocal function.

PubMed

Madazio, Glaucya; Leão, Sylvia; Behlau, Mara

2011-01-01

To identify the discriminative characteristics of the phonatory deviation diagram (PDD) in rough, breathy and tense voices. One hundred and ninety-six samples of normal and dysphonic voices from adults were submitted to perceptual auditory evaluation, focusing on the predominant vocal quality and the degree of deviation. Acoustic analysis was performed with the VoxMetria (CTS Informatica). Significant differences were observed between the dysphonic and normal groups (p < 0.001), and also between the breathy and rough samples (p = 0.044) and the breathy and tense samples (p < 0.001). All normal voices were positioned in the inferior left quadrant, 45% of the rough voices in the inferior right quadrant, 52.6% of the breathy voices in the superior right quadrant and 54.3% of the tense voices in the inferior left quadrant of the PDD. In the inferior left quadrant, 93.8% of voices with no deviation were located and 72.7% of voices with mild deviation; voices with moderate deviation were distributed in the inferior and superior right quadrants, the latter ones containing the most deviant voices and 80% of voices with severe deviation. The PDD was able to discriminate normal from dysphonic voices, and the distribution was related to the type and degree of voice alteration. Copyright © 2011 S. Karger AG, Basel.

Laser arytenoidectomy in children with bilateral vocal fold immobility.

PubMed

Worley, G; Bajaj, Y; Cavalli, L; Hartley, B

2007-01-01

Bilateral vocal fold immobility in children is a challenging problem because a balance between good airway and voice quality has to be achieved. Surgery to improve the airway is often postponed or avoided because of fear of losing the voice. In this study our results of laser arytenoidectomy in children are described. This was a retrospective case notes review at a tertiary level paediatric ENT department. The six patients in this case series ranged from nine to 16 years old at the time of laser arytenoidectomy. Post-operative airway and voice quality were assessed. All children in the series had an adequate post-operative airway. Four of these patients had tracheostomies pre-operatively and achieved decannulation. All six patients rated their post-operative voice as better than pre-operatively. This is principally due to increased loudness associated with increased airflow through the larynx, particularly after tracheostomy decannulation. It is recommended that special care should be taken not to disturb the anterior two thirds of the vocal fold during the surgery in order to achieve a good post-operative voice outcome.

Voice quality change in future professional voice users after 9 months of voice training.

PubMed

Timmermans, Bernadette; De Bodt, Marc; Wuyts, Floris; Van de Heyning, Paul

2004-01-01

Sixty-eight students of a school for audiovisual communication participated in this study. A part of them, 49 students, received voice training for 9 months (the trained group); 19 subjects received no specific voice training (the untrained group). A multidimensional test battery containing the GRBAS scale, videolaryngostroboscopy, Maximum Phonation Time (MPT), jitter, lowest intensity (IL), highest frequency (FoH), Dysphonia Severity Index (DSI) and Voice Handicap Index (VHI) was applied before and after training to evaluate training outcome. The voice training is made up of technical workshops in small groups (five to eight subjects) and vocal coaching in the ateliers. In the technical workshops, basic skills are trained (posture, breathing technique, articulation and diction), and in the ateliers, the speech and language pathologist assists the subjects in the practice of their voice work. This study revealed a significant amelioration over time for the objective measurements [Dysphonia Severity Index: from 2.3 to 4.5 ( P<0.001)] and the self-evaluation [Voice Handicap Index, from 23 to 18.4 ( P=0.016)] for the trained group only. This outcome favors the systematic introduction of voice training during the schooling of professional voice users.

The impact of vocal rehabilitation on quality of life and voice handicap in patients with total laryngectomy

PubMed Central

Ţiple, Cristina; Drugan, Tudor; Dinescu, Florina Veronica; Mureşan, Rodica; Chirilă, Magdalena; Cosgarea, Marcel

2016-01-01

Background: Health-related quality of life (HRQL) and voice handicap index (VHI) of laryngectomies seem to be relevant regarding voice rehabilitation. The aim of this study is to assess the impact on HRQL and VHI of laryngectomies, following voice rehabilitation. Materials and Methods: A retrospective study done at the Ear, Nose, and Throat Department of the Emergency County Hospital. Sixty-five laryngectomees were included in this study, of which 62 of them underwent voice rehabilitation. Voice handicap and QOL were assessed using the QOL questionnaires developed by the European Organisation for Research and Treatment of Cancer (EORTC); variables used were functional scales (physical, role, cognitive, emotional, and social), symptom scales (fatigue, pain, and nausea and vomiting), global QOL scale (pain, swallowing, senses, speech, social eating, social contact, and sexuality), and the functional, physical, and emotional aspects of the voice handicap (one-way ANOVA test). Results: The mean age of the patients was 59.22 (standard deviation = 9.00) years. A total of 26 (40%) patients had moderate VHI (between 31 and 60) and 39 (60%) patients had severe VHI (higher than 61). Results of the HRQL questionnaires showed that patients who underwent speech therapy obtained better scores in most scales (P = 0.000). Patients with esophageal voice had a high score for functional scales compared with or without other voice rehabilitation methods (P = 0.07), and the VHI score for transesophageal prosthesis was improved after an adjustment period. The global health status and VHI scores showed a statistically significant correlation between speaker groups. Conclusion: The EORTC and the VHI questionnaires offer more information regarding life after laryngectomy. PMID:28331513

Investigating the Effects of Glottal Stop Productions on Voice in Children With Cleft Palate Using Multidimensional Voice Assessment Methods.

PubMed

Aydınlı, Fatma Esen; Özcebe, Esra; Kulak Kayıkçı, Maviş E; Yılmaz, Taner; Özgür, Fatma F

2016-11-01

The aim was to investigate the effects of glottal stop productions (GS) on voice in children with cleft palate using multidimensional voice assessment methods. This is a prospective case-control study. Children with repaired cleft palate (n = 34) who did not have any vocal fold lesions were separated into two groups based on the results of the articulation test. The glottal stop group (GSG) consisted of 17 children who had GS. The control group (CG) consisted of an equal number of age- and gender-matched children who did not have GS. The voice evaluation protocol included acoustic analysis, Pediatric Voice Handicap Index (pVHI), and perceptual analysis (Grade, Roughness, Breathiness, Asthenia, Strain method). The velopharyngeal statuses of the groups were compared using the nasopharyngoscopy and the nasometer. The total pVHI score and the subscales of the pVHI were found to be significantly higher in the GSG. The F0, jitter, and shimmer were found to be numerically higher in the GSG with the difference being statistically significant in jitter (P < 0.05). Audioperceptual analysis revealed a difference in overall voice quality and roughness between the groups. Greater incidence of significant velopharyngeal insufficiency and higher nasalance scores were found in the GSG (P < 0.05). These results may indicate that the vocal quality characteristics of children with GS differ from children who do not have this type of production. It is suggested that children with cleft palate who have GS should receive a comprehensive speech and language pathology intervention including voice therapy techniques. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Electroglottogram waveform types.

PubMed

Painter, C

1988-01-01

Electroglottography is a useful, non-invasive technique that can assist in the assessment of vocal fold dysfunction. However, if it is to become a useful clinical tool, there is a need for normative studies of the electroglottogram waveform types that characterize trained professional voice users, untrained non-professional speakers and patients with voice disorders and for a way of quantifying and objectively comparing similarities and differences. This report describes our methodology and an investigation into the waveform types characterizing one trained professional voice user phonating in 15 experimental sessions under various fundamental frequency, intensity and voice quality conditions. A number of strong tendencies were noted. In normal voice the lower frequencies and intensities represent one pole of a scale of a mode of phonation, while the higher frequencies and intensities depict the other pole. In these studies breathy voice data overlapped the lower end of the scale and tense voice data overlapped the upper end.

Cross-cultural equivalence and evaluation of psychometric properties of voice handicap index into Persian.

PubMed

Moradi, Negin; Pourshahbaz, Abbas; Soltani, Majid; Javadipour, Shiva; Hashemi, Hedieh; Soltaninejad, Nasibeh

2013-03-01

Quality of life is one of the important aspects in the assessment of health and treatment data output. The purpose of this study was to adapt and determine reliability and validity of Voice Handicap Index (VHI) in Persian. The subjects were 80 patients with voice disorders and 80 volunteers without any voice disorders as a control group. All subjects filled in the Persian version of VHI. The test was repeated 2 weeks later. The reliability and validity were studied. All items had significant discrimination coefficient. The internal consistency and reliability of test and retest in VHI total score and three subtests were achieved. It seems that the Persian version of VHI is a valid and reliable questionnaire, which voice therapists may use for completing their evaluation for patients with voice disorders, and it gives more information about the nature of voice disorder to specialists. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Voice disorders in teachers and the general population: effects on work performance, attendance, and future career choices.

PubMed

Roy, Nelson; Merrill, Ray M; Thibeault, Susan; Gray, Steven D; Smith, Elaine M

2004-06-01

To examine the frequency and adverse effects of voice disorders on job performance and attendance in teachers and the general population, 2,401 participants from Iowa and Utah (n1 = 1,243 teachers and n2 = 1,279 nonteachers) were randomly selected and were interviewed by telephone using a voice disorder questionnaire. Teachers were significantly more likely than nonteachers to have experienced multiple voice symptoms and signs including hoarseness, discomfort, and increased effort while using their voice, tiring or experiencing a change in voice quality after short use, difficulty projecting their voice, trouble speaking or singing softly, and a loss of their singing range (all odds ratios [ORs] p <.05). Furthermore, teachers consistently attributed these voice symptoms to their occupation and were significantly more likely to indicate that their voice limited their ability to perform certain tasks at work, and had reduced activities or interactions as a result. Teachers, as compared with nonteachers, had missed more workdays over the preceding year because of voice problems and were more likely to consider changing occupations because of their voice (all comparisons p <.05). These findings strongly suggest that occupationally related voice dysfunction in teachers can have significant adverse effects on job performance, attendance, and future career choices.

A new voice rating tool for clinical practice.

PubMed

Gould, James; Waugh, Jessica; Carding, Paul; Drinnan, Michael

2012-07-01

Perceptual rating of voice quality is a key component in the comprehensive assessment of voice, but there are practical difficulties in making reliable measurements. We have developed the Newcastle Audio Ranking (NeAR) test, a new referential system for the rating of voice parameters. In this article, we present our first results using NeAR. We asked five experts and 11 naive raters to assess 15 male and 15 female voices using the NeAR test. We assessed: validity with respect to the GRBAS scale; interrater reliability; sensitivity to subtle voice differences; and the performance of expert versus naïve raters. There was a uniformly excellent agreement with GRBAS (r=0.87) and interrater agreement (intraclass correlation coefficient=0.86). Considering each GRBAS grade of voice separately, there was still good interrater agreement in NeAR, implying it has good sensitivity to subtle changes. All these results were equally true for expert and naive raters. The NeAR test is a promising new tool in the assessment of voice disorders. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Reference-free automatic quality assessment of tracheoesophageal speech.

PubMed

Huang, Andy; Falk, Tiago H; Chan, Wai-Yip; Parsa, Vijay; Doyle, Philip

2009-01-01

Evaluation of the quality of tracheoesophageal (TE) speech using machines instead of human experts can enhance the voice rehabilitation process for patients who have undergone total laryngectomy and voice restoration. Towards the goal of devising a reference-free TE speech quality estimation algorithm, we investigate the efficacy of speech signal features that are used in standard telephone-speech quality assessment algorithms, in conjunction with a recently introduced speech modulation spectrum measure. Tests performed on two TE speech databases demonstrate that the modulation spectral measure and a subset of features in the standard ITU-T P.563 algorithm estimate TE speech quality with better correlation (up to 0.9) than previously proposed features.

Simulation of singing qualities governed by lower vocal tract adjustments

NASA Astrophysics Data System (ADS)

Titze, Ingo R.

2003-04-01

In previous meetings, voice qualities such as pressed, ring, yawn, and twang were discussed in a speech context. It was shown that these qualities have unique spectral characteristics brought about by combinations of glottal and lower vocal tract adjustments (the epilarynx tube and the pharynx). Yawn has a wide glottis, a wide epilarynx tube, and a wide pharynx. On the contrary, twang has a general narrowing of all these airway sections. Ring has a wide pharynx and a relatively narrow epilarynx tube. A pressed voice is primary laryngeal, with a narrowed glottis. In this presentation, similar adjustments are made for singing with a voice simulator that controls vocal tract area functions and glottal flow pulses by rules. Results suggest that various singing styles, such as country-western, opera, or pop, may in part be characterized by these unique combinations of source and filter adjustments.

Reliability and Validity of the Turkish Version of the Voice-Related Quality of Life Measure.

PubMed

Tezcaner, Zahide Çiler; Aksoy, Songül

2017-03-01

This study aims to test the validity and reliability of the Turkish version of the Voice-Related Quality of Life (V-RQOL) questionnaire. This is a nonrandomized, prospective study with control group. The questionnaire was administered to 249 individuals-130 with vocal complaint and 119 without-with a mean age of 37.8 ± 12.3 years. The Turkish version of the Voice Handicap Index (VHI) and perceptual voice evaluation measures were also administered at 2-14 days for retest reliability. The instrument was submitted to validity and reliability evaluation. The V-RQOL measure showed a strong internal consistency and test-retest reliability; the Cronbach's alpha coefficient for the overall V-RQOL was 0.969, the physical functioning domain was 0.949, and the social-emotional domain was 0.940. In the test-retest reliability test, the overall V-RQOL was found to be 0.989. The construct validity of the V-RQOL was determined based on the strength and direction of its relation to the VHI and the perceptual voice evaluation measure. The higher the VHI level, the lower the physical functioning, social-emotional, and overall score levels of the V-RQOL (r = -0.927, r = -0.912, r = -0.944, respectively; P < 0.001). Following the perceptual voice self-assessment, a statistically significant difference was found between the V-RQOL scores of individuals who defined their voices as good, very good, and perfect, and those who defined their voices as bad and very bad (P < 0.001). The results suggest that the Turkish version of the V-RQOL measure has reliability and validity and may play a crucial role in evaluating Turkish-speaking patients with voice disorders. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Fundamental frequency and voice perturbation measures in smokers and non-smokers: An acoustic and perceptual study

NASA Astrophysics Data System (ADS)

Freeman, Allison

This research examined the fundamental frequency and perturbation (jitter % and shimmer %) measures in young adult (20-30 year-old) and middle-aged adult (40-55 year-old) smokers and non-smokers; there were 36 smokers and 36 non-smokers. Acoustic analysis was carried out utilizing one task: production of sustained /a/. These voice samples were analyzed utilizing Multi-Dimensional Voice Program (MDVP) software, which provided values for fundamental frequency, jitter %, and shimmer %.These values were analyzed for trends regarding smoking status, age, and gender. Statistical significance was found regarding the fundamental frequency, jitter %, and shimmer % for smokers as compared to non-smokers; smokers were found to have significantly lower fundamental frequency values, and significantly higher jitter % and shimmer % values. Statistical significance was not found regarding fundamental frequency, jitter %, and shimmer % for age group comparisons. With regard to gender, statistical significance was found regarding fundamental frequency; females were found to have statistically higher fundamental frequencies as compared to males. However, the relationships between gender and jitter % and shimmer % lacked statistical significance. These results indicate that smoking negatively affects voice quality. This study also examined the ability of untrained listeners to identify smokers and non-smokers based on their voices. Results of this voice perception task suggest that listeners are not accurately able to identify smokers and non-smokers, as statistical significance was not reached. However, despite a lack of significance, trends in data suggest that listeners are able to utilize voice quality to identify smokers and non-smokers.

Effects of consensus training on the reliability of auditory perceptual ratings of voice quality.

PubMed

Iwarsson, Jenny; Reinholt Petersen, Niels

2012-05-01

This study investigates the effect of consensus training of listeners on intrarater and interrater reliability and agreement of perceptual voice analysis. The use of such training, including a reference voice sample, could be assumed to make the internal standards held in memory common and more robust, which is of great importance to reduce the variability of auditory perceptual ratings. A prospective design with testing before and after training. Thirteen students of audiologopedics served as listening subjects. The ratings were made using a multidimensional protocol with four-point equal-appearing interval scales. The stimuli consisted of text reading by authentic dysphonic patients. The consensus training for each perceptual voice parameter included (1) definition, (2) underlying physiology, (3) presentation of carefully selected sound examples representing the parameter in three different grades followed by group discussions of perceived characteristics, and (4) practical exercises including imitation to make use of the listeners' proprioception. Intrarater reliability and agreement showed a marked improvement for intermittent aphonia but not for vocal fry. Interrater reliability was high for most parameters before training with a slight increase after training. Interrater agreement showed marked increases for most voice quality parameters as a result of the training. The results support the recommendation of specific consensus training, including use of a reference voice sample material, to calibrate, equalize, and stabilize the internal standards held in memory by the listeners. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Bilateral Vocal Fold Medialization: A Treatment for Abductor Spasmodic Dysphonia.

PubMed

Dewan, Karuna; Berke, Gerald S

2017-11-10

Abductor spasmodic dysphonia, a difficult-to-treat laryngologic condition, is characterized by spasms causing the vocal folds to remain abducted despite efforts to adduct them during phonation. Traditional treatment for abductor spasmodic dysphonia-botulinum toxin injection into the posterior cricoarytenoid muscle-can be both technically challenging and uncomfortable. Due to the difficulty of needle placement, it is often unsuccessful. The purpose of this investigation is to present a previously undescribed treatment for abductor spasmodic dysphonia-bilateral vocal fold medialization. A retrospective case review of all cases of abductor spasmodic dysphonia treated in a tertiary care laryngology practice with bilateral vocal fold medialization over a 10-year period was performed. The Voice Handicap Index and the Voice-Related Quality of Life surveys were utilized to assess patient satisfaction with voice outcome. Six patients with abductor spasmodic dysphonia treated with bilateral vocal fold medialization were identified. Disease severity ranged from mild to severe. All six patients reported statistically significant improvement in nearly all Voice Handicap Index and Voice-Related Quality of Life parameters. They reported fewer voice breaks and greater ease of communication. Results were noted immediately and symptoms continue to be well controlled for many years following medialization. Bilateral vocal fold medialization is a safe and effective treatment for abductor spasmodic dysphonia. It is performed under local anesthesia and provides phonation improvement in the short and long term. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Phonotrauma associated with crying.

PubMed

Murry, T; Rosen, C A

2000-12-01

Vocal fold hemorrhage often results in a sudden change in voice quality. Traumatic use of the voice (phonation or singing) is generally thought to be the cause of the vocal fold hemorrhage. The current report reviews three cases in which the traumatic event was crying. In one case, the patient's voice was only used for crying. All three patients were female and all were professional singers. The treatment of these individuals consisted of voice rest and subsequent phonomicrosurgery for lesions associated with the vocal fold hemorrhage. These case studies suggest that crying as a traumatic vocal behavior may result in vocal fold hemorrhage.

Can health insurance improve access to quality care for the Indian poor?

PubMed

Michielsen, Joris; Criel, Bart; Devadasan, Narayanan; Soors, Werner; Wouters, Edwin; Meulemans, Herman

2011-08-01

Recently, the Indian government launched health insurance schemes for the poor both to protect them from high health spending and to improve access to high-quality health services. This article aims to review the potentials of health insurance interventions in order to improve access to quality care in India based on experiences of community health insurance schemes. PubMed, Ovid MEDLINE (R), All EBM Reviews, CSA Sociological Abstracts, CSA Social Service Abstracts, EconLit, Science Direct, the ISI Web of Knowledge, Social Science Research Network and databases of research centers were searched up to September 2010. An Internet search was executed. One thousand hundred and thirty-three papers were assessed for inclusion and exclusion criteria. Twenty-five papers were selected providing information on eight schemes. A realist review was performed using Hirschman's exit-voice theory: mechanisms to improve exit strategies (financial assets and infrastructure) and strengthen patient's long voice route (quality management) and short voice route (patient pressure). All schemes use a mix of measures to improve exit strategies and the long voice route. Most mechanisms are not effective in reality. Schemes that focus on the patients' bargaining position at the patient-provider interface seem to improve access to quality care. Top-down health insurance interventions with focus on exit strategies will not work out fully in the Indian context. Government must actively facilitate the potential of CHI schemes to emancipate the target group so that they may transform from mere passive beneficiaries into active participants in their health.

[An across-scales analysis of the voice self-concept questionnaire (FESS)].

PubMed

Nusseck, Manfred; Richter, Bernhard; Echternach, Matthias; Spahn, Claudia

2018-04-01

The questionnaire for the assessment of the voice selfconcept (FESS) contains three sub-scales indicating the personal relation with the own voice. The scales address the relationship with one's own voice, the awareness of the use of one's own voice, and the perception of the connection between voice and emotional changes. A comprehensive approach across the three scales supporting a simplified interpretation of the results was still missing. The FESS questionnaire was used in a sample of 536 German teachers. With a discrimination analysis, commonalities in the scale characteristics were investigated. For a comparative validation with voice health and psychological and physiological wellbeing, the Voice Handicap Index (VHI), the questionnaire for Work-related Behavior and Experience Patterns (AVEM), and the questionnaire for Health-related Quality of Life (SF-12) were additionally collected. The analysis provided four different groups of voice self-concept: group 1 with healthy values in the voice self-concept and wellbeing scales, group 2 with a low voice self-concept and mean wellbeing values, group 3 with a high awareness of the voice use and mean wellbeing values and group 4 with low values in all scales. The results show that a combined approach across all scales of the questionnaire for the assessment of the voice self-concept enables a more detailed interpretation of the characteristics in the voice self-concept. The presented groups provide an applicable use supporting medical diagnoses. © Georg Thieme Verlag KG Stuttgart · New York.

Adductor spasmodic dysphonia: Relationships between acoustic indices and perceptual judgments

NASA Astrophysics Data System (ADS)

Cannito, Michael P.; Sapienza, Christine M.; Woodson, Gayle; Murry, Thomas

2003-04-01

This study investigated relationships between acoustical indices of spasmodic dysphonia and perceptual scaling judgments of voice attributes made by expert listeners. Audio-recordings of The Rainbow Passage were obtained from thirty one speakers with spasmodic dysphonia before and after a BOTOX injection of the vocal folds. Six temporal acoustic measures were obtained across 15 words excerpted from each reading sample, including both frequency of occurrence and percent time for (1) aperiodic phonation, (2) phonation breaks, and (3) fundamental frequency shifts. Visual analog scaling judgments were also obtained from six voice experts using an interactive computer interface to quantify four voice attributes (i.e., overall quality, roughness, brokenness, breathiness) in a carefully psychoacoustically controlled environment, using the same reading passages as stimuli. Number and percent aperiodicity and phonation breaks correlated significanly with perceived overall voice quality, roughness, and brokenness before and after the BOTOX injection. Breathiness was correlated with aperidocity only prior to injection, while roughness also correlated with frequency shifts following injection. Factor analysis reduced perceived attributes to two principal components: glottal squeezing and breathiness. The acoustic measures demonstrated a strong regression relationship with perceived glottal squeezing, but no regression relationship with breathiness was observed. Implications for an analysis of pathologic voices will be discussed.

[Comparative studies of the quality of the esophageal voice following laryngectomy: the insufflation test and reverse speech audiometry].

PubMed

Böhme, G; Clasen, B

1989-09-01

We carried out a transnasal insufflation test according to Blom and Singer on 27 laryngectomy patients as well as a speech communications test with the help of reverse speech audiometry, i.e. the post laryngectomy telephone test according to Zenner and Pfrang. The combined evaluation of both tests provided basic information on the quality of the esophagus voice and functionability of the speech organs. Both tests can be carried out quickly and easily and allow a differentiated statement to be made on the application possibilities of a esophagus voice, electronic speech aids and voice prothesis. Three groups could be identified from our results: 1. Insufflation test and reverse speech test provided conformable good or very good results. The esophagus voice was well understood. 2. Complete failure in the insufflation and telephone tests calls for further examinations to exclude any spasm, stricture, divertical and scarred membrane stenosis as well as tumor relapse in the region of the pharyngo-esophageal segments. 3. Organic causes must be looked for in the area of the nozzle as well as cranial nerve failure and social-determined causes in the case of normal insufflation and considerably reduced speech communication in the telephone test.

Effectiveness of Vocal Therapy for the Elderly When Applying Conventional and Intensive Approaches: A Randomized Clinical Trial.

PubMed

Godoy, Juliana; Silverio, Kelly; Brasolotto, Alcione

2018-05-21

The aim of this study was to verify the effects of the method Vocal Therapy for the Elderly and the differences in treatment efficacy when it was administered intensively or in the conventional way. Twenty-seven elderly individuals were randomized into two groups and referred for 16 sessions of vocal therapy. The Intensive Group (IG) had therapy four times a week, whereas the Conventional Group had it twice a week. The effects of the therapy were assessed by auditory-perceptual analysis, the Voice-Related Quality of Life protocol, and visual-perceptive analysis of laryngoscopy examinations. The first stage consisted of evaluating the vocal quality and self-assessment of 15 subjects before and after a time period equal to that which they would undergo in vocal therapy. The second stage consisted of comparing the assessments of all participants in the week preceding the beginning of treatment, in the week following the end of treatment, and 1 month after that. There was no difference between perceptual voice parameters and self-assessment when the subjects were not undergoing therapy. When comparing the periods immediately before and after therapy, there was improvement in vocal quality and Voice-Related Quality of Life. One month later, the benefits that had been revealed through the self-assessment protocol, and some of the improvements in vocal parameters were maintained. There was no difference between the IG and Conventional Group with the exception of vocal fold bowing, which decreased in the IG group. The Vocal Therapy for the Elderly program is effective for treating voice presbyphonia. An intensive approach may be superior with regard to vocal fold bowing. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal Qualities in Music Theater Voice: Perceptions of Expert Pedagogues.

PubMed

Bourne, Tracy; Kenny, Dianna

2016-01-01

To gather qualitative descriptions of music theater vocal qualities including belt, legit, and mix from expert pedagogues to better define this voice type. This is a prospective, semistructured interview. Twelve expert teachers from United States, United Kingdom, Asia, and Australia were interviewed by Skype and asked to identify characteristics of music theater vocal qualities including vocal production, physiology, esthetics, pitch range, and pedagogical techniques. Responses were compared with published studies on music theater voice. Belt and legit were generally described as distinct sounds with differing physiological and technical requirements. Teachers were concerned that belt should be taught "safely" to minimize vocal health risks. There was consensus between teachers and published research on the physiology of the glottis and vocal tract; however, teachers were not in agreement about breathing techniques. Neither were teachers in agreement about the meaning of "mix." Most participants described belt as heavily weighted, thick folds, thyroarytenoid-dominant, or chest register; however, there was no consensus on an appropriate term. Belt substyles were named and generally categorized by weightedness or tone color. Descriptions of male belt were less clear than for female belt. This survey provides an overview of expert pedagogical perspectives on the characteristics of belt, legit, and mix qualities in the music theater voice. Although teacher responses are generally in agreement with published research, there are still many controversial issues and gaps in knowledge and understanding of this vocal technique. Breathing techniques, vocal range, mix, male belt, and vocal registers require continuing investigation so that we can learn more about efficient and healthy vocal function in music theater singing. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Medialization thyroplasty in glottis insufficiency due to unilateral vocal fold paralysis and after laser cordectomies - preliminary report.

PubMed

Rzepakowska, Anna; Osuch-Wójcikiewicz, Ewa; Sielska-Badurek, Ewelina; Niemczyk, Kazimierz

2017-02-28

Medialization thyroplasty (type I) is surgical procedure performed on the thyroid cartilage. The major indication for this surgery is significant glottis insufficiency due to unilateral vocal fold paresis. However the proce¬dure is also performed after vocal fold resections during cordectomy. The evaluation of voice results in patients after medialisation throplasty. In Otolaryngology Department of Medical University of Warsaw there were performed so far 8 thyroplasty procedures under local anaesthesia with implantation of medical silicon protesis. 6 patients had unilat¬eral vocal fold paresis and the rest two underwent in the past laser cordectomy due to T1a vocal carcinoma. There were no complications during and post the surgery. The follow up examination in 1st , 3rd, 6th i 12th months postoperatively revealed for all patients significant improvement of glottal closure in laryngeal videostrobos¬copy. The voice quality improved both in perceptual evaluation (GRBAS scale) and acoustic analysis (F0, jitter, shim¬mer, NHR) in both patients groups. However the rate of improvement was much more significant in group with uni¬lateral vocal fold paresis. In all patients the maximum phonation time (MPT) increased. The self-evaluation of voice quality with Voice Handicap Index questionnaire confirmed also individual improvement. The speech rehabilitations is not successful in each patient with glottis insufficiency. The medialisation thyroplasty remains the standard procedure for permanent improvement of voice quality in those cases.

[Social consequence of a dysphonic voice, design and validation of a questionnaire and first results].

PubMed

Revis, J; Robieux, C; Ghio, A; Giovanni, A

2013-01-01

In our society, based on communication, dysphonia becomes a handicap that could be responsible of work discrimination. Actually, several commercial services are provided by phone only, and voice quality is mandatory for the employees. This work aim was to determine the social picture relayed by dysphonia. Our hypothesis was that dysphonia sounds pejorative compared to normal voice. 40 voice samples (30 dysphonic and 10 normal) were presented randomly to a perceptual jury of 20 naïve listener. The task was for each of them to fill a questionnaire, designed specifically to describe the speaker's look and personality. 20 items were evaluated, divided into 4 categories: health, temperament, appearance, and way of life. The results showed significant differences between normal subjects and dysphonic patients. For instance, the pathological voices were depicted as more tired, introverted, sloppy than normal voices, and less trustable. No significant differences were found according to the severity of voice disorders. This work is presently continued. It allowed to validate our questionnaire and has offers great perspectives on patient's management and voice therapy.

Effects of Voice Therapy on Laryngeal Motor Units During Phonation in Chronic Superior Laryngeal Nerve Paresis Dysphonia.

PubMed

Kaneko, Mami; Hitomi, Takefumi; Takekawa, Takashi; Tsuji, Takuya; Kishimoto, Yo; Hirano, Shigeru

2017-09-26

Injury to the superior laryngeal nerve can result in dysphonia, and in particular, loss of vocal range. It can be an especially difficult problem to address with either voice therapy or surgical intervention. Some clinicians and scientists suggest that combining vocal exercises with adjunctive neuromuscular electrical stimulation may enhance the positive effects of voice therapy for superior laryngeal nerve paresis (SLNP). However, the effects of voice therapy without neuromuscular electrical stimulation are unknown. The purpose of this retrospective study was to demonstrate the clinical effectiveness of voice therapy for rehabilitating chronic SLNP dysphonia in two subjects, using interspike interval (ISI) variability of laryngeal motor units by laryngeal electromyography (LEMG). Both patients underwent LEMG and were diagnosed with having 70% recruitment of the cricothyroid muscle, and 70% recruitment of the cricothyroid and thyroarytenoid muscles, respectively. Both patients received voice therapy for 3 months. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 were performed before and after voice therapy. Mean ISI variability during steady phonation was also assessed. After voice therapy, both patients showed improvement in vocal assessments by acoustic, aerodynamic, GRBAS, and Voice Handicap Index-10 analysis. LEMG indicated shortened ISIs in both cases. This study suggests that voice therapy for chronic SLNP dysphonia can be useful for improving SLNP and voice quality. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Evaluation of music department students who passed the entrance exam with phonetogram (Voice Range Profile)].

PubMed

Gökdoğan, Çağıl; Gökdoğan, Ozan; Şahin, Esra; Yılmaz, Metin

2014-01-01

This study aims to evaluate phonetogram data of the students in the department of music who passed the entrance exam. The phonetogram data of 44 individuals with a good voice quality in the department of music and age-matched individuals who were not trained in the field of music or not involved in music amateurish as the control group were compared. The voice of both groups were recorded using the voice range profile within the scope of Kay Elemetrics CSL (Model 4300 B) programmed. There was a significant difference in the voice range profile parameters including max Fo, Fo range, Fo range (St), min dB SPL, and max dB sound pressure level (p<0.05). Our study results suggest that the voice interval of the department of music is higher than the control group and that plays a major role in their acceptance to the department of music.

High-speed digital phonoscopy images analyzed by Nyquist plots

NASA Astrophysics Data System (ADS)

Yan, Yuling

2012-02-01

Vocal-fold vibration is a key dynamic event in voice production, and the vibratory characteristics of the vocal fold correlate closely with voice quality and health condition. Laryngeal imaging provides direct means to observe the vocal fold vibration; in the past, however, available modalities were either too slow or impractical to resolve the actual vocal fold vibrations. This limitation has now been overcome by high-speed digital imaging (HSDI) (or high-speed digital phonoscopy), which records images of the vibrating vocal folds at a rate of 2000 frames per second or higher- fast enough to resolve a specific, sustained phonatory vocal fold vibration. The subsequent image-based functional analysis of voice is essential to better understanding the mechanism underlying voice production, as well as assisting the clinical diagnosis of voice disorders. Our primary objective is to develop a comprehensive analytical platform for voice analysis using the HSDI recordings. So far, we have developed various analytical approaches for the HSDI-based voice analyses. These include Nyquist plots and associated analysese that are used along with FFT and Spectrogram in the analysis of the HSDI data representing normal voice and specific voice pathologies.

Design of a digital voice data compression technique for orbiter voice channels

NASA Technical Reports Server (NTRS)

1975-01-01

Candidate techniques were investigated for digital voice compression to a transmission rate of 8 kbps. Good voice quality, speaker recognition, and robustness in the presence of error bursts were considered. The technique of delayed-decision adaptive predictive coding is described and compared with conventional adaptive predictive coding. Results include a set of experimental simulations recorded on analog tape. The two FM broadcast segments produced show the delayed-decision technique to be virtually undegraded or minimally degraded at .001 and .01 Viterbi decoder bit error rates. Preliminary estimates of the hardware complexity of this technique indicate potential for implementation in space shuttle orbiters.

The relationship between voice climate and patients’ experience of timely care in primary care clinics

PubMed Central

Nembhard, Ingrid M.; Yuan, Christina T.; Shabanova, Veronika; Cleary, Paul D.

2017-01-01

Background Aspects of the patient care experience, despite being central to quality care, are often problematic. In particular, patients frequently report problems with timeliness of care. As yet, research offers little insight on setting characteristics that contribute to patients’ experience of timely care. Purpose The aims of this study were to assess the relationship between organizational climate and patients’ reports of timely care in primary care clinics and to broadly examine the link between staff’s work environment and patient care experiences. We test hypotheses about the relationship between voice climate—staff feeling safe to speak up about issues—and reported timeliness of care, consistency in reported voice climate across professions, and how climate differences for various professions relate to timely care. Methodology We conducted a cross-sectional study of employees (n = 1,121) and patients (n = 8,164) affiliated with 37 clinics participating in a statewide reporting initiative. Employees were surveyed about clinics’ voice climate, and patients were surveyed about the timeliness of care. Hypotheses were tested using analysis of variance and generalized estimating equations. Findings Clinical and administrative staff (e.g., nurses and office assistants) reported clinics’ climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians). The greater the difference in reported support for voice between professional groups, the less patients reported experiencing timely care in three respects: obtaining an appointment, seeing the doctor within 15 minutes of appointment time, and receiving test results. In clinics where staff reported climates supportive of voice, patients indicated receiving more timely care. Clinical leaders’ reports of voice climate had no relationship to reported timeliness of care. Practical Implications Our findings suggest the importance of clinics developing a strong climate for voice, particularly for clinical and administrative staff, to support better service quality for patients. PMID:24589927

Validation and Adaptation of the Singing Voice Handicap Index for Egyptian Singing Voice.

PubMed

Abou-Elsaad, Tamer; Baz, Hemmat; Afsah, Omayma; Abo-Elsoud, Hend

2017-01-01

Measuring the severity of a voice disorder is difficult. This can be achieved by both subjective and objective measures. The Voice Handicap Index is the most known and used self-rating tool for voice disorders. The Classical Singing Handicap Index (CSHI) is a self-administered questionnaire measuring the impact of vocal deviation on the quality of life of singers. The objective of this study was to develop an Arabic version of the CSHI and to test its validity and reliability in Egyptian singers with different singing styles with normal voice and with voice disorders. The interpreted version was administered to 70 Egyptian singers including artistic singers (classical and popular) and specialized singers (Quran reciters and priests) who were divided into 40 asymptomatic singers (control group) and 30 singers with voice disorders. Participants' responses were statistically analyzed to assess the validity and reliability, and to compare the patient group with the control group. Quran reciters, patients with no previous professional training, and patients with vocal fold lesions demonstrated the highest scores. The Arabic version of CSHI is found to be a reliable, valid, and sensitive self-assessment tool that can be used in the clinical practice for the evaluation of the impact of voice disorders on singing voice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Objective speech quality assessment and the RPE-LTP coding algorithm in different noise and language conditions.

PubMed

Hansen, J H; Nandkumar, S

1995-01-01

The formulation of reliable signal processing algorithms for speech coding and synthesis require the selection of a prior criterion of performance. Though coding efficiency (bits/second) or computational requirements can be used, a final performance measure must always include speech quality. In this paper, three objective speech quality measures are considered with respect to quality assessment for American English, noisy American English, and noise-free versions of seven languages. The purpose is to determine whether objective quality measures can be used to quantify changes in quality for a given voice coding method, with a known subjective performance level, as background noise or language conditions are changed. The speech coding algorithm chosen is regular-pulse excitation with long-term prediction (RPE-LTP), which has been chosen as the standard voice compression algorithm for the European Digital Mobile Radio system. Three areas are considered for objective quality assessment which include: (i) vocoder performance for American English in a noise-free environment, (ii) speech quality variation for three additive background noise sources, and (iii) noise-free performance for seven languages which include English, Japanese, Finnish, German, Hindi, Spanish, and French. It is suggested that although existing objective quality measures will never replace subjective testing, they can be a useful means of assessing changes in performance, identifying areas for improvement in algorithm design, and augmenting subjective quality tests for voice coding/compression algorithms in noise-free, noisy, and/or non-English applications.

Is Menstrual Dysphonia Associated With Greater Disability and Lower Quality of Life?

PubMed

Barillari, Maria Rosaria; Volpe, Umberto; Innaro, Nadia; Barillari, Umberto

2016-01-01

The aim of the present study had been to examine the relationships between menstrual dysphonia and measures of psychosocial distress, in a sample of female professional voice users. This is a prospective study of 52 consecutive professional voice users, aged 18-40 years, affected by transient dysphonia related to the menstrual cycle and recruited in the Division of Phoniatrics and Audiology of the Second University of Naples, from April 2011 to September 2014. The following evaluation protocol was used: videoendoscopy, the GIRBAS scale, the Voice Handicap Index, and the determination of sexual hormonal plasma levels both during the menstrual and the luteal phase of the cycle. Furthermore, we measured, in all patients, the levels of perceived disability and quality of life during and after the dysphonia episodes by means of the Manchester Short Assessment of Quality of Life and the Sheehan disability scale. Laryngoscopic evaluation revealed that only minor morphologic changes were present during the first days of the follicular phase, usually returning to normal morphology after the menstrual period was over. However, we found that dysphonia episodes of varying degree were present in most evaluated subjects; women with a moderate degree of dysphonia also had a lower quality of life and greater overall disability, during menses. Despite minimal morphologic signs of laryngeal pathology, menstrual dysphonia might represent a disease which is frequent among female professional voice users, which in turn is associated with a certain degree of disability and lower quality of life during premenstrual and menstrual phases. Copyright © 2016. Published by Elsevier Inc.

The Role of Occupational Voice Demand and Patient-Rated Impairment in Predicting Voice Therapy Adherence.

PubMed

Ebersole, Barbara; Soni, Resha S; Moran, Kathleen; Lango, Miriam; Devarajan, Karthik; Jamal, Nausheen

2018-05-01

Examine the relationship among the severity of patient-perceived voice impairment, perceptual dysphonia severity, occupational voice demand, and voice therapy adherence. Identify clinical predictors of increased risk for therapy nonadherence. A retrospective cohort study of patients presenting with a chief complaint of persistent dysphonia at an interdisciplinary voice center was done. The Voice Handicap Index-10 (VHI-10) and the Voice-Related Quality of Life (V-RQOL) survey scores, clinician rating of dysphonia severity using the Grade score from the Grade, Roughness Breathiness, Asthenia, and Strain scale, occupational voice demand, and patient demographics were tested for associations with therapy adherence, defined as completion of the treatment plan. Classification and Regression Tree (CART) analysis was performed to establish thresholds for nonadherence risk. Of 166 patients evaluated, 111 were recommended for voice therapy. The therapy nonadherence rate was 56%. Occupational voice demand category, VHI-10, and V-RQOL scores were the only factors significantly correlated with therapy adherence (P < 0.0001, P = 0.018, and P = 0.008, respectively). CART analysis found that patients with low or no occupational voice demand are significantly more likely to be nonadherent with therapy than those with high occupational voice demand (P < 0.001). Furthermore, a VHI-10 score of ≤29 or a V-RQOL score of >40 is a significant cutoff point for predicting therapy nonadherence (P < 0.011 and P < 0.004, respectively). Occupational voice demand and patient perception of impairment are significantly and independently correlated with therapy adherence. A VHI-10 score of ≤9 or a V-RQOL score of >40 is a significant cutoff point for predicting nonadherence risk. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Relationship between Voice Complaints and Subjective and Objective Measures of Vocal Function in Iranian Female Teachers.

PubMed

Faham, Maryam; Jalilevand, Nahid; Torabinezhad, Farhad; Silverman, Erin Pearson; Ahmadi, Akram; Anaraki, Zahra Ghayoumi; Jafari, Narges

2017-07-01

Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints. Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)." Voice samples were collected during reading, counting, and vowel prolongation tasks. Teachers were also asked to document any voice symptoms they experienced. Voice samples were analyzed using Dr. Speech program (4th version; Tiger Ltd., USA), and labeled "normal" or "abnormal" according to the "grade" dimension "G" from GRBAS scale. Twenty-one teachers were assigned to the VC group based on self-assessment data. There were statistically significant differences between the two groups with regard to self-reported voice symptoms of hoarseness, breathiness, pitch breaks, and vocal fatigue (P < 0.05). Fourteen participants in the VC group and 40 from the W-VC group were determined to demonstrate "abnormal" vocal quality on perceptual assessment. Only harmonic-to-noise ratio was significantly higher for the W-VC group (ES = 0.55). Teachers with and without voice complaints differed in the incidence, but not type of voice symptoms. Teachers' voice complaints did not correspond to perceptual and acoustic measures. This suggests a potential unmet need for teachers to receive further education on voice disorders. Copyright © 2017 The Voice Foundation. All rights reserved.

Telemedicine using free voice over internet protocol (VoIP) technology.

PubMed

Miller, David J; Miljkovic, Nikola; Chiesa, Chad; Callahan, John B; Webb, Brad; Boedeker, Ben H

2011-01-01

Though dedicated videoteleconference (VTC) systems deliver high quality, low-latency audio and video for telemedical applications, they require expensive hardware and extensive infrastructure. The purpose of this study was to investigate free commercially available Voice over Internet Protocol (VoIP) software as a low cost alternative for telemedicine.

The Best College--Or the Best Fit?

ERIC Educational Resources Information Center

Crane, Patti

2003-01-01

Every year the college rankings in "U.S. News & World Report" raise voices disparaging the rankings' methods, validity and contribution to status-driven consumerism. Now, voices are rising against a September 2002 "Worth" magazine article, which ranks preparatory schools not according to the quality of education, but merely on which schools appear…

78 FR 30896 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

..., Associated Form and OMB Number: Interactive Customer Evaluation (ICE)/Enterprise Voice of the Customer (EVoC...)/ Enterprise Voice of the Customer (EVoC) System automates and minimizes the use of the current manual paper... service provider on the quality of their experience and their satisfaction level. This is a management...

Combined Functional Voice Therapy in Singers With Muscle Tension Dysphonia in Singing.

PubMed

Sielska-Badurek, Ewelina; Osuch-Wójcikiewicz, Ewa; Sobol, Maria; Kazanecka, Ewa; Rzepakowska, Anna; Niemczyk, Kazimierz

2017-07-01

The purpose of this study was to evaluate vocal tract function and the voice quality in singers with muscle tension dysphonia (MTD) after undergoing combined functional voice therapy of the singing voice. This is a prospective, randomized study. Forty singers (29 females and 11 males, mean age: 24.6 ± 8.8 years) with MTD were enrolled in the study. The study group consisted of 20 singers who underwent combined functional voice therapy (10-15 individual sessions, 30-40 minutes each). Singers who did not opt for vocal rehabilitation consisted of the control group. Effects of rehabilitation were assessed with videolaryngostroboscopy, palpation of the vocal tract structures, flexible fiberoptic evaluation of the pharynx and the larynx, perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, and the Voice Handicap Index. After combined functional voice therapy in the study group, great improvement was noticed in palpation of the vocal tract structures (P < 0.001), perceptual voice assessment (P < 0.001), phonetograms (P = 0.002), and singing range obtained from acoustic analysis of glissando (P < 0.001). In the control group, no statistically significant differences were found between the first and the second assessments. Combined functional voice therapy proved to be an efficacious treatment method in singers with MTD in singing. Development of palpation and perceptual singing voice examination protocols enables one to compare results before and after rehabilitation in clinics. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Modulation of voice related to tremor and vibrato

NASA Astrophysics Data System (ADS)

Lester, Rosemary Anne

Modulation of voice is a result of physiologic oscillation within one or more components of the vocal system including the breathing apparatus (i.e., pressure supply), the larynx (i.e. sound source), and the vocal tract (i.e., sound filter). These oscillations may be caused by pathological tremor associated with neurological disorders like essential tremor or by volitional production of vibrato in singers. Because the acoustical characteristics of voice modulation specific to each component of the vocal system and the effect of these characteristics on perception are not well-understood, it is difficult to assess individuals with vocal tremor and to determine the most effective interventions for reducing the perceptual severity of the disorder. The purpose of the present studies was to determine how the acoustical characteristics associated with laryngeal-based vocal tremor affect the perception of the magnitude of voice modulation, and to determine if adjustments could be made to the voice source and vocal tract filter to alter the acoustic output and reduce the perception of modulation. This research was carried out using both a computational model of speech production and trained singers producing vibrato to simulate laryngeal-based vocal tremor with different voice source characteristics (i.e., vocal fold length and degree of vocal fold adduction) and different vocal tract filter characteristics (i.e., vowel shapes). It was expected that, by making adjustments to the voice source and vocal tract filter that reduce the amplitude of the higher harmonics, the perception of magnitude of voice modulation would be reduced. The results of this study revealed that listeners' perception of the magnitude of modulation of voice was affected by the degree of vocal fold adduction and the vocal tract shape with the computational model, but only by the vocal quality (corresponding to the degree of vocal fold adduction) with the female singer. Based on regression analyses, listeners' judgments were predicted by modulation information in both low and high frequency bands. The findings from these studies indicate that production of a breathy vocal quality might be a useful compensatory strategy for reducing the perceptual severity of modulation of voice for individuals with tremor affecting the larynx.

Rating, ranking, and understanding acoustical quality in university classrooms

NASA Astrophysics Data System (ADS)

Hodgson, Murray

2002-08-01

Nonoptimal classroom acoustical conditions directly affect speech perception and, thus, learning by students. Moreover, they may lead to voice problems for the instructor, who is forced to raise his/her voice when lecturing to compensate for poor acoustical conditions. The project applied previously developed simplified methods to predict speech intelligibility in occupied classrooms from measurements in unoccupied and occupied university classrooms. The methods were used to predict the speech intelligibility at various positions in 279 University of British Columbia (UBC) classrooms, when 70% occupied, and for four instructor voice levels. Classrooms were classified and rank ordered by acoustical quality, as determined by the room-average speech intelligibility. This information was used by UBC to prioritize classrooms for renovation. Here, the statistical results are reported to illustrate the range of acoustical qualities found at a typical university. Moreover, the variations of quality with relevant classroom acoustical parameters were studied to better understand the results. In particular, the factors leading to the best and worst conditions were studied. It was found that 81% of the 279 classrooms have "good," "very good," or "excellent" acoustical quality with a "typical" (average-male) instructor. However, 50 (18%) of the classrooms had "fair" or "poor" quality, and two had "bad" quality, due to high ventilation-noise levels. Most rooms were "very good" or "excellent" at the front, and "good" or "very good" at the back. Speech quality varied strongly with the instructor voice level. In the worst case considered, with a quiet female instructor, most of the classrooms were "bad" or "poor." Quality also varies with occupancy, with decreased occupancy resulting in decreased quality. The research showed that a new classroom acoustical design and renovation should focus on limiting background noise. They should promote high instructor speech levels at the back of the classrooms. This involves, in part, limiting the amount of sound absorption that is introduced into classrooms to control reverberation. Speech quality is not very sensitive to changes in reverberation, so controlling it for its own sake should not be a design priority. copyright 2002 Acoustical Society of America.

Voice disorder in systemic lupus erythematosus

PubMed Central

de Macedo, Milena S. F. C.; da Silva Filho, Manoel

2017-01-01

Systemic lupus erythematosus (SLE) is a chronic disease characterized by progressive tissue damage. In recent decades, novel treatments have greatly extended the life span of SLE patients. This creates a high demand for identifying the overarching symptoms associated with SLE and developing therapies that improve their life quality under chronic care. We hypothesized that SLE patients would present dysphonic symptoms. Given that voice disorders can reduce life quality, identifying a potential SLE-related dysphonia could be relevant for the appraisal and management of this disease. We measured objective vocal parameters and perceived vocal quality with the GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) scale in SLE patients and compared them to matched healthy controls. SLE patients also filled a questionnaire reporting perceived vocal deficits. SLE patients had significantly lower vocal intensity and harmonics to noise ratio, as well as increased jitter and shimmer. All subjective parameters of the GRBAS scale were significantly abnormal in SLE patients. Additionally, the vast majority of SLE patients (29/36) reported at least one perceived vocal deficit, with the most prevalent deficits being vocal fatigue (19/36) and hoarseness (17/36). Self-reported voice deficits were highly correlated with altered GRBAS scores. Additionally, tissue damage scores in different organ systems correlated with dysphonic symptoms, suggesting that some features of SLE-related dysphonia are due to tissue damage. Our results show that a large fraction of SLE patients suffers from perceivable dysphonia and may benefit from voice therapy in order to improve quality of life. PMID:28414781

Listening to Schneiderian Voices: A Novel Phenomenological Analysis

PubMed Central

Rosen, Cherise; Chase, Kayla A.; Jones, Nev; Grossman, Linda S.; Gin, Hannah; Sharma, Rajiv P.

2016-01-01

Background/Aims This paper reports on analyses designed to elucidate phenomenological characteristics, content and experience specifically targeting participants with Schneiderian voices conversing/commenting (VC) while exploring difference in clinical presentation and quality of life compared to those with voices not conversing (VNC). Methods This mixed-method investigation of Schneiderian voices included standardized clinical metrics and exploratory phenomenological interviews designed to elicit in-depth information about characteristics, content, meaning and personification of AVHs. Results The subjective experience of VC show a striking pattern of VC that are experienced as internal at initial onset and during longer-term course of illness when compared to the VNC group. Participants in the VC group were more likely to attribute origins of their voices to an external source such as God, telepathic communication, or mediumistic sources. VC and VNC were described as characterological entities that were distinct from self (I/we versus you). We also found an association between VC and positive, cognitive, and depression symptom profile. However, we did not find a significant group difference in overall quality of life. Conclusions The clinical portrait of VC is complex, multisensory, and distinct, and suggests a need for further research into biopsychosocial interface between subjective experience, socioenvironmental constraints, individual psychology, and biological architecture of intersecting symptoms. PMID:27304081

Synchronous electrical stimulation of laryngeal muscles: an alternative for enhancing recovery of unilateral recurrent laryngeal nerve paralysis.

PubMed

Garcia Perez, Alejandro; Hernández López, Xochiquetzal; Valadez Jiménez, Víctor Manuel; Minor Martínez, Arturo; Ysunza, Pablo Antonio

2014-07-01

Although electrical stimulation of the larynx has been widely studied for treating voice disorders, its effectiveness has not been assessed under safety and comfortable conditions. This article describes design, theoretical issues, and preliminary evaluation of an innovative system for transdermal electrical stimulation of the larynx. The proposed design includes synchronization of electrical stimuli with laryngeal neuromuscular activity. To study whether synchronous electrical stimulation of the larynx could be helpful for improving voice quality in patients with dysphonia due to unilateral recurrent laryngeal nerve paralysis (URLNP). A 3-year prospective study was carried out at the Instituto Nacional de Rehabilitacion in the Mexico City. Ten patients were subjected to transdermal current electrical stimulation synchronized with the fundamental frequency of the vibration of the vocal folds during phonation. The stimulation was triggered during the phase of maximum glottal occlusion. A complete acoustic voice analysis was performed before and after the period of electrical stimulation. Acoustic analysis revealed significant improvements in all parameters after the stimulation period. Transdermal synchronous electrical stimulation of vocal folds seems to be a safe and reliable procedure for enhancing voice quality in patients with (URLNP). Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Comparative effectiveness of propranolol and botulinum for the treatment of essential voice tremor.

PubMed

Justicz, Natalie; Hapner, Edie R; Josephs, Joshua S; Boone, Benjamin C; Jinnah, Hyder A; Johns, Michael M

2016-01-01

To assess the comparative effectiveness of botulinum toxin and propranolol in patients with essential vocal tremor (EVT). Individual prospective cohort study. Study patients were recruited at the Emory Voice Center from patients seeking treatment for EVT. Exclusion criteria included current β-blocker treatment, spasmodic dysphonia, or other disease that prevented the use of propranolol therapy. A 10-week washout period from prior botulinum toxin treatment occurred before enrollment. Patients were assessed via the Voice-Related Quality-Of-Life (VRQOL) questionnaire, Quality of life in Essential Tremor questionnaire, and blinded perceptual voice assessment. These assessments were made at baseline voice 2 weeks after propranolol therapy and 4 weeks after botulinum toxin injection. Eighteen patients were enrolled. After 2 to 4 weeks of propranolol therapy (with a maximum dosage of 60 mg to 90 mg per day), patients report an average ΔVRQOL of 9.31. Six patients report significant VRQOL improvement >10, with the rest reporting changes between -7.5 and 7.5. Fifteen patients were followed for at least 4 weeks after botulinum toxin injection, reporting an average improvement in scaled VRQOL of 22.00. Blinded perceptual voice assessment demonstrates an improvement in overall severity of tremor with botulinum toxin. In some patients with EVT, propranolol led to significant vocal improvement with no major side effects. Although botulinum toxin remains the gold-standard therapy for patients with EVT, propranolol represents a possible alternative or adjuvant therapy for certain patients. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Comparative Effectiveness of Propranolol and Botulinum for the Treatment of Essential Voice Tremor

PubMed Central

Justicz, Natalie; Hapner, Edie R.; Josephs, Joshua S.; Boone, Benjamin C.; Jinnah, Hyder A.; Johns, Michael M.

2016-01-01

Objectives/Hypothesis To assess the comparative effectiveness of botulinum toxin and propranolol in patients with essential vocal tremor (EVT). Study Design Individual prospective cohort study. Methods Study patients were recruited at the Emory Voice Center from patients seeking treatment for EVT. Exclusion criteria included current β-blocker treatment, spasmodic dysphonia, or other disease that prevented the use of propranolol therapy. A 10-week washout period from prior botulinum toxin treatment occurred before enrollment. Patients were assessed via the Voice-Related Quality-Of-Life (VRQOL) questionnaire, Quality of life in Essential Tremor questionnaire, and blinded perceptual voice assessment. These assessments were made at baseline voice 2 weeks after propranolol therapy and 4 weeks after botulinum toxin injection. Results Eighteen patients were enrolled. After 2 to 4 weeks of propranolol therapy (with a maximum dosage of 60 mg to 90 mg per day), patients report an average ΔVRQOL of 9.31. Six patients report significant VRQOL improvement >10, with the rest reporting changes between −7.5 and 7.5. Fifteen patients were followed for at least 4 weeks after botulinum toxin injection, reporting an average improvement in scaled VRQOL of 22.00. Blinded perceptual voice assessment demonstrates an improvement in overall severity of tremor with botulinum toxin. Conclusions In some patients with EVT, propranolol led to significant vocal improvement with no major side effects. Although botulinum toxin remains the gold-standard therapy for patients with EVT, propranolol represents a possible alternative or adjuvant therapy for certain patients. PMID:26198384

[Acoustic characteristics of adductor spasmodic dysphonia].

PubMed

Yang, Yang; Wang, Li-Ping

2008-06-01

To explore the acoustic characteristics of adductor spasmodic dysphonia. The acoustic characteristics, including acoustic signal of recorded voice, three-dimensional sonogram patterns and subjective assessment of voice, between 10 patients (7 women, 3 men) with adductor spasmodic dysphonia and 10 healthy volunteers (5 women, 5 men), were compared. The main clinical manifestation of adductor spasmodic dysphonia included the disorders of sound quality, rhyme and fluency. It demonstrated the tension dysphonia when reading, acoustic jitter, momentary fluctuation of frequency and volume, voice squeezing, interruption, voice prolongation, and losing normal chime. Among 10 patients, there were 1 mild dysphonia (abnormal syllable number < 25%), 6 moderate dysphonia (abnormal syllable number 25%-49%), 1 severe dysphonia (abnormal syllable number 50%-74%) and 2 extremely severe dysphonia (abnormal syllable number > or = 75%). The average reading time in 10 patients was 49 s, with reading time extension and aphasia area interruption in acoustic signals, whereas the average reading time in health control group was 30 s, without voice interruption. The aphasia ratio averaged 42%. The respective symptom syllable in different patients demonstrated in the three-dimensional sonogram. There were voice onset time prolongation, irregular, interrupted and even absent vowel formants. The consonant of symptom syllables displayed absence or prolongation of friction murmur in the block-friction murmur occasionally. The acoustic characteristics of adductor spasmodic dysphonia is the disorders of sound quality, rhyme and fluency. The three-dimensional sonogram of the symptom syllables show distinctive changes of proportional vowels or consonant phonemes.

Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery.

PubMed

Couch, Stephanie; Zieba, Dominique; Van der Linde, Jeannie; Van der Merwe, Anita

2015-03-26

As a professional voice user, it is imperative that a speech-language pathologist's(SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours,poor vocal hygiene and environmental factors. To determine the effect of service delivery on the perceptual and acoustic features of voice. A quasi-experimental., pre-test-post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria(South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.

Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

PubMed Central

Couch, Stephanie; Zieba, Dominique; van der Merwe, Anita

2015-01-01

Background As a professional voice user, it is imperative that a speech-language pathologist's (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. Objectives To determine the effect of service delivery on the perceptual and acoustic features of voice. Method A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. Results A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Conclusion Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested. PMID:26304213

Whispering - The hidden side of auditory communication.

PubMed

Frühholz, Sascha; Trost, Wiebke; Grandjean, Didier

2016-11-15

Whispering is a unique expression mode that is specific to auditory communication. Individuals switch their vocalization mode to whispering especially when affected by inner emotions in certain social contexts, such as in intimate relationships or intimidating social interactions. Although this context-dependent whispering is adaptive, whispered voices are acoustically far less rich than phonated voices and thus impose higher hearing and neural auditory decoding demands for recognizing their socio-affective value by listeners. The neural dynamics underlying this recognition especially from whispered voices are largely unknown. Here we show that whispered voices in humans are considerably impoverished as quantified by an entropy measure of spectral acoustic information, and this missing information needs large-scale neural compensation in terms of auditory and cognitive processing. Notably, recognizing the socio-affective information from voices was slightly more difficult from whispered voices, probably based on missing tonal information. While phonated voices elicited extended activity in auditory regions for decoding of relevant tonal and time information and the valence of voices, whispered voices elicited activity in a complex auditory-frontal brain network. Our data suggest that a large-scale multidirectional brain network compensates for the impoverished sound quality of socially meaningful environmental signals to support their accurate recognition and valence attribution. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Ambulatory Voice Monitoring to Investigate Common Voice Disorders: Research Update

PubMed Central

Mehta, Daryush D.; Van Stan, Jarrad H.; Zañartu, Matías; Ghassemi, Marzyeh; Guttag, John V.; Espinoza, Víctor M.; Cortés, Juan P.; Cheyne, Harold A.; Hillman, Robert E.

2015-01-01

Many common voice disorders are chronic or recurring conditions that are likely to result from inefficient and/or abusive patterns of vocal behavior, referred to as vocal hyperfunction. The clinical management of hyperfunctional voice disorders would be greatly enhanced by the ability to monitor and quantify detrimental vocal behaviors during an individual’s activities of daily life. This paper provides an update on ongoing work that uses a miniature accelerometer on the neck surface below the larynx to collect a large set of ambulatory data on patients with hyperfunctional voice disorders (before and after treatment) and matched-control subjects. Three types of analysis approaches are being employed in an effort to identify the best set of measures for differentiating among hyperfunctional and normal patterns of vocal behavior: (1) ambulatory measures of voice use that include vocal dose and voice quality correlates, (2) aerodynamic measures based on glottal airflow estimates extracted from the accelerometer signal using subject-specific vocal system models, and (3) classification based on machine learning and pattern recognition approaches that have been used successfully in analyzing long-term recordings of other physiological signals. Preliminary results demonstrate the potential for ambulatory voice monitoring to improve the diagnosis and treatment of common hyperfunctional voice disorders. PMID:26528472

Voice and choice by delegation.

PubMed

van de Bovenkamp, Hester; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

2013-02-01

In many Western countries, options for citizens to influence public services are increased to improve the quality of services and democratize decision making. Possibilities to influence are often cast into Albert Hirschman's taxonomy of exit (choice), voice, and loyalty. In this article we identify delegation as an important addition to this framework. Delegation gives individuals the chance to practice exit/choice or voice without all the hard work that is usually involved in these options. Empirical research shows that not many people use their individual options of exit and voice, which could lead to inequality between users and nonusers. We identify delegation as a possible solution to this problem, using Dutch health care as a case study to explore this option. Notwithstanding various advantages, we show that voice and choice by delegation also entail problems of inequality and representativeness.

Subjective and objective voice evaluation in Sjögren's syndrome.

PubMed

Saltürk, Ziya; Özdemir, Erdi; Kumral, Tolgar Lütfi; Karabacakoğlu, Zeynep; Kumral, Esra; Yildiz, Hatice Elvin; Mersinlioğlu, Gökhan; Atar, Yavuz; Berkiten, Güler; Yildirim, Güven; Uyar, Yavuz

2017-04-01

Objective The aim of this study is to assess the subjective and objective aspects of voice in Sjögren's syndrome. Methods The study enrolled 10 women with Sjögren's syndrome and 12 healthy women. Maximum phonation time, fundamental frequency, jitter, shimmer, and noise-to-harmonics ratio were determined during acoustic voice analysis. The Stroboscopy Evaluation Rating Form was used for the laryngostroboscopic evaluation. A subjective evaluation was performed using the Turkish version of Voice Handicap Index-10. Results The mean age of the Sjögren's syndrome and control groups was 46 ± 13.89 and 41.27 ± 6.99 years, respectively, and did not differ (P = 0.131). In the laryngostroboscopic evaluation, the smoothness and straightness of vocal folds, regularity, and glottal closure differed significantly. In the acoustic and aerodynamic analyses, none of the parameters differed statistically, while the Sjögren's syndrome group had significantly higher Voice Handicap Index-10 scores than the controls. Conclusion Sjögren's syndrome affects the voice and voice quality.

Assessment of voice and speech symptoms in early Parkinson's disease by the Robertson dysarthria profile.

PubMed

Defazio, Giovanni; Guerrieri, Marta; Liuzzi, Daniele; Gigante, Angelo Fabio; di Nicola, Vincenzo

2016-03-01

Changes in voice and speech are thought to involve 75-90% of people with PD, but the impact of PD progression on voice/speech parameters is not well defined. In this study, we assessed voice/speech symptoms in 48 parkinsonian patients staging <3 on the modified Hoehn and Yahr scale and 37 healthy subjects using the Robertson dysarthria profile (a clinical-perceptual method exploring all components potentially involved in speech difficulties), the Voice handicap index (a validated measure of the impact of voice symptoms on quality of life) and the speech evaluation parameter contained in the Unified Parkinson's Disease Rating Scale part III (UPDRS-III). Accuracy and metric properties of the Robertson dysarthria profile were also measured. On Robertson dysarthria profile, all parkinsonian patients yielded lower scores than healthy control subjects. Differently, the Voice Handicap Index and the speech evaluation parameter contained in the UPDRS-III could detect speech/voice disturbances in 10 and 75% of PD patients, respectively. Validation procedure in Parkinson's disease patients showed that the Robertson dysarthria profile has acceptable reliability, satisfactory internal consistency and scaling assumptions, lack of floor and ceiling effects, and partial correlations with UPDRS-III and Voice Handicap Index. We concluded that speech/voice disturbances are widely identified by the Robertson dysarthria profile in early parkinsonian patients, even when the disturbances do not carry a significant level of disability. Robertson dysarthria profile may be a valuable tool to detect speech/voice disturbances in Parkinson's disease.

Training the Speaking Voice through Singing.

ERIC Educational Resources Information Center

Sipley, Kenneth L.

Speech teachers and singing teachers have much in common. Both attempt in their teaching to develop the most powerful and effective instrument possible while trying to avoid vocal problems. Both have studied the physiology of the vocal mechanism to assist them in their teaching. Both are concerned with the expressive qualities of the voice as well…

Office-based Autologous Fat Injection Laryngoplasty for Vocal Process Granuloma.

PubMed

Hu, Hao-Chun; Hung, Yi-Ting; Lin, Shu-Yi; Chang, Shyue-Yih

2016-11-01

To present the outcomes of office-based autologous fat injection laryngoplasty for the treatment of vocal process granuloma in conjunction with glottic insufficiency. Retrospective chart review. This study included nine patients with vocal process granuloma in conjunction with glottic insufficiency who received autologous fat injection laryngoplasty. Videolaryngostroboscopic data, objective voice assessment, perceptual measurements of vocal quality, and subjective ratings of voice quality were examined before and after treatment. Of the nine patients, seven (78%) exhibited complete remission. The other two patients (22%) exhibited a partial response following the injection. In a subgroup of five patients who were refractory to antireflux and voice therapies, the resolution rate was 60%. Phonatory function presented significant improvements in jitter, noise-to-harmonic ratio, maximal phonation time, and asthenia. Videolaryngostroboscopic rating revealed significant improvements in closure phase ratio in the vibratory cycle. Autologous fat injection laryngoplasty can ameliorate glottic insufficiency and the resulting hyperfunctional behavior of the larynx. This therapy also encourages remission of vocal process granuloma and may represent an alternative treatment strategy. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

What can vortices tell us about vocal fold vibration and voice production.

PubMed

Khosla, Sid; Murugappan, Shanmugam; Gutmark, Ephraim

2008-06-01

Much clinical research on laryngeal airflow has assumed that airflow is unidirectional. This review will summarize what additional knowledge can be obtained about vocal fold vibration and voice production by studying rotational motion, or vortices, in laryngeal airflow. Recent work suggests two types of vortices that may strongly contribute to voice quality. The first kind forms just above the vocal folds during glottal closing, and is formed by flow separation in the glottis; these flow separation vortices significantly contribute to rapid closing of the glottis, and hence, to producing loudness and high frequency harmonics in the acoustic spectrum. The second is a group of highly three-dimensional and coherent supraglottal vortices, which can produce sound by interaction with structures in the vocal tract. Present work is also described that suggests that certain laryngeal pathologies, such as asymmetric vocal fold tension, will significantly modify both types of vortices, with adverse impact on sound production: decreased rate of glottal closure, increased broadband noise, and a decreased signal to noise ratio. Recent research supports the hypothesis that glottal airflow contains certain vortical structures that significantly contribute to voice quality.

The interaction of criminal procedure and outcome.

PubMed

Laxminarayan, Malini; Pemberton, Antony

2014-01-01

Procedural quality is an important aspect of crime victims' experiences in criminal proceedings and consists of different dimensions. Two of these dimensions are procedural justice (voice) and interpersonal justice (respectful treatment). Social psychological research has suggested that both voice and respectful treatment are moderated by the impact of outcomes of justice procedures on individuals' reactions. To add to this research, we extend this assertion to the criminal justice context, examining the interaction between the assessment of procedural quality and outcome favorability with victim's trust in the legal system and self-esteem. Hierarchical regression analyses reveal that voice, respectful treatment and outcome favorability are predictive of trust in the legal system and self-esteem. Further investigation reveals that being treated with respect is only related to trust in the legal system when outcome favorability is high. Copyright © 2014 Elsevier Ltd. All rights reserved.

Comparison of Acoustic and Stroboscopic Findings and Voice Handicap Index between Allergic Rhinitis Patients and Controls.

PubMed

Koç, Eltaf Ayça Özbal; Koç, Bülent; Erbek, Selim

2014-12-01

In our experience Allergic Rhinitis (AR) patients suffer from voice problems more than health subjects. To investigate the acoustic analysis of voice, stroscopic findings of larynx and Voice Handicap Index scores in allergic rhinitis patients compared with healthy controls. Case-control study. Thirty adult patients diagnosed with perennial allergic rhinitis were compared with 30 age- and sex-matched healthy controls without allergy. All assessments were performed in the speech physiology laboratory and the testing sequence was as follows: 1. Voice Handicap Index (VHI) questionnaire, 2. Laryngovideostroboscopy, 3. Acoustic analyses. No difference was observed between the allergic rhinitis and control groups regarding mean Maximum Phonation Time (MPT) values, Fo values, and stroboscopic assessment (p>0.05). On the other hand, mean VHI score (p=0.001) and s/z ratio (p=0.011) were significantly higher in the allergic rhinitis group than in controls. Our findings suggest that the presence of allergies could have effects on laryngeal dysfunction and voice-related quality of life.

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users

PubMed Central

Koller, Roger; Guignard, Jérémie; Caversaccio, Marco; Kompis, Martin; Senn, Pascal

2017-01-01

Background Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users. Objective We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions. Methods Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS). Results Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001). Conclusions Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality. PMID:28438727

Influence of Telecommunication Modality, Internet Transmission Quality, and Accessories on Speech Perception in Cochlear Implant Users.

PubMed

Mantokoudis, Georgios; Koller, Roger; Guignard, Jérémie; Caversaccio, Marco; Kompis, Martin; Senn, Pascal

2017-04-24

Telecommunication is limited or even impossible for more than one-thirds of all cochlear implant (CI) users. We sought therefore to study the impact of voice quality on speech perception with voice over Internet protocol (VoIP) under real and adverse network conditions. Telephone speech perception was assessed in 19 CI users (15-69 years, average 42 years), using the German HSM (Hochmair-Schulz-Moser) sentence test comparing Skype and conventional telephone (public switched telephone networks, PSTN) transmission using a personal computer (PC) and a digital enhanced cordless telecommunications (DECT) telephone dual device. Five different Internet transmission quality modes and four accessories (PC speakers, headphones, 3.5 mm jack audio cable, and induction loop) were compared. As a secondary outcome, the subjective perceived voice quality was assessed using the mean opinion score (MOS). Speech telephone perception was significantly better (median 91.6%, P<.001) with Skype compared with PSTN (median 42.5%) under optimal conditions. Skype calls under adverse network conditions (data packet loss > 15%) were not superior to conventional telephony. In addition, there were no significant differences between the tested accessories (P>.05) using a PC. Coupling a Skype DECT phone device with an audio cable to the CI, however, resulted in higher speech perception (median 65%) and subjective MOS scores (3.2) than using PSTN (median 7.5%, P<.001). Skype calls significantly improve speech perception for CI users compared with conventional telephony under real network conditions. Listening accessories do not further improve listening experience. Current Skype DECT telephone devices do not fully offer technical advantages in voice quality. ©Georgios Mantokoudis, Roger Koller, Jérémie Guignard, Marco Caversaccio, Martin Kompis, Pascal Senn. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.04.2017.

Transmasculine people's vocal situations: a critical review of gender-related discourses and empirical data.

PubMed

Azul, David

2015-01-01

Transmasculine people assigned female sex at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Some voice researchers and clinicians suggest that transmasculine people do not need attention because testosterone treatment leads to a satisfactory masculinization of their voice organs and voices. Others, however, argue that transmasculine people are a heterogeneous group whose members might not share the same body type, gender identity or desire for medical approaches to gender transitioning. Therefore, testosterone-induced voice changes may not necessarily meet the needs and expectations of all transmasculine people. To evaluate the gender-related discursive and empirical data about transmasculine people's vocal situations to identify gaps in the current state of knowledge and to make suggestions for future voice research and clinical practice. A comprehensive review of peer-reviewed academic and clinical literature was conducted. Publications were identified by searching seven electronic databases and bibliographies of relevant articles. Thirty-one publications met inclusion criteria. Discourses and empirical data were analysed thematically. Potential problem areas that transmasculine people may experience were identified and the quality of evidence appraised. The extent and quality of voice research conducted with transmasculine people so far was found to be limited. There was mixed evidence to suggest that transmasculine people's vocal situations could be regarded as problematic. The diversity that characterizes the transmasculine population received little attention and the complexity of the factors that contribute to a successful or unsuccessful vocal communication of gender in this group appeared to be under-researched. While most transmasculine people treated with testosterone can expect a lowering of their pitch, it remains unclear whether the extent of the pitch change is enough to result in a voice that is recognized by others as male. More research into the different factors affecting transmasculine people's vocal situations that takes account of the diversity within the population is needed. © 2014 Royal College of Speech and Language Therapists.

Tracheoesophageal Prosthesis Use Is Associated With Improved Overall Quality of Life in Veterans With Laryngeal Cancer.

PubMed

Patel, Ramya S; Mohr, Tiffany; Hartman, Christine; Stach, Carol; Sikora, Andrew G; Zevallos, Jose P; Sandulache, Vlad C

2018-05-01

Veterans have an increased risk of laryngeal cancer, yet their oncologic and functional outcomes remain understudied. We sought to determine the longitudinal impact of tracheoesophageal puncture and voice prosthesis on quality-of-life measures in veterans following total laryngectomy (TL). We performed a cross-sectional analysis of TL patients (n = 68) treated at the Michael E. DeBakey Veterans Affairs Medical Center using the Voice Handicap Index (VHI), MD Anderson Dysphagia Index (MDADI), and University of Washington Quality of Life Index (UW-QOL). Using tracheoesophageal (TE) speech was associated with significantly better VHI, MDADI, and UW-QOL scores compared to other forms of communication. The association between TE speech use on VHI, MDADI, and UQ-QOL persisted even when the analysis was limited to patients with >5-year follow-up and was maintained on multivariate analysis that accounted for a history of radiation and laryngectomy for recurrent laryngeal cancer. Using tracheoesophageal speech after total laryngectomy is associated with durable improvements in quality of life and functional outcomes in veterans. Tracheoesophageal voice restoration should be attempted whenever technically feasible in patients that meet the complex psychosocial and physical requirements to appropriately utilize TE speech.

Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis.

PubMed

Shi, J; Chen, S; Chen, D; Wang, W; Xia, S; Zheng, H

2011-02-01

(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life. Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated. Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient. Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Quality of life of patients with recurrent respiratory papillomatosis.

PubMed

San Giorgi, Michel R M; Aaltonen, Leena-Maija; Rihkanen, Heikki; Tjon Pian Gi, Robin E A; van der Laan, Bernard F A M; Hoekstra-Weebers, Josette E H M; Dikkers, Frederik G

2017-08-01

Recurrent respiratory papillomatosis (RRP) is a disease with a high disease burden. Few studies have assessed quality of life (QoL) of RRP patients. This study compares QoL of these patients with controls. Associations between QoL and sociodemographic and illness-related factors are examined, as is uptake of psychosocial care and speech therapy. Prospective cross-sectional questionnaire research. Ninety-one RRP patients (response = 67%) from two university hospitals in the Netherlands and Finland completed the following patient reported outcome measures: (HADS), 15-dimensional health-related quality-of-life scale (15D), Voice Handicap Index (VHI) and the RAND 36-item health-related quality-of-life survey instrument (RAND-36) assessing health-related QoL and voice handicap, and they provided sociodemographic, illness-related, and allied healthcare use. Descriptive analyses, χ 2 tests, t tests, analysis of variance tests, and Pearson correlations were computed to describe the study population and to examine differences between groups. RRP patients had significantly higher mean scores on depression, health-related QoL (15D) and on voice problems (VHI), and significantly lower mean scores on anxiety than controls. Dutch patients had more pain and a decreased general health perception (RAND-36) than controls. Dutch patients and older patients were more depressed, women were more anxious, older patients had lower health-related QoL, and smoking was significantly associated with voice handicap. Patients who had received psychosocial care had significantly higher HADS-depression mean scores than patients who did not receive psychosocial care. Having RRP has significant effect on voice-related QoL and depression, but has no negative effect on anxiety and health-related QoL. Risk factors for decreased functioning are different than previously hypothesized by many authors. Prevention should be aimed at these risk factors. 4. Laryngoscope, 127:1826-1831, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Voice Quality Modelling for Expressive Speech Synthesis

PubMed Central

Socoró, Joan Claudi

2014-01-01

This paper presents the perceptual experiments that were carried out in order to validate the methodology of transforming expressive speech styles using voice quality (VoQ) parameters modelling, along with the well-known prosody (F 0, duration, and energy), from a neutral style into a number of expressive ones. The main goal was to validate the usefulness of VoQ in the enhancement of expressive synthetic speech in terms of speech quality and style identification. A harmonic plus noise model (HNM) was used to modify VoQ and prosodic parameters that were extracted from an expressive speech corpus. Perception test results indicated the improvement of obtained expressive speech styles using VoQ modelling along with prosodic characteristics. PMID:24587738

Emirati Teachers' Perceptions of Voice Handicap.

PubMed

Natour, Yaser S; Sartawi, Abdealaziz M; Al Muhairy, Ousha; Efthymiou, Effie; Marie, Basem S

2016-05-01

The purpose of the study was to explore Emirati teachers' perceptions of voice handicap and to analyze their acoustic characteristics to determine whether acoustic measures of teachers' voice would verify their perceptions of voice handicap. Sixty-six Emirati school teachers (33 men and 33 women), with different years of teaching experience and age, and 100 control participants (50 men and 50 women) underwent vocal assessment that included the Voice Handicap Index (VHI-Arab) and acoustic measures (F0, jitter%, shimmer%, signal to noise ratio [SNR]). Significant differences between the teachers' group scores and the control group scores on the following subscales of VHI-Arab: physical (P = 0.006), emotional (P = 0.004), and total score of the test (P = 0.002). No significant differences were found among teachers in the three VHI subscales, and the total score regarding gender (functional P = 0.307; physical P = 0.341; emotional P = 0.126; and total P = 0.184), age (functional P = 0.972; physical P = 0.525; emotional P = 0.772; and total P = 0.848), and years of teaching experience (functional P = 0.319; physical P = 0.619; emotional P = 0.926; and total P = 0.638). The significant differences between the teacher's group and the control group in three acoustic measures: F0 (P = 0.000), shimmer% (P = 0.000), and SNR (P = 0.000) were further investigated. Significant differences were found among female and male teachers in F0 (P = 0.00) and SNR (P = 0.007). As for teachers' age, significant differences were found in SNR (P = 0.028). Teachers' years of experience did not show significant differences in any of the acoustic measures. Teachers have a higher perception of voice handicap. However, they were able to produce better voice quality than control participants were, as expressed in better SNRs. This might have been caused either by manipulation of vocal properties or abusive overloading the vocal system to produce a procedurally acceptable voice quality. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice problems of group fitness instructors: diagnosis, treatment, perceived and experienced attitudes and expectations of the industry.

PubMed

Rumbach, Anna F

2013-11-01

To determine the anatomical and physiological nature of voice problems and their treatment in those group fitness instructors (GFIs) who have sought a medical diagnosis; the impact of voice disorders on quality of life and their contribution to activity limitations and participation restrictions; and the perceived attitudes and level of support from the industry at large in response to instructor's voice disorders and need for treatment. Prospective self-completion questionnaire design. Thirty-eight individuals (3 males and 35 females) currently active in the Australian fitness industry who had been diagnosed with a voice disorder completed an online self-completion questionnaire administered via SurveyMonkey. Laryngeal pathology included vocal fold nodules (N = 24), vocal fold cysts (N = 2), vocal fold hemorrhage (N = 1), and recurrent chronic laryngitis (N = 3). Eight individuals reported vocal strain and muscle tension dysphonia without concurrent vocal fold pathology. Treatment methods were variable, with 73.68% (N = 28) receiving voice therapy alone, 7.89% (N = 3) having voice therapy in combination with surgery, and 10.53% (N = 4) having voice therapy in conjunction with medication. Three individuals (7.89%) received no treatment for their voice disorder. During treatment, 82% of the cohort altered their teaching practices. Half of the cohort reported that their voice problems led to social withdrawal, decreased job satisfaction, and emotional distress. Greater than 65% also reported being dissatisfied with the level of industry and coworker support during the period of voice recovery. This study identifies that GFIs are susceptible to a number of voice disorders that impact their social and professional lives, and there is a need for more proactive training and advice on voice care for instructors, as well as those in management positions within the industry to address mixed approaches and opinions regarding the importance of voice care. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

An efficient protocol for providing integrated voice/data services to mobiles over power-limited satellite channels

NASA Astrophysics Data System (ADS)

Bose, Sanjay K.

1991-02-01

Various mobile satellite communication systems are being developed for providing integrated voice/data services over a shared satellite transponder which is power-limited in nature. A common strategy is to use slotted ALOHA request channels to request channel assignments for voice/data calls from a network management station. To maximize efficiency in a system with a power-limited satellite transponder, it is proposed that the bursty nature of voice sources be exploited by the NMS to 'over-assign' channels. This may cause problems of inefficiency and potential instability, as well as a degradation in the quality of service. Augmenting this with the introduction of simple state-dependent control procedures provides systems which exhibit more desirable operational features.

Trans Male Voice in the First Year of Testosterone Therapy: Make No Assumptions

ERIC Educational Resources Information Center

Hancock, Adrienne B.; Childs, Kayla D.; Irwig, Michael S.

2017-01-01

Purpose: The purpose of this study was to prospectively examine changes in gender-related voice domain of pitch measured by fundamental frequency, function-related domains of vocal quality, range, and habitual pitch level and the self-perceptions of transmasculine people during their first year of testosterone treatment. Method: Seven trans men…

Voice Quality and Gender Stereotypes: A Study of Lebanese Women with Reinke's Edema

ERIC Educational Resources Information Center

Matar, Nayla; Portes, Cristel; Lancia, Leonardo; Legou, Thierry; Baider, Fabienne

2016-01-01

Purpose Women with Reinke's edema (RW) report being mistaken for men during telephone conversations. For this reason, their masculine-sounding voices are interesting for the study of gender stereotypes. The study's objective is to verify their complaint and to understand the cues used in gender identification. Method Using a self-evaluation study,…

Pitch Elevation in Male-to-female Transgender Persons-the Würzburg Approach.

PubMed

Meister, Jonas; Hagen, Rudolf; Shehata-Dieler, Wafaa; Kühn, Heike; Kraus, Fabian; Kleinsasser, Norbert

2017-03-01

The present study reports objective and subjective voice results of Wendler's glottoplasty modified by Hagen. This is an outcomes research study. A total of 21 patients underwent Wendler's glottoplasty modified by Hagen. Parameters in the follow-up session were laryngoscopy, voice range profile, Voice Handicap Index, Life Satisfaction Questionnaire, and a visual analog scale for individual satisfaction with the voice. The fundamental frequency was elevated into the typical female fundamental frequency range. Furthermore, an elevation of the lower frequency limit was shown without a reduction of the frequency range. About one third of the population feels affected by the restricted dynamic range. This change of the vocal pitch is seen as part of the voice feminization by some of the patients. The Dysphonia Severity Index as a marker for voice quality was unchanged. Subjective satisfaction with the voice showed a strong correlation with the individual elevation of the pitch. Wendler's glottoplasty modified by Hagen is an effective and low-risk method of raising the vocal pitch of male-to-female transgender persons. However, elevated Scores of the Voice Handicap Index indicated that in everyday life, transgender persons continue to feel handicapped because of their voice. Another indicator for the lack of social acceptance and integration is the reduced general life satisfaction in the Life Satisfaction Questionnaire especially in the domain "friends, acquaintances, relatives." Therefore, a better multidisciplinary therapy concept for voice feminization is necessary. Copyright © 2017. Published by Elsevier Inc.

Vocal therapy of hyperkinetic dysphonia.

PubMed

Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

2014-01-01

Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. The subjective acoustic analysis revealed a significant (p<0.01) reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025) in all dysphonia parameters except SD FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (p<0.05). Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

Risk Factors of Voice Disorders and Impact of Vocal Hygiene Awareness Program Among Teachers in Public Schools in Egypt.

PubMed

Bolbol, Sarah A; Zalat, Marwa M; Hammam, Rehab A M; Elnakeb, Nasser L

2017-03-01

Even though many studies have explored the problem of voice disorders among teachers worldwide, this problem is still not adequately studied in Egypt. The following study was conducted to investigate the risk factors of voice disorders among an Egyptian sample of school teachers, to measure the effect of a vocal hygiene awareness program on them, and to investigate their vocal cord lesions. One hundred fifty-six teachers working in public schools and 180 administrative workers in the Faculty of Medicine in the same city participated in this study. They completed a self-administered questionnaire investigating voice disorders, and were subjected to a voice awareness program and a clinical examination. Voice-related symptoms and Voice Handicap Index were statistically significantly higher among teachers compared with the control subjects. Work duration and high frequency of classes per week of ≥15 were the most statistically significant indicators influencing a teacher's voice. Three months after application of vocal hygiene awareness program, the teachers who were studied showed a statistically significant increase in their awareness about vocal hygiene tips. Egyptian teachers working in public schools are dealing with classes that include a great number of students per class. They also have to deal with unprofessional facilities and limited assisting resources. Therefore, they are highly exposed to the risk of voice-related disorders. Increasing awareness about healthy behavior with the voice in their occupations will help in improving their quality of work and in minimizing any permanent impairments and/or disability. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects of Voice Rehabilitation After Radiation Therapy for Laryngeal Cancer: A Randomized Controlled Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tuomi, Lisa, E-mail: lisa.tuomi@vgregion.se; Andréll, Paulin; Finizia, Caterina

Background: Patients treated with radiation therapy for laryngeal cancer often experience voice problems. The aim of this randomized controlled trial was to assess the efficacy of voice rehabilitation for laryngeal cancer patients after having undergone radiation therapy and to investigate whether differences between different tumor localizations with regard to rehabilitation outcomes exist. Methods and Materials: Sixty-nine male patients irradiated for laryngeal cancer participated. Voice recordings and self-assessments of communicative dysfunction were performed 1 and 6 months after radiation therapy. Thirty-three patients were randomized to structured voice rehabilitation with a speech-language pathologist and 36 to a control group. Furthermore, comparisons withmore » 23 healthy control individuals were made. Acoustic analyses were performed for all patients, including the healthy control individuals. The Swedish version of the Self Evaluation of Communication Experiences after Laryngeal Cancer and self-ratings of voice function were used to assess vocal and communicative function. Results: The patients who received vocal rehabilitation experienced improved self-rated vocal function after rehabilitation. Patients with supraglottic tumors who received voice rehabilitation had statistically significant improvements in voice quality and self-rated vocal function, whereas the control group did not. Conclusion: Voice rehabilitation for male patients with laryngeal cancer is efficacious regarding patient-reported outcome measurements. The patients experienced better voice function after rehabilitation. Patients with supraglottic tumors also showed an improvement in terms of acoustic voice outcomes. Rehabilitation with a speech-language pathologist is recommended for laryngeal cancer patients after radiation therapy, particularly for patients with supraglottic tumors.« less

Functional outcome of vocal fold medialization thyroplasty with a hydroxyapatite implant.

PubMed

Storck, Claudio; Brockmann, Meike; Schnellmann, Elvira; Stoeckli, Sandro J; Schmid, Stephan

2007-06-01

Unilateral vocal fold paralysis can cause a persistent incomplete glottal closure during phonation, resulting in impaired voice function. The aim of this study was to evaluate functional results of medialization thyroplasty using a hydroxyapatite implant (VoCoM). Prospective observational cohort study. Between 1999 and 2003, a total of 26 patients (19 men, 7 women) undergoing medialization thyroplasty using a hydroxyapatite implant because of unilateral vocal fold paralysis were enrolled in the study. To evaluate voice function, the following parameters were measured preoperatively and postoperatively: mean fundamental frequency, mean sound pressure level, frequency and amplitude range (voice range profile), and maximum phonation time. A perceptual assessment of hoarseness was conducted using the Roughness, Breathiness, Hoarseness scale. Furthermore, the magnitude of voice related impairment of the patient's communication skills was rated on a 7-point scale. A combined parameter called the Voice Dysfunction Index (VDI) was used to rate vocal performance. All patients showed a statistically significant improvement in the VDI, in perceptual voice analysis, in maximum phonation time, and in the dynamic range of voice. One patient experienced a postoperative wound hemorrhage as a minor complication. No further complications or implant extrusions were observed. Medialization thyroplasty using a hydroxyapatite implant is a secure and efficient phonosurgical procedure. Voice quality and patient satisfaction improve significantly after treatment.

Masculine Voices Predict Well-Being in Female-to-Male Transgender Individuals.

PubMed

Watt, Seth O; Tskhay, Konstantin O; Rule, Nicholas O

2018-05-01

Voices convey important social information about an individual's identity, including gender. This is especially relevant to transgender individuals, who cite voice alteration as a primary goal of the gender alignment process. Although the voice is a primary target of testosterone therapy among female-to-male (FTM) trans people, little research has explored the effects of such changes on their psychological well-being. Here, we investigated how FTMs' vocal gender related to their well-being. A total of 77 FTMs (M age  = 25.45 years, SD = 6.77) provided voice samples and completed measures of their well-being and psychological health. An independent group of 32 naïve raters (M age  = 22.16 years, SD = 8.21) subsequently rated the voice samples for masculinity. We found that FTMs whose voices sounded more congruent with their experienced gender (i.e., sounded more masculine) reported greater well-being (better life satisfaction, quality of life, and self-esteem; lower levels of anxiety and depression) than FTMs with less gender congruent (i.e., more feminine) voices (β = .48). The convergence between outwardly perceived vocal gender and gender identity brought about through hormone replacement therapy may therefore support greater well-being for FTMs.

Targeted exercise therapy for voice and swallow in persons with Parkinson’s disease

PubMed Central

Russell, John A.; Ciucci, Michelle R.; Connor, Nadine P.; Schallert, Timothy

2010-01-01

Sensorimotor deficits affecting voice and swallowing ability can have a devastating impact on the quality of life of people with Parkinson disease (PD). Recent scientific findings in animal models of PD pinpoint targeted exercise therapy as a potential treatment to reduce neurochemical loss and decrease parkinsonian symptoms. Although there may be beneficial effects, targeted exercise therapy is not a standard component of therapy for the cranial sensiromotor deficits seen in PD. In this paper we review the scientific evidence for targeted training for voice and swallowing deficits. The literature search revealed 19 publications that included targeted training for voice and only one publication that included targeted training for swallowing. We summarize 3 main findings: 1) targeted training may be associated with lasting changes in voice behavior, 2) targeted training of sensorimotor actions with anatomical or functional overlap with voice and swallowing may improve voice and swallowing to some degree, but it is unknown whether these effects endure over time, and 3) evidence regarding cranial sensorimotor interventions for Parkinson disease is sparse. We concluded that targeted training for voice and swallow is a promising but under-studied intervention for cranial sensorimotor deficits associated with PD and posit that animal models can be useful in designing empirically based studies that further the science on targeted training. PMID:20233583

Tridimensional assessment of adductor spasmodic dysphonia pre- and post-treatment with Botulinum toxin.

PubMed

Dejonckere, P H; Neumann, K J; Moerman, M B J; Martens, J P; Giordano, A; Manfredi, C

2012-04-01

Spasmodic dysphonia voices form, in the same way as substitution voices, a particular category of dysphonia that seems not suited for a standardized basic multidimensional assessment protocol, like the one proposed by the European Laryngological Society. Thirty-three exhaustive analyses were performed on voices of 19 patients diagnosed with adductor spasmodic dysphonia (SD), before and after treatment with Botulinum toxin. The speech material consisted of 40 short sentences phonetically selected for constant voicing. Seven perceptual parameters (traditional and dedicated) were blindly rated by a panel of experienced clinicians. Nine acoustic measures (mainly based on voicing evidence and periodicity) were achieved by a special analysis program suited for strongly irregular signals and validated with synthesized deviant voices. Patients also filled in a VHI-questionnaire. Significant improvement is shown by all three approaches. The traditional GRB perceptual parameters appear to be adequate for these patients. Conversely, the special acoustic analysis program is successful in objectivating the improved regularity of vocal fold vibration: the basic jitter remains the most valuable parameter, when reliably quantified. The VHI is well suited for the voice-related quality of life. Nevertheless, when considering pre-therapy and post-therapy changes, the current study illustrates a complete lack of correlation between the perceptual, acoustic, and self-assessment dimensions. Assessment of SD-voices needs to be tridimensional.

Evaluating iPhone recordings for acoustic voice assessment.

PubMed

Lin, Emily; Hornibrook, Jeremy; Ormond, Tika

2012-01-01

This study examined the viability of using iPhone recordings for acoustic measurements of voice quality. Acoustic measures were compared between voice signals simultaneously recorded from 11 normal speakers (6 females and 5 males) through an iPhone (model A1303, Apple, USA) and a comparison recording system. Comparisons were also conducted between the pre- and post-operative voices recorded from 10 voice patients (4 females and 6 males) through the iPhone. Participants aged between 27 and 79 years. Measures from iPhone and comparison signals were found to be highly correlated. Findings of the effects of vowel type on the selected measures were consistent between the two recording systems and congruent with previous findings. Analysis of the patient data revealed that a selection of acoustic measures, such as vowel space area and voice perturbation measures, consistently demonstrated a positive change following phonosurgery. The present findings indicated that the iPhone device tested was useful for tracking voice changes for clinical management. Preliminary findings regarding factors such as gender and type of pathology suggest that intra-subject, instead of norm-referenced, comparisons of acoustic measures would be more useful in monitoring the progression of a voice disorder or tracking the treatment effect. Copyright © 2012 S. Karger AG, Basel.

Silence and voicing accumulations in Italian primary school teachers with and without voice disorders

PubMed Central

Bottalico, Pasquale; Graetzer, Simone; Astolfi, Arianna; Hunter, Eric J.

2016-01-01

Objectives The relationship between the silence and voicing accumulations of primary school teachers and the teachers’ clinical status was examined. The goal was to determine whether more voicing accumulations and fewer silence accumulations were measured for the vocally unhealthy subjects than for the healthy subjects, which would imply more vocal loading and fewer short-term recovery moments. Methods 26 Italian primary school teachers were allocated by clinicians to three groups: (1) with organic voice disorders, (2) with subjectively mild organic alteration and/or functional voice symptoms, and (3) normal voice quality and physiology. Continuous silence and voicing periods were measured with the APM3200 during the teachers’ 4-hour workdays. The accumulations were grouped into 7 time intervals, ranging from 0.03–0.9 s to 3.16–10 s, according to Italian prosody. The effects of group on silence and voicing accumulations were evaluated. Results Regarding silence accumulations, Group 1 accumulated higher values in intervals between 0.1 and 3.15 s than other groups, while Groups 2 and 3 did not differ from each other. Voicing accumulations between 0.17 and 3.15 s were higher for subjects with a structural disorder. A higher time dose was accumulated by these subjects (40.6%) than other subjects (Group 2, 31.9%; Group 3, 32.3%). Conclusions While previous research has suggested that a rest period of a few seconds may produce some vocal fatigue recovery, these results indicate that periods shorter than 3.16 s may not have an observable effect on recovery. The results provide insight into how vocal fatigue and vocal recovery may relate to voice disorders in occupational voice users. PMID:27316793

Vocal Performance of Group Fitness Instructors Before and After Instruction: Changes in Acoustic Measures and Self-Ratings.

PubMed

Dallaston, Katherine; Rumbach, Anna F

2016-01-01

(1) To quantify acute changes in acoustic parameters of the voices of group fitness instructors (GFIs) before and after exercise instruction. (2) To determine whether these changes are discernible perceptually by the instructor. This is a pilot prospective cohort study. Participants were six female GFIs, based in Brisbane, Australia. Participants performed a series of vocal tasks before and after instruction of a 60-minute exercise class. Data were obtained pertaining to fundamental frequency (pitch), intensity (volume), jitter, shimmer, harmonic-to-noise ratio (HNR), maximum duration of sustained phonation (MDSP), and pitch range. Additionally, self-ratings of voice quality were obtained before and after instruction. Data were analyzed using the Wilcoxon signed rank test. Significant increases (P ≤ 0.05) were found in fundamental frequency and intensity after instruction. No significant changes in jitter, shimmer, HNR, or MDSP were found before and after instruction. For the group, no significant change in self-ratings of voice quality occurred before and after instruction. Statistically significant changes in pitch and volume were found on acoustic analysis. However, these subtle changes remained within the limits of what is considered normal and representative of the participant's age and gender. Further research into the effects of exercise instruction on the voice is needed. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A comparison of the VHI, VHI-10, and V-RQOL for measuring the effect of botox therapy in adductor spasmodic dysphonia.

PubMed

Morzaria, Sanjay; Damrose, Edward J

2012-05-01

Although disease-specific quality-of-life (QOL) instruments are an invaluable outcome measure in spasmodic dysphonia, there is no consensus on which QOL instrument should be used. To determine the responsiveness of the Voice Handicap Index (VHI), Voice Handicap Index-10 (VHI-10), and Voice-Related Quality of Life (V-RQOL) to the treatment effect of botulinum toxin (Botox) in adductor spasmodic dysphonia (ADSD). Stanford University Voice and Swallowing Center. Prospective case series (level of evidence=4). Consecutive ADSD patients with a stable Botox dose-response relationship were recruited prospectively. VHI, VHI-10, and V-RQOL scores were obtained pretreatment and during the middle third of the posttreatment injection cycle. Thrity-seven patients completed the follow-up. The average total Botox dose was 0.88 units. The average follow-up time after injection was 7.84 weeks. The pretreatment QOL scores reflected the burden of the disease. All the three instruments were highly correlated in subscale and total scores. After treatment, all three instruments showed significant improvement. The VHI, VHI-10, and V-RQOL all reflected the morbidity associated with ADSD and were significantly responsive to the effect of Botox therapy. The choice of instrument should be based on physician preference. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Comparison of Effects Produced by Physiological Versus Traditional Vocal Warm-up in Contemporary Commercial Music Singers.

PubMed

Portillo, María Priscilla; Rojas, Sandra; Guzman, Marco; Quezada, Camilo

2018-03-01

The present study aimed to observe whether physiological warm-up and traditional singing warm-up differently affect aerodynamic, electroglottographic, acoustic, and self-perceived parameters of voice in Contemporary Commercial Music singers. Thirty subjects were asked to perform a 15-minute session of vocal warm-up. They were randomly assigned to one of two types of vocal warm-up: physiological (based on semi-occluded exercises) or traditional (singing warm-up based on open vowel [a:]). Aerodynamic, electroglottographic, acoustic, and self-perceived voice quality assessments were carried out before (pre) and after (post) warm-up. No significant differences were found when comparing both types of vocal warm-up methods, either in subjective or in objective measures. Furthermore, the main positive effect observed in both groups when comparing pre and post conditions was a better self-reported quality of voice. Additionally, significant differences were observed for sound pressure level (decrease), glottal airflow (increase), and aerodynamic efficiency (decrease) in the traditional warm-up group. Both traditional and physiological warm-ups produce favorable voice sensations. Moreover, there are no evident differences in aerodynamic and electroglottographic variables when comparing both types of vocal warm-ups. Some changes after traditional warm-up (decreased intensity, increased airflow, and decreased aerodynamic efficiency) could imply an early stage of vocal fatigue. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of Spinal Manipulative Therapy on the Singing Voice.

PubMed

Fachinatto, Ana Paula A; Duprat, André de Campos; Silva, Marta Andrada E; Bracher, Eduardo Sawaya Botelho; Benedicto, Camila de Carvalho; Luz, Victor Botta Colangelo; Nogueira, Maruan Nogueira; Fonseca, Beatriz Suster Gomes

2015-09-01

This study investigated the effect of spinal manipulative therapy (SMT) on the singing voice of male individuals. Randomized, controlled, case-crossover trial. Twenty-nine subjects were selected among male members of the Heralds of the Gospel. This association was chosen because it is a group of persons with similar singing activities. Participants were randomly assigned to two groups: (A) chiropractic SMT procedure and (B) nontherapeutic transcutaneous electrical nerve stimulation (TENS) procedure. Recordings of the singing voice of each participant were taken immediately before and after the procedures. After a 14-day period, procedures were switched between groups: participants who underwent SMT on the first day were subjected to TENS and vice versa. Recordings were subjected to perceptual audio and acoustic evaluations. The same recording segment of each participant was selected. Perceptual audio evaluation was performed by a specialist panel (SP). Recordings of each participant were randomly presented thus making the SP blind to intervention type and recording session (before/after intervention). Recordings compiled in a randomized order were also subjected to acoustic evaluation. No differences in the quality of the singing on perceptual audio evaluation were observed between TENS and SMT. No differences in the quality of the singing voice of asymptomatic male singers were observed on perceptual audio evaluation or acoustic evaluation after a single spinal manipulative intervention of the thoracic and cervical spine. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Development of a glottal area index that integrates glottal gap size and open quotient

PubMed Central

Chen, Gang; Kreiman, Jody; Gerratt, Bruce R.; Neubauer, Juergen; Shue, Yen-Liang; Alwan, Abeer

2013-01-01

Because voice signals result from vocal fold vibration, perceptually meaningful vibratory measures should quantify those aspects of vibration that correspond to differences in voice quality. In this study, glottal area waveforms were extracted from high-speed videoendoscopy of the vocal folds. Principal component analysis was applied to these waveforms to investigate the factors that vary with voice quality. Results showed that the first principal component derived from tokens without glottal gaps was significantly (p < 0.01) associated with the open quotient (OQ). The alternating-current (AC) measure had a significant effect (p < 0.01) on the first principal component among tokens exhibiting glottal gaps. A measure AC/OQ, defined as the ratio of AC to OQ, was proposed to combine both amplitude and temporal characteristics of the glottal area waveform for both complete and incomplete glottal closures. Analyses of “glide” phonations in which quality varied continuously from breathy to pressed showed that the AC/OQ measure was able to characterize the corresponding continuum of glottal area waveform variation, regardless of the presence or absence of glottal gaps. PMID:23464035

Masculine men articulate less clearly.

PubMed

Kempe, Vera; Puts, David A; Cárdenas, Rodrigo A

2013-12-01

In previous research, acoustic characteristics of the male voice have been shown to signal various aspects of mate quality and threat potential. But the human voice is also a medium of linguistic communication. The present study explores whether physical and vocal indicators of male mate quality and threat potential are linked to effective communicative behaviors such as vowel differentiation and use of more salient phonetic variants of consonants. We show that physical and vocal indicators of male threat potential, height and formant position, are negatively linked to vowel space size, and that height and levels of circulating testosterone are negatively linked to the use of the aspirated variant of the alveolar stop consonant /t/. Thus, taller, more masculine men display less clarity in their speech and prefer phonetic variants that may be associated with masculine attributes such as toughness. These findings suggest that vocal signals of men's mate quality and/or dominance are not confined to the realm of voice acoustics but extend to other aspects of communicative behavior, even if this means a trade-off with speech patterns that are considered communicatively advantageous, such as clarity and indexical cues to higher social class.

Wet voice as a sign of penetration/aspiration in Parkinson's disease: does testing material matter?

PubMed

Sampaio, Marília; Argolo, Natalie; Melo, Ailton; Nóbrega, Ana Caline

2014-10-01

Wet voice is a perceptual vocal quality that is commonly used as an indicator of penetration and/or aspiration in clinical swallowing assessments and bedside screening tests. Our aim was to describe the clinimetric characteristics of this clinical sign using various fluid materials and one solid food in the Parkinson's disease (PD) population. Consecutive PD individuals were submitted for simultaneous fiberoptic endoscopic evaluation of swallowing (FEES) and voice recording. Speech therapists rated the presence or absence of wetness and other voice abnormalities. Two binary endpoints of FEES were selected for comparison with an index test: low penetration (LP) and low penetration and/or aspiration (LP/ASP). The accuracy of wet voice changed according to the testing material in PD patients. Overall, the specificity of this indicator was better than its sensitivity, and the wafer cookie and yogurt drink yielded the best indices. Our data show that wet voice is clearly indicative of LP or LP/ASP in PD patients in case of positive test. However, in the case of a negative result, the wet voice test should be repeated or combined with other clinical tests to include or exclude the risk of LP or LP/ASP.

IP voice over ATM satellite: experimental results over satellite channels

NASA Astrophysics Data System (ADS)

Saraf, Koroush A.; Butts, Norman P.

1999-01-01

IP telephony, a new technology to provide voice communication over traditional data networks, has the potential to revolutionize telephone communication within the modern enterprise. This innovation uses packetization techniques to carry voice conversations over IP networks. This packet switched technology promises new integrated services, and lower cost long-distance communication compared to traditional circuit switched telephone networks. Future satellites will need to carry IP traffic efficiently in order to stay competitive in servicing the global data- networking and global telephony infrastructure. However, the effects of Voice over IP over switched satellite channels have not been investigated in detail. To fully understand the effects of satellite channels on Voice over IP quality; several experiments were conducted at Lockheed Martin Telecommunications' Satellite Integration Lab. The result of those experiments along with suggested improvements for voice communication over satellite are presented in this document. First, a detailed introduction of IP telephony as a suitable technology for voice communication over future satellites is presented. This is followed by procedures for the experiments, along with results and strategies. In conclusion we hope that these capability demonstrations will alleviate any uncertainty regarding the applicability of this technology to satellite networks.

Voice Problems in New Zealand Teachers: A National Survey.

PubMed

Leão, Sylvia H de S; Oates, Jennifer M; Purdy, Suzanne C; Scott, David; Morton, Randall P

2015-09-01

This study determined the prevalence and nature of voice problems in New Zealand (NZ) teachers using a national self-report questionnaire. Epidemiological cross-sectional survey. Participants were 1879 primary and secondary teachers (72.5% females). Three prevalence timeframes were estimated. Severity of voice problems, recovery time, days away from work, symptoms, health assistance, and voice education were also investigated. Prevalence of self-reported vocal problems was 33.2% during their teaching career, 24.7% over the teaching year, and 13.2% on the day of the survey. Primary teachers (P<0.001; odds ratio [OR]=1.74; confidence interval [CI]=1.33-2.40), females (P=0.008; OR=1.63; CI=1.13-2.37), and those aged 51-60 years (P=0.010; OR=1.45; CI=1.11-3.00) were more likely to report problems. Among teachers reporting voice problems during the year, 47% were moderate or severe; for 30%, voice recovery took more than 1 week. Approximately 28% stayed away from work 1-3 days owing to a vocal problem and 9% for more than 3 days. Women reported longer recovery times and more days away. Symptoms associated with voice problems (P<0.001) were voice quality alteration (OR=4.35; CI=3.40-5.57), vocal effort (OR=1.15; CI=0.96-1.37), voice breaks (OR=1.55; CI=1.30-1.84), voice projection difficulty (OR=1.25; CI=1.04-1.50), and throat discomfort (OR=1.22; CI=1.02-1.47). Of the teachers reporting voice problems, only 22.5% consulted a health practitioner. Only 38% of the teachers with chronic voice problems visited an otolaryngologist. Higher hours of voice training/education were associated with fewer self-reported voice problems. Voice problems are of concern for NZ teachers, as has been reported for teachers in other countries. There is still limited awareness among teachers about vocal health, potential risks, and specialized health services for voice problems. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Evolving Spiking Neural Networks for Recognition of Aged Voices.

PubMed

Silva, Marco; Vellasco, Marley M B R; Cataldo, Edson

2017-01-01

The aging of the voice, known as presbyphonia, is a natural process that can cause great change in vocal quality of the individual. This is a relevant problem to those people who use their voices professionally, and its early identification can help determine a suitable treatment to avoid its progress or even to eliminate the problem. This work focuses on the development of a new model for the identification of aging voices (independently of their chronological age), using as input attributes parameters extracted from the voice and glottal signals. The proposed model, named Quantum binary-real evolving Spiking Neural Network (QbrSNN), is based on spiking neural networks (SNNs), with an unsupervised training algorithm, and a Quantum-Inspired Evolutionary Algorithm that automatically determines the most relevant attributes and the optimal parameters that configure the SNN. The QbrSNN model was evaluated in a database composed of 120 records, containing samples from three groups of speakers. The results obtained indicate that the proposed model provides better accuracy than other approaches, with fewer input attributes. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Surgery of benign vocal fold lesions].

PubMed

Olthoff, A

2016-09-01

Surgical treatment of benign vocal fold lesions can be indicated for clinical or functional reasons. The principles of phonosurgery have to be maintained in either case. The appropriate phonosurgical technique depends on the type of vocal fold lesion. Depending on the findings, phonosurgery aims to maintain or improve voice quality. The evaluation of clinical and functional results includes indirect laryngoscopy, videostroboscopy, and voice analysis.

The Voice of THIMUN Youth: Action Papers of the Annual Session (2nd, The Hague, Netherlands, January 27-February 1, 2002).

ERIC Educational Resources Information Center

Williams, David L., Ed.; Munstermann, Ulrich, Ed.; Gamble, Helen E. W., Ed.

These Action Papers of seven committees of The Hague International Model United Nations (THIMUN) Youth Assembly represent the efforts of young people, who have been given the opportunity to voice their personal opinions on issues permanently on the international agenda. The Committee on Education and Employment analyzes improving quality of…

"Im Gonna Tell You All about It": Authorial Voice and Conventional Skills in Writing Assessment and Educational Practice

ERIC Educational Resources Information Center

Humphrey, Regan C.; Walton, Marsha D.; Davidson, Alice J.

2014-01-01

Writing assessments have attended to the mechanics of writing, reflecting a value on the teaching of writing conventions. One quality of writing rarely assessed is authorial voice, a personal style that communicates the author's stance toward events reported and the author's relationship to the audience. The authors explore associations among…

The Voice/Data Communications system in the Health, Education, Telecommunications Experiments. Satellite Technology Demonstration, Technical Report No. 0417.

ERIC Educational Resources Information Center

Janky, James M.; And Others

The diligent use of two-way voice links via satellites substantially improves the quality and the availability of health care and educational services in remote areas. This improvement was demonstrated in several experiments that were sponsored by the Department of Health, Education, and Welfare and the National Aeronautics and Space…

Role of immediate recurrent laryngeal nerve reconstruction in surgery for thyroid cancers with fixed vocal cords.

PubMed

Iwaki, Shinobu; Maeda, Tatsuyoshi; Saito, Miki; Otsuki, Naoki; Takahashi, Miki; Wakui, Emi; Shinomiya, Hirotaka; Morimoto, Koichi; Inoue, Hiroyuki; Masuoka, Hiroo; Miyauchi, Akira; Nibu, Ken-Ichi

2017-03-01

Quality of voice after immediate recurrent laryngeal nerve (RLN) reconstruction in thyroid cancers has not been thoroughly studied. Thirteen patients with fixed vocal cords (fixed vocal cord group) and 8 patients with intact or impaired mobile vocal cords (mobile vocal cord group) who had immediate RLN reconstruction simultaneously with total thyroidectomy, and patients who had arytenoid adduction and thyroplasty for vocal cord paralysis caused by previous surgery (arytenoid adduction thyroplasty group) were enrolled in this study. Preoperative phonation efficiency index was significantly lower (p = .008) in the fixed vocal cord group than in the mobile vocal cord group. One year after surgery, all voice parameters of the patients in the fixed vocal cord group had improved, compared with their preoperative data. The fixed vocal cord group had attained satisfactory voice qualities equivalent to those of the mobile vocal cord group in terms of various voice parameters. The present results support the idea that immediate RLN reconstruction at the time of surgery for thyroid cancers may spare the need for subsequent arytenoid adduction thyroplasty even in the patients with preoperatively fixed vocal cords. © 2016 Wiley Periodicals, Inc. Head Neck 39: 427-431, 2017. © 2016 Wiley Periodicals, Inc.

Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners.

PubMed

Isetti, Derek; Xuereb, Linnea; Eadie, Tanya L

2014-05-01

To determine whether unfamiliar listeners' perceptions of speakers with adductor spasmodic dysphonia (ADSD) differ from control speakers on the parameters of relative age, confidence, tearfulness, and vocal effort and are related to speaker-rated vocal effort or voice-specific quality of life. Twenty speakers with ADSD (including 6 speakers with ADSD plus tremor) and 20 age- and sex-matched controls provided speech recordings, completed a voice-specific quality-of-life instrument (Voice Handicap Index; Jacobson et al., 1997), and rated their own vocal effort. Twenty listeners evaluated speech samples for relative age, confidence, tearfulness, and vocal effort using rating scales. Listeners judged speakers with ADSD as sounding significantly older, less confident, more tearful, and more effortful than control speakers (p < .01). Increased vocal effort was strongly associated with decreased speaker confidence (rs = .88-.89) and sounding more tearful (rs = .83-.85). Self-rated speaker effort was moderately related (rs = .45-.52) to listener impressions. Listeners' perceptions of confidence and tearfulness were also moderately associated with higher Voice Handicap Index scores (rs = .65-.70). Unfamiliar listeners judge speakers with ADSD more negatively than control speakers, with judgments extending beyond typical clinical measures. The results have implications for counseling and understanding the psychosocial effects of ADSD.

[Computed assisted voice recognition. A dream or reality in the pathologist's routine work?].

PubMed

Delling, G; Delling, D

1999-03-01

During the last 30 years the analysis of human speech with powerful computers has taken great strides; therefore, cost-effective, comfortable solutions are now available for use in professional routine work. The advantages of using voice recognition are the creation of new documentation or archives, reduced personnel costs and, last but not least, independence in cases of unforeseen notification of illness or owing to annual leave. For voice recognition systems to be used easily, a considerable amount of time must be invested for the first 3 months. Younger colleagues in particular will be more motivated to dictate more precisely and more detailed because of the introduction of voice recognition. The effects on other sectors of medical training, quality control, histology report preparation, and transmission can only be speculated.

Gaining customer knowledge: obtaining and using customer judgments for hospitalwide quality improvement.

PubMed

Nelson, E C; Caldwell, C; Quinn, D; Rose, R

1991-03-01

Customer knowledge is an essential feature of hospitalwide quality improvement. All systems and processes have customers. The aim is to use customer knowledge and voice of the customer measurement to plan, design, improve, and monitor these systems and processes continuously. In this way, the hospital stands the best chance of meeting customers' needs and, hopefully, delivering services that are so outstanding that customers will be surprised and delighted. There are many methods, both soft and hard, that can be used to increase customer knowledge. One useful strategy is to use a family of quality measures that reflect the voice of the customer. These measures can generate practical and powerful customer knowledge information that is essential to performing strategic planning, deploying quality policy, designing new services, finding targets for improvements, and monitoring those continuous improvements based on customers' judgments.

Self-perception of voice in transgender persons during cross-sex hormone therapy.

PubMed

Bultynck, Charlotte; Pas, Charlotte; Defreyne, Justine; Cosyns, Marjan; den Heijer, Martin; T'Sjoen, Guy

2017-12-01

Self-perception of voice has a significant psychosocial impact on transgender persons. Research about the evolution of self-perception of voice during cross-sex hormone therapy (CSHT) is lacking. The aim of this study was to examine if self-perception of voice changes during CSHT, and if a change of serum testosterone levels as a result of CSHT can predict a change of self-perception of voice. Prospective longitudinal study. The Transsexual Voice Questionnaire (TVQ), consisting of three factors-anxiety and avoidance (AA), gender identity (GI), and voice quality (VQ)-was used. Transgender persons completed the TVQ at baseline (80 trans men and 103 trans women), after 3 and 12 months of CSHT follow-up. Trans men: From 0 to 3 months, 0 to 12 months, and 3 to 2 months of CSHT, the AA and GI scores improved. From 0 to 3 months of CSHT, the increasing testosterone level was predictive for the improvements of AA and GI scores. Trans women: From 0 to 3 months, the GI score improved. From 0 to 12 months, the AA, GI, and VQ scores improved. Improvements of self-perception of voice could not be predicted by changing serum testosterone levels. During CSHT, self-perception of voice improves in both trans men and trans women. In trans men only, the improving self-perception of voice during the first 3 months can be attributed to the CSHT. For trans women, this study supports that testosterone has acted irreversibly virializing to the voice before CSHT, if they already went through male puberty. 4. Laryngoscope, 127:2796-2804, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Acoustic and Perceptual Effects of Left–Right Laryngeal Asymmetries Based on Computational Modeling

PubMed Central

Samlan, Robin A.; Story, Brad H.; Lotto, Andrew J.; Bunton, Kate

2015-01-01

Purpose Computational modeling was used to examine the consequences of 5 different laryngeal asymmetries on acoustic and perceptual measures of vocal function. Method A kinematic vocal fold model was used to impose 5 laryngeal asymmetries: adduction, edge bulging, nodal point ratio, amplitude of vibration, and starting phase. Thirty /a/ and /I/ vowels were generated for each asymmetry and analyzed acoustically using cepstral peak prominence (CPP), harmonics-to-noise ratio (HNR), and 3 measures of spectral slope (H1*-H2*, B0-B1, and B0-B2). Twenty listeners rated voice quality for a subset of the productions. Results Increasingly asymmetric adduction, bulging, and nodal point ratio explained significant variance in perceptual rating (R2 = .05, p < .001). The same factors resulted in generally decreasing CPP, HNR, and B0-B2 and in increasing B0-B1. Of the acoustic measures, only CPP explained significant variance in perceived quality (R2 = .14, p < .001). Increasingly asymmetric amplitude of vibration or starting phase minimally altered vocal function or voice quality. Conclusion Asymmetries of adduction, bulging, and nodal point ratio drove acoustic measures and perception in the current study, whereas asymmetric amplitude of vibration and starting phase demonstrated minimal influence on the acoustic signal or voice quality. PMID:24845730

Acoustic analysis of voice in children with cleft palate and velopharyngeal insufficiency.

PubMed

Villafuerte-Gonzalez, Rocio; Valadez-Jimenez, Victor M; Hernandez-Lopez, Xochiquetzal; Ysunza, Pablo Antonio

2015-07-01

Acoustic analysis of voice can provide instrumental data concerning vocal abnormalities. These findings can be used for monitoring clinical course in cases of voice disorders. Cleft palate severely affects the structure of the vocal tract. Hence, voice quality can also be also affected. To study whether the main acoustic parameters of voice, including fundamental frequency, shimmer and jitter are significantly different in patients with a repaired cleft palate, as compared with normal children without speech, language and voice disorders. Fourteen patients with repaired unilateral cleft lip and palate and persistent or residual velopharyngeal insufficiency (VPI) were studied. A control group was assembled with healthy volunteer subjects matched by age and gender. Hypernasality and nasal emission were perceptually assessed in patients with VPI. Size of the gap as assessed by videonasopharyngoscopy was classified in patients with VPI. Acoustic analysis of voice including Fundamental frequency (F0), shimmer and jitter were compared between patients with VPI and control subjects. F0 was significantly higher in male patients as compared with male controls. Shimmer was significantly higher in patients with VPI regardless of gender. Moreover, patients with moderate VPI showed a significantly higher shimmer perturbation, regardless of gender. Although future research regarding voice disorders in patients with VPI is needed, at the present time it seems reasonable to include strategies for voice therapy in the speech and language pathology intervention plan for patients with VPI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The interaction of tone with voicing and foot structure: evidence from Kera phonetics and phonology

NASA Astrophysics Data System (ADS)

Pearce, Mary Dorothy

This thesis uses acoustic measurements as a basis for the phonological analysis of the interaction of tone with voicing and foot structure in Kera (a Chadic language). In both tone spreading and vowel harmony, the iambic foot acts as a domain for spreading. Further evidence for the foot comes from measurements of duration, intensity and vowel quality. Kera is unusual in combining a tone system with a partially independent metrical system based on iambs. In words containing more than one foot, the foot is the tone bearing unit (TBU), but in shorter words, the TBU is the syllable. In perception and production experiments, results show that Kera speakers, unlike English and French, use the fundamental frequency as the principle cue to 'Voicing" contrast. Voice onset time (VOT) has only a minor role. Historically, tones probably developed from voicing through a process of tonogenesis, but synchronically, the feature voice is no longer contrastive and VOT is used in an enhancing role. Some linguists have claimed that Kera is a key example for their controversial theory of long-distance voicing spread. But as voice is not part of Kera phonology, this thesis gives counter-evidence to the voice spreading claim. An important finding from the experiments is that the phonological grammars are different between village women, men moving to town and town men. These differences are attributed to French contact. The interaction between Kera tone and voicing and contact with French have produced changes from a 2-way voicing contrast, through a 3-way tonal contrast, to a 2-way voicing contrast plus another contrast with short VOT. These diachronic and synchronic tone/voicing facts are analysed using laryngeal features and Optimality Theory. This thesis provides a body of new data, detailed acoustic measurements, and an analysis incorporating current theoretical issues in phonology, which make it of interest to Africanists and theoreticians alike.

Distinct Disease and Functional Characteristics of Thyroid Surgery-Related Vocal Fold Palsy.

PubMed

Tseng, Wen-Chun; Pei, Yu-Cheng; Wong, Alice M K; Li, Hsueh-Yu; Fang, Tuan-Jen

2016-07-01

Iatrogenic trauma induced by thyroid surgery is the most common etiology of unilateral vocal fold paralysis (UVFP). UVFP after thyroid surgery may lead to profound physical and psychosocial distress. This study comprehensively evaluated UVFP caused by thyroid surgery, and compared the results with those caused by other surgical trauma. Patients with surgery-related UVFP were evaluated using quantitative laryngeal electromyography, videolaryngostroboscopy, voice acoustic analysis, the Voice Outcome Survey, and the Short Form-36 Health Survey quality-of-life questionnaire. Patients with thyroid surgery and other surgeries were compared. A total of 105 patients were recruited, of whom 52 and 53 were assigned to the thyroid surgery and the other surgery group, respectively. Patients in the thyroid surgery group had a higher proportion of external branch of superior laryngeal nerve (eSLN) involvement, longer duration from disease onset to the first laryngeal electromyography examination, lower jitter, higher harmonic-to-noise ratio, and better quality of life compared with the other surgery group. Specifically for patients in the thyroid surgery group, those with eSLN involvement tended to have more pronounced impairment in jitter and shimmer compared with patients without eSLN involvement. UVFP caused by thyroid surgery has a distinct clinical presentation with relatively high involvement in the eSLN, better voice acoustics, longer waiting time before asking for evaluation, and less impact on quality of life. The involvement of eSLN in these patients further impaired their voice. Early referral is suggested for these patients, especially with suspected eSLN injury.

Effects of steam inhalation on voice quality-related acoustic measures.

PubMed

Mahalingam, Shenbagavalli; Boominathan, Prakash

2016-10-01

To investigate the effects of steam inhalation using a facial steamer on voice quality-related acoustic measures. Prospective outcome research: single-blinded experimental study. Forty-five vocally healthy female subjects ranging in age from 18 to 30 years (Mean age: 22.41 years; standard deviation [SD]: 8.91) participated in the study. Phonation samples were recorded under three different conditions in triplicate: baseline recording, immediately after mouth breathing (dehydration), and immediately after 3 minutes of steam inhalation via the mouth (rehydration). In the initial voice recording (prior to dehydration), mean jitter (0.42 %; SD: 0.07), shimmer (2.20 dB; SD: 0.45), and harmonics-to-noise ratio (HNR) (21.60; SD: 2.41) values were within normal limits. After short-term mouth breathing (dehydration, approximately 10 minutes), the mean jitter (1.57 %; SD: 1.82) and shimmer (4.73 dB; SD: 1.83) were significantly increased (P < 0.05), and HNR (18.64; SD: 3.16) was reduced (P < 0.05). After steam inhalation (rehydration) for 3 minutes, mean jitter (0.48 %; SD: 0.12) and shimmer (2.70 dB; SD: 0.71) showed significant decrease (P < 0.05), and HNR (20.10; SD: 3.69) showed significant increase (P < 0.05). All parameters statistically significantly improved from post dehydration values. The simple procedure of steam inhalation using a facial steamer displayed positive effects on parameters proposed to reflect voice quality. 4. Laryngoscope, 126:2305-2309, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Euclidean Distances as measures of speaker similarity including identical twin pairs: A forensic investigation using source and filter voice characteristics.

PubMed

San Segundo, Eugenia; Tsanas, Athanasios; Gómez-Vilda, Pedro

2017-01-01

There is a growing consensus that hybrid approaches are necessary for successful speaker characterization in Forensic Speaker Comparison (FSC); hence this study explores the forensic potential of voice features combining source and filter characteristics. The former relate to the action of the vocal folds while the latter reflect the geometry of the speaker's vocal tract. This set of features have been extracted from pause fillers, which are long enough for robust feature estimation while spontaneous enough to be extracted from voice samples in real forensic casework. Speaker similarity was measured using standardized Euclidean Distances (ED) between pairs of speakers: 54 different-speaker (DS) comparisons, 54 same-speaker (SS) comparisons and 12 comparisons between monozygotic twins (MZ). Results revealed that the differences between DS and SS comparisons were significant in both high quality and telephone-filtered recordings, with no false rejections and limited false acceptances; this finding suggests that this set of voice features is highly speaker-dependent and therefore forensically useful. Mean ED for MZ pairs lies between the average ED for SS comparisons and DS comparisons, as expected according to the literature on twin voices. Specific cases of MZ speakers with very high ED (i.e. strong dissimilarity) are discussed in the context of sociophonetic and twin studies. A preliminary simplification of the Vocal Profile Analysis (VPA) Scheme is proposed, which enables the quantification of voice quality features in the perceptual assessment of speaker similarity, and allows for the calculation of perceptual-acoustic correlations. The adequacy of z-score normalization for this study is also discussed, as well as the relevance of heat maps for detecting the so-called phantoms in recent approaches to the biometric menagerie. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Epidemiology of Vocal Health in Young Adults Attending College in the United States.

PubMed

Hartley, Naomi A; Breen, Ellen; Thibeault, Susan L

2016-10-01

The purpose of this study was to document typical vocal health characteristics (including voice-related activities, behaviors, and symptomatology) of young adults attending college and to determine lifetime and point prevalence rates of voice disorders. Undergraduates at University of Wisconsin-Madison completed an anonymous online survey detailing vocal use, symptomatology, impact, sociodemographics, and voice-related quality of life. Univariate analyses and multivariate regression models isolated risk factors for lifetime and point prevalence rates of a voice disorder. Vocal health and associated factors were analyzed for 652 students (predominantly 18-25 years of age). Lifetime prevalence rate of a voice disorder was 33.9% (point prevalence = 4.45%). Change in voice function (odds ratio [OR] = 2.77), seasonal or chronic postnasal drip (OR = 2.11), hoarseness (OR = 2.08), and restrictions to social activity (OR = 2.07; all p < .05) were identified as the strongest predictors of disorder. A total of 46% of students reported some form of voice problem in the past year, most frequently lasting between 1 and 6 days (39%). Voice usage in social and work settings exceeded demands in the classroom. Young adults in college frequently experience disturbances to vocal health; however, this is not usually perceived to interfere with communication. Relative weighting of risk factors appears to differ from older adults, highlighting the need for individualized evaluation and management, with reference to age-appropriate normative reference points.

Professional Quality of Life of Veterans Affairs Staff and Providers in a Patient-Centered Care Environment.

PubMed

Locatelli, Sara M; LaVela, Sherri L

2015-01-01

Changes to the work environment prompted by the movement toward patient-centered care have the potential to improve occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement. This study was conducted to examine professional quality of life among providers at patient-centered care pilot facilities. Surveys were conducted with 76 Veterans Affairs employees/providers at facilities piloting patient-centered care interventions, to assess demographics, workplace practices and views (team-based environment, employee voice, quality of communication, and turnover intention), and professional quality of life (compassion satisfaction, burnout, and secondary traumatic stress).Professional quality-of-life subscales were not related to employee position type, age, or gender. Employee voice measures were related to lower burnout and higher compassion satisfaction. In addition, employees who were considering leaving their position showed higher burnout and lower compassion satisfaction scores. None of the work practices showed relationships with secondary traumatic stress.

Human vocal attractiveness as signaled by body size projection.

PubMed

Xu, Yi; Lee, Albert; Wu, Wing-Li; Liu, Xuan; Birkholz, Peter

2013-01-01

Voice, as a secondary sexual characteristic, is known to affect the perceived attractiveness of human individuals. But the underlying mechanism of vocal attractiveness has remained unclear. Here, we presented human listeners with acoustically altered natural sentences and fully synthetic sentences with systematically manipulated pitch, formants and voice quality based on a principle of body size projection reported for animal calls and emotional human vocal expressions. The results show that male listeners preferred a female voice that signals a small body size, with relatively high pitch, wide formant dispersion and breathy voice, while female listeners preferred a male voice that signals a large body size with low pitch and narrow formant dispersion. Interestingly, however, male vocal attractiveness was also enhanced by breathiness, which presumably softened the aggressiveness associated with a large body size. These results, together with the additional finding that the same vocal dimensions also affect emotion judgment, indicate that humans still employ a vocal interaction strategy used in animal calls despite the development of complex language.

[The association between health-related quality of life and voice as evaluated by an acoustic analysis in elderly Japanese nursing home residents].

PubMed

Hara, Shuichi; Miura, Hiroko; Yamasaki, Kiyoko; Morisaki, Naoko; Sumi, Yasunori

2015-01-01

We carried out a cross-sectional study investigating the association between health-related quality of life (HRQOL) and voice, as evaluated by an acoustic analysis, in elderly residents of a nursing home. The HRQOL of 61 elderly nursing home residents (mean age: 82.1±8.3 years) was assessed via the SF-8 Health Survey questionnaire, Japanese version (SF-8). The subjects' voices were recorded and analyzed by a voice assessment software program, which calculated the pitch period perturbation quotient (PPQ), amplitude perturbation quotient (APQ), and noise-to-harmonic ratio (NHR). Subjects who scored under the 25th percentile on general health (GH), vitality (VT), or physical summary (PCS) in the SF-8 showed significantly higher PPQ, APQ, and NHR scores in comparison to their counterparts (p<0.05). After adjustment for age, lower GH scores were found to be associated with higher PPQ, APQ, and NHR scores; lower VT scores were associated with higher APQ and NHR scores; and lower PCS scores were associated with higher APQ and NHR scores (p<0.05). The results of the acoustic analysis indicated that voice was associated with HRQOL in the elderly nursing home residents of the present study. Among the acoustic parameters that were analyzed, PPQ, APQ, and NHR may be an influential factor that can be used to assess HRQOL, independently of the effects of age, in elderly individuals.

Pathways to Youth Empowerment and Community Connectedness: A Study of Youth-Adult Partnership in Malaysian After-School, Co-Curricular Programs.

PubMed

Zeldin, Shepherd; Krauss, Steven Eric; Kim, Taehan; Collura, Jessica; Abdullah, Haslinda

2016-08-01

After-school programs are prevalent across the world, but there is a paucity of research that examines quality within the "black box" of programs at the point of service. Grounded in current theory, this research examined hypothesized pathways between the experience of youth-adult partnership (youth voice in decision-making; supportive adult relationships), the mediators of program safety and engagement, and the developmental outcomes of youth empowerment (leadership competence, policy control) and community connectedness (community connections, school attachment). Surveys were administered to 207 ethnically diverse (47.3 % female; 63.3 % Malay) youth, age 15-16, attending after-school co-curricular programs in Kuala Lumpur, Malaysia. Results showed that youth voice in program decision-making predicted both indicators of youth empowerment. Neither youth voice nor supportive adult relationships was directly associated with community connectedness, however. Program engagement mediated the associations between youth-adult partnership and empowerment. In contrast, program safety mediated the associations between youth-adult partnership and community connectedness. The findings indicate that the two core components of youth-adult partnership-youth voice and supportive adult relationships-may operate through different, yet complementary, pathways of program quality to predict developmental outcomes. Implications for future research are highlighted. For reasons of youth development and youth rights, the immediate challenge is to create opportunities for youth to speak on issues of program concern and to elevate those adults who are able and willing to help youth exercise their voice.

A study of VHI scores and acoustic features in street vendors as occupational voice users.

PubMed

Natour, Yaser S; Darawsheh, Wesam B; Bashiti, Sara; Wari, Majd; Taha, Juhayna; Odeh, Thair

to investigate acoustic features of phonation and perception of voice handicap in street vendors. Eighty-eight participants (44 street vendors, 44 controls) were recruited. The mean age of the group was 38.9±16.0 years (range: 20-78 years). Scores of the Arabic version of the Voice Handicap Index (VHI-Arab) were used for analysis. Acoustic measures of fundamental frequency (F 0 ), jitter, shimmer, and signal-to-noise ratio (SNR) were also analyzed. Analysis showed a significant difference between street vendors and controls in the total score of the VHI-Arab (p<0.001) as well as scores of all three VHI-Arab subsections: functional (p<0.001), physical (p<0.001), and emotional (p=0.025). Weak correlations were found among all of the VHI scores and acoustic measures (-0.219≤ r≤0.355), except for SNR where a moderate negative correlations were found (r=-0.555; -0.4) between the VHI (physical and total) scores and SNR values. Significant differences also were found in F 0 , jitter, and SNR among specific subgroups of street vendors when stratified by weekly hours worked (p<0.05), and in jitter (p=0.39) when stratified by educational level. Perception of voice handicap and a possible effect on vocal quality in street vendors were noted. The effect of factors, namely work hours and educational level, on voice quality should be further studied. Copyright © 2017. Published by Elsevier Inc.

The effects of stress on singing voice accuracy.

PubMed

Larrouy-Maestri, Pauline; Morsomme, Dominique

2014-01-01

The quality of a music performance can be lessened or enhanced if the performer experiences stressful conditions. In addition, the quality of a sung performance requires control of the fundamental frequency of the voice, which is particularly sensitive to stress. The present study aimed to clarify the effects of stress on singing voice accuracy. Thirty-one music students were recorded in a stressful condition (ie, a music examination) and a nonstressful condition. Two groups were defined according to the challenge level of the music examination (first and second music levels). Measurements were made by self-reported state anxiety (CSAI-2R questionnaire) and by observing heart rate activity (electrocardiogram) during each performance. In addition, the vocal accuracy of the sung performances was objectively analyzed. As expected, state anxiety and heart rate were significantly higher on the day of the music examination than in the nonstressful condition for all the music students. However, the effect of stress was positive for the first-year students but negative for the second-year students, for whom the music examination was particularly challenging. In addition, highly significant correlations were found between the intensity of cognitive symptoms and the vocal accuracy criteria. This study highlights the contrasting effects of stress on singing voice accuracy but also the need to consider the challenge level and perception of the symptoms in experimental and pedagogical settings. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Objective and subjective assessment of tracheoesophageal prosthesis voice outcome.

PubMed

D'Alatri, Lucia; Bussu, Francesco; Scarano, Emanuele; Paludetti, Gaetano; Marchese, Maria Raffaella

2012-09-01

To investigate the relationships between objective measures and the results of subjective assessment of voice quality and speech intelligibility in patients submitted to total laryngectomy and tracheoesophageal (TE) puncture. Retrospective. Twenty patients implanted with voice prosthesis were studied. After surgery, the entire sample performed speech rehabilitation. The assessment protocol included maximum phonation time (MPT), number of syllables per deep breath, acoustic analysis of the sustained vowel /a/ and of a bisyllabic word, perceptual evaluation (pleasantness and intelligibility%), and self-assessment. The correlation between pleasantness and intelligibility% was statistically significant. Both the latter were significantly correlated with the acoustic signal type, the number of formant peaks, and the F2-F1 difference. The intelligibility% and number of formant peaks were significantly correlated with the MPT and number of syllables per deep breath. Moreover, significant correlations were found between the number of formant peaks and both intelligibility% and pleasantness. The higher the number of syllables per deep breath and the longer the MPT, significantly higher was the number of formant peaks and the intelligibility%. The study failed to show significant correlation between patient's self-assessment of voice quality and both pleasantness and communication effectiveness. The multidimensional assessment seems to be a reliable tool to evaluate the TE functional outcome. Particularly, the results showed that both pleasantness and intelligibility of TE speech are correlated to the availability of expired air and the function of the vocal tract. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration.

PubMed

Bonte, Katrien; Huvenne, Wouter; De Loof, Marie; Deron, Philippe; Viaene, Annick; Duprez, Fréderic; Vermeersch, Hubert

2015-12-01

Intractable aspiration is a serious, often life-threatening condition due to its potential impact on pulmonary function. Aspiration requires therapeutic measures, starting with conservative management but often necessitating surgical treatment. The basic surgical principle is to separate the alimentary and respiratory tracts through a variety of procedures which, unfortunately, nearly all result in the loss of phonation, with the exception of total laryngectomy (TL) which includes the placement of an indwelling voice prosthesis. In this study, we present a modified laryngotracheal separation (LTS) technique that, we believe, offers multiple advantages compared to standard TL. After reviewing the medical records of 35 patients with intractable aspiration who have undergone LTS, we describe the surgical technique and present the postoperative result. In a second surgical procedure about two months following LTS, we aimed to achieve voice restoration by placement of an indwelling voice prosthesis. Intractable aspiration was successfully treated in all patients. Placement of an indwelling voice prosthesis during a second operation was successful in 15 patients, representing the largest reported cohort thus far. LTS is a reliable surgical technique to treat intractable aspiration, with restoration of oral intake, thereby improving the general condition and quality of life of these unfortunate patients. Furthermore, voice restoration can be achieved in selected patients, by placement of a voice prosthesis.

A Single-Institutional Experience of 15 Years of Treating T3 Laryngeal Cancer With Primary Radiotherapy, With or Without Chemotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl; Tans, Lisa; Rooij, Peter van

2012-07-01

Purpose: To retrospectively analyze the outcomes, toxicity, quality of life, and voice quality of patients with T3 laryngeal cancer treated with radiotherapy and to identify subgroups of patients in whom the addition of chemotherapy to radiotherapy is necessary. Methods and Materials: Between March 1996 and November 2009, 170 consecutive patients with T3 tumor were treated with (chemo)radiotherapy. Endpoints of the study were local control (LC), locoregional control (LRC), disease-free survival (DFS), overall survival (OS), late toxicity, quality of life, and voice handicap index. Results: After a median follow-up time of 32 months (range, 7-172), the 3-year actuarial rates of LC,more » LRC, DFS, and OS were 73%, 70%, 64%, and 61%, respectively, and the 5-year figures were 68%, 65%, 60%, and 49%, respectively. At last follow-up, 84 patients (49.5%) were still alive, 65 of them (77.3%) without local progression. Laryngectomy was performed in 16 patients, leaving 49 patients with anatomic organ preservation, corresponding to an actuarial laryngectomy-free survival of 58.3% at 3 years. The figures for patients treated with chemoradiotherapy and radiotherapy alone were 76.8% and 53.5%, respectively (p = 0.001). Chemoradiotherapy was the only significant predictor for LC on multivariate analysis. The overall 5-year cumulative incidence of late Grade {>=}2 toxicity was 28.2%. Chemoradiotherapy, compared with radiotherapy alone, resulted in slight increase in late toxicity and slight deterioration of quality of life and voice-handicap-index scores. However, the differences were statistically not significant. Conclusion: The addition of chemotherapy to radiotherapy in T3 laryngeal cancer significantly improved LC and laryngectomy-free survival without statistically significant increases in late toxicity or deterioration of quality of life or voice handicap index.« less

Voice related quality of life in pediatric patients with a history of prematurity.

PubMed

Walz, Patrick C; Hubbell, Michael P; Elmaraghy, Charles A

2014-07-01

To determine incidence of dysphonia in patients with history of prematurity and evaluate the correlation between dysphonia and risk factors unique to premature infants. The aim of this study is to determine parent-perceived vocal quality in patients with history of prematurity and whether duration of intubation, number of intubations, and incidence of patent ductus arteriosus repair were correlated with these perceptions. Cohort study of premature patients presenting to outpatient clinics from January 2010 to January 2013 in tertiary care center. Patients gestational age ≤37 weeks at birth without history of tracheostomy or known vocal fold pathology were eligible. A volunteer sample was obtained from patients presenting in Otolaryngology clinics from January 2010 to January 2013 whose parents agreed to complete surveys. Outcomes were assessed via parental completion of pediatric voice outcomes score (pVOS) and pediatric voice-related quality of life (pVRQOL) instruments. The primary outcome assessed was the incidence of dysphonia in infants with a history of prematurity without known vocal pathology. Additionally, patient factors associated with dysphonia were evaluated. The hypothesis tested was formulated prior to data collection. Sixty-nine participants were included. Mean age at follow-up was 28 (3-197) months. Mean gestational age was 29 (23-37) weeks. Mean intubation duration was 3 (0-22) weeks and median number of intubations was 1 (range 0-5). Voice outcome scores varied widely with pVRQOL scores demonstrating a mean of 89.2±18.1 (25-100) and pVOS with a mean of 11.4±2.2 (0-13). Univariate analysis utilized Spearman correlation coefficients for continuous variables and Wilcoxon Two-sample test for categorical groups. Significance was set at p<0.05. All significant univariate associations were placed in a multivariate model. Duration of intubation ≥4 weeks was the only factor which correlated with dysphonia on multivariate analysis (p=0.0028, OR=6.4, 95% CI=1.9-21.6). The data suggest that prolonged intubation is associated with poorer long term parent-perceived voice quality in premature patients. Further study is required to correlate parent perceptions with objective vocal quality data and physical findings of vocal pathology. These data may increase the clinician's suspicion for and evaluation of dysphonia in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Indirect vs Direct Voice Therapy for Children With Vocal Nodules: A Randomized Clinical Trial.

PubMed

Hartnick, Christopher; Ballif, Catherine; De Guzman, Vanessa; Sataloff, Robert; Campisi, Paolo; Kerschner, Joseph; Shembel, Adrianna; Reda, Domenic; Shi, Helen; Sheryka Zacny, Elinore; Bunting, Glenn

2018-02-01

Benign vocal fold nodules affect 12% to 22% of the pediatric population, and 95% of otolaryngologists recommend voice therapy as treatment. However, no randomized clinical trials that we are aware of have shown its benefits. To determine the impact of voice therapy in children with vocal fold nodules according to pretherapy and posttherapy scores on the Pediatric Voice-Related Quality of Life (PVRQOL) survey; secondary objectives included changes in phonatory parameters. For this multicenter randomized clinical trial, 114 children ages 6 to 10 years with vocal fold nodules, PVRQOL scores less than 87.5, and dysphonia for longer than 12 weeks were recruited from outpatient voice and speech clinics. This age range was identified because these patients have not experienced pubertal changes of the larynx, tolerate stroboscopy, and cooperate with voice therapy. Participants were blinded to treatment arm. Participants received either indirect or direct therapy for 8 to 12 weeks. Indirect therapy focused on education and discussion of voice principles, while direct treatment used the stimulus, response, antecedent paradigm. The primary outcome measure was PVRQOL score change before and after treatment. Secondary phonatory measures were also compared. Overall, 114 children were recruited for study (mean [SD] age, 8 [1.4] years; 83 males [73%]); with 57 randomized to receive either indirect or direct therapy. Both direct and indirect therapy approaches showed significant differences in PVRQOL scores pretherapy to posttherapy. The mean increase in PVRQOL score for direct therapy was 19.2, and 14.7 for indirect therapy (difference, 4.5; 95.3% CI, -10.8 to 19.8). Of 44 participants in the direct therapy group, 27 (61%) achieved a clinically meaningful PVRQOL improvement, compared with 26 of 49 (53%) for indirect therapy (difference, 8%; 95% CI, -12 to 28). Post hoc stratification showed robust effects in the direct therapy group for older children (Cohen d = 0.50) and the latter two-thirds of participants (Cohen d = 0.46). Vocal fold nodules reduced in size in 31% (22 of 70) and completely resolved in 11% (8 of 70) of participants who consented to a second set of images after going through the recruitment process. Both direct and indirect voice therapy improved voice-related quality of life in children with vocal fold nodules, although there was no significant difference between approaches. Future studies may focus upon which voice therapy approaches are effective in treating age-defined populations. clinicaltrials.gov Identifier: NCT01255735.

Voice disorders in the workplace: productivity in spasmodic dysphonia and the impact of botulinum toxin.

PubMed

Meyer, Tanya K; Hu, Amanda; Hillel, Allen D

2013-11-01

The impact of the disordered voice on standard work productivity measures and employment trends is difficult to quantify; this is in large part due to the heterogeneity of the disease processes. Spasmodic dysphonia (SD), a chronic voice disorder, may be a useful model to study this impact. Self-reported work measures (worked missed, work impairment, overall work productivity, and activity impairment) were studied among patients receiving botulinum toxin (BTX) treatments for SD. It was hypothesized that there would be a substantial difference in work-related measures between the best and worst voicing periods. In addition, job types, employment shifts, and vocal requirements during the course of vocal disability from SD were investigated for each individual, and the impact of SD on these patterns was studied. A total of 145 patients with SD, either adductor or abductor, who were established in routine therapeutic BTX injections agreed to participate in a self-administered questionnaire study. Seventy-two participants were currently working and provided highly detailed information on work-related measures. Their answers characterized the effect of SD on their employment status, productivity at work, activity impairment outside of work, employment retention or change, and whether the individual perceived that BTX therapy affected these measures. Patients were asked to complete the Work Productivity and Activity Impairment (WPAI) instrument to determine these measures for their best and worst voicing weeks over the duration since their previous BTX injection. Voice-specific quality of life instruments (Voice Handicap Index-10) and perceptual assessments (Consensus Auditory Perceptual Evaluation of Voice) were elicited to provide correlations of work measures with patient-perceived voice handicap and clinician-perceived voice quality. Cross-sectional analysis using self-administered questionnaire. A total of 108 patients reported ever working during their diagnosis and treatment of SD, and 72 patients were currently working and had undergone BTX therapy for at least 1 year at the time of the analysis. Currently employed patients reported a mean 4.4% decrease in work missed (absenteeism), a 28.1% decrease in work impairment (presenteeism), a 29.4% decrease in work productivity, and a 21.4% decrease in activity impairment (P <.001) in their best, as compared to their worst voicing period over their last BTX injection cycle. Presenteeism accounted for the major component of the percent work productivity impairment calculation. There was neither apparent shift in job categories nor any change in the vocal demands of their employment over the course of their disease. Among patients that have worked during their diagnosis of SD, greater than 98% report that BTX injections helped them at work. Patients with SD reported that their vocal dysfunction caused a significant negative effect on work productivity and increase in activity impairment. There was a significant improvement in their voice-related work parameters from their worst to best voicing periods over their last BTX injection cycle. Patients undergoing long-term BTX treatment report a positive effect of this treatment in their workplace. Spasmodic dysphonia is a meaningful model in which to study the effects of voice disorders on work productivity and employment patterns. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

The Belt voice: Acoustical measurements and esthetic correlates

NASA Astrophysics Data System (ADS)

Bounous, Barry Urban

This dissertation explores the esthetic attributes of the Belt voice through spectral acoustical analysis. The process of understanding the nature and safe practice of Belt is just beginning, whereas the understanding of classical singing is well established. The unique nature of the Belt sound provides difficulties for voice teachers attempting to evaluate the quality and appropriateness of a particular sound or performance. This study attempts to provide answers to the question "does Belt conform to a set of measurable esthetic standards?" In answering this question, this paper expands on a previous study of the esthetic attributes of the classical baritone voice (see "Vocal Beauty", NATS Journal 51,1) which also drew some tentative conclusions about the Belt voice but which had an inadequate sample pool of subjects from which to draw. Further, this study demonstrates that it is possible to scientifically investigate the realm of musical esthetics in the singing voice. It is possible to go beyond the "a trained voice compared to an untrained voice" paradigm when evaluating quantitative vocal parameters and actually investigate what truly beautiful voices do. There are functions of sound energy (measured in dB) transference which may affect the nervous system in predictable ways and which can be measured and associated with esthetics. This study does not show consistency in measurements for absolute beauty (taste) even among belt teachers and researchers but does show some markers with varying degrees of importance which may point to a difference between our cognitive learned response to singing and our emotional, more visceral response to sounds. The markers which are significant in determining vocal beauty are: (1) Vibrancy-Characteristics of vibrato including speed, width, and consistency (low variability). (2) Spectral makeup-Ratio of partial strength above the fundamental to the fundamental. (3) Activity of the voice-The quantity of energy being produced. (4) Consistency of the voice-How low is the variability in the energy patterns of the voice.

Using VoiceThread to Promote Collaborative Learning in On-Line Clinical Nurse Leader Courses.

PubMed

Fox, Ola H

The movement to advance the clinical nurse leader (CNL) as an innovative new role for meeting higher health care quality standards continues with CNL programs offered on-line at colleges and universities nationwide. Collaborative learning activities offer the opportunity for CNL students to gain experience in working together in small groups to negotiate and solve care process problems. The challenge for nurse educators is to provide collaborative learning activities in an asynchronous learning environment that can be considered isolating by default. This article reports on the experiences of 17 CNL students who used VoiceThread, a cloud-based tool that allowed them to communicate asynchronously with one another through voice comments for collaboration and sharing knowledge. Participants identified benefits and drawbacks to using VoiceThread for collaboration as compared to text-based discussion boards. Students reported that the ability to hear the voice of their peers and the instructor helped them feel like they were in a classroom communicating with "real" instructor and peers. Students indicated a preference for on-line classes that used VoiceThread discussions to on-line classes that used only text-based discussion boards. Copyright © 2016 Elsevier Inc. All rights reserved.

Design of Phoneme MIDI Codes Using the MIDI Encoding Tool “Auto-F” and Realizing Voice Synthesizing Functions Based on Musical Sounds

NASA Astrophysics Data System (ADS)

Modegi, Toshio

Using our previously developed audio to MIDI code converter tool “Auto-F”, from given vocal acoustic signals we can create MIDI data, which enable to playback the voice-like signals with a standard MIDI synthesizer. Applying this tool, we are constructing a MIDI database, which consists of previously converted simple harmonic structured MIDI codes from a set of 71 Japanese male and female syllable recorded signals. And we are developing a novel voice synthesizing system based on harmonically synthesizing musical sounds, which can generate MIDI data and playback voice signals with a MIDI synthesizer by giving Japanese plain (kana) texts, referring to the syllable MIDI code database. In this paper, we propose an improved MIDI converter tool, which can produce temporally higher-resolution MIDI codes. Then we propose an algorithm separating a set of 20 consonant and vowel phoneme MIDI codes from 71 syllable MIDI converted codes in order to construct a voice synthesizing system. And, we present the evaluation results of voice synthesizing quality between these separated phoneme MIDI codes and their original syllable MIDI codes by our developed 4-syllable word listening tests.

Tracheostomy cannulas and voice prosthesis

PubMed Central

Kramp, Burkhard; Dommerich, Steffen

2011-01-01

Cannulas and voice prostheses are mechanical aids for patients who had to undergo tracheotomy or laryngectomy for different reasons. For better understanding of the function of those artificial devices, first the indications and particularities of the previous surgical intervention are described in the context of this review. Despite the established procedure of percutaneous dilatation tracheotomy e.g. in intensive care units, the application of epithelised tracheostomas has its own position, especially when airway obstruction is persistent (e.g. caused by traumata, inflammations, or tumors) and a longer artificial ventilation or special care of the patient are required. In order to keep the airways open after tracheotomy, tracheostomy cannulas of different materials with different functions are available. For each patient the most appropriate type of cannula must be found. Voice prostheses are meanwhile the device of choice for rapid and efficient voice rehabilitation after laryngectomy. Individual sizes and materials allow adaptation of the voice prostheses to the individual anatomical situation of the patients. The combined application of voice prostheses with HME (Head and Moisture Exchanger) allows a good vocal as well as pulmonary rehabilitation. Precondition for efficient voice prosthesis is the observation of certain surgical principles during laryngectomy. The duration of the prosthesis mainly depends on material properties and biofilms, mostly consisting of funguses and bacteries. The quality of voice with valve prosthesis is clearly superior to esophagus prosthesis or electro-laryngeal voice. Whenever possible, tracheostoma valves for free-hand speech should be applied. Physicians taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost. PMID:22073098

Vocal and neural responses to unexpected changes in voice pitch auditory feedback during register transitions

PubMed Central

Patel, Sona; Lodhavia, Anjli; Frankford, Saul; Korzyukov, Oleg; Larson, Charles R.

2016-01-01

Objective/Hypothesis It is known that singers are able to control their voice to maintain a relatively constant vocal quality while transitioning between vocal registers; however, the neural mechanisms underlying this effect are not understood. It was hypothesized that greater attention to the acoustical feedback of the voice and increased control of the vocal musculature during register transitions compared to singing within a register would be represented as neurological differences in event-related potentials (ERPs). Study Design/Methods Nine singers sang musical notes at the high end of the modal register (the boundary between the modal and head/falsetto registers) and at the low end (the boundary between the modal and fry/pulse registers). While singing, the pitch of the voice auditory feedback was unexpectedly shifted either into the adjacent register (“toward” the register boundary) or within the modal register (“away from” the boundary). Singers were instructed to maintain a constant pitch and ignore any changes to their voice feedback. Results Vocal response latencies and magnitude of the accompanying N1 and P2 ERPs were greatest at the lower (modal-fry) boundary when the pitch shift carried the subjects’ voices into the fry register as opposed to remaining within the modal register. Conclusions These findings suggest that when a singer lowers the pitch of their voice such that it enters the fry register from the modal register, there is increased sensory-motor control of the voice, reflected as increased magnitude of the neural potentials to help minimize qualitative changes in the voice. PMID:26739860

Voice - How humans communicate?

PubMed

Tiwari, Manjul; Tiwari, Maneesha

2012-01-01

Voices are important things for humans. They are the medium through which we do a lot of communicating with the outside world: our ideas, of course, and also our emotions and our personality. The voice is the very emblem of the speaker, indelibly woven into the fabric of speech. In this sense, each of our utterances of spoken language carries not only its own message but also, through accent, tone of voice and habitual voice quality it is at the same time an audible declaration of our membership of particular social regional groups, of our individual physical and psychological identity, and of our momentary mood. Voices are also one of the media through which we (successfully, most of the time) recognize other humans who are important to us-members of our family, media personalities, our friends, and enemies. Although evidence from DNA analysis is potentially vastly more eloquent in its power than evidence from voices, DNA cannot talk. It cannot be recorded planning, carrying out or confessing to a crime. It cannot be so apparently directly incriminating. As will quickly become evident, voices are extremely complex things, and some of the inherent limitations of the forensic-phonetic method are in part a consequence of the interaction between their complexity and the real world in which they are used. It is one of the aims of this article to explain how this comes about. This subject have unsolved questions, but there is no direct way to present the information that is necessary to understand how voices can be related, or not, to their owners.

A report on alterations to the speaking and singing voices of four women following hormonal therapy with virilizing agents.

PubMed

Baker, J

1999-12-01

Four women aged between 27 and 58 years sought otolaryngological examination due to significant alterations to their voices, the primary concerns being hoarseness in vocal quality, lowering of habitual pitch, difficulty projecting their speaking voices, and loss of control over their singing voices. Otolaryngological examination with a mirror or flexible laryngoscope revealed no apparent abnormality of vocal fold structure or function, and the women were referred for speech pathology with diagnoses of functional dysphonia. Objective acoustic measures using the Kay Visipitch indicated significant lowering of the mean fundamental frequency for each woman, and perceptual analysis of the patients' voices during quiet speaking, projected voice use, and comprehensive singing activities revealed a constellation of features typically noted in the pubescent male. The original diagnoses of a functional dysphonia were queried, prompting further exploration of each woman's medical history, revealing in each case onset of vocal symptoms shortly after commencing treatment for conditions with medications containing virilizing agents (eg, Danocrine (danazol), Deca-Durabolin (nandrolene decanoate), and testosterone). Although some of the vocal symptoms decreased in severity with the influences from 6 months voice therapy and after withdrawal from the drugs, a number of symptoms remained permanent, suggesting each subject had suffered significant alterations in vocal physiology, including muscle tissue changes, muscle coordination dysfunction, and propioceptive dysfunction. This retrospective study is presented in order to illustrate that it was both the projected speaking voice and the singing voice that proved so highly sensitive to the virilization effects. The implications for future prospective research studies and responsible clinical practice are discussed.

Multidimensional assessment of vocal changes in benign vocal fold lesions after voice therapy.

PubMed

Schindler, Antonio; Mozzanica, Francesco; Maruzzi, Patrizia; Atac, Murat; De Cristofaro, Valeria; Ottaviani, Francesco

2013-06-01

To evaluate through a multidimensional protocol voice changes after voice therapy in patients with benign vocal fold lesions. 65 consecutive patients affected by benign vocal fold lesions were enrolled. Depending on videolaryngostroboscopy the patients were divided into 3 groups: 23 patients with Reinke's oedema, 22 patients with vocal fold cysts and 20 patients with gelatinous polyp. Each subject received 10 voice therapy sessions and was evaluated, before and after voice therapy, through a multidimensional protocol including videolaryngostroboscopy, perception, acoustics, aerodynamics and self-rating by the patient. Data were compared using Wilcoxon signed-rank test. Kruskal-Wallis test was used to analyse the mean variation difference between the three groups of patients. Mann-Whitney test was used for post hoc analysis. Only in 11 cases videolaryngostroboscopy revealed an improvement of the initial pathology. However a significant improvement was observed in perceptual, acoustic and self-assessment ratings in the 3 groups of patients. In particular the parameters of G, R and A of the GIRBAS scale, and the noise to harmonic ratio, Jitter and shimmer scores improved after rehabilitation. A significant improvement of all the parameters of Voice Handicap Index after rehabilitation treatment was found. No significant difference among the three groups of patients was visible, except for self-assessment ratings. Voice therapy may provide a significant improvement in perceptual, acoustic and self-assessed voice quality in patients with benign glottal lesions. Utilization of voice therapy may allow some patients to avoid surgical intervention. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Tracheostomy cannulas and voice prosthesis.

PubMed

Kramp, Burkhard; Dommerich, Steffen

2009-01-01

Cannulas and voice prostheses are mechanical aids for patients who had to undergo tracheotomy or laryngectomy for different reasons. For better understanding of the function of those artificial devices, first the indications and particularities of the previous surgical intervention are described in the context of this review. Despite the established procedure of percutaneous dilatation tracheotomy e.g. in intensive care units, the application of epithelised tracheostomas has its own position, especially when airway obstruction is persistent (e.g. caused by traumata, inflammations, or tumors) and a longer artificial ventilation or special care of the patient are required. In order to keep the airways open after tracheotomy, tracheostomy cannulas of different materials with different functions are available. For each patient the most appropriate type of cannula must be found. Voice prostheses are meanwhile the device of choice for rapid and efficient voice rehabilitation after laryngectomy. Individual sizes and materials allow adaptation of the voice prostheses to the individual anatomical situation of the patients. The combined application of voice prostheses with HME (Head and Moisture Exchanger) allows a good vocal as well as pulmonary rehabilitation. Precondition for efficient voice prosthesis is the observation of certain surgical principles during laryngectomy. The duration of the prosthesis mainly depends on material properties and biofilms, mostly consisting of funguses and bacteries. The quality of voice with valve prosthesis is clearly superior to esophagus prosthesis or electro-laryngeal voice. Whenever possible, tracheostoma valves for free-hand speech should be applied. Physicians taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost.

Vocal fundamental and formant frequencies affect perceptions of speaker cooperativeness.

PubMed

Knowles, Kristen K; Little, Anthony C

2016-01-01

In recent years, the perception of social traits in faces and voices has received much attention. Facial and vocal masculinity are linked to perceptions of trustworthiness; however, while feminine faces are generally considered to be trustworthy, vocal trustworthiness is associated with masculinized vocal features. Vocal traits such as pitch and formants have previously been associated with perceived social traits such as trustworthiness and dominance, but the link between these measurements and perceptions of cooperativeness have yet to be examined. In Experiment 1, cooperativeness ratings of male and female voices were examined against four vocal measurements: fundamental frequency (F0), pitch variation (F0-SD), formant dispersion (Df), and formant position (Pf). Feminine pitch traits (F0 and F0-SD) and masculine formant traits (Df and Pf) were associated with higher cooperativeness ratings. In Experiment 2, manipulated voices with feminized F0 were found to be more cooperative than voices with masculinized F0(,) among both male and female speakers, confirming our results from Experiment 1. Feminine pitch qualities may indicate an individual who is friendly and non-threatening, while masculine formant qualities may reflect an individual that is socially dominant or prestigious, and the perception of these associated traits may influence the perceived cooperativeness of the speakers.

Office-Based Autologous Fat Injection Laryngoplasty for Glottic Insufficiency in Patients Under 50 Years Old.

PubMed

Hu, Hao-Chun; Hung, Yi-Ting; Lin, Shu-Yi; Tung, Tao-Hsin; Chang, Shyue-Yih

2018-04-17

We sought to determine the outcomes of office-based autologous fat injection laryngoplasty in the treatment of patients under 50 years old with glottic insufficiency but without neurological problems or acquired organic lesions in the vocal fold. We conducted a retrospective chart review of consecutive patients under 50 years of age who underwent office-based autologous fat injection laryngoplasty for glottic insufficiency. None of the patients presented neurological problems or acquired organic lesions in the vocal fold. Videolaryngostroboscopic data, objective voice assessment, perceptual measurements of vocal quality, and subjective ratings of voice quality were evaluated before and after treatment. The 23 patients (7 men and 16 women) in this study presented significant improvements in phonatory function in terms of maximum phonation time, jitter, grade, asthenia, and Voice Handicap Index-10 (VHI-10) values at 3 months. Significant improvements in terms of jitter, noise-to-harmonic ratio, grade, roughness, breathiness, asthenia, and the VHI-10 values were also observed at 6 months. Glottic insufficiency in younger patients without neurological problems or acquired organic lesions in the vocal fold can be treated effectively using office-based autologous fat injection laryngoplasty. Significant improvements in phonatory function were observed even 6 months after surgery. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Analysis of Postsurgical Health-Related Quality of Life and Quality of Voice of Patients With Laryngeal Carcinoma.

PubMed

Luo, Jie; Wu, Jieli; Lv, Kexing; Li, Kaichun; Wu, Jianhui; Wen, Yihui; Li, Xiaoling; Tang, Haocheng; Jiang, Aiyun; Wang, Zhangfeng; Wen, Weiping; Lei, Wenbin

2016-01-01

This study aims to analyze the postsurgical health-related quality of life (HRQOL) and quality of voice (QOV) of patients with laryngeal carcinoma with an expectation of improving the treatment and HRQOL of these patients. Based on the collection of information of patients with laryngeal carcinoma regarding clinical characteristics (age, TNM stage, with or without laryngeal preservation and/or neck dissection, with or without postoperative irradiation and/or chemotherapy, etc.), QOV using Voice Handicap Index (VIH) scale and HRQOL using EORTC QLQ-C30 and EORTCQLQ-H&N35 scales, the differences of postsurgical HRQOL related to their clinical characteristics were analyzed using univariate nonparametric tests, the main factors impacting the postsurgical HRQOL were analyzed using regression analyses (generalized linear models) and the correlation between QOV and HRQOL analyzed using spearman correlation analysis. A total of 92 patients were enrolled in this study, on whom the use of EORTC QLQ-C30, EORTC QLQ-H&N35 and VHI scales revealed that: the differences of HRQOL were significant among patients with different ages, TNM stages, and treatment modalities; the main factors impacting the postsurgical HRQOL were pain, speech disorder, and dry mouth; and QOV was significantly correlated with HRQOL. For the patients with laryngeal carcinoma included in our study, the quality of life after open surgeries were impacted by many factors predominated by pain, speech disorder, and dry mouth. It is suggested that doctors in China do more efforts on the patients' postoperative pain and xerostomia management and speech rehabilitation with the hope of improving the patients' quality of life.

Perception of emotionally loaded vocal expressions and its connection to responses to music. A cross-cultural investigation: Estonia, Finland, Sweden, Russia, and the USA

PubMed Central

Waaramaa, Teija; Leisiö, Timo

2013-01-01

The present study focused on voice quality and the perception of the basic emotions from speech samples in cross-cultural conditions. It was examined whether voice quality, cultural, or language background, age, or gender were related to the identification of the emotions. Professional actors (n2) and actresses (n2) produced non-sense sentences (n32) and protracted vowels (n8) expressing the six basic emotions, interest, and a neutral emotional state. The impact of musical interests on the ability to distinguish between emotions or valence (on an axis positivity – neutrality – negativity) from voice samples was studied. Listening tests were conducted on location in five countries: Estonia, Finland, Russia, Sweden, and the USA with 50 randomly chosen participants (25 males and 25 females) in each country. The participants (total N = 250) completed a questionnaire eliciting their background information and musical interests. The responses in the listening test and the questionnaires were statistically analyzed. Voice quality parameters and the share of the emotions and valence identified correlated significantly with each other for both genders. The percentage of emotions and valence identified was clearly above the chance level in each of the five countries studied, however, the countries differed significantly from each other for the identified emotions and the gender of the speaker. The samples produced by females were identified significantly better than those produced by males. Listener's age was a significant variable. Only minor gender differences were found for the identification. Perceptual confusion in the listening test between emotions seemed to be dependent on their similar voice production types. Musical interests tended to have a positive effect on the identification of the emotions. The results also suggest that identifying emotions from speech samples may be easier for those listeners who share a similar language or cultural background with the speaker. PMID:23801972

Effect on long-term average spectrum of pop singers' vocal warm-up with vocal function exercises.

PubMed

Guzman, Marco; Angulo, Mabel; Muñoz, Daniel; Mayerhoff, Ross

2013-04-01

Abstract This case-control study aimed to investigate if there is any change on the spectral slope declination immediately after vocal function exercises (VFE) vs traditional vocal warm-up exercises in normal singers. Thirty-eight pop singers with perceptually normal voices were divided into two groups: an experimental group (n = 20) and a control group (n = 18). One single session with VFE for the experimental group and traditional singing warm-up exercises for the control group was applied. Voice was recorded before and after the exercises. The recorded tasks were to read a phonetically balanced text and to sing a song. Long-term average spectrum (LTAS) analysis included alpha ratio, L1-L0 ratio, and singing power ratio (SPR). Acoustic parameters of voice samples pre- and post-training were compared. Comparison between VFE and control group was also performed. Significant changes after treatment included the alpha ratio and singing power ratio in speaking voice, and SPR in the singing voice for VFE group. The traditional vocal warm-up of the control group also showed pre-post changes. Significant differences between VFE group and control group for alpha ratio and SPR were found in speaking voice samples. This study demonstrates that VFE have an immediate effect on the spectrum of the voice, specifically a decrease on the spectral slope declination. The results of this study provide support for the advantageous effect of VFE as vocal warm-up on voice quality.

Voice tuning with new instruments for type II thyroplasty in the treatment of adductor spasmodic dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji; Toya, Yutaka; Kumai, Yoshihiko

2016-10-01

Adductor spasmodic dysphonia is a rare voice disorder characterized by strained and strangled voice quality with intermittent phonatory breaks and adductory vocal fold spasms. Type II thyroplasty differs from previous treatments in that this surgery does not involve any surgical intervention into the laryngeal muscle, nerve or vocal folds. Type II thyroplasty intervenes in the thyroid cartilage, which is unrelated to the lesion. This procedure, conducted with the aim of achieving lateralization of the vocal folds, requires utmost surgical caution due to the extreme delicacy of the surgical site, critically sensitive adjustment, and difficult procedures to maintain the incised cartilages at a correct position. During surgery, the correct separation of the incised cartilage edges with voice monitoring is the most important factor determining surgical success and patient satisfaction. We designed new surgical instruments: a thyroid cartilage elevator for undermining the thyroid cartilage, and spacer devices to gauge width while performing voice monitoring. These devices were designed to prevent surgical complications, and to aid in selecting the optimal size of titanium bridges while temporally maintaining a separation during voice monitoring. We designed new surgical instruments, including a thyroid cartilage elevator and spacer devices. Precise surgical procedures and performing voice tuning during surgery with the optimal separation width of the thyroid cartilage are key points for surgical success. We introduce the technique of voice tuning using these surgical tools in order to achieve a better outcome with minimal surgical complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Effects of voice-sparing cricotracheal resection on phonation in women.

PubMed

Tanner, Kristine; Dromey, Christopher; Berardi, Mark L; Mattei, Lisa M; Pierce, Jenny L; Wisco, Jonathan J; Hunter, Eric J; Smith, Marshall E

2017-09-01

Individuals with idiopathic subglottic stenosis (SGS) are at risk for voice disorders prior to and following surgical management. This study examined the nature and severity of voice disorders in patients with SGS before and after a revised cricotracheal resection (CTR) procedure designed to minimize adverse effects on voice function. Eleven women with idiopathic SGS provided presurgical and postsurgical audio recordings. Voice Handicap Index (VHI) scores were also collected. Cepstral, signal-to-noise, periodicity, and fundamental frequency (F 0 ) analyses were undertaken for connected speech and sustained vowel samples. Listeners made auditory-perceptual ratings of overall quality and monotonicity. Paired samples statistical analyses revealed that mean F 0 decreased from 215 Hz (standard deviation [SD] = 40 Hz) to 201 Hz (SD = 65 Hz) following surgery. In general, VHI scores decreased after surgery. Voice disorder severity based on the Cepstral Spectral Index of Dysphonia (KayPentax, Montvale, NJ) for sustained vowels decreased (improved) from 41 (SD = 41) to 25 (SD = 21) points; no change was observed for connected speech. Semitone SD (2.2 semitones) did not change from pre- to posttreatment. Auditory-perceptual ratings demonstrated similar results. These preliminary results indicate that this revised CTR procedure is promising in minimizing adverse voice effects while offering a longer-term surgical outcome for SGS. Further research is needed to determine causal factors for pretreatment voice disorders, as well as to optimize treatments in this population. 4. Laryngoscope, 127:2085-2092, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Comparison of treatment outcomes of transnasal vocal fold polypectomy versus microlaryngoscopic surgery.

PubMed

Wang, Chi-Te; Liao, Li-Jen; Huang, Tsung-Wei; Lo, Wu-Chia; Cheng, Po-Wen

2015-05-01

Office-based procedures have been proposed for the treatment of vocal polyps, including indirect laryngoscopic surgery and angiolytic laser photocoagulation. Our previous report documented good treatment outcomes by combining the two aforementioned procedures. This study was intended to further compare the treatment outcomes of office transnasal vocal fold polypectomy (VFP) with those of microlaryngoscopic surgery (MLS). A matched cohort study. This study retrospectively enrolled 50 age-, gender-, and size-matched patients with vocal polyps treated by VFP or MLS at a tertiary teaching hospital from January 2012 to October 2013. Treatment outcomes were evaluated before, 2 weeks, and 6 weeks after the procedures via perceptual rating of voice quality, acoustic measurement of the speech signal, 10-item voice-handicap index, maximal phonation time, subjective rating of voice quality, and videolaryngostroboscopic evaluation. Both VFP and MLS resulted in significant clinical improvements 2 and 6 weeks postoperatively. Study results exhibited similar objective outcomes between VFP and MLS, whereas patients who received VFP reported higher subjective voice quality than those receiving MLS 2 weeks postoperatively. Six weeks after the procedures, the objective and subjective treatment outcomes were not significantly different between the two treatment groups. This study shows that transnasal VFP may be used as an effective alternative treatment for small vocal polyps. Patients who received office VFP experienced rapid symptomatic relief with a higher degree of subjective effectiveness than MLS 2 weeks postoperatively, whereas the overall treatment outcomes showed a comparable level of effectiveness for both modalities. 3B. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Multidimensional vocal assessment after laser treatment for recurrent respiratory papillomatosis.

PubMed

Kono, Takeyuki; Yabe, Haruna; Uno, Kosuke; Saito, Koichiro; Ogawa, Kaoru

2017-03-01

Recurrent respiratory papillomatosis (RRP) is a benign epithelial tumor that exhibits a high frequency of recurrence. This study assesses the vocal function after laser treatment for RRP, particularly in relation to the frequency of surgery. Retrospective study. Thirty RRP patients who underwent laser surgery that controlled the tumor were included. Preoperative and postoperative Grade, Roughness, Breathiness, Asthenia, and Strain Scale, videostroboscopic findings, aerodynamic and acoustic parameters, and self-assessment questionnaires were measured and compared with an age- and sex-matched control group. Subsequently, to evaluate the association between postoperative voice quality and the number of surgeries, the patients were divided into three groups (group 1: single surgery, group 2: 2-5 surgeries, group3: >6 surgeries), and comparative multidimensional vocal assessments were performed. The mean number of surgeries was 3.4 (range, 1-8). Although all patients exhibited poorer vocal function than the control group preoperatively, they showed improvement in postoperative subjective and objective parameters. However, four patients who underwent one surgery with relatively aggressive ablation exhibited vocal cord scarring and deteriorated objective parameters. All remaining patients showed voice quality that was on par with the control group. Subgroup analysis proved no association between post-therapeutic voice quality and the patient characteristics, including preoperative staging and the number of surgical treatments performed. RRP patients can achieve a close to normal voice with high satisfaction even after recurrent surgical treatment when ablation of a subepithelial lesion using sufficient laser energy is adequate. 3b Laryngoscope, 127:679-684, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Training outcome in future professional voice users after 18 months of voice training.

PubMed

Timmermans, Bernadette; De Bodt, Marc S; Wuyts, Floris L; Van de Heyning, Paul H

2004-01-01

The goal of this study is to define the long-term influence of vocal hygiene education and the effectiveness of voice training in 46 students. Half of the subjects, called the trained group (n = 23), received vocal hygiene education during 1 school year and voice training during 2 school years (18 months). The other half, also 23 subjects, received neither vocal hygiene education nor voice training as such (called the untrained group). The voice training is made up of technical workshops (30 h a year in groups of 5-8 subjects) and vocal coaching in the radio and drama projects (30 h whole class). In the lectures (30 h) a theoretical background on breathing, articulation, voicing and vocal hygiene was discussed. A multidimensional test battery containing the GRBAS scale, videolaryngostroboscopy, maximum phonation time, jitter, lowest intensity, highest frequency, Dysphonia Severity Index (DSI) and Voice Handicap Index (VHI) was applied before and after 18 months to evaluate the effect of voice training over time. A questionnaire on daily habits was presented before the lectures, and after 18 months to detect the long-term effect of the lectures. The objectively measured voice quality (DSI) of the trained group improved significantly over time (p < 0.001) due to training (p = 0.008), which was not the case in the untrained group. The self-assessed VHI, on the other hand, changed over time (p < 0.001) in both groups. For the trained group the VHI changed from 18.4 to 14.4 and in the untrained group from 20.1 to 15.3. It is important to note that the VHI scores of both groups remained high. The interpretation of the results of the daily habit questionnaire is disturbing: the initial high degree of smoking, vocal abuse, stress and late meals was not influenced by the lectures or training and remained high. This study proves the positive outcome and emphasizes the need for a well-organized voice training program in future professional voice users. However, the lectures and training on vocal hygiene failed to improve voice-conserving habits. Copyright 2004 S. Karger AG, Basel

Voice and Aging

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About Your Voice

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Acoustic Properties of the Voice Source and the Vocal Tract: Are They Perceptually Independent?

PubMed

Erickson, Molly L

2016-11-01

This study sought to determine whether the properties of the voice source and vocal tract are perceptually independent. Within-subjects design. This study employed a paired-comparison paradigm where listeners heard synthetic voices and rated them as same or different using a visual analog scale. Stimuli were synthesized using three different source slopes and two different formant patterns (mezzo-soprano and soprano) on the vowel /a/ at four pitches: A3, C4, B4, and F5. Whereas formant pattern was the strongest effect, difference in source slope also affected perceived quality difference. Source slope and formant pattern were not independently perceived. These results suggest that when judging laryngeal adduction using perceptual information, judgments may not be accurate when the stimuli are of differing formant patterns. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal fold vibrations: high-speed imaging, kymography, and acoustic analysis: a preliminary report.

PubMed

Larsson, H; Hertegård, S; Lindestad, P A; Hammarberg, B

2000-12-01

To evaluate a new analysis system, High-Speed Tool Box (H. Larsson, custom-made program for image analysis, version 1.1, Department of Logopedics and Phoniatrics, Huddinge University Hospital, Huddinge, Sweden, 1998) for studying vocal fold vibrations using a high-speed camera and to relate findings from these analyses to sound characteristics. A Weinberger Speedcam + 500 system (Weinberger AG, Dietikon, Switzerland) was used with a frame rate of 1,904 frames per second. Images were stored and analyzed digitally. Analysis included automatic glottal edge detection and calculation of glottal area variations, as well as kymography. These signals were compared with acoustic waveforms using the Soundswell program (Hitech Development AB, Stockholm, Sweden). The High-Speed Tool Box was applied on two types of high-speed recordings: a diplophonic phonation and a tremor voice. Relations between glottal vibratory patterns and the sound waveform were analyzed. In the diplophonic phonation, the glottal area waveform, as well as the kymogram, showed a specific pattern of repetitive glottal closures, which was also seen in the acoustic waveform. In the tremor voice, fundamental frequency (F0) fluctuations in the acoustic waveform were reflected in slow variations in amplitude in the glottal area waveform. For studying details of mucosal movements during these kinds of abnormal vibrations, the glottal area waveform was particularly useful. Our results suggest that this combined high-speed acoustic-kymographic analysis package is a promising aid for separating and specifying different voice qualities such as diplophonia and voice tremor. Apart from clinical use, this finding should be of help for specification of the terminology of different voice qualities.

Child voice and noise: a pilot study of noise in day cares and the effects on 10 children's voice quality according to perceptual evaluation.

PubMed

McAllister, Anita M; Granqvist, Svante; Sjölander, Peta; Sundberg, Johan

2009-09-01

The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

The Effects of Phonation Into Glass, Plastic, and LaxVox Tubes in Singers: A Systematic Review.

PubMed

Mendes, Amanda Louize Félix; Dornelas do Carmo, Rodrigo; Dias de Araújo, Aline Menezes Guedes; Paranhos, Luiz Renato; da Mota, Camila Silva Oliveira; Dias, Sheila Schneiberg Valença; Reis, Francisco Prado; Aragão, José Aderval

2018-05-03

The present study aimed to perform a systematic literature review to assess the effects of phonation therapy on voice quality and function in singers. The systematic search was performed in February and updated in October 2017. No restriction of year, language, or publication status was applied. The primary electronic databases searched were LILACS, SciELO, PubMed, and Cochrane. Kappa coefficient was used to assess the agreement between examiners in judging article eligibility. The eligible articles were analyzed based on their risk of bias using the tools proposed by the Joanna Briggs Institute. Mendeley Desktop 1.13.3 software package (Mendeley Ltd, London, UK) was used to standardize the references of identified articles. The general sample consisted of 1965 articles screened out of the electronic databases. Two examiners analyzed the sample in the search for eligible articles. The agreement between examiners reached excellent outcomes (kappa coefficient = 0.88). After the selection, phase 6 articles remained eligible. Together, the eligible studies accounted 141 subjects (65 men and 76 women) aged between 18 and 72 years old. Electroglottography was considered as the most common method (83.33%) of assessment of the effects of phonation therapy in singers. The most prevalent exercises within the therapies were phonation into straws and phonation into glass tubes. The phonation into glass tubes immersed in water, straws, and LaxVox tubes promoted positive effects on the voice quality in singers, such as more comfortable phonation, better voice projection, and economy in voice emission. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Group climate in the voice therapy of patients with Parkinson's Disease.

PubMed

Diaféria, Giovana; Madazio, Glaucya; Pacheco, Claudia; Takaki, Patricia Barbarini; Behlau, Mara

2017-09-04

To verify the impact that group dynamics and coaching strategies have on the PD patients voice, speech and communication, as well as the group climate. 16 individuals with mild to moderate dysarthria due to the PD were divided into two groups: the CG (8 patients), submitted to traditional therapy with 12 regular therapy sessions plus 4 additional support sessions; and the EG (8 patients), submitted to traditional therapy with 12 regular therapy sessions plus 4 sessions with group dynamics and coaching strategies. The Living with Dysarthria questionnaire (LwD), the self-evaluation of voice, speech and communication, and the perceptual-auditory analysis of the vocal quality were assess in 3 moments: pre-traditional therapy (pre); post-traditional therapy (post 1); and post support sessions/coaching strategies (post 2); in post 1 and post 2 moments, the Group Climate Questionnaire (GCQ) was also applied. CG and EG showed an improvement in the LwD from pre to post 1 and post 2 moments. Voice self-evaluation was better for the EG - when pre was compared with post 2 and when post 1 was compared with post 2 - ranging from regular to very good; both groups presented improvement in the communication self-evaluation. The perceptual-auditory evaluation of the vocal quality was better for the EG in the post 1 moment. No difference was found for the GCQ; however, the EG presented lower avoidance scores in post 2. All patients showed improvement in the voice, speech and communication self-evaluation; EG showed lower avoidance scores, creating a more collaborative and propitious environment for speech therapy.

Using voice to create hospital progress notes: Description of a mobile application and supporting system integrated with a commercial electronic health record.

PubMed

Payne, Thomas H; Alonso, W David; Markiel, J Andrew; Lybarger, Kevin; White, Andrew A

2018-01-01

We describe the development and design of a smartphone app-based system to create inpatient progress notes using voice, commercial automatic speech recognition software, with text processing to recognize spoken voice commands and format the note, and integration with a commercial EHR. This new system fits hospital rounding workflow and was used to support a randomized clinical trial testing whether use of voice to create notes improves timeliness of note availability, note quality, and physician satisfaction with the note creation process. The system was used to create 709 notes which were placed in the corresponding patient's EHR record. The median time from pressing the Send button to appearance of the formatted note in the Inbox was 8.8 min. It was generally very reliable, accepted by physician users, and secure. This approach provides an alternative to use of keyboard and templates to create progress notes and may appeal to physicians who prefer voice to typing. Copyright © 2017 Elsevier Inc. All rights reserved.

A posteriori error estimates in voice source recovery

NASA Astrophysics Data System (ADS)

Leonov, A. S.; Sorokin, V. N.

2017-12-01

The inverse problem of voice source pulse recovery from a segment of a speech signal is under consideration. A special mathematical model is used for the solution that relates these quantities. A variational method of solving inverse problem of voice source recovery for a new parametric class of sources, that is for piecewise-linear sources (PWL-sources), is proposed. Also, a technique for a posteriori numerical error estimation for obtained solutions is presented. A computer study of the adequacy of adopted speech production model with PWL-sources is performed in solving the inverse problems for various types of voice signals, as well as corresponding study of a posteriori error estimates. Numerical experiments for speech signals show satisfactory properties of proposed a posteriori error estimates, which represent the upper bounds of possible errors in solving the inverse problem. The estimate of the most probable error in determining the source-pulse shapes is about 7-8% for the investigated speech material. It is noted that a posteriori error estimates can be used as a criterion of the quality for obtained voice source pulses in application to speaker recognition.

Voice outcomes after concurrent chemoradiotherapy for advanced nonlaryngeal head and neck cancer: a prospective study.

PubMed

Paleri, Vinidh; Carding, Paul; Chatterjee, Sanjoy; Kelly, Charles; Wilson, Janet Ann; Welch, Andrew; Drinnan, Michael

2012-12-01

The voice impact of treatment for nonlaryngeal head and neck primary sites remains unknown. We conducted a prospective study of a consecutive sample of patients undergoing chemoradiation for nonlaryngeal head and neck cancer. The Voice Symptom Scale (VoiSS) was completed, and voice recordings were made at 3 time-points. Of 42 recruited patients, 34 completed the measures before and in the early posttreatment phase (mean 16.5 weeks), while 21 patients were assessed at the final time-point (mean, 20.4 months). VoiSS scores showed statistically significant progressive deterioration in the total score (p = .02) and impairment subscale (p < .0001) through to the final assessment. Acoustic measures and perceptual ratings deteriorated significantly (p < .001) in the early posttreatment weeks and improved at the final assessment, but not to the baseline. Interrater agreement was excellent for expert measures. To the best of our knowledge, this is the first prospective study to show that chemoradiation therapy for nonlaryngeal head and neck cancer has a significant effect on the patients' self-reported voice quality, even in the long term. Copyright © 2012 Wiley Periodicals, Inc.

Laryngeal (Voice Box) Cancer

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Keeping Your Voice Healthy

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Tips for Healthy Voices

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Teacher Quality, Professionalism and Professional Development: Findings from a European Project

ERIC Educational Resources Information Center

Hilton, Gillian; Flores, Maria Assunção; Niklasson, Laila

2013-01-01

This paper presents and discusses findings from a European project concerning strengthening the teacher's voice in defining professional quality. In the project tools were developed and evaluated to help teachers reflect on their professional quality. Twelve countries participated and twelve tools were tested with help of student teachers,…

Student Voices Speak Quality Assurance: Continual Improvement in Online Social Work Education

ERIC Educational Resources Information Center

Secret, Mary; Bentley, Kia J.; Kadolph, Jessie C.

2016-01-01

As social work education expands instruction through the rise of distance education, educators seek new ways to improve quality in online courses. Quality assurance standards and student feedback offer valuable insights to ensure satisfying and effective online learning experiences. An examination of these two assessment approaches concurrently in…

Expert Voices: What Cooperating Teachers and Teacher Candidates Say about Quality Student Teaching Placements and Experiences

ERIC Educational Resources Information Center

Torrez, Cheryl A. Franklin; Krebs, Marjori M.

2012-01-01

This study investigated characteristics and attributes of the student teaching experience to better understand what makes a quality student teaching experience. This article reflects a holistic approach by addressing the overall context of a quality student teaching experience that includes the environment, characteristics of successful…

Characteristics and professional use of voice in street children in Aracaju, Brazil.

PubMed

Sales, Neuza Josina; Gurgel, Ricardo Queiroz; Gonçalves, Maria Inês Rebelo; Cunha, Edílson; Barreto, Valeria Maria Prado; Todt Neto, João Carlos; D'Avila, Jeferson Sampaio

2010-07-01

The objective of the study was to evaluate voice characteristics of children engaged in street selling, which involves an essentially professional use of voice in this population. A controlled cross-sectional study was carried out. A randomly chosen sample of 200 school children with a history of street selling assisted by public social services and 400 school children without this experience was selected. Seven- to 10-year-old children of both sexes were studied. Both groups were interviewed and given vocal assessment (auditory-perceptual assessment and spectrographic acoustic measures) and otorhinolaryngological evaluation (physical and videonasolaryngoscopic examination). Children with abnormal results in both groups were compared using chi(2) (Chi-squared test). The significance level was established at 5% (P<0.05). Voice problems were detected more frequently in working children (106-53%) than in regular school children (90-22.5%). The control group achieved better school performance as more children in this group attend school regularly than street children, although age-for-grade deficit was similar. The control group had more access to medical visits (80-40%) and treatment with a doctor (34-17%). Language assessment has shown that the control group had more dysphonia (73-37%) and myofunctional orofacial disorders (20-10%). Street children had more normal voice but had more nasal disorders and greater glottal closure than the school control group. Voice disorders were present in both groups, but less frequently in street children. Although subject to inadequate living conditions, street children had better voice quality than the control group. An explanation could be that by adapting their voice professionally for selling goods in the streets, they developed adequate resilience to their difficult living conditions. Copyright (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Effects of Medications on Voice

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Dysphagia, Speech, Voice, and Trismus following Radiotherapy and/or Chemotherapy in Patients with Head and Neck Carcinoma: Review of the Literature

PubMed Central

Koetsenruijter, K. W. J.; Swan, K.; Bogaardt, H.

2016-01-01

Introduction. Patients with head and neck cancer suffer from various impairments due to the primary illness, as well as secondary consequences of the oncological treatment. This systematic review describes the effects of radiotherapy and/or chemotherapy on the functions of the upper aerodigestive tract in patients with head and neck cancer. Methods. A systematic literature search was performed by two independent reviewers using the electronic databases PubMed and Embase. All dates up to May 2016 were included. Results. Of the 947 abstracts, sixty articles met the inclusion criteria and described one or more aspects of the sequelae of radiotherapy and/or chemotherapy. Forty studies described swallowing-related problems, 24 described voice-related problems, seven described trismus, and 25 studies described general quality of life. Only 14 articles reported that speech pathologists conducted the interventions, of which only six articles described in detail what the interventions involved. Conclusion. In general, voice quality improved following intervention, whereas quality of life, dysphagia, and oral intake deteriorated during and after treatment. However, as a consequence of the diversity in treatment protocols and patient characteristics, the conclusions of most studies cannot be easily generalised. Further research on the effects of oncological interventions on the upper aerodigestive tract is needed. PMID:27722170

Acoustic correlates of Japanese expressions associated with voice quality of male adults

NASA Astrophysics Data System (ADS)

Kido, Hiroshi; Kasuya, Hideki

2004-05-01

Japanese expressions associated with the voice quality of male adults were extracted by a series of questionnaire surveys and statistical multivariate analysis. One hundred and thirty-seven Japanese expressions were collected through the first questionnaire and careful investigations of well-established Japanese dictionaries and articles. From the second questionnaire about familiarity with each of the expressions and synonymity that were addressed to 249 subjects, 25 expressions were extracted. The third questionnaire was about an evaluation of their own voice quality. By applying a statistical clustering method and a correlation analysis to the results of the questionnaires, eight bipolar expressions and one unipolar expression were obtained. They constituted high-pitched/low-pitched, masculine/feminine, hoarse/clear, calm/excited, powerful/weak, youthful/elderly, thick/thin, tense/lax, and nasal, respectively. Acoustic correlates of each of the eight bipolar expressions were extracted by means of perceptual evaluation experiments that were made with sentence utterances of 36 males and by a statistical decision tree method. They included an average of the fundamental frequency (F0) of the utterance, speaking rate, spectral tilt, formant frequency parameter, standard deviation of F0 values, and glottal noise, when SPL of each of the stimuli was maintained identical in the perceptual experiments.

An initial study of voice characteristics of children using two different sound coding strategies in comparison to normal hearing children.

PubMed

Coelho, Ana Cristina; Brasolotto, Alcione Ghedini; Bevilacqua, Maria Cecília

2015-06-01

To compare some perceptual and acoustic characteristics of the voices of children who use the advanced combination encoder (ACE) or fine structure processing (FSP) speech coding strategies, and to investigate whether these characteristics differ from children with normal hearing. Acoustic analysis of the sustained vowel /a/ was performed using the multi-dimensional voice program (MDVP). Analyses of sequential and spontaneous speech were performed using the real time pitch. Perceptual analyses of these samples were performed using visual-analogic scales of pre-selected parameters. Seventy-six children from three years to five years and 11 months of age participated. Twenty-eight were users of ACE, 23 were users of FSP, and 25 were children with normal hearing. Although both groups with CI presented with some deviated vocal features, the users of ACE presented with voice quality more like children with normal hearing than the users of FSP. Sound processing of ACE appeared to provide better conditions for auditory monitoring of the voice, and consequently, for better control of the voice production. However, these findings need to be further investigated due to the lack of comparative studies published to understand exactly which attributes of sound processing are responsible for differences in performance.

Speech transport for packet telephony and voice over IP

NASA Astrophysics Data System (ADS)

Baker, Maurice R.

1999-11-01

Recent advances in packet switching, internetworking, and digital signal processing technologies have converged to allow realizable practical implementations of packet telephony systems. This paper provides a tutorial on transmission engineering for packet telephony covering the topics of speech coding/decoding, speech packetization, packet data network transport, and impairments which may negatively impact end-to-end system quality. Particular emphasis is placed upon Voice over Internet Protocol given the current popularity and ubiquity of IP transport.

Electroglottogram waveform types of untrained speakers.

PubMed

Painter, C

1990-01-01

Electroglottography is a useful, non-invasive technique that can assist in the assessment of vocal fold dysfunction. However, if it is to become a useful clinical tool, there is a need for normative studies of the electroglottogram waveform types that characterize different groups of speakers. This report compares the electroglottogram waveform types characterizing one trained professional voice user phonating in 15 experimental sessions under various fundamental frequencies, intensities and voice qualities with those obtained from 52 untrained non-professional speakers.

An adaptive narrow band frequency modulation voice communication system

NASA Technical Reports Server (NTRS)

Wishna, S.

1972-01-01

A narrow band frequency modulation communication system is described which provides for the reception of good quality voice at low carrier-to-noise ratios. The high level of performance is obtained by designing a limiter and phase lock loop combination as a demodulator, so that the bandwidth of the phase lock loop decreases as the carrier level decreases. The system was built for the position location and aircraft communication equipment experiment of the ATS 6 program.

Portuguese Adaptation and Input for the Validation of the Views on Inpatient Care (VOICE) Outcome Measure to Assess Service Users'Perceptions of Inpatient Psychiatric Care.

PubMed

Palha, João; Palha, Filipa; Dias, Pedro; Gonçalves-Pereira, Manuel

2017-11-29

Patient satisfaction is an important measure of health care quality. Patients' views have seldom been considered in the construction of measures addressing satisfaction with inpatient facilities in psychiatry. The Views on Inpatient Care - VOICE - is a first service-user generated outcome measure relying solely on their perceptions of acute care, representing a valuable indicator of service users' perceived quality of care. The present study aimed to contribute to the validation of the Portuguese version of VOICE. The questionnaire was translated into Portuguese and applied to a sample of eighty-five female inpatients of a psychiatric institution. Data analysis focused on assessing reliability and exploring the impact of demographic and clinical variables on participants' satisfaction. Internal consistency of the questionnaire was high (α = 0.87). Participants' age and marital status were associated with differences in scores, with older patients and patients who were married or involved in a close relationship presenting higher satisfaction levels. The questionnaire demonstrated good internal consistency and acceptability, as well as construct validity. Further studies should expand the analysis of the psychometric properties of this measure e.g., test-retest reliability. The Portuguese version of VOICE is a promising tool to assess service users' perceptions of inpatient psychiatric care in Portugal.

Vocal symptoms, voice activity, and participation profile and professional performance of call center operators.

PubMed

Piwowarczyk, Tatiana Carvalho; Oliveira, Gisele; Lourenço, Luciana; Behlau, Mara

2012-03-01

To analyze the phonatory and laryngopharyngeal symptoms reported by call center operators; and quantify the impact of these symptoms on quality of life, and the association between these issues and professional performance, number of monthly calls, and number of missed workdays. Call center operators (n=157) from a billing call center completed the Vocal Signs and Symptoms Questionnaire and the Brazilian version of the Voice Activity and Participation Profile (VAPP). The company provided data regarding professional performance, average number of monthly calls, and number of missed workdays for each employee. The mean number of current symptoms (6.8) was greater in the operators than data for the general population (1.7). On average, 4.2 symptoms were attributed to occupational factors. The average number of symptoms did not correlate with professional performance (P=0.571). However, fewer symptoms correlated with decreased missed workdays and higher mean monthly call figures. The VAPP scores were relatively low, suggesting little impact of voice difficulties on call center operator's quality of life. However, subjects with elevated VAPP scores also had poorer professional performance. The presence of vocal symptoms does not necessarily relate to decreased professional performance. However, an association between higher vocal activity limitation and participation scores and poorer professional performance was observed. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Invisible Voices: An Intersectional Exploration of Quality of Life for Elderly South Asian Immigrant Women in a Canadian Sample.

PubMed

Alvi, Shahid; Zaidi, Arshia U

2017-06-01

Despite the emerging presence of South Asian elderly population in Canada, there continues to be a paucity of research concerning the immigration and acculturation experiences of these marginalized elderly populations and their quality of life. This research builds knowledge of the quality of life experiences faced by South Asian elderly immigrant women residing in Canada using an intersectional analytical framework. While there is a gradually developing body of research regarding elder persons globally, the present research is unique in that explores challenges, stresses and strains, and builds an understanding of the treatment of older ethnic minorities and immigrant families. Furthermore, this research has implications for policies and practices governing these growing aging populations. Finally, this research gives voice to a "silenced" and invisible group of elders whose stories may help to make improvements in the quality of living and well-being for the aging South Asian immigrant population in Canada.

Towards a Quality Framework for Adult Learners in Recovery: Ensuring Quality with Equity

ERIC Educational Resources Information Center

Doyle, Patricia

2017-01-01

The RECOVEU project is an effort to conceive of a quality-learning programme with equity for adult learners in recovery. It emerged in the context of European recommendations that member states support recovering users to access education in order to improve their chances of achieving social integration. However, by privileging the voices of those…

Voice-related quality of life (V-RQOL) following type I thyroplasty for unilateral vocal fold paralysis.

PubMed

Hogikyan, N D; Wodchis, W P; Terrell, J E; Bradford, C R; Esclamado, R M

2000-09-01

Unilateral vocal fold paralysis is a common clinical problem which frequently causes severe dysphonia. Various treatment options exist for this condition, with the type I thyroplasty being one of the more commonly performed surgical procedures for vocal rehabilitation. The Voice-Related Quality of Life (V-RQOL) Measure is a validated outcomes instrument for voice disorders. This study measured the V-RQOL of patients with unilateral vocal fold paralysis who had undergone a type I thyroplasty and compared these scores to those of patients with untreated and uncompensated unilateral vocal fold paralysis and to normals. Treated patients had significantly higher domain and overall V-RQOL scores than untreated patients, but also scored lower than normals. These differences were true across gender and age. Patients who were more distant from surgery had lower V-RQOL scores than those who had more recently been treated. It is concluded that type I thyroplasty leads to a significantly higher V-RQOL for patients with unilateral vocal fold paralysis. This study also demonstrates further the utility of patient-oriented measures of treatment outcome.

Common Problems That Can Affect Your Voice

MedlinePlus

... Programs Professional Development Home AcademyU Home Study Course Maintenance of Certification Conferences & Events Practice Management Home Resources Quality Clinical Data Registry Research Reimbursement ...

Using Receiver Operating Characteristic Curve to Define the Cutoff Points of Voice Handicap Index Applied to Young Adult Male Smokers.

PubMed

Tafiadis, Dionysios; Chronopoulos, Spyridon K; Kosma, Evangelia I; Voniati, Louiza; Raptis, Vasilis; Siafaka, Vasiliki; Ziavra, Nausica

2017-07-11

Voice performance is an inextricable key factor of everyday life. Obviously, the deterioration of voice quality can cause various problems to human communication and can therefore reduce the performance of social skills (relevant to voice). The deterioration could be originated from changes inside the system of the vocal tract and larynx. Various prognostic methods exist, and among them is the Voice Handicap Index (VHI). This tool includes self-reported questionnaires, used for determining the cutoff points of total score and of its three domains relevant to young male Greek smokers. The interpretation of the calculated cutoff points can serve as a strong indicator of imminent or future evaluation by a clinician. Consistent with previous calculation, the VHI can also act as a feedback for smokers' voice condition and as monitoring procedure toward smoking cessation. Specifically, the sample consisted of 130 male nondysphonic smokers (aged 18-33 years) who all participated in the VHI test procedure. The test results (through receiver operating characteristic analysis) concluded to a total cutoff point score of 19.50 (sensitivity: 0.838, 1-specificity: 0). Also, in terms of constructs, the Functional domain was equal to 7.50 (sensitivity: 0.676, 1-specificity: 0.032), the Physical domain was equal to 7.50 (sensitivity: 0.706, 1-specificity: 0.032), and the Emotional domain was equal to 6.50 (sensitivity: 0.809, 1-specificity: 0.048). Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Objective voice and speech analysis of persons with chronic hoarseness by prosodic analysis of speech samples.

PubMed

Haderlein, Tino; Döllinger, Michael; Matoušek, Václav; Nöth, Elmar

2016-10-01

Automatic voice assessment is often performed using sustained vowels. In contrast, speech analysis of read-out texts can be applied to voice and speech assessment. Automatic speech recognition and prosodic analysis were used to find regression formulae between automatic and perceptual assessment of four voice and four speech criteria. The regression was trained with 21 men and 62 women (average age 49.2 years) and tested with another set of 24 men and 49 women (48.3 years), all suffering from chronic hoarseness. They read the text 'Der Nordwind und die Sonne' ('The North Wind and the Sun'). Five voice and speech therapists evaluated the data on 5-point Likert scales. Ten prosodic and recognition accuracy measures (features) were identified which describe all the examined criteria. Inter-rater correlation within the expert group was between r = 0.63 for the criterion 'match of breath and sense units' and r = 0.87 for the overall voice quality. Human-machine correlation was between r = 0.40 for the match of breath and sense units and r = 0.82 for intelligibility. The perceptual ratings of different criteria were highly correlated with each other. Likewise, the feature sets modeling the criteria were very similar. The automatic method is suitable for assessing chronic hoarseness in general and for subgroups of functional and organic dysphonia. In its current version, it is almost as reliable as a randomly picked rater from a group of voice and speech therapists.

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma

PubMed Central

Waddell, Roger K.

2005-01-01

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia. PMID:19674642

[Effects of a voice metronome on compression rate and depth in telephone assisted, bystander cardiopulmonary resuscitation: an investigator-blinded, 3-armed, randomized, simulation trial].

PubMed

van Tulder, Raphael; Roth, Dominik; Krammel, Mario; Laggner, Roberta; Schriefl, Christoph; Kienbacher, Calvin; Lorenzo Hartmann, Alexander; Novosad, Heinz; Constantin Chwojka, Christof; Havel, Christoph; Schreiber, Wolfgang; Herkner, Harald

2015-01-01

We investigated the effect on compression rate and depth of a conventional metronome and a voice metronome in simulated telephone-assisted, protocol-driven bystander Cardiopulmonary resucitation (CPR) compared to standard instruction. Thirty-six lay volunteers performed 10 minutes of compression-only CPR in a prospective, investigator-blinded, 3-arm study on a manikin. Participants were randomized either to standard instruction ("push down firmly, 5 cm"), a regular metronome pacing 110 beats per minute (bpm), or a voice metronome continuously prompting "deep-deepdeep- deeper" at 110 bpm. The primary outcome was deviation from the ideal chest compression target range (50 mm compression depth x 100 compressions per minute x 10 minutes = 50 m). Secondary outcomes were CPR quality measures (compression and leaning depth, rate, no-flow times) and participants' related physiological response (heart rate, blood pressure and nine hole peg test and borg scales score). We used a linear regression model to calculate effects. The mean (SD) deviation from the ideal target range (50 m) was -11 (9) m in the standard group, -20 (11) m in the conventional metronome group (adjusted difference [95%, CI], 9.0 [1.2-17.5 m], P=.03), and -18 (9) m in the voice metronome group (adjusted difference, 7.2 [-0.9-15.3] m, P=.08). Secondary outcomes (CPR quality measures and physiological response of participants to CPR performance) showed no significant differences. Compared to standard instruction, the conventional metronome showed a significant negative effect on the chest compression target range. The voice metronome showed a non-significant negative effect and therefore cannot be recommended for regular use in telephone-assisted CPR.

Precision and Disclosure in Text and Voice Interviews on Smartphones

PubMed Central

Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L.; Johnston, Michael; Vickers, Lucas; Yan, H. Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data—fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information—than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey. PMID:26060991

Precision and Disclosure in Text and Voice Interviews on Smartphones.

PubMed

Schober, Michael F; Conrad, Frederick G; Antoun, Christopher; Ehlen, Patrick; Fail, Stefanie; Hupp, Andrew L; Johnston, Michael; Vickers, Lucas; Yan, H Yanna; Zhang, Chan

2015-01-01

As people increasingly communicate via asynchronous non-spoken modes on mobile devices, particularly text messaging (e.g., SMS), longstanding assumptions and practices of social measurement via telephone survey interviewing are being challenged. In the study reported here, 634 people who had agreed to participate in an interview on their iPhone were randomly assigned to answer 32 questions from US social surveys via text messaging or speech, administered either by a human interviewer or by an automated interviewing system. 10 interviewers from the University of Michigan Survey Research Center administered voice and text interviews; automated systems launched parallel text and voice interviews at the same time as the human interviews were launched. The key question was how the interview mode affected the quality of the response data, in particular the precision of numerical answers (how many were not rounded), variation in answers to multiple questions with the same response scale (differentiation), and disclosure of socially undesirable information. Texting led to higher quality data-fewer rounded numerical answers, more differentiated answers to a battery of questions, and more disclosure of sensitive information-than voice interviews, both with human and automated interviewers. Text respondents also reported a strong preference for future interviews by text. The findings suggest that people interviewed on mobile devices at a time and place that is convenient for them, even when they are multitasking, can give more trustworthy and accurate answers than those in more traditional spoken interviews. The findings also suggest that answers from text interviews, when aggregated across a sample, can tell a different story about a population than answers from voice interviews, potentially altering the policy implications from a survey.

The Effects of the Menstrual Cycle on Vibratory Characteristics of the Vocal Folds Investigated With High-Speed Digital Imaging.

PubMed

Kunduk, Melda; Vansant, Mathew B; Ikuma, Takeshi; McWhorter, Andrew

2017-03-01

This study investigated the effect of menstrual cycle on vocal fold vibratory characteristics in young women using high-speed digital imaging. This study examined the menstrual phase effect on five objective high-speed imaging parameters and two self-rated perceptual parameters. The effects of oral birth control use were also investigated. Thirteen subjects with no prior voice complaints were included in this study. All data were collected at three different time periods (premenses, postmenses, ovulation) over the course of one menstrual cycle. For five of the 13 subjects, data were collected for two consecutive cycles. Six of 13 subjects were oral birth control users. From high-speed imaging data, five objective parameters were computed: fundamental frequency, fundamental frequency deviation, harmonics-to-noise ratio, harmonic richness factor, and ratio of first and second harmonics. They were supplemented by two self-rated parameters: Reflux Severity Index and perceptual voice quality rating. Analysis included mixed model linear analysis with repeated measures. Results indicated no significant main effects for menstrual phase, between-cycle, or birth control use in the analysis for mean fundamental frequency, fundamental frequency deviation, harmonics-to-noise ratio, harmonic richness factor, first and second harmonics, Reflux Severity Index, and perceptual voice quality rating. Additionally, there were no interaction effects. Hormone fluctuations observed across the menstrual cycle do not appear to have direct effect on vocal fold vibratory characteristics in young women with no voice concerns. Birth control use, on the other hand, may have influence on spectral richness of vocal fold vibration. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perceptual structure of adductor spasmodic dysphonia and its acoustic correlates.

PubMed

Cannito, Michael P; Doiuchi, Maki; Murry, Thomas; Woodson, Gayle E

2012-11-01

To examine the perceptual structure of voice attributes in adductor spasmodic dysphonia (ADSD) before and after botulinum toxin treatment and identify acoustic correlates of underlying perceptual factors. Reliability of perceptual judgments is considered in detail. Pre- and posttreatment trial with comparison to healthy controls, using single-blind randomized listener judgments of voice qualities, as well as retrospective comparison with acoustic measurements. Oral readings were recorded from 42 ADSD speakers before and after treatment as well as from their age- and sex-matched controls. Experienced judges listened to speech samples and rated attributes of overall voice quality, breathiness, roughness, and brokenness, using computer-implemented visual analog scaling. Data were adjusted for regression to the mean and submitted to principal components factor analysis. Acoustic waveforms, extracted from the reading samples, were analyzed and measurements correlated with perceptual factor scores. Four reliable perceptual variables of ADSD voice were effectively reduced to two underlying factors that corresponded to hyperadduction, most strongly associated with roughness, and hypoadduction, most strongly associated with breathiness. After treatment, the hyperadduction factor improved, whereas the hypoadduction factor worsened. Statistically significant (P<0.01) correlations were observed between perceived roughness and four acoustic measures, whereas breathiness correlated with aperiodicity and cepstral peak prominence (CPPs). This study supported a two-factor model of ADSD, suggesting perceptual characterization by both hyperadduction and hypoadduction before and after treatment. Responses of the factors to treatment were consistent with previous research. Correlations among perceptual and acoustic variables suggested that multiple acoustic features contributed to the overall impression of roughness. Although CPPs appears to be a partial correlate of perceived breathiness, a physical basis of this percept remained less clear. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy--effects of surgery.

PubMed

Lundeborg, Inger; Hultcrantz, Elisabeth; Ericsson, Elisabeth; McAllister, Anita

2012-07-01

To evaluate outcome of two types of tonsil surgery (tonsillectomy [TE]+adenoidectomy or tonsillotomy [TT]+adenoidectomy) on vocal function perceptually and acoustically. Sixty-seven children, aged 50-65 months, on waiting list for tonsil surgery were randomized to TE (n=33) or TT (n=34). Fifty-seven age- and gender-matched healthy preschool children were controls. Twenty-eight of them, aged 48-59 months, served as control group before surgery, and 29, aged 60-71 months, served as control group after surgery. Before surgery and 6 months postoperatively, the children were recorded producing three sustained vowels (/ɑ/, /u/, and /i/) and 14 words. The control groups were recorded only once. Three trained speech and language pathologists performed the perceptual analysis using visual analog scale for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio, and the center frequencies of formants 1-3. Before surgery, the children were rated to have more hyponasality and compressed/throaty voice (P<0.05) and lower mean pitch (P<0.01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formants. After surgery, there were no differences perceptually. Perturbation measures decreased but were still higher compared with those of control group (P<0.05). Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods. Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery, the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Vanguard/PLACE experiment system design and test plan

NASA Technical Reports Server (NTRS)

Taylor, R. E.

1973-01-01

A system design and test plan are described for operational evaluation of the NASA-Goddard position location and aircraft communications equipment (PLACE), at C band (4/6GHz), using NASA's ship, the USNS Vanguard, and the ATS 3 and ATS 5 synchronous satellites. The Sea Test phase, extending from March 29, 1973 to April 15, 1973 was successfully completed; the principal objectives of the experiment were achieved. Typical PLACE-computed, position-location data is shown for the Vanguard. Position location and voice-quality measurements were excellent; ship position was determined within 2 nmi; high-quality, 2-way voice transmissions resulted as determined from audience participation, intelligibility and articulation-index analysis. A C band/L band satellite trilateration experiment is discussed.

Perception of emotional nonsense sentences in China, Egypt, Estonia, Finland, Russia, Sweden, and the USA.

PubMed

Waaramaa, Teija

2015-10-01

The present study focused on the identification of emotions in cross-cultural conditions on different continents and among subjects with divergent language backgrounds. The aim was to investigate whether the perception of the basic emotions from nonsense vocal samples was universal, dependent on voice quality, musicality, and/or gender. Listening tests for 350 participants were conducted on location in a variety of cultures: China, Egypt, Estonia, Finland, Russia, Sweden, and the USA. The results suggested that the voice quality parameters played a role in the identification of emotions without the linguistic content. Cultural background may affect the interpretation of the emotions more than the presumed universality. Musical interest tended to facilitate emotion identification. No gender differences were found.

Military Psychology. Volume 9, Number 4, 1997. Effects of Chemical Protective Clothing on Military Performance

DTIC Science & Technology

1997-01-01

restrict limb movement and impede tactile, visual, auditory , and olfactory functioning. When worn at the MOPP IV level, CPC becomes an encapsulated...gas mask. This index was less than the level of acceptability of voice communication of 75% (Bensel, 1997/this issue). This finding is of concern...because even the two voice resonators in the M40 facepiece, compared to one in the M17, do not produce quality speech. Restricted and optically

Intra- and Inter-database Study for Arabic, English, and German Databases: Do Conventional Speech Features Detect Voice Pathology?

PubMed

Ali, Zulfiqar; Alsulaiman, Mansour; Muhammad, Ghulam; Elamvazuthi, Irraivan; Al-Nasheri, Ahmed; Mesallam, Tamer A; Farahat, Mohamed; Malki, Khalid H

2017-05-01

A large population around the world has voice complications. Various approaches for subjective and objective evaluations have been suggested in the literature. The subjective approach strongly depends on the experience and area of expertise of a clinician, and human error cannot be neglected. On the other hand, the objective or automatic approach is noninvasive. Automatic developed systems can provide complementary information that may be helpful for a clinician in the early screening of a voice disorder. At the same time, automatic systems can be deployed in remote areas where a general practitioner can use them and may refer the patient to a specialist to avoid complications that may be life threatening. Many automatic systems for disorder detection have been developed by applying different types of conventional speech features such as the linear prediction coefficients, linear prediction cepstral coefficients, and Mel-frequency cepstral coefficients (MFCCs). This study aims to ascertain whether conventional speech features detect voice pathology reliably, and whether they can be correlated with voice quality. To investigate this, an automatic detection system based on MFCC was developed, and three different voice disorder databases were used in this study. The experimental results suggest that the accuracy of the MFCC-based system varies from database to database. The detection rate for the intra-database ranges from 72% to 95%, and that for the inter-database is from 47% to 82%. The results conclude that conventional speech features are not correlated with voice, and hence are not reliable in pathology detection. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice disorders in children and its relationship with auditory, acoustic and vocal behavior parameters.

PubMed

Simões-Zenari, Marcia; Nemr, Katia; Behlau, Mara

2012-06-01

Parameters to distinguish normal from deviant voices in early childhood have not been established. The current study sought to auditorily and acoustically characterize voices of children, and to study the relationship between vocal behavior reported by teachers and the presence of vocal aberrations. One hundred children between four and 6 years and 11 months, who attended early childhood educational institutions, were included. The sample comprised 50 children with normal voices (NVG) and 50 with deviant voices (DVG) matched by gender and age. All participants were submitted to auditory and acoustic analysis of vocal quality and had their vocal behaviors assessed by teachers through a specific protocol. DVG had a higher incidence of breathiness (p<0.001) and roughness (p<0.001), but not vocal strain (p=0.546), which was similar in both groups. The average F(0) was lower in the DVG and a higher noise component was observed in this group as well. Regarding the protocol used "Aspects Related to Phonotrauma - Children's Protocol", higher means were observed for children from DVG in all analyzed aspects and also on the overall means (DVG=2.15; NVG=1.12, p<0.001). In NVG, a higher incidence of vocal behavior without alterations or with discrete alterations was observed, whereas a higher incidence of moderate, severe or extreme alterations of vocal behavior was observed in DVG. Perceptual assessment of voice, vocal acoustic parameters (F(0), noise and GNE), and aspects related to vocal trauma and vocal behavior differentiated the groups of children with normal voice and deviant voice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Predicting fundamental frequency from mel-frequency cepstral coefficients to enable speech reconstruction.

PubMed

Shao, Xu; Milner, Ben

2005-08-01

This work proposes a method to reconstruct an acoustic speech signal solely from a stream of mel-frequency cepstral coefficients (MFCCs) as may be encountered in a distributed speech recognition (DSR) system. Previous methods for speech reconstruction have required, in addition to the MFCC vectors, fundamental frequency and voicing components. In this work the voicing classification and fundamental frequency are predicted from the MFCC vectors themselves using two maximum a posteriori (MAP) methods. The first method enables fundamental frequency prediction by modeling the joint density of MFCCs and fundamental frequency using a single Gaussian mixture model (GMM). The second scheme uses a set of hidden Markov models (HMMs) to link together a set of state-dependent GMMs, which enables a more localized modeling of the joint density of MFCCs and fundamental frequency. Experimental results on speaker-independent male and female speech show that accurate voicing classification and fundamental frequency prediction is attained when compared to hand-corrected reference fundamental frequency measurements. The use of the predicted fundamental frequency and voicing for speech reconstruction is shown to give very similar speech quality to that obtained using the reference fundamental frequency and voicing.

The value of visualizing tone of voice.

PubMed

Pullin, Graham; Cook, Andrew

2013-10-01

Whilst most of us have an innate feeling for tone of voice, it is an elusive quality that even phoneticians struggle to describe with sufficient subtlety. For people who cannot speak themselves this can have particularly profound repercussions. Augmentative communication often involves text-to-speech, a technology that only supports a basic choice of prosody based on punctuation. Given how inherently difficult it is to talk about more nuanced tone of voice, there is a risk that its absence from current devices goes unremarked and unchallenged. Looking ahead optimistically to more expressive communication aids, their design will need to involve more subtle interactions with tone of voice-interactions that the people using them can understand and engage with. Interaction design can play a role in making tone of voice visible, tangible, and accessible. Two projects that have already catalysed interdisciplinary debate in this area, Six Speaking Chairs and Speech Hedge, are introduced together with responses. A broader role for design is advocated, as a means to opening up speech technology research to a wider range of disciplinary perspectives, and also to the contributions and influence of people who use it in their everyday lives.

Understanding the Barriers to Accessing Symptom-Specific Cognitive Behavior Therapy (CBT) for Distressing Voices: Reflecting on and Extending the Lessons Learnt From the CBT for Psychosis Literature

PubMed Central

Hazell, Cassie M.; Greenwood, Kathryn; Fielding-Smith, Sarah; Rammou, Aikaterini; Bogen-Johnston, Leanne; Berry, Clio; Jones, Anna-Marie; Hayward, Mark

2018-01-01

The experience of hearing voices (‘auditory hallucinations’) can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of cognitive behavior therapy (CBT) for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the United Kingdom. CBT for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidence-based psychological therapies within clinical services. These barriers are discussed in relation to the United Kingdom mental health services, and we offer suggestions for future research to enhance our understanding of these barriers.

Telehealth: voice therapy using telecommunications technology.

PubMed

Mashima, Pauline A; Birkmire-Peters, Deborah P; Syms, Mark J; Holtel, Michael R; Burgess, Lawrence P A; Peters, Leslie J

2003-11-01

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group). Seventy-two patients with voice disorders served as participants. Based on evaluation by otolaryngologists, 31 participants were diagnosed with vocal nodules, 29 were diagnosed with edema, 9 were diagnosed with unilateral vocal fold paralysis, and 3 presented with vocal hyperfunction with no laryngeal pathology. Fifty-one participants (71%) completed the vocal rehabilitation protocol. Outcome measures included perceptual judgments of voice quality, acoustic analyses of voice, patient satisfaction ratings, and fiber-optic laryngoscopy. There were no differences in outcome measures between the conventional group and the remote video teleconference group. Participants in both groups showed positive changes on all outcome measures after completing the vocal rehabilitation protocol. Reasons for participants discontinuing therapy prematurely provided support for the telehealth model of service delivery.

Outcomes assessment following treatment of spasmodic dysphonia with botulinum toxin.

PubMed

Courey, M S; Garrett, C G; Billante, C R; Stone, R E; Portell, M D; Smith, T L; Netterville, J L

2000-09-01

Spasmodic dysphonia (SD), a disabling focal dystonia involving the laryngeal musculature, is most commonly treated by the intramuscular injection of botulinum toxin (BTX). Although the treatment is well tolerated and generally produces clinical voice improvement, it has never been statistically shown to alter the patient's perception of voice quality or general health. Declining resources for medical care mandate that treatment outcomes be documented. A prospective analysis of the effects of BTX on the patient's perception of voice and general health was undertaken. The Voice Handicap Index (VHI) and Short Form 36 (SF-36) surveys were administered to patients before treatment and 1 month after. Pretreatment and posttreatment scores were analyzed with a Student's t-test. On the VHI, improvements in the patients' perception of their functional, physical, and emotional voice handicap reached statistical significance (p < or = .0005). On the SF-36, patients had statistically significant improvements in mental health (p < or = .03) and social functioning (p < or = .04). Treatment of SD with BTX significantly lessened the patients' perception of dysphonia. In addition, it improved their social functioning and their perception of their mental health. These outcome measures justify the continued treatment of SD with BTX.

Understanding the Barriers to Accessing Symptom-Specific Cognitive Behavior Therapy (CBT) for Distressing Voices: Reflecting on and Extending the Lessons Learnt From the CBT for Psychosis Literature.

PubMed

Hazell, Cassie M; Greenwood, Kathryn; Fielding-Smith, Sarah; Rammou, Aikaterini; Bogen-Johnston, Leanne; Berry, Clio; Jones, Anna-Marie; Hayward, Mark

2018-01-01

The experience of hearing voices ('auditory hallucinations') can cause significant distress and disruption to quality of life for people with a psychosis diagnosis. Psychological therapy in the form of cognitive behavior therapy (CBT) for psychosis is recommended for the treatment of positive symptoms, including distressing voices, but is rarely available to patients in the United Kingdom. CBT for psychosis has recently evolved with the development of symptom-specific therapies that focus upon only one symptom of psychosis at a time. Preliminary findings from randomized controlled trials suggest that these symptom-specific therapies can be more effective for distressing voices than the use of broad CBT protocols, and have the potential to target voices trans-diagnostically. Whilst this literature is evolving, consideration must be given to the potential for a symptom-specific approach to overcome some of the barriers to delivery of evidence-based psychological therapies within clinical services. These barriers are discussed in relation to the United Kingdom mental health services, and we offer suggestions for future research to enhance our understanding of these barriers.

The management of vocal fold nodules in children: a national survey of speech-language pathologists.

PubMed

Signorelli, Monique E; Madill, Catherine J; McCabe, Patricia

2011-06-01

The purpose of this study was to determine the management options and voice therapy techniques currently being used by practicing speech-language pathologists (SLPs) to treat vocal fold nodules (VFNs) in children. The sources used by SLPs to inform and guide their clinical decisions when managing VFNs in children were also explored. Sixty-two SLPs completed a 23-item web-based survey. Data was analysed using frequency counts, content analyses, and supplementary analyses. SLPs reported using a range of management options and voice therapy techniques to treat VFNs in children. Voice therapy was reportedly the most frequently used management option across all respondents, with the majority of SLPs using a combination of indirect and direct voice therapy techniques. When selecting voice therapy techniques, the majority of SLPs reported that they did not use the limited external evidence available to guide their clinical decisions. Additionally, the majority of SLPs reported that they frequently relied on lower levels of evidence or non-evidence-based sources to guide clinical practice both in the presence and absence of higher quality evidence. Further research needs to investigate strategies to remove the barriers that impede SLPs use of external evidence when managing VFNs in children.

Modeling and Analysis of Hybrid Cellular/WLAN Systems with Integrated Service-Based Vertical Handoff Schemes

NASA Astrophysics Data System (ADS)

Xia, Weiwei; Shen, Lianfeng

We propose two vertical handoff schemes for cellular network and wireless local area network (WLAN) integration: integrated service-based handoff (ISH) and integrated service-based handoff with queue capabilities (ISHQ). Compared with existing handoff schemes in integrated cellular/WLAN networks, the proposed schemes consider a more comprehensive set of system characteristics such as different features of voice and data services, dynamic information about the admitted calls, user mobility and vertical handoffs in two directions. The code division multiple access (CDMA) cellular network and IEEE 802.11e WLAN are taken into account in the proposed schemes. We model the integrated networks by using multi-dimensional Markov chains and the major performance measures are derived for voice and data services. The important system parameters such as thresholds to prioritize handoff voice calls and queue sizes are optimized. Numerical results demonstrate that the proposed ISHQ scheme can maximize the utilization of overall bandwidth resources with the best quality of service (QoS) provisioning for voice and data services.

Numerical simulation of self-sustained oscillation of a voice-producing element based on Navier-Stokes equations and the finite element method.

PubMed

de Vries, Martinus P; Hamburg, Marc C; Schutte, Harm K; Verkerke, Gijsbertus J; Veldman, Arthur E P

2003-04-01

Surgical removal of the larynx results in radically reduced production of voice and speech. To improve voice quality a voice-producing element (VPE) is developed, based on the lip principle, called after the lips of a musician while playing a brass instrument. To optimize the VPE, a numerical model is developed. In this model, the finite element method is used to describe the mechanical behavior of the VPE. The flow is described by two-dimensional incompressible Navier-Stokes equations. The interaction between VPE and airflow is modeled by placing the grid of the VPE model in the grid of the aerodynamical model, and requiring continuity of forces and velocities. By applying and increasing pressure to the numerical model, pulses comparable to glottal volume velocity waveforms are obtained. By variation of geometric parameters their influence can be determined. To validate this numerical model, an in vitro test with a prototype of the VPE is performed. Experimental and numerical results show an acceptable agreement.

Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease.

PubMed

Karlsen, Tom; Sandvik, Lorentz; Heimdal, John-Helge; Hjermstad, Marianne Jensen; Aarstad, Anne Kari Hersvik; Aarstad, Hans Jørgen

2017-03-01

Patients with voice-related disorders are often treated by a multidisciplinary team including assessment by patient-reported outcome measures. The present paper aims at documenting the importance of including general health-related quality of life (HRQoL) measures to clinical investigations. The participants (N = 80 larynx cancer, N = 32 recurrent palsy, N = 23 dysfunctional, N = 75 degenerative/inflammation, N = 19 various) were included consecutively at the laryngology clinic at Haukeland University Hospital. In addition, HRQoL data were included from one national group with laryngectomies (N = 105), one group with various patients formerly treated for head and neck squamous cell carcinoma (N = 96), and one population-based reference group (N = 1956). Obtained were the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ), the Voice Handicap Index (VHI), and the Eysenck Personality Inventory (EPI) neuroticism scores. By analysis of variance, we have determined significant dependence of groups analyzing the sum global QoL/health index (F = 9.47; P <0.001), the functional HRQoL sum score (F 5,2373  = 7.14, P <0.001), and the symptom sum HRQoL scores (F 7,2381  = 8.13; P <0.001). In particular, patients with recurrent palsy and laryngeal cancer had lowered HRQoL. At the index levels, in particular dyspnea scores, were scored depending on larynx disease group (F 7,2288  = 24.4; P <0.001). The VHI score correlated with the EORTC H&N35 "speech" index with a common variance of 52%. VHI scores correlated with level of neuroticism with 8% common variance (P <0.001) and EORTC scores with 22% (P <0.001). In particular, among patients with voice-related disease, those with recurrent palsy and laryngeal cancer had lower HRQoL. Furthermore, the HRQoL and VHI scores were inversely tied to neuroticism. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Conducting Graduate Tracer Studies for Quality Assurance in East African Universities: A Focus on Graduate Students Voices on Quality Culture

ERIC Educational Resources Information Center

Badiru, Egesah Omar; Wahome, Mary

2016-01-01

The purpose of this paper is to propose a guide for graduate trace studies (GTS) to be adopted by universities and other higher education institutions (HEIs) in East Africa. Their essential role notwithstanding, graduate tracer studies present viable opportunities through which quality assurance (QA) can be institutionalized and mainstreamed in…

Advancing Equity in Illinois's ESSA Plan

ERIC Educational Resources Information Center

Ostro, Ginger

2017-01-01

Advance Illinois is an independent, objective voice for a healthy public education system that prepares all students in Illinois for success in college, careers, and civic life. Advocacy efforts have focused on securing equitable funding for schools, Common Core State Standards, high-quality assessments, and teacher quality efforts. As advocates…

Voice and Aging

MedlinePlus

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Functional hoarseness in children: short-term play therapy with family dynamic counseling as therapy of choice.

PubMed

Kollbrunner, Jürg; Seifert, Eberhard

2013-09-01

Children with nonorganic voice disorders (NVDs) are treated mainly using direct voice therapy techniques such as the accent method or glottal attack changes and indirect methods such as vocal hygiene and voice education. However, both approaches tackle only the symptoms and not etiological factors in the family dynamics and therefore often enjoy little success. The aim of the "Bernese Brief Dynamic Intervention" (BBDI) for children with NVD was to extend the effectiveness of pediatric voice therapies with a psychosomatic concept combining short-term play therapy with the child and family dynamic counseling of the parents. This study compares the therapeutic changes in three groups where different procedures were used, before intervention and 1 year afterward: counseling of parents (one to two consultations; n = 24), Brief Dynamic Intervention on the lines of the BBDI (three to five play therapy sessions with the child plus two to four sessions with the parents; n = 20), and traditional voice therapy (n = 22). A Voice Questionnaire for Parents developed by us with 59 questions to be answered on a four-point Likert scale was used to measure the change. According to the parents' assessment, a significant improvement in voice quality was achieved in all three methods. Counseling of parents (A) appears to have led parents to give their child more latitude, for example, they stopped nagging the child or demanding that he/she should behave strictly by the rules. After BBDI (B), the mothers were more responsive to their children's wishes and the children were more relaxed and their speech became livelier. At home, they called out to them less often at a distance, which probably improved parent-child dialog. Traditional voice therapy (C) seems to have had a positive effect on the children's social competence. BBDI seems to have the deepest, widest, and therefore probably the most enduring therapeutic effect on children with NVD. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Laryngeal (Voice Box) Cancer

MedlinePlus

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Tips for Healthy Voices

MedlinePlus

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Effect of the menstrual cycle on voice quality.

PubMed

Silverman, E M; Zimmer, C H

1978-01-01

The question addressed was whether most young women with no vocal training exhibit premenstrual hoarseness. Spectral (acoustical) analyses of the sustained productions of three vowels produced by 20 undergraduates at and at premenstruation were rated for degree of hoarseness. Statistical analysis of the data indicated that the typical subject was no more hoarse of premenstruation than at ovulation. To determine whether this finding represented a genuine characteristic of women's voices or a type II statistical error, a systematic replication was undertaken with another sample of 27 undergraduates. The finding replicated that of the original investigation, suggesting that premenstrual hoarseness is a rarely occurring condition among young women with no vocal training. The apparent differential effect of the menstrual cycle on trained as opposed to untrained voices deserves systematic investigation.

Comparison of Supraglottic Activity and Spectral Slope Between Theater Actors and Vocally Untrained Subjects.

PubMed

Guzman, Marco; Ortega, Andres; Olavarria, Christian; Muñoz, Daniel; Cortés, Pedro; Azocar, Maria Josefina; Cayuleo, David; Quintana, Felipe; Silva, Catalina

2016-11-01

The present study aimed to assess supraglottic activity in theater actors and to observe whether they present differences compared with subjects with no voice training. Acoustic and perceptual analyses were also performed. A total of 20 participants were divided into two groups: an experimental group of trained theater actors, and a comparative group of subjects with no voice training. Absence of laryngeal pathology was confirmed by rigid videostroboscopy. Flexible laryngoscopy was performed to assess supraglottic activity during speaking phonatory tasks. Voice recording was also carried out. Four blinded judges were asked to assess laryngoscopic and perceptual variables using a visual analog scale. A comparison between groups, phonatory tasks, and loudness levels was performed. Multivariate linear regression showed that trained participants had a higher degree of both laryngeal and pharyngeal activities compared with untrained participants. Moreover, phonatory tasks at high intensity showed higher activity than those at medium and low intensities for most phonatory tasks and laryngoscopic parameters. Vocally trained participants evidenced higher values for all spectral variables compared with untrained participants. Actors have a greater degree of both laryngeal and pharyngeal activities than vocally untrained subjects. Apparently, this higher activity is associated to speaking voice training and not to a hyperfunctional vocal behavior. Anterior-posterior laryngeal compression is greater than medial compression. Intensity and phonatory tasks have an effect on all laryngoscopic variables. Supraglottic activity during professional speaking voice may be not necessarily a hyperfunctional behavior, but a strategy to avoid vocal fold damage while producing the desired voice quality. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Dysphonia in adults with developmental stuttering: A descriptive study.

PubMed

Botha, Anél; Ras, Elizbé; Abdoola, Shabnam; Van der Linde, Jeannie

2017-06-26

Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised. This study aimed to describe the vocal characteristics of PWS. Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41). The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

Vocal Acoustic and Auditory-Perceptual Characteristics During Fluctuations in Estradiol Levels During the Menstrual Cycle: A Longitudinal Study.

PubMed

Arruda, Polyanna; Diniz da Rosa, Marine Raquel; Almeida, Larissa Nadjara Alves; de Araujo Pernambuco, Leandro; Almeida, Anna Alice

2018-03-07

Estradiol production varies cyclically, changes in levels are hypothesized to affect the voice. The main objective of this study was to investigate vocal acoustic and auditory-perceptual characteristics during fluctuations in the levels of the hormone estradiol during the menstrual cycle. A total of 44 volunteers aged between 18 and 45 were selected. Of these, 27 women with regular menstrual cycles comprised the test group (TG) and 17 combined oral contraceptive users comprised the control group (CG). The study was performed in two phases. In phase 1, anamnesis was performed. Subsequently, the TG underwent blood sample collection for measurement of estradiol levels and voice recording for later acoustic and auditory-perceptual analysis. The CG underwent only voice recording. Phase 2 involved the same measurements as phase 1 for each group. Variables were evaluated using descriptive and inferential analysis to compare groups and phases and to determine relationships between variables. Voice changes were found during the menstrual cycle, and such changes were determined to be related to variations in estradiol levels. Impaired voice quality was observed to be associated with decreased levels of estradiol. The CG did not demonstrate significant vocal changes during phases 1 and 2. The TG showed significant increases in vocal parameters of roughness, tension, and instability during phase 2 (the period of low estradiol levels) when compared with the CG. Low estradiol levels were also found to be negatively correlated with the parameters of tension, instability, and jitter and positively correlated with fundamental voice frequency. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji

2017-07-01

Objectives Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long-term solution; however, long-term voice outcome data are lacking. The objective of this study was to assess the long-term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Forty-seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow-ups and, in some cases, were sent to patients who missed follow-up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index-10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges. Results Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow-up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index-10 score improved significantly, from 26.3 to 9.4 (n = 17, P = .0009). Conclusions Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.

Perceptual analyses of spasmodic dysphonia before and after treatment.

PubMed

Cannito, Michael P; Woodson, Gayle E; Murry, Thomas; Bender, Brenda

2004-12-01

To evaluate expert listeners' perceptions of voice and fluency in persons with adductor spasmodic dysphonia (ADSD) before and after treatment with botulinum toxin type A (Botox), as a function of initial severity of the disorder (while controlling for patients' age at injection). Simple before-and-after trial with blinded randomized listener judgments. Ambulatory care clinic at a single medical center. Forty-two consecutive patients with ADSD who underwent examination, with a 3- to 6-week follow-up, after initial botulinum toxin type A injection. There were also 42 age- and sex-matched healthy control subjects. Injections of botulinum toxin type A into the thyroarytenoid muscle(s). Computer-implemented visual analog scaling judgments of voice quality and speech fluency made by expert listeners under psychoacoustically controlled conditions. Response to botulinum toxin type A varied markedly as a function of pretreatment severity of ADSD. More severe initial symptoms exhibited greater magnitudes of improvement. Patients with mild dysphonia did not exhibit pretreatment to posttreatment change. Following treatment, voice and fluency remained significantly (P<.05) poorer in ADSD than in healthy speakers. Older patients exhibited less improvement than younger patients when the effect of initial severity was statistically controlled. Voice quality and fluency improved for most patients following treatment, but older patients and those with milder dysphonia exhibited the least optimal responses to the procedure. Patients who were profoundly impaired demonstrated the greatest amount of improvement. Computer-implemented visual analog scaling provided a reliable clinical tool for determining treatment-related changes in those with ADSD.

Acoustic evolution of old Italian violins from Amati to Stradivari.

PubMed

Tai, Hwan-Ching; Shen, Yen-Ping; Lin, Jer-Horng; Chung, Dai-Ting

2018-06-05

The shape and design of the modern violin are largely influenced by two makers from Cremona, Italy: The instrument was invented by Andrea Amati and then improved by Antonio Stradivari. Although the construction methods of Amati and Stradivari have been carefully examined, the underlying acoustic qualities which contribute to their popularity are little understood. According to Geminiani, a Baroque violinist, the ideal violin tone should "rival the most perfect human voice." To investigate whether Amati and Stradivari violins produce voice-like features, we recorded the scales of 15 antique Italian violins as well as male and female singers. The frequency response curves are similar between the Andrea Amati violin and human singers, up to ∼4.2 kHz. By linear predictive coding analyses, the first two formants of the Amati exhibit vowel-like qualities (F1/F2 = 503/1,583 Hz), mapping to the central region on the vowel diagram. Its third and fourth formants (F3/F4 = 2,602/3,731 Hz) resemble those produced by male singers. Using F1 to F4 values to estimate the corresponding vocal tract length, we observed that antique Italian violins generally resemble basses/baritones, but Stradivari violins are closer to tenors/altos. Furthermore, the vowel qualities of Stradivari violins show reduced backness and height. The unique formant properties displayed by Stradivari violins may represent the acoustic correlate of their distinctive brilliance perceived by musicians. Our data demonstrate that the pioneering designs of Cremonese violins exhibit voice-like qualities in their acoustic output. Copyright © 2018 the Author(s). Published by PNAS.

Do body mass index and fat volume influence vocal quality, phonatory range, and aerodynamics in females?

PubMed

Barsties, Ben; Verfaillie, Rudi; Roy, Nelson; Maryn, Youri

2013-01-01

To analyze the impact of body weight and body fat volume on selected parameters of vocal quality, phonatory range, and aerodynamics in females. Based on measurements of body mass index in combination with body fat volume, 29 normophonic female subjects were classified as normal weight, underweight, and obese. Voice quality was investigated via auditory-perceptual ratings of breathiness, roughness, and overall dysphonia severity, via various acoustic measures and a multiparametric index. Phonatory range performance was examined using selected measures of the voice range profile and speech range profile. Measures of vocally relevant aerodynamics included vital capacity (i.e., VC), expected VC, phonation quotient, and maximum phonation time (i.e., MPT). Significant differences between the three weight groups were found across several measures of intensity, VC, MPT, and shimmer. As compared to the other groups, significantly higher values of maximum and minimum intensity levels, as well as sound pressure level during habitual running speech were observed for the obese group (all p-values<0.05); whereas, the underweight group had significantly lower values for VC and ratio of expected to measured VC (p-values<0.01). Furthermore, underweight subjects differed significantly as compared to normal weight subjects with lower MPT (p=0.025) and higher lowest-F0 (p=0.035). Finally the obese group showed significantly lower shimmer values than the normal weight subjects (p<0.05). Body weight and body fat volume appear to influence select objective measures of voice quality, vocal aerodynamics, and phonatory range performance.

[Role of psychological factors in pathogenesis of disturbances of voice caused with vocal nodules].

PubMed

Ratajczak, Jan; Grzywacz, Krzysztof; Wojdas, Andrzej; Rapiejko, Piotr; Jurkiewicz, Dariusz

2008-01-01

Hoarseness is most frequent complaint notified by ill in phoniatric outpatient clinics. Looking of causes notified of disturbances of voice often we ascertain in larynx existence of vocal nodules. Changes these come into being in consequence of excessive or irregular phonations. Single incident of disturbances of voice caused with oedema changes nascent of in consequence of inappropriate work with voice does not wake of our trouble, instead returns this of type of complaint provoke to other researches coexisting of etiological factors this diseases. Estimation of influence of individual personality trait of ill on formation of vocal nodules. One examined 20 patients with vocal nodules classified to treatments operating and 20 without disturbances of voice. All patients were subjected to otolaryngological and stroboscopic examinations. Character created of voice one examined at help of scale GRBAS, instead influence of disturbances of voice on quality of life ill at help of test VHI. Psychological examinations one executed using questionnaire State-Trait-Anxiety-Inventory (STAI), questionnaire NEO-FFI and questionnaire of aggression Buss-Perry. Obtained results showed, that persons with returning vocal nodules, both during of research as in different situations everyday lives characterizes with higher level of fear and have greater inclination to worry oneself. Ill from groups examined in greater degree are extroverts, show greater activity and more are contagious socially in comparison to persons of comparative group. Attitude this in situations extorting rivalry will be able to be ruthless, are well organized guided, scrupulous and consistently endeavour to aim. Wanting efficiently to treat persons with returning vocal nodules we should subject to ill psychological examination and in once of ascertainment of irregularity to correct it, what at simultaneous correct treatment of organic changes should diminish frequency or to eliminate returns of disease. Skill psychological looks on patient by therapists treating disturbances of voice and speeches in case not large emotional instabilities probably would be able to improve results of treatment ill not only with functional disturbances of voice but also with disturbances of voice caused with organic changes in larynx.

Evaluation of voice codecs for the Australian mobile satellite system

NASA Technical Reports Server (NTRS)

Bundrock, Tony; Wilkinson, Mal

1990-01-01

The evaluation procedure to choose a low bit rate voice coding algorithm is described for the Australian land mobile satellite system. The procedure is designed to assess both the inherent quality of the codec under 'normal' conditions and its robustness under 'severe' conditions. For the assessment, normal conditions were chosen to be random bit error rate with added background acoustic noise and the severe condition is designed to represent burst error conditions when mobile satellite channel suffers from signal fading due to roadside vegetation. The assessment is divided into two phases. First, a reduced set of conditions is used to determine a short list of candidate codecs for more extensive testing in the second phase. The first phase conditions include quality and robustness and codecs are ranked with a 60:40 weighting on the two. Second, the short listed codecs are assessed over a range of input voice levels, BERs, background noise conditions, and burst error distributions. Assessment is by subjective rating on a five level opinion scale and all results are then used to derive a weighted Mean Opinion Score using appropriate weights for each of the test conditions.

Teachers' Voices: Work Environment Conditions That Impact Teacher Practice and Program Quality

ERIC Educational Resources Information Center

Whitebook, Marcy; King, Elizabeth; Philipp, George; Sakai, Laura

2016-01-01

Early childhood teachers routinely face insufficient teaching supports and inadequate rewards for their education and commitment (e.g., low pay, lack of professional supports, and lack of benefits). These shortcomings contribute to poor program quality and fuel high levels of teacher turnover, preventing program improvement and making it…

Voices in Education: Accountability in Teacher Education and the National Council on Teacher Quality

ERIC Educational Resources Information Center

Paulson, Sharon; Marchant, Greg

2011-01-01

Personally, the authors have seen the evolution of teacher education for over 30 years. From "diagnostic/prescriptive teaching" through "reflective practice," the quality of the programs and students has improved greatly. Turning that subjective appraisal into a quantifiable evaluation is a tricky enterprise in education. However, the demand for…

E-Learning and the Development of "Voice" in Business Studies Education

ERIC Educational Resources Information Center

Hart, Mike; Rush, David

2007-01-01

Purpose: This paper seeks to engage in an examination of "Quality in Business Education" (the QUBE project) with a specific brief to examine student involvement in the quality process. Design/methodology/approach: The work was carried out in conjunction with five partner institutions. The semantic distinctions between the terms…

Caring Teacher Qualities that Affect School Participation and Attendance: Student Portraits

ERIC Educational Resources Information Center

Grimm, Helen M.

2009-01-01

This study explores the perspectives of four high school students focusing on the identification of caring teacher qualities and the influence those characteristics have on school participation and attendance. Data was collected using interviews rather than survey in order to hear the often-unheard voices of students. Portraits of each student…

Listening to the Voice of the Customer.

ERIC Educational Resources Information Center

Schauerman, Sam; And Others

One of the major tenets of Total Quality Management (TQM) is that organizations need to adopt a strong customer focus. At El Camino College (ECC) in Torrance, California, a matrix was developed to identify and describe ECC's direct and indirect internal and external customers. ECC then applied Quality Function Deployment (QFD), a strategic tool…

Inuit Voices on Quality Education in Nunavut: Policy Implications

ERIC Educational Resources Information Center

Fredua-Kwarteng, Eric

2016-01-01

This paper is based on a research that explored how Inuit community members in Nunavut Territory, Canada, conceptualized quality education in the socio-cultural context of the territory. Data were collected through telephone interviews of 13 Inuit community members in Nunavut and document reviews both of which were conducted in 2010. The data…

An investigation of abdominal muscle recruitment for sustained phonation in 25 healthy singers.

PubMed

Macdonald, Ian; Rubin, John S; Blake, Ed; Hirani, Shashi; Epstein, Ruth

2012-11-01

The purpose of this study was to investigate the baseline muscle thickness and recruitment patterns of the transversus abdominis muscle (TAM) and the internal oblique muscle (IOM) during semisupine phonation in a group of healthy performers. This was a 2 × 3×2 within-group, repeated-measure study in which 25 professional vocalists--12 male and 13 female performed a series of sustained pitches in differing vocal qualities. Measurements were taken with ultrasound (Sonosite Micromaxx Ultrasound System) of the baseline thickness and % recruitment during voicing, of two deep abdominal muscles--TAM and the IOM. Correlations between TAM and IOM absolute change scores, TAM and IOM percentage change scores, and changes in muscle thickness (absolute and percentage) and age were examined using Spearman's correlations. Gender differences in the four types of change scores within each combination of pitch and quality were conducted with one-way analysis of variances. Differences in muscle thickness change 1) absolute scores and 2) percentage change in TAM and IOM, by pitch and quality (and their interactions) were analyzed using linear mixed models, using restricted maximum likelihood estimations, employing a Toeplitz variance-covariance matrix structure in SPSS (IBM, 2011). Post hoc analyses for independent variable group differences used Sidak's correction for multiple comparisons. Alpha level was set to 0.05. In terms of absolute contractions (changes in the actual millimeter thickness of the muscle), the IOM was greater than the TAM. However in terms of percentage changes in muscles during phonation, the TAM was always greater than the IOM. The TAM as a percentage change was recruited preferentially and significantly in most vocal qualities tested. Although there were differences in muscle mass and recruitment patterns between genders, and males had thicker muscle mass at rest, differences due to muscle mass were not conclusive. Overall this study supports the argument that the peri-abdominal muscles do indeed play a role in supporting the "performing" or athletic voice in healthy subjects, and will hopefully act as a database for further research in individuals with healthy and injured voices. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Instrumental and perceptual evaluations of two related singers.

PubMed

Buder, Eugene H; Wolf, Teresa

2003-06-01

The primary goal of this study was to characterize a performer's singing and speaking voice. One woman was not admitted to a premier choral group, but her sister, who was comparable in physical characteristics and background, was admitted and provided a valuable control subject. The perceptual judgment of a vocal coach who conducted the group's auditions was decisive in discriminating these 2 singers. The singer not admitted to the group described a history of voice pathology, lacked a functional head register, and spoke with a voice characterized by hoarseness. Multiple listener judgments and acoustic and aerodynamic evaluations of both singers provided a more systematic basis for determining: 1) the phonatory basis for this judgment; 2) whether similar judgments would be made by groups of vocal coaches and speech-language pathologists; and 3) whether the type of tasks (e.g., sung vs. spoken) would influence these judgments. Statistically significant differences were observed between the ratings of vocal health provided by two different groups of listeners. Significant interactions were also observed as a function of the types of voice samples heard by these listeners. Instrumental analyses provided evidence that, in comparison to her sister, the rejected singer had a compromised vocal range, glottal insufficiencies as assessed aerodynamically and electroglottographically, and impaired acoustic quality, especially in her speaking voice.

Automatic estimation of voice onset time for word-initial stops by applying random forest to onset detection.

PubMed

Lin, Chi-Yueh; Wang, Hsiao-Chuan

2011-07-01

The voice onset time (VOT) of a stop consonant is the interval between its burst onset and voicing onset. Among a variety of research topics on VOT, one that has been studied for years is how VOTs are efficiently measured. Manual annotation is a feasible way, but it becomes a time-consuming task when the corpus size is large. This paper proposes an automatic VOT estimation method based on an onset detection algorithm. At first, a forced alignment is applied to identify the locations of stop consonants. Then a random forest based onset detector searches each stop segment for its burst and voicing onsets to estimate a VOT. The proposed onset detection can detect the onsets in an efficient and accurate manner with only a small amount of training data. The evaluation data extracted from the TIMIT corpus were 2344 words with a word-initial stop. The experimental results showed that 83.4% of the estimations deviate less than 10 ms from their manually labeled values, and 96.5% of the estimations deviate by less than 20 ms. Some factors that influence the proposed estimation method, such as place of articulation, voicing of a stop consonant, and quality of succeeding vowel, were also investigated. © 2011 Acoustical Society of America

Self-reported changes in the professional singing voice after surgical intervention treatment for breast cancer: a survey pilot study of female professional singers.

PubMed

Baroody, Margaret M; Barnes-Burroughs, Kathryn; Rodriguez, Michael C; Sataloff, Dahlia M; Sataloff, Robert Thayer

2013-03-01

The effects of breast cancer surgical treatment on the professional singing voice are unknown. The purpose of this study was to discover whether there are self-perceived changes in the quality and/or process of singing experienced by professional female singers who have undergone surgical intervention for the treatment of diagnosed breast cancer-including any changes perceived from the use of radiation, chemotherapy, and other drug treatments related to those surgeries. A voluntary subject pool comprised female professional singers who have undergone surgery for breast cancer was recruited from professional singing networks. Participants underwent evaluation through an anonymous online survey, psychometrically vetted for content and instrument reliability/validity before administration. Valid participants (N=56) responded to 45 questions regarding surgical procedures, related therapies, and self-perceived vocal effects. Analysis of results produced a preliminary description of types of voice change, duration of changes, and qualitative self-perceptions. This initial report reveals that there are self-perceived singing voice changes experienced by professional singers treated for breast cancer. However, additional research is needed to determine the degree of vocal impact perceived to be attributable to individual surgical interventions and related therapies. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Singing ability is rooted in vocal-motor control of pitch.

PubMed

Hutchins, Sean; Larrouy-Maestri, Pauline; Peretz, Isabelle

2014-11-01

The inability to vocally match a pitch can be caused by poor pitch perception or by poor vocal-motor control. Although previous studies have tried to examine the relationship between pitch perception and vocal production, they have failed to control for the timbre of the target to be matched. In the present study, we compare pitch-matching accuracy with an unfamiliar instrument (the slider) and with the voice, designed such that the slider plays back recordings of the participant's own voice. We also measured pitch accuracy in singing a familiar melody ("Happy Birthday") to assess the relationship between single-pitch-matching tasks and melodic singing. Our results showed that participants (all nonmusicians) were significantly better at matching recordings of their own voices with the slider than with their voice, indicating that vocal-motor control is an important limiting factor on singing ability. We also found significant correlations between the ability to sing a melody in tune and vocal pitch matching, but not pitch matching on the slider. Better melodic singers also tended to have higher quality voices (as measured by acoustic variables). These results provide important evidence about the role of vocal-motor control in poor singing ability and demonstrate that single-pitch-matching tasks can be useful in measuring general singing abilities.

A comparison of recordings of sentences and spontaneous speech: perceptual and acoustic measures in preschool children's voices.

PubMed

McAllister, Anita; Brandt, Signe Kofoed

2012-09-01

A well-controlled recording in a studio is fundamental in most voice rehabilitation. However, this laboratory like recording method has been questioned because voice use in a natural environment may be quite different. In children's natural environment, high background noise levels are common and are an important factor contributing to voice problems. The primary noise source in day-care centers is the children themselves. The aim of the present study was to compare perceptual evaluations of voice quality and acoustic measures from a controlled recording with recordings of spontaneous speech in children's natural environment in a day-care setting. Eleven 5-year-old children were recorded three times during a day at the day care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated three times. Recordings were randomized and analyzed acoustically and perceptually. Statistic analyses showed that fundamental frequency was significantly higher in spontaneous speech (P<0.01) as was hyperfunction (P<0.001). The only characteristic the controlled sentences shared with spontaneous speech was degree of hoarseness (Spearman's rho=0.564). When data for boys and girls were analyzed separately, a correlation was found for the parameter breathiness (rho=0.551) for boys, and for girls the correlation for hoarseness remained (rho=0.752). Regarding acoustic data, none of the measures correlated across recording conditions for the whole group. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

High-frequency energy in singing and speech

NASA Astrophysics Data System (ADS)

Monson, Brian Bruce

While human speech and the human voice generate acoustical energy up to (and beyond) 20 kHz, the energy above approximately 5 kHz has been largely neglected. Evidence is accruing that this high-frequency energy contains perceptual information relevant to speech and voice, including percepts of quality, localization, and intelligibility. The present research was an initial step in the long-range goal of characterizing high-frequency energy in singing voice and speech, with particular regard for its perceptual role and its potential for modification during voice and speech production. In this study, a database of high-fidelity recordings of talkers was created and used for a broad acoustical analysis and general characterization of high-frequency energy, as well as specific characterization of phoneme category, voice and speech intensity level, and mode of production (speech versus singing) by high-frequency energy content. Directionality of radiation of high-frequency energy from the mouth was also examined. The recordings were used for perceptual experiments wherein listeners were asked to discriminate between speech and voice samples that differed only in high-frequency energy content. Listeners were also subjected to gender discrimination tasks, mode-of-production discrimination tasks, and transcription tasks with samples of speech and singing that contained only high-frequency content. The combination of these experiments has revealed that (1) human listeners are able to detect very subtle level changes in high-frequency energy, and (2) human listeners are able to extract significant perceptual information from high-frequency energy.

Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.

PubMed

Sanuki, Tetsuji; Yumoto, Eiji; Kodama, Narihiro; Minoda, Ryosei; Kumai, Yoshihiko

2014-06-01

To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Speech enhancement on smartphone voice recording

NASA Astrophysics Data System (ADS)

Tris Atmaja, Bagus; Nur Farid, Mifta; Arifianto, Dhany

2016-11-01

Speech enhancement is challenging task in audio signal processing to enhance the quality of targeted speech signal while suppress other noises. In the beginning, the speech enhancement algorithm growth rapidly from spectral subtraction, Wiener filtering, spectral amplitude MMSE estimator to Non-negative Matrix Factorization (NMF). Smartphone as revolutionary device now is being used in all aspect of life including journalism; personally and professionally. Although many smartphones have two microphones (main and rear) the only main microphone is widely used for voice recording. This is why the NMF algorithm widely used for this purpose of speech enhancement. This paper evaluate speech enhancement on smartphone voice recording by using some algorithms mentioned previously. We also extend the NMF algorithm to Kulback-Leibler NMF with supervised separation. The last algorithm shows improved result compared to others by spectrogram and PESQ score evaluation.

Detection of high-frequency energy changes in sustained vowels produced by singers

PubMed Central

Monson, Brian B.; Lotto, Andrew J.; Ternström, Sten

2011-01-01

The human voice spectrum above 5 kHz receives little attention. However, there are reasons to believe that this high-frequency energy (HFE) may play a role in perceived quality of voice in singing and speech. To fulfill this role, differences in HFE must first be detectable. To determine human ability to detect differences in HFE, the levels of the 8- and 16-kHz center-frequency octave bands were individually attenuated in sustained vowel sounds produced by singers and presented to listeners. Relatively small changes in HFE were in fact detectable, suggesting that this frequency range potentially contributes to the perception of especially the singing voice. Detection ability was greater in the 8-kHz octave than in the 16-kHz octave and varied with band energy level. PMID:21476681

Evaluating voice characteristics of first-year acting students in Israel: factor analysis.

PubMed

Amir, Ofer; Primov-Fever, Adi; Kushnir, Tami; Kandelshine-Waldman, Osnat; Wolf, Michael

2013-01-01

Acting students require diverse, high-quality, and high-intensity vocal performance from early stages of their training. Demanding vocal activities, before developing the appropriate vocal skills, put them in high risk for developing vocal problems. A retrospective analysis of voice characteristics of first-year acting students using several voice evaluation tools. A total of 79 first-year acting students (55 women and 24 men) were assigned into two study groups: laryngeal findings (LFs) and no laryngeal findings, based on stroboscopic findings. Their voice characteristics were evaluated using acoustic analysis, aerodynamic examination, perceptual scales, and self-report questionnaires. Results obtained from each set of measures were examined using a factor analysis approach. Significant differences between the two groups were found for a single fundamental frequency (F(0))-Regularity factor; a single Grade, Roughness, Breathiness, Asthenia, Strain perceptual factor; and the three self-evaluation factors. Gender differences were found for two acoustic analysis factors, which were based on F(0) and its derivatives, namely an aerodynamic factor that represents expiratory volume measurements and a single self-evaluation factor that represents the tendency to seek therapy. Approximately 50% of the first-year acting students had LFs. These students differed from their peers in the control group in a single acoustic analysis factor, as well as perceptual and self-report factors. No group differences, however, were found for the aerodynamic factors. Early laryngeal examination and voice evaluation of future professional voice users could provide a valuable individual baseline, to which later examinations could be compared, and assist in providing personally tailored treatment. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Correlation of VHI-30 to Acoustic Measurements Across Three Common Voice Disorders.

PubMed

Dehqan, Ali; Yadegari, Fariba; Scherer, Ronald C; Dabirmoghadam, Peyman

2017-01-01

Voice disorders that affect the quality of voice also result in varying degrees of psychological and social problems. The research question here is whether the correlations between Voice Handicap Index (VHI)-30 scores and objective acoustic measures differ in patients with different types of voice disorders. The subjects were divided into three groups: muscle tension dysphonia (MTD), benign mid-membranous vocal fold lesions, and unilateral vocal fold paralysis (UVFP). All participants were male. The mean age for the groups were 32.85 ± 8.6 years in the MTD group, 33.24 ± 7.32 years in the benign lesions group, and 34.24 ± 7.51 years in the UVFP group. The participants completed the Persian VHI-30 questionnaire. PRAAT software was used to obtain acoustic analyses. There was a significant correlation between the physical subscale of the VHI-30 and the total score of the VHI-30 and maximum phonation time (MPT) in the MTD group. Also, there was a significant correlation between the total VHI-30 score and the MPT value. There were relatively strong and significant correlations between the physical subscale of the VHI-30 with jitter and shimmer, harmonics-to-noise ratio (HNR) for the group with benign lesions such as nodules and polyps. Also, in this group, there was a significant correlation between the total VHI-30 score and the jitter value. The physical scale had strong and significant correlations between jitter, shimmer, and HNR in the unilateral paralysis group. Findings suggest that although the VHI-30 and the acoustic measurements of voice provide independent information, they are associated to some extent. Copyright © 2017 The Voice Foundation. All rights reserved.

'It's like there are two people in my head': a phenomenological exploration of anorexia nervosa and its relationship to the self.

PubMed

Williams, Sarah; Reid, Marie

2012-01-01

This study explores the lived experience of anorexia nervosa from the perspective of those who use pro-recovery websites for eating disorders. Fourteen people participated in an online focus group or an e-interview. Data were analysed using interpretative phenomenological analysis. Participants described their disorder as a functional tool for avoiding and coping with negative emotions, changing their identity and obtaining control. A central theme was the experience of an 'anorexic voice' with both demonic and friendly qualities. This voice felt like an external entity that criticised individuals and sometimes dominated their sense of self, particularly as anorexia nervosa got worse. Applying dialogical theory suggests a new model of anorexia nervosa, where the anorexic voice is a self-critical position, which disagrees with and attempts to dominate the more rational self. It is suggested that to move on from anorexia nervosa, the individual needs to address his/her anorexic voice and develop a new dominant position that accepts and values his/her sense of self.

Construction site Voice Operated Information System (VOIS) test

NASA Astrophysics Data System (ADS)

Lawrence, Debbie J.; Hettchen, William

1991-01-01

The Voice Activated Information System (VAIS), developed by USACERL, allows inspectors to verbally log on-site inspection reports on a hand held tape recorder. The tape is later processed by the VAIS, which enters the information into the system's database and produces a written report. The Voice Operated Information System (VOIS), developed by USACERL and Automated Sciences Group, through a ESACERL cooperative research and development agreement (CRDA), is an improved voice recognition system based on the concepts and function of the VAIS. To determine the applicability of the VOIS to Corps of Engineers construction projects, Technology Transfer Test Bad (T3B) funds were provided to the Corps of Engineers National Security Agency (NSA) Area Office (Fort Meade) to procure and implement the VOIS, and to train personnel in its use. This report summarizes the NSA application of the VOIS to quality assurance inspection of radio frequency shielding and to progress payment logs, and concludes that the VOIS is an easily implemented system that can offer improvements when applied to repetitive inspection procedures. Use of VOIS can save time during inspection, improve documentation storage, and provide flexible retrieval of stored information.

Computational Modeling of Fluid–Structure–Acoustics Interaction during Voice Production

PubMed Central

Jiang, Weili; Zheng, Xudong; Xue, Qian

2017-01-01

The paper presented a three-dimensional, first-principle based fluid–structure–acoustics interaction computer model of voice production, which employed a more realistic human laryngeal and vocal tract geometries. Self-sustained vibrations, important convergent–divergent vibration pattern of the vocal folds, and entrainment of the two dominant vibratory modes were captured. Voice quality-associated parameters including the frequency, open quotient, skewness quotient, and flow rate of the glottal flow waveform were found to be well within the normal physiological ranges. The analogy between the vocal tract and a quarter-wave resonator was demonstrated. The acoustic perturbed flux and pressure inside the glottis were found to be at the same order with their incompressible counterparts, suggesting strong source–filter interactions during voice production. Such high fidelity computational model will be useful for investigating a variety of pathological conditions that involve complex vibrations, such as vocal fold paralysis, vocal nodules, and vocal polyps. The model is also an important step toward a patient-specific surgical planning tool that can serve as a no-risk trial and error platform for different procedures, such as injection of biomaterials and thyroplastic medialization. PMID:28243588

Speech waveform perturbation analysis: a perceptual-acoustical comparison of seven measures.

PubMed

Askenfelt, A G; Hammarberg, B

1986-03-01

The performance of seven acoustic measures of cycle-to-cycle variations (perturbations) in the speech waveform was compared. All measures were calculated automatically and applied on running speech. Three of the measures refer to the frequency of occurrence and severity of waveform perturbations in special selected parts of the speech, identified by means of the rate of change in the fundamental frequency. Three other measures refer to statistical properties of the distribution of the relative frequency differences between adjacent pitch periods. One perturbation measure refers to the percentage of consecutive pitch period differences with alternating signs. The acoustic measures were tested on tape recorded speech samples from 41 voice patients, before and after successful therapy. Scattergrams of acoustic waveform perturbation data versus an average of perceived deviant voice qualities, as rated by voice clinicians, are presented. The perturbation measures were compared with regard to the acoustic-perceptual correlation and their ability to discriminate between normal and pathological voice status. The standard deviation of the distribution of the relative frequency differences was suggested as the most useful acoustic measure of waveform perturbations for clinical applications.

Telecommunications Systems Career Ladder, AFSC 307XO.

DTIC Science & Technology

1981-01-01

standard test tone levels perform impulse noise tests make in-service or out-of- service quality check.s on composite signal transmission levels Even...service or out-of- service quality control (QC) reports maintain trouble and restoration record forms (DD Form 1443) direct circuit or system checks...include: perform fault isolation on analog circuits make in-service or out-of- service quality checks on voice frequency carrier telegraph (VFCT) terminals

Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review.

PubMed

Lechien, J R; Blecic, S; Huet, K; Delvaux, V; Piccaluga, M; Roland, V; Harmegnies, B; Saussez, S

2018-06-01

To investigate voice quality (VQ) impairments in idiopathic Parkinson's disease (IPD) and to explore the impact of medical treatments and L-Dopa challenge testing on voice. Relevant studies published between January 1980 and June 2017 describing VQ evaluations in IPD were retrieved using PubMed, Scopus, Biological Abstracts, BioMed Central and Cochrane databases. Issues of clinical relevance, including IPD treatment efficiency and voice quality outcomes, were evaluated for each study. The grade of recommendation for each publication was determined according to the Oxford Centre for Evidence-Based Medicine evidence levels. The database research yielded 106 relevant publications, of which 33 studies met the inclusion criteria, for a total of 964 patients with IPD. Data were extracted by 3 independent physicians who identified 21, 11 and 1 trials with IIIb, IIb and IIa evidence levels, respectively. The main VQ assessment tools used were acoustic testing (N = 27), aerodynamic testing (N = 10), subjective measurements (N = 8) and videolaryngostroboscopy (N = 3). The majority of trials (N = 32/33) identified subjective or objective VQ improvements after medical treatment (N = 10) or better VQ evaluations in healthy subjects compared to patients with IPD (N = 22). Especially, our analysis supports that VQ overall improves during the L-Dopa challenge testing, making the VQ evaluation an additional tool for the IPD diagnosis. The methodology used to assess subjective and objective VQ substantially varied from 1 study to another. All of the included studies took into consideration the patient's clinical profile in the VQ analysis. The majority of studies supported that VQ assessments remain useful as outcome measures of the effectiveness of medical treatment and could be helpful for the IPD diagnosis based on L-Dopa challenge testing. Further controlled studies using standardised and transparent methodology for measuring acoustic parameters are necessary to confirm the place of each tool in both IPD diagnosis and treatment evaluation. © 2018 John Wiley & Sons Ltd.

ATC/pilot voice communications: A survey of the literature

NASA Astrophysics Data System (ADS)

Prinzo, O. Veronika; Britton, Thomas W.

1993-11-01

The first radio-equipped control tower in the United States opened at the Cleveland Municipal Airport in 1930. From that time to the present, voice radio communications have played a primary role in air safety. Verbal communications in air traffic control (ATC) operations have been frequently cited as causal factors in operational errors and pilot deviations in the FAA Operational Error and Deviation System, the NASA Aviation Safety Reporting System (ASRS), and reports derived from government sponsored research projects. Collectively, the data provided by these programs indicate that communications constitute a significant problem for pilots and controllers. Although the communications problem was well known the research literature was fragmented, making it difficult to appreciate the various types of verbal communications problems that existed and their unique influence on the quality of ATC/pilot communications. This is a survey of the voice radio communications literature. The 43 reports in the review represent survey data, field studies, laboratory studies, narrative reports, and reviews. The survey topics pertain to communications taxonomies, acoustical correlates and cognitive/psycholinguistic perspectives. Communications taxonomies were used to identify the frequency and types of information that constitute routine communications, as well as those communications involved in operational errors, pilot deviations, and other safety-related events. Acoustical correlate methodologies identified some qualities of a speaker's voice, such as loudness, pitch, and speech rate, which might be used potentially to monitor stress, mental workload, and other forms of psychological or physiological factors that affect performance. Cognitive/psycho-linguistic research offered an information processing perspective for understanding how pilots' and controllers' memory and language comprehension processes affect their ability to communicate effectively with one another. This analysis of the ATC/pilot voice radio communications literature was performed to provide an organized summary for the systematic study of interactive communications between controllers and pilots. Recommendations are given for new research initiatives, communications-based instructional materials, and human factors applications for new communications systems.

A recursive linear predictive vocoder

NASA Astrophysics Data System (ADS)

Janssen, W. A.

1983-12-01

A non-real time 10 pole recursive autocorrelation linear predictive coding vocoder was created for use in studying effects of recursive autocorrelation on speech. The vocoder is composed of two interchangeable pitch detectors, a speech analyzer, and speech synthesizer. The time between updating filter coefficients is allowed to vary from .125 msec to 20 msec. The best quality was found using .125 msec between each update. The greatest change in quality was noted when changing from 20 msec/update to 10 msec/update. Pitch period plots for the center clipping autocorrelation pitch detector and simplified inverse filtering technique are provided. Plots of speech into and out of the vocoder are given. Formant versus time three dimensional plots are shown. Effects of noise on pitch detection and formants are shown. Noise effects the voiced/unvoiced decision process causing voiced speech to be re-constructed as unvoiced.

Automatic intelligibility classification of sentence-level pathological speech

PubMed Central

Kim, Jangwon; Kumar, Naveen; Tsiartas, Andreas; Li, Ming; Narayanan, Shrikanth S.

2014-01-01

Pathological speech usually refers to the condition of speech distortion resulting from atypicalities in voice and/or in the articulatory mechanisms owing to disease, illness or other physical or biological insult to the production system. Although automatic evaluation of speech intelligibility and quality could come in handy in these scenarios to assist experts in diagnosis and treatment design, the many sources and types of variability often make it a very challenging computational processing problem. In this work we propose novel sentence-level features to capture abnormal variation in the prosodic, voice quality and pronunciation aspects in pathological speech. In addition, we propose a post-classification posterior smoothing scheme which refines the posterior of a test sample based on the posteriors of other test samples. Finally, we perform feature-level fusions and subsystem decision fusion for arriving at a final intelligibility decision. The performances are tested on two pathological speech datasets, the NKI CCRT Speech Corpus (advanced head and neck cancer) and the TORGO database (cerebral palsy or amyotrophic lateral sclerosis), by evaluating classification accuracy without overlapping subjects’ data among training and test partitions. Results show that the feature sets of each of the voice quality subsystem, prosodic subsystem, and pronunciation subsystem, offer significant discriminating power for binary intelligibility classification. We observe that the proposed posterior smoothing in the acoustic space can further reduce classification errors. The smoothed posterior score fusion of subsystems shows the best classification performance (73.5% for unweighted, and 72.8% for weighted, average recalls of the binary classes). PMID:25414544

Exploring the anatomical encoding of voice with a mathematical model of the vocal system.

PubMed

Assaneo, M Florencia; Sitt, Jacobo; Varoquaux, Gael; Sigman, Mariano; Cohen, Laurent; Trevisan, Marcos A

2016-11-01

The faculty of language depends on the interplay between the production and perception of speech sounds. A relevant open question is whether the dimensions that organize voice perception in the brain are acoustical or depend on properties of the vocal system that produced it. One of the main empirical difficulties in answering this question is to generate sounds that vary along a continuum according to the anatomical properties the vocal apparatus that produced them. Here we use a mathematical model that offers the unique possibility of synthesizing vocal sounds by controlling a small set of anatomically based parameters. In a first stage the quality of the synthetic voice was evaluated. Using specific time traces for sub-glottal pressure and tension of the vocal folds, the synthetic voices generated perceptual responses, which are indistinguishable from those of real speech. The synthesizer was then used to investigate how the auditory cortex responds to the perception of voice depending on the anatomy of the vocal apparatus. Our fMRI results show that sounds are perceived as human vocalizations when produced by a vocal system that follows a simple relationship between the size of the vocal folds and the vocal tract. We found that these anatomical parameters encode the perceptual vocal identity (male, female, child) and show that the brain areas that respond to human speech also encode vocal identity. On the basis of these results, we propose that this low-dimensional model of the vocal system is capable of generating realistic voices and represents a novel tool to explore the voice perception with a precise control of the anatomical variables that generate speech. Furthermore, the model provides an explanation of how auditory cortices encode voices in terms of the anatomical parameters of the vocal system. Copyright © 2016 Elsevier Inc. All rights reserved.

Genetic expression programming-based DBA for enhancing peer-assisted music-on-demand service in EPON

NASA Astrophysics Data System (ADS)

Liem, Andrew Tanny; Hwang, I.-Shyan; Nikoukar, AliAkbar; Lee, Jhong-Yue

2015-03-01

Today, the popularity of peer-assisted music-on-demand (MoD) has increased significantly worldwide. This service allows users to access large music library tracks, listen to music, and share their playlist with other users. Unlike the conventional voice traffic, such an application maintains music quality that ranges from 160 kbps to 320 kbps, which most likely consumes more bandwidth than other traffics. In the access network, Ethernet passive optical network (EPON) is one of the best candidates for delivering such a service because of being cost-effective and with high bandwidth. To maintain music quality, a stutter needs to be prevented because of either network effects or when the due user was not receiving enough resources to play in a timely manner. Therefore, in this paper, we propose two genetic expression programming (GEP)-based dynamic bandwidth allocations (DBAs). The first DBA is a generic DBA that aims to find an optimum formula for voice, video, and data services. The second DBA aims to find optimum formulas so that Optical Line Terminal (OLT) can satisfy not only the voice and Peer-to-Peer (P2P) MoD traffics but also reduce the stutter. Optical Network Unit (ONU) traits such as REPORT and GATE messages, cycle time, and mean packet delay are set to be predictor variables. Simulation results show that our proposed DBAs can satisfy the voice and P2P MoD services packet delay and monitor other overall system performances such as expedited forwarding (EF) jitter, packet loss, bandwidth waste, and system throughputs.

Acoustic Analysis and Electroglottography in Elite Vocal Performers.

PubMed

Villafuerte-Gonzalez, Rocio; Valadez-Jimenez, Victor M; Sierra-Ramirez, Jose A; Ysunza, Pablo Antonio; Chavarria-Villafuerte, Karen; Hernandez-Lopez, Xochiquetzal

2017-05-01

Acoustic analysis of voice (AAV) and electroglottography (EGG) have been used for assessing vocal quality in patients with voice disorders. The effectiveness of these procedures for detecting mild disturbances in vocal quality in elite vocal performers has been controversial. To compare acoustic parameters obtained by AAV and EGG before and after vocal training to determine the effectiveness of these procedures for detecting vocal improvements in elite vocal performers. Thirty-three elite vocal performers were studied. The study group included 14 males and 19 females, ages 18-40 years, without a history of voice disorders. Acoustic parameters were obtained through AAV and EGG before and after vocal training using the Linklater method. Nonsignificant differences (P > 0.05) were found between values of fundamental frequency (F 0 ), shimmer, and jitter obtained by both procedures before vocal training. Mean F 0 was similar after vocal training. Jitter percentage as measured by AAV showed nonsignificant differences (P > 0.05) before and after vocal training. Shimmer percentage as measured by AAV demonstrated a significant reduction (P < 0.05) after vocal training. As measured by EGG after vocal training, shimmer and jitter were significantly reduced (P < 0.05); open quotient was significantly increased (P < 0.05); and irregularity was significantly reduced (P < 0.05). AAV and EGG were effective for detecting improvements in vocal function after vocal training in male and female elite vocal performers undergoing vocal training. EGG demonstrated better efficacy for detecting improvements and provided additional parameters as compared to AAV. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Quality of life and functional evaluation in patients with tongue base tumors treated exclusively with transoral robotic surgery: A 1-year follow-up study.

PubMed

Mercante, Giuseppe; Masiello, Alessandra; Sperduti, Isabella; Cristalli, Giovanni; Pellini, Raul; Spriano, Giuseppe

2015-10-01

To evaluate quality-of-life (QoL), swallowing and voice in patients with base of tongue (BOT) tumors treated with transoral robotic surgery (TORS) alone without any adjuvant treatment. The study was a prospective, single-center cohort trial. Swallowing, QoL and voice were evaluated in 13 patients with T1 or T2 oropharyngeal carcinomas of the BOT. Patients underwent evaluation using the following: a dysphagia score (DS); fiberoptic endoscopic evaluation-of-swallowing with the penetration aspiration scale (PAS); the MD Anderson Dysphagia Inventory (MDADI); and the Voice Handicap Index-10 (VHI-10). Subjective (DS) and objective (PAS) evaluation of swallowing produced mean scores of 1.08, 2.23 and 1.46 before surgery and at 6 and 12 months after surgery, respectively, for both tests. A significant difference was found when comparing DS and PAS data at baseline and 6 months after surgery; while no difference was observed between the baseline and 12 months after surgery. The mean values of the MDADI and VHI scores recorded before surgery, and at 6 and 12 months after surgery did not show any statistical difference. Objective swallowing deterioration in the first 6 months after TORS alone for BOT tumors was possible, but complete recovery of deglutition was observed within 12 months. No changes were reported in the patients' self-perceived status of swallowing and voice dysfunction, and related QoL after 1 year. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Experiences of hearing voices: analysis of a novel phenomenological survey

PubMed Central

Woods, Angela; Jones, Nev; Alderson-Day, Ben; Callard, Felicity; Fernyhough, Charles

2015-01-01

Summary Background Auditory hallucinations—or voices—are a common feature of many psychiatric disorders and are also experienced by individuals with no psychiatric history. Understanding of the variation in subjective experiences of hallucination is central to psychiatry, yet systematic empirical research on the phenomenology of auditory hallucinations remains scarce. We aimed to record a detailed and diverse collection of experiences, in the words of the people who hear voices themselves. Methods We made a 13 item questionnaire available online for 3 months. To elicit phenomenologically rich data, we designed a combination of open-ended and closed-ended questions, which drew on service-user perspectives and approaches from phenomenological psychiatry, psychology, and medical humanities. We invited people aged 16–84 years with experience of voice-hearing to take part via an advertisement circulated through clinical networks, hearing voices groups, and other mental health forums. We combined qualitative and quantitative methods, and used inductive thematic analysis to code the data and χ2 tests to test additional associations of selected codes. Findings Between Sept 9 and Nov 29, 2013, 153 participants completed the study. Most participants described hearing multiple voices (124 [81%] of 153 individuals) with characterful qualities (106 [69%] individuals). Less than half of the participants reported hearing literally auditory voices—70 (46%) individuals reported either thought-like or mixed experiences. 101 (66%) participants reported bodily sensations while they heard voices, and these sensations were significantly associated with experiences of abusive or violent voices (p=0·024). Although fear, anxiety, depression, and stress were often associated with voices, 48 (31%) participants reported positive emotions and 49 (32%) reported neutral emotions. Our statistical analysis showed that mixed voices were more likely to have changed over time (p=0·030), be internally located (p=0·010), and be conversational in nature (p=0·010). Interpretation This study is, to our knowledge, the largest mixed-methods investigation of auditory hallucination phenomenology so far. Our survey was completed by a diverse sample of people who hear voices with various diagnoses and clinical histories. Our findings both overlap with past large-sample investigations of auditory hallucination and suggest potentially important new findings about the association between acoustic perception and thought, somatic and multisensorial features of auditory hallucinations, and the link between auditory hallucinations and characterological entities. Funding Wellcome Trust. PMID:26360085

Hoarse voice in adults: an evidence-based approach to the 12 minute consultation.

PubMed

Syed, I; Daniels, E; Bleach, N R

2009-02-01

The hoarse voice is a common presentation in the adult ENT clinic. It is estimated that otolaryngology/voice clinics receive over 50 000 patients with dysphonia each year. Good vocal function is estimated to be required for around 1/3 of the labour force to fulfil their job requirements. The assessment and management of the patient with a hoarse voice is potentially a complex and protracted process as the aetiology is often multi-factorial. This article provides a guide for the clinician in the general ENT clinic to make a concise, thorough assessment of the hoarse patient and engage in an evidence based approach to investigation and management. Literature search performed on 4 October 2008 using EMBASE, MEDLINE, Cochrane databases using subject headings hoarse voice or dysphonia in combination with diagnosis, management, investigation, treatment, intervention and surgery. General vocal hygiene is beneficial for non organic dysphonia but the evidence base for individual components is poor. There is a good evidence base for the use of voice therapy as first line treatment of organic dysphonia such as vocal fold nodules and polyps. There is little evidence for surgical intervention as first line therapy for most common benign vocal fold lesions. Surgery is, however, the treatment of choice for hoarseness due to papillomatosis. Both CO(2) laser and microdissection are equally acceptable modalities for surgical resection of common benign vocal fold lesions. Laryngopharyngeal reflux is commonly cited as a cause of hoarseness but the evidence base for treatment with gastric acid suppression is poor. Despite the widespread use of proton pump inhibitors for treating laryngopharyngeal reflux, there is high quality evidence to suggest that they are no more effective than placebo. A concise and thorough approach to assessment in the general ENT clinic will provide the diagnosis and facilitate the management of the hoarse voice in the majority of cases. Voice therapy is an important tool that should be utilised in the general ENT clinic and should not be restricted to the specialist voice clinic. If there is no improvement after initial measures, the larynx appears normal and/or the patient has failed initial speech & language therapy, referral to a specialist voice clinic may be helpful. More research is still required particularly with regard to laryngopharyngeal reflux which is often cited as an important cause of hoarseness but is still poorly understood.

Sensing of Particular Speakers for the Construction of Voice Interface Utilized in Noisy Environment

NASA Astrophysics Data System (ADS)

Sawada, Hideyuki; Ohkado, Minoru

Human is able to exchange information smoothly using voice under different situations such as noisy environment in a crowd and with the existence of plural speakers. We are able to detect the position of a source sound in 3D space, extract a particular sound from mixed sounds, and recognize who is talking. By realizing this mechanism with a computer, new applications will be presented for recording a sound with high quality by reducing noise, presenting a clarified sound, and realizing a microphone-free speech recognition by extracting particular sound. The paper will introduce a realtime detection and identification of particular speaker in noisy environment using a microphone array based on the location of a speaker and the individual voice characteristics. The study will be applied to develop an adaptive auditory system of a mobile robot which collaborates with a factory worker.

Multipath/RFI/modulation study for DRSS-RFI problem: Voice coding and intelligibility testing for a satellite-based air traffic control system

NASA Technical Reports Server (NTRS)

Birch, J. N.; Getzin, N.

1971-01-01

Analog and digital voice coding techniques for application to an L-band satellite-basedair traffic control (ATC) system for over ocean deployment are examined. In addition to performance, the techniques are compared on the basis of cost, size, weight, power consumption, availability, reliability, and multiplexing features. Candidate systems are chosen on the bases of minimum required RF bandwidth and received carrier-to-noise density ratios. A detailed survey of automated and nonautomated intelligibility testing methods and devices is presented and comparisons given. Subjective evaluation of speech system by preference tests is considered. Conclusion and recommendations are developed regarding the selection of the voice system. Likewise, conclusions and recommendations are developed for the appropriate use of intelligibility tests, speech quality measurements, and preference tests with the framework of the proposed ATC system.

Presbiphonya.

PubMed

Bruzzi, Caterina; Salsi, Daria; Minghetti, Domenico; Negri, Maurizio; Casolino, Delfo; Sessa, Michele

2017-04-28

This article attempts to describe the aging process of the vocal folds and the main features of the aged voice. In the world ageing population era, aging diseases and aging disorders are crucial. Voice disorders (presbyphonia) are common in the elderly and have a significant impact on communication and quality of life. Some of these disorders depend on the vocal folds, which consist of an extracellular matrix (ECM), fibrous proteins, interstitial proteins, and glycosaminoglycans. The density and spatial arrangement of these elements are important, as changes in their deposition can alter the biomechanical properties and vibratory function of the vocal folds. The aging voice process is analyzed in detail from mechanical factors like pulmonary bellows alteration, to hormonal factors and life style. The elderly people undergoe mechanical, anatomical and functional changes: alterations of the pulmonary bellows, systemic changes like hormonal disregulation, and laryngeal changes, that resulting in hoarseness, which is difficult to treat.

Effects of Within-Talker Variability on Speech Intelligibility in Mandarin-Speaking Adult and Pediatric Cochlear Implant Patients

PubMed Central

Su, Qiaotong; Galvin, John J.; Zhang, Guoping; Li, Yongxin

2016-01-01

Cochlear implant (CI) speech performance is typically evaluated using well-enunciated speech produced at a normal rate by a single talker. CI users often have greater difficulty with variations in speech production encountered in everyday listening. Within a single talker, speaking rate, amplitude, duration, and voice pitch information may be quite variable, depending on the production context. The coarse spectral resolution afforded by the CI limits perception of voice pitch, which is an important cue for speech prosody and for tonal languages such as Mandarin Chinese. In this study, sentence recognition from the Mandarin speech perception database was measured in adult and pediatric Mandarin-speaking CI listeners for a variety of speaking styles: voiced speech produced at slow, normal, and fast speaking rates; whispered speech; voiced emotional speech; and voiced shouted speech. Recognition of Mandarin Hearing in Noise Test sentences was also measured. Results showed that performance was significantly poorer with whispered speech relative to the other speaking styles and that performance was significantly better with slow speech than with fast or emotional speech. Results also showed that adult and pediatric performance was significantly poorer with Mandarin Hearing in Noise Test than with Mandarin speech perception sentences at the normal rate. The results suggest that adult and pediatric Mandarin-speaking CI patients are highly susceptible to whispered speech, due to the lack of lexically important voice pitch cues and perhaps other qualities associated with whispered speech. The results also suggest that test materials may contribute to differences in performance observed between adult and pediatric CI users. PMID:27363714

Can we perceptually rate alaryngeal voice? Developing the Sunderland Tracheoesophageal Voice Perceptual Scale.

PubMed

Hurren, A; Hildreth, A J; Carding, P N

2009-12-01

To investigate the inter and intra reliability of raters (in relation to both profession and expertise) when judging two alaryngeal voice parameters: 'Overall Grade' and 'Neoglottal Tonicity'. Reliable perceptual assessment is essential for surgical and therapeutic outcome measurement but has been minimally researched to date. Test of inter and intra rater agreement from audio recordings of 55 tracheoesophageal speakers. Cancer Unit. Twelve speech and language therapists and ten Ear, Nose and Throat surgeons. Perceptual voice parameters of 'Overall Grade' rated with a 0-3 equally appearing interval scale and 'Neoglottal Tonicity' with an 11-point bipolar semantic scale. All raters achieved 'good' agreement for 'Overall Grade' with mean weighted kappa coefficients of 0.78 for intra and 0.70 for inter-rater agreement. All raters achieved 'good' intra-rater agreement for 'Neoglottal Tonicity' (0.64) but inter-rater agreement was only 'moderate' (0.40). However, the expert speech and language therapists sub-group attained 'good' inter-rater agreement with this parameter (0.63). The effect of 'Neoglottal Tonicity' on 'Overall Grade' was examined utilising only expert speech and language therapists data. Linear regression analysis resulted in an r-squared coefficient of 0.67. Analysis of the perceptual impression of hypotonicity and hypertonicity in relation to mean 'Overall Grade' score demonstrated neither tone was linked to a more favourable grade (P = 0.42). Expert speech and language therapist raters may be the optimal judges for tracheoesophageal voice assessment. Tonicity appears to be a good predictor of 'Overall Grade'. These scales have clinical applicability to investigate techniques that facilitate optotonic neoglottal voice quality.

Common Vocal Effects and Partial Glottal Vibration in Professional Nonclassical Singers.

PubMed

Caffier, Philipp P; Ibrahim Nasr, Ahmed; Ropero Rendon, Maria Del Mar; Wienhausen, Sascha; Forbes, Eleanor; Seidner, Wolfram; Nawka, Tadeus

2018-05-01

To multidimensionally investigate common vocal effects in experienced professional nonclassical singers, to examine their mechanism of production and reproducibility, to demonstrate the existence of partial glottal vibration, and to assess the potential of damage to the voice from nonclassical singing. Individual cohort study. Ten male singers aged between 25 and 46 years (34 ± 7 years [mean ± SD]) with different stylistic backgrounds were recruited (five pop/rock/metal, five musical theater). Participants repeatedly presented the usual nonclassical vocal effects and techniques in their repertoire. All performances were documented and analyzed using established instruments (eg, auditory-perceptual assessment, videolaryngostroboscopy, electroglottography, voice function diagnostics). The vocal apparatus of all singers was healthy and capable of high performance. Typical nonclassical vocal effects were breathy voice, creaky voice, vocal fry, grunting, distortion, rattle, belt, and twang. All effects could be easily differentiated from each other. They were intraindividually consistently repeatable and also interindividually produced in a similar manner. A special feature in one singer was the first evidence of partial glottal vibration when belting in the high register. The unintended transition to this reduced voice quality was accompanied by physical fatigue and inflexible respiratory support. The long-lasting use of the investigated nonclassical vocal effects had no negative impact on trained singers. The possibility of long-term damage depends on the individual constitution, specific use, duration, and extent of the hyperfunction. The incidence of partial glottal vibration and its consequences require continuing research to learn more about efficient and healthy vocal function in nonclassical singing. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effects of melody and technique on acoustical and musical features of western operatic singing voices.

PubMed

Larrouy-Maestri, Pauline; Magis, David; Morsomme, Dominique

2014-05-01

The operatic singing technique is frequently used in classical music. Several acoustical parameters of this specific technique have been studied but how these parameters combine remains unclear. This study aims to further characterize the Western operatic singing technique by observing the effects of melody and technique on acoustical and musical parameters of the singing voice. Fifty professional singers performed two contrasting melodies (popular song and romantic melody) with two vocal techniques (with and without operatic singing technique). The common quality parameters (energy distribution, vibrato rate, and extent), perturbation parameters (standard deviation of the fundamental frequency, signal-to-noise ratio, jitter, and shimmer), and musical features (fundamental frequency of the starting note, average tempo, and sound pressure level) of the 200 sung performances were analyzed. The results regarding the effect of melody and technique on the acoustical and musical parameters show that the choice of melody had a limited impact on the parameters observed, whereas a particular vocal profile appeared depending on the vocal technique used. This study confirms that vocal technique affects most of the parameters examined. In addition, the observation of quality, perturbation, and musical parameters contributes to a better understanding of the Western operatic singing technique. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test.

PubMed

Labanca, Ludimila; Guimarães, Fernando Sales; Costa-Guarisco, Letícia Pimenta; Couto, Erica de Araújo Brandão; Gonçalves, Denise Utsch

2017-11-01

Given the high prevalence of presbycusis and its detrimental effect on quality of life, screening tests can be useful tools for detecting hearing loss in primary care settings. This study therefore aimed to determine the accuracy and reproducibility of the whispered voice test as a screening method for detecting hearing impairment in older people. This cross-sectional study was carried out with 210 older adults aged between 60 and 97 years who underwent the whispered voice test employing ten different phrases and using audiometry as a reference test. Sensitivity, specificity and positive and negative predictive values were calculated and accuracy was measured by calculating the area under the ROC curve. The test was repeated on 20% of the ears by a second examiner to assess inter-examiner reproducibility (IER). The words and phrases that showed the highest area under the curve (AUC) and IER values were: "shoe" (AUC = 0.918; IER = 0.877), "window" (AUC = 0.917; IER = 0.869), "it looks like it's going to rain" (AUC = 0.911; IER = 0.810), and "the bus is late" (AUC = 0.900; IER = 0.810), demonstrating that the whispered voice test is a useful screening tool for detecting hearing loss among older people. It is proposed that these words and phrases should be incorporated into the whispered voice test protocol.

Changing Our Selves, Our Schools, and Our School System: Students Take on the New York City Quality Review Process

ERIC Educational Resources Information Center

Parkham, Shamika; McBroom, Aravis

2015-01-01

In this chapter, two student members of the Student Voice Collaborative (SVC) describe their experiences as "Student Shadows" during the annual Quality Review process, used throughout the New York Department of Education to evaluate how well schools are organized to support student achievement. They chronicle how this experience enhanced…

Sex hormones and the female voice.

PubMed

Abitbol, J; Abitbol, P; Abitbol, B

1999-09-01

In the following, the authors examine the relationship between hormonal climate and the female voice through discussion of hormonal biochemistry and physiology and informal reporting on a study of 197 women with either premenstrual or menopausal voice syndrome. These facts are placed in a larger historical and cultural context, which is inextricably bound to the understanding of the female voice. The female voice evolves from childhood to menopause, under the varied influences of estrogens, progesterone, and testosterone. These hormones are the dominant factor in determining voice changes throughout life. For example, a woman's voice always develops masculine characteristics after an injection of testosterone. Such a change is irreversible. Conversely, male castrati had feminine voices because they lacked the physiologic changes associated with testosterone. The vocal instrument is comprised of the vibratory body, the respiratory power source and the oropharyngeal resonating chambers. Voice is characterized by its intensity, frequency, and harmonics. The harmonics are hormonally dependent. This is illustrated by the changes that occur during male and female puberty: In the female, the impact of estrogens at puberty, in concert with progesterone, produces the characteristics of the female voice, with a fundamental frequency one third lower than that of a child. In the male, androgens released at puberty are responsible for the male vocal frequency, an octave lower than that of a child. Premenstrual vocal syndrome is characterized by vocal fatigue, decreased range, a loss of power and loss of certain harmonics. The syndrome usually starts some 4-5 days before menstruation in some 33% of women. Vocal professionals are particularly affected. Dynamic vocal exploration by televideoendoscopy shows congestion, microvarices, edema of the posterior third of the vocal folds and a loss of its vibratory amplitude. The authors studied 97 premenstrual women who were prescribed a treatment of multivitamins, venous tone stimulants (phlebotonics), and anti-edematous drugs. We obtained symptomatic improvement in 84 patients. The menopausal vocal syndrome is characterized by lowered vocal intensity, vocal fatigue, a decreased range with loss of the high tones and a loss of vocal quality. In a study of 100 menopausal women, 17 presented with a menopausal vocal syndrome. To rehabilitate their voices, and thus their professional lives, patients were prescribed hormone replacement therapy and multi-vitamins. All 97 women showed signs of vocal muscle atrophy, reduction in the thickness of the mucosa and reduced mobility in the cricoarytenoid joint. Multi-factorial therapy (hormone replacement therapy and multi-vitamins) has to be individually adjusted to each case depending on body type, vocal needs, and other factors.

The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.

PubMed

Van Lierde, Kristiane M; De Bodt, Marc; Dhaeseleer, Evelien; Wuyts, Floris; Claeys, Sofie

2010-05-01

The purpose of the present study is to measure the effectiveness of two treatment techniques--vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)--in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

[Objective study of the voice quality following partial laryngectomy].

PubMed

Remacle, M; Millet, B

1991-01-01

The high resolution frequency analyzer is used for the study of the vocal quality after partial laryngectomy. The post-operative plot after speech therapy is of good quality when respecting one vocal fold. On the contrary, the heard vocal sound does not correspond to the harmonics of the fundamental frequency but to intense noise from irregular vibrations of the residual laryngeal mucosa (ventricular folds, arytenoids). High resolution frequency analysis contributes to the follow-up of the partial laryngectomy.

Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

PubMed

Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

2015-06-01

Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

PubMed

Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

2015-09-01

Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time.

Comprehensive Outcome Researches of Intralesional Steroid Injection on Benign Vocal Fold Lesions.

PubMed

Wang, Chi-Te; Lai, Mei-Shu; Hsiao, Tzu-Yu

2015-09-01

This study investigated multidimensional treatment outcomes, including prognostic factors and side effects of vocal fold steroid injection (VFSI). We recruited 126 consecutive patients, including patients with 49 nodules, 47 polyps, and 30 mucus retention cysts. All the patients received VFSI under local anesthesia in the office settings. Treatment outcomes were evaluated 1 and 2 months after the procedure, including endoscopic evaluation, perceptual voice quality (GRB scores), acoustic analysis, and 10-item Voice Handicap Index (VHI-10). More than 80% of the patients reported subjective improvements after VFSI. Objective measurements revealed significant improvements from baseline in most of the outcome parameters (P<0.05). Higher occupational vocal demands and fibrotic vocal nodules were significantly associated with poorer clinical responses as measured by the VHI-10 and GRB scores, respectively. For vocal polyps, dysphonia for more than 12 months were significantly associated with higher postoperative VHI-10 scores, whereas patients with laryngopharyngeal reflux (LPR) showed significantly poor postoperative voice quality as measured by GRB scores. Side effects after VFSI included hematoma (27%), triamcinolone deposits (4%), and vocal atrophy (1%), which resolved spontaneously within 1-2 months. Presentation with vocal fold ectasias/varicosities and higher vocal demands were significantly correlated with postoperative vocal hematoma. This study demonstrated significant improvements after VFSI in vocal nodules, polyps, and cysts. Occupational vocal demand and subtypes of vocal nodules are closely related to the treatment outcomes after VFSI, whereas symptom duration and LPR were significant prognostic factors for VFSI treatment outcomes in vocal polyps. Side effects after receiving VFSI were mostly self-limited without sequel, whereas the incidence rates might be varied by the injection approach and the timing for postoperative follow-up. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Effect of hydration and vocal rest on the vocal fatigue in amateur karaoke singers.

PubMed

Yiu, Edwin M L; Chan, Rainy M M

2003-06-01

Karaoke singing is a very popular entertainment among young people in Asia. It is a leisure singing activity with the singer's voice amplified with special acoustic effects in the backdrop of music. Music video and song captions are shown on television screen to remind the singers during singing. It is not uncommon to find participants singing continuously for four to five hours each time. As most of the karaoke singers have no formal training in singing, these amateur singers are more vulnerable to developing voice problems under these intensive singing activities. This study reports the performance of 20 young amateur singers (10 males and 10 females, aged between 20-25 years) on a series of phonatory function tasks carried out during continuous karaoke singing. Half of the singers were given water to drink and short duration of vocal rests at regular intervals during singing and the other half sang continuously without taking any water or rest. The subjects who were given hydration and vocal rests sang significantly longer than those who did not take any water or rest. The voice quality, as measured by perceptual and acoustic measures, and vocal function, as measured by phonetogram, did not show any significant changes during singing in the subjects who were given water and rest during the singing. However, subjects who sang continuously without drinking water and taking rests showed significant changes in the jitter measure and the highest pitch they could produce during singing. These results suggest that hydration and vocal rests are useful strategies to preserve voice function and quality during karaoke singing. This information is useful educational information for karaoke singers.

VHF Ranging and Position Fixing Experiment Using ATS Satellites: Final Report on Phases 1 and 2, 25 November 1968 - 1 May 1971

NASA Technical Reports Server (NTRS)

1971-01-01

The testing program with the ATS-1 and ATS-3 spacecraft showed that geostationary satellites can provide superior communications and position surveillance for mobile craft. Inexpensive modifications to conventional mobile communications equipment aboard the craft can provide reliable, high quality voice and digital communications with distant ground stations and other vehicles, and automatic surveillance of the positions of all the craft by a ground facility. The tests also demonstrated the location and automatic readout of remote data collection platforms. Frequency modulation signals with the narrow audio and radio frequency bandwidths of terrestrial mobile radio communications were relayed through the VHF transponders of the geostationary satellites. The voice and digital communications were far superior in reliability and quality to long-distance mobile communications by other means. It was shown that one satellite can provide nearly uniform high quality performance over approximately one-third of the earth's surface. Position fixes by range measurement from the two satellites were accurate to approximately one nautical mile, except near the equator and the poles.

Consider the Costs.

ERIC Educational Resources Information Center

Jackson, Laura Christion

1995-01-01

This article discusses the drawbacks of alumni merchandising, with alumni association directors voicing concerns about overloading alumni with solicitations and detracting from the associations' primary mission. It argues that if alumni associations must resort to merchandising, they should offer only high quality products. (MDM)

Mixed Methods Research on the Role of Pupils as Assessors in Quality Assurance of Schools in Malta

ERIC Educational Resources Information Center

Pulis, Angele

2018-01-01

This article describes a study conducted in Malta on pupil voice in the role of assessor. The purpose of the study was to provide a fresh perspective on school quality assurance in Malta, by asking those who are directly affected--the pupils themselves. The data provided by the study could help educational leaders, together with the whole school…

The Induction Mentor Voice: A Phenomenological Study of Effective Practices for High Quality K-12 Teacher Induction Mentoring

ERIC Educational Resources Information Center

Doering, Sagui Araceli

2018-01-01

In education, mentoring is pivotal in the early development and long-term success and self-directed efficacy of new teachers. With increasing acknowledgment of the importance of mentoring as the preferred means of induction support for new teachers, mentors can serve to positively impact the overall quality of teaching and learning. Yet, like the…

Educating Early Educators: Voices of Early Childhood Educators Participating in Formal Education as Part of a Statewide Quality Rating Improvement System

ERIC Educational Resources Information Center

Griess, Carolyn J.

2012-01-01

Early childhood education has gained national attention as a tool for increasing outcomes and reducing risks for young children and their families. In an effort to ensure that early childhood programs are of high quality, many states are implementing systems that identify levels of criteria that denote excellence. Pennsylvania has adopted such a…

Cross-Cultural Adaptation and Validation of the Voice Handicap Index into Thai.

PubMed

Jaruchinda, Pariyanan; Suwanwarangkool, Thadchai

2015-12-01

The voice handicap index (VHI) is one of the most utilized instruments for measuring a patient's self-assessment of voice severity. The VHI has been translated into several languages, but not in Thai. To examine the psychometric properties of a Thai translation of the voice Handicap Index (VHI) and assess the applicability in the screening diagnosis. After receiving permission from the American Speech Language Hearing Association (ASHA), the original VHI had been translated and adapted to Thai by forward and backward standard translation. Eighty-five patients with voice disorders, divided in four groups according to the etiology of the diseases (neurogenic, structural, functional, and inflammatory), and 30 asymptomatic subjects were included in the present study. Internal consistency was analyzed through Cronbach's a coefficient. For the VHI test-retest reliability analysis, the Thai VHI was completed twice by 22 patients and assessed through the intraclass correlation coefficient. For clinical validity evaluation, the VHI scores from the pathological group were compared with the control group and compared among the four different pathological groups. The cutoff point for distinguishing the normal from the patient group was assessed by ROC analysis. Effects of age and gender on VHI scores were also evaluated. The Thai VHI showed a significant high internal consistency and test-retest reliability (Cronbach's α = 0.96 and r = 0.843, respectively). Mann-Whitney U test was used to compare the control group and pathological groups and revealed significant difference in total scores and its three domains scores (p < 0.001). ROC analysis demonstrated that a VHI score of 13 should be considered the threshold for revealing the impact of quality of life in voice disorder patients. Age and gender were not affect the VHI scores in both control and patient groups. The Thai VHI has high reliability and validity. The Thai version of VHI is considered to be a self-assessment tool for the severity of voice disorders in Thai patients.

Tracking voice change after thyroidectomy: application of spectral/cepstral analyses.

PubMed

Awan, Shaheen N; Helou, Leah B; Stojadinovic, Alexander; Solomon, Nancy Pearl

2011-04-01

This study evaluates the utility of perioperative spectral and cepstral acoustic analyses to monitor voice change after thyroidectomy. Perceptual and acoustic analyses were conducted on speech samples (sustained vowel /α/ and CAPE-V sentences) provided by 70 participants (36 women and 34 men) at four study time points: prior to thyroid surgery and 2 weeks, 3 months and 6 months after thyroidectomy. Repeated measures analyses of variance focused on the relative amplitude of the dominant harmonic in the voice signal (cepstral peak prominence, CPP), the ratio of low-to-high spectral energy, and their respective standard deviations (SD). Data were also examined for relationships between acoustic measures and perceptual ratings of overall severity of voice quality. Results showed that perceived overall severity and the acoustic measures of the CPP and its SD (CPPsd) computed from sentence productions were significantly reduced at 2-week post-thyroidectomy for 20 patients (29% of the sample) who had self-reported post-operative voice change. For this same group of patients, the CPP and CPPsd computed from sentence productions improved significantly from 2-weeks post-thyroidectomy to 6-months post-surgery. CPP and CPPsd also correlated well with perceived overall severity (r = -0.68 and -0.79, respectively). Measures of CPP from sustained vowel productions were not as effective as those from sentence productions in reflecting voice deterioration in the post-thyroidectomy patients at the 2-week post-surgery time period, were weaker correlates with perceived overall severity, and were not as effective in discriminating negative voice outcome (NegVO) from normal voice outcome (NormVO) patients as compared to the results from the sentence-level stimuli. Results indicate that spectral/cepstral analysis methods can be used with continuous speech samples to provide important objective data to document the effects of dysphonia in a post-thyroidectomy patient sample. When used in conjunction with patient's self-report and other general measures of vocal dysfunction, the acoustic measures employed in this study contribute to a complete profile of the patient's vocal condition.

Adaptation and validation of Spanish version of the pediatric Voice Handicap Index (P-VHI).

PubMed

Sanz, Lorena; Bau, Patricia; Arribas, Ignacio; Rivera, Teresa

2015-09-01

The voice in childhood is a communication tool and a form of emotional expression. It is estimated that 6 to 23% of children may have voice disorders. There is a test, the Pediatric Voice Handicap Index (P-VHI), validated in English to assess the specific impact on quality of life of children with speech pathology. Spanish is the second most widely used language in the world in terms of number of speakers, with over 500 million native speakers, so it is necessary to have tools that allow us to evaluate the effects of dysphonia in Spanish-speaking children. The aim of our study is the validation of the Spanish version of the P-VHI. We performed a cross-sectional study including patients between 4 and 15 years of age. The English P-VHI validated version was translated into Spanish and this translation was reviewed and modified by three specialists in Otorhinolaryngology. There were two study groups, children who had dysphonia (n=44) and a control group of children without alterations in voice (n=44). The questionnaire was always answered by parents. Significant differences were found between the group of children with dysphonia and the control group in the overall P-VHI score and the different subscales (p<0.001). Optimal internal consistency with a good Cronbach's alpha (α=0.81) was found, with high test-retest reliability (Wilcoxon z: -0847, p>0.05). The Spanish version of the P-VHI is a validated tool that has good internal consistency. It is a reliable test that evaluates the Voice Handicap Index in the pediatric population, with easy application for daily clinical practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Do Women's Voices Provide Cues of the Likelihood of Ovulation? The Importance of Sampling Regime

PubMed Central

Fischer, Julia; Semple, Stuart; Fickenscher, Gisela; Jürgens, Rebecca; Kruse, Eberhard; Heistermann, Michael; Amir, Ofer

2011-01-01

The human voice provides a rich source of information about individual attributes such as body size, developmental stability and emotional state. Moreover, there is evidence that female voice characteristics change across the menstrual cycle. A previous study reported that women speak with higher fundamental frequency (F0) in the high-fertility compared to the low-fertility phase. To gain further insights into the mechanisms underlying this variation in perceived attractiveness and the relationship between vocal quality and the timing of ovulation, we combined hormone measurements and acoustic analyses, to characterize voice changes on a day-to-day basis throughout the menstrual cycle. Voice characteristics were measured from free speech as well as sustained vowels. In addition, we asked men to rate vocal attractiveness from selected samples. The free speech samples revealed marginally significant variation in F0 with an increase prior to and a distinct drop during ovulation. Overall variation throughout the cycle, however, precluded unequivocal identification of the period with the highest conception risk. The analysis of vowel samples revealed a significant increase in degree of unvoiceness and noise-to-harmonic ratio during menstruation, possibly related to an increase in tissue water content. Neither estrogen nor progestogen levels predicted the observed changes in acoustic characteristics. The perceptual experiments revealed a preference by males for voice samples recorded during the pre-ovulatory period compared to other periods in the cycle. While overall we confirm earlier findings in that women speak with a higher and more variable fundamental frequency just prior to ovulation, the present study highlights the importance of taking the full range of variation into account before drawing conclusions about the value of these cues for the detection of ovulation. PMID:21957453

Acoustic Measures of Voice and Physiologic Measures of Autonomic Arousal during Speech as a Function of Cognitive Load.

PubMed

MacPherson, Megan K; Abur, Defne; Stepp, Cara E

2017-07-01

This study aimed to determine the relationship among cognitive load condition and measures of autonomic arousal and voice production in healthy adults. A prospective study design was conducted. Sixteen healthy young adults (eight men, eight women) produced a sentence containing an embedded Stroop task in each of two cognitive load conditions: congruent and incongruent. In both conditions, participants said the font color of the color words instead of the word text. In the incongruent condition, font color differed from the word text, creating an increase in cognitive load relative to the congruent condition in which font color and word text matched. Three physiologic measures of autonomic arousal (pulse volume amplitude, pulse period, and skin conductance response amplitude) and four acoustic measures of voice (sound pressure level, fundamental frequency, cepstral peak prominence, and low-to-high spectral energy ratio) were analyzed for eight sentence productions in each cognitive load condition per participant. A logistic regression model was constructed to predict the cognitive load condition (congruent or incongruent) using subject as a categorical predictor and the three autonomic measures and four acoustic measures as continuous predictors. It revealed that skin conductance response amplitude, cepstral peak prominence, and low-to-high spectral energy ratio were significantly associated with cognitive load condition. During speech produced under increased cognitive load, healthy young adults show changes in physiologic markers of heightened autonomic arousal and acoustic measures of voice quality. Future work is necessary to examine these measures in older adults and individuals with voice disorders. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Stochastic mechanical model of vocal folds for producing jitter and for identifying pathologies through real voices.

PubMed

Cataldo, E; Soize, C

2018-06-06

Jitter, in voice production applications, is a random phenomenon characterized by the deviation of the glottal cycle length with respect to a mean value. Its study can help in identifying pathologies related to the vocal folds according to the values obtained through the different ways to measure it. This paper aims to propose a stochastic model, considering three control parameters, to generate jitter based on a deterministic one-mass model for the dynamics of the vocal folds and to identify parameters from the stochastic model taking into account real voice signals experimentally obtained. To solve the corresponding stochastic inverse problem, the cost function used is based on the distance between probability density functions of the random variables associated with the fundamental frequencies obtained by the experimental voices and the simulated ones, and also on the distance between features extracted from the voice signals, simulated and experimental, to calculate jitter. The results obtained show that the model proposed is valid and some samples of voices are synthesized considering the identified parameters for normal and pathological cases. The strategy adopted is also a novelty and mainly because a solution was obtained. In addition to the use of three parameters to construct the model of jitter, it is the discussion of a parameter related to the bandwidth of the power spectral density function of the stochastic process to measure the quality of the signal generated. A study about the influence of all the main parameters is also performed. The identification of the parameters of the model considering pathological cases is maybe of all novelties introduced by the paper the most interesting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mobile Communication Devices, Ambient Noise, and Acoustic Voice Measures.

PubMed

Maryn, Youri; Ysenbaert, Femke; Zarowski, Andrzej; Vanspauwen, Robby

2017-03-01

The ability to move with mobile communication devices (MCDs; ie, smartphones and tablet computers) may induce differences in microphone-to-mouth positioning and use in noise-packed environments, and thus influence reliability of acoustic voice measurements. This study investigated differences in various acoustic voice measures between six recording equipments in backgrounds with low and increasing noise levels. One chain of continuous speech and sustained vowel from 50 subjects with voice disorders (all separated by silence intervals) was radiated and re-recorded in an anechoic chamber with five MCDs and one high-quality recording system. These recordings were acquired in one condition without ambient noise and in four conditions with increased ambient noise. A total of 10 acoustic voice markers were obtained in the program Praat. Differences between MCDs and noise condition were assessed with Friedman repeated-measures test and posthoc Wilcoxon signed-rank tests, both for related samples, after Bonferroni correction. (1) Except median fundamental frequency and seven nonsignificant differences, MCD samples have significantly higher acoustic markers than clinical reference samples in minimal environmental noise. (2) Except median fundamental frequency, jitter local, and jitter rap, all acoustic measures on samples recorded with the reference system experienced significant influence from room noise levels. Fundamental frequency is resistant to recording system, environmental noise, and their combination. All other measures, however, were impacted by both recording system and noise condition, and especially by their combination, often already in the reference/baseline condition without added ambient noise. Caution is therefore warranted regarding implementation of MCDs as clinical recording tools, particularly when applied for treatment outcomes assessments. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Evaluation of Psychometric Properties of Voice Activity and Participation Profile (VAPP): A Spanish Version.

PubMed

Bermúdez-de-Alvear, Rosa M; Gálvez-Ruiz, Pablo; Martínez-Arquero, A Ginés; Rando-Márquez, Sara; Fernández-Contreras, Elena

2018-06-11

This study aimed to analyze the psychometric properties of the Spanish version of the Voice Activity and Participation Profile (SVAPP) questionnaire. A randomized, cross-sectional sampling strategy with controls was used. Two samples with a total of 169 participants were analyzed, specifically 61 men (mean age 37.02) and 108 women (mean age 37.78). Of these participants, 112 were patients and 57 were controls. The instrument was submitted to reliability (internal consistency and corrected item-total correlations) and reproducibility analyses. Validation assessment was based on the construct validity, convergent validity, discriminant validity, and concurrent validity. The global internal consistency was excellent (Cronbach's α = 0.976), corrected item-total correlations were satisfactory and ranged 0.63-0.89, and factor loadings were above 0.50. The different subscales showed good internal consistency (alpha coefficients ranged 0.830-0.956) and test-retest values were consistently associated. The exploratory factor analysis evidenced a strongly defined five factors internal structure, with factors loadings ranging 0.51-0.86. Convergent validity demonstrated that all subscales and scores were very strongly correlated (Pearson r above 0.735) and significantly associated. The discriminant validity analysis showed that SVAPP had good specificity to distinguish dysphonic from healthy voice subjects. Concurrent validity with Voice Handicap Index Spanish version (SVHI) showed very strong correlations between total scores, and between SVHI total score and SVAPP Daily and Social Communication subscales; correlations between both tests subscales were strong; only between SVAPP Work and SVHI Physical sections correlations were moderate. The findings of the present study demonstrated evidence for the SVAPP questionnaire reliability and validity, and provided insightful implications of voice disorders on Spanish patients' quality of life. However, further investigations are required. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

47 CFR 1.7000 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Purpose. 1.7000 Section 1.7000 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Implementation of Section 706 of... telecommunications capability that enables users to originate and receive high-quality voice, data, graphics, and...

Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis.

PubMed

Tomicic, Alemka; Martínez, Claudio; Pérez, J Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane

2015-01-01

This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient-therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode.

Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

PubMed

Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

2014-12-01

Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

Practice Patterns of Speech-Language Pathologists in Pediatric Vocal Health.

PubMed

Hartley, Naomi A; Braden, Maia; Thibeault, Susan L

2017-05-17

The purpose of this study was to investigate current practices of speech-language pathologists (SLPs) in the management of pediatric vocal health, with specific analysis of the influence of clinical specialty and workplace setting on management approaches. American Speech-Language-Hearing Association-certified clinicians providing services within the United States (1%-100% voice caseload) completed an anonymous online survey detailing clinician demographics; employment location and service delivery models; approaches to continuing professional development; and specifics of case management, including assessment, treatment, and discharge procedures. Current practice patterns were analyzed for 100 SLPs (0-42 years of experience; 77 self-identifying as voice specialists) providing services in 34 U.S. states across a range of metropolitan and nonmetropolitan workplace settings. In general, SLPs favored a multidisciplinary approach to management; included perceptual, instrumental, and quality of life measures during evaluation; and tailored intervention to the individual using a combination of therapy approaches. In contrast with current practice guidelines, only half reported requiring an otolaryngology evaluation prior to initiating treatment. Both clinical specialty and workplace setting were found to affect practice patterns. SLPs in school settings were significantly less likely to consider themselves voice specialists compared with all other work environments. Those SLPs who considered themselves voice specialists were significantly more likely to utilize voice-specific assessment and treatment approaches. SLP practice largely mirrors current professional practice guidelines; however, potential exists to further enhance client care. To ensure that SLPs are best able to support children in successful communication, further research, education, and advocacy are required.

Somatotype and Body Composition of Normal and Dysphonic Adult Speakers.

PubMed

Franco, Débora; Fragoso, Isabel; Andrea, Mário; Teles, Júlia; Martins, Fernando

2017-01-01

Voice quality provides information about the anatomical characteristics of the speaker. The patterns of somatotype and body composition can provide essential knowledge to characterize the individuality of voice quality. The aim of this study was to verify if there were significant differences in somatotype and body composition between normal and dysphonic speakers. Cross-sectional study. Anthropometric measurements were taken of a sample of 72 adult participants (40 normal speakers and 32 dysphonic speakers) according to International Society for the Advancement of Kinanthropometry standards, which allowed the calculation of endomorphism, mesomorphism, ectomorphism components, body density, body mass index, fat mass, percentage fat, and fat-free mass. Perception and acoustic evaluations as well as nasoendoscopy were used to assign speakers into normal or dysphonic groups. There were no significant differences between normal and dysphonic speakers in the mean somatotype attitudinal distance and somatotype dispersion distance (in spite of marginally significant differences [P < 0.10] in somatotype attitudinal distance and somatotype dispersion distance between groups) and in the mean vector of the somatotype components. Furthermore, no significant differences were found between groups concerning the mean of percentage fat, fat mass, fat-free mass, body density, and body mass index after controlling by sex. The findings suggested no significant differences in the somatotype and body composition variables, between normal and dysphonic speakers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Troubling Some Generalisations on Teacher Education in the English-Speaking World: The Case of the Republic of Ireland

ERIC Educational Resources Information Center

O'Donoghue, Tom; Harford, Judith

2010-01-01

There is a great deal of talk about a crisis in teaching across the English-speaking world, about the quality of teachers leaving much to be desired, and about the quality of student outcomes dropping. This, in turn, has resulted in various aspects of teacher preparation coming under severe scrutiny. In general, disquiet has been voiced about the…

Economic Growth with Environmental Quality

ERIC Educational Resources Information Center

Environmental Science and Technology, 1977

1977-01-01

Producers of environmental control equipment have formed the Environmental Industry Council (EIC) in order to acquire a voice in the Washington legislative machinery. The Council is interested in changes in tax policy and in publicizing case histories where environmental controls have led to industrial savings. (BT)

A Dose of Writing Reality: Helping Students become Better Writers

ERIC Educational Resources Information Center

Thompson, Christine Love

2011-01-01

When teachers are overly focused on the teaching of grammar instead of the teaching of writing, students' quality of work suffers. Teachers should provide examples of writer's craft and author's voice to help students learn how to write their own stories.

Effect of tape recording on perturbation measures.

PubMed

Jiang, J; Lin, E; Hanson, D G

1998-10-01

Tape recorders have been shown to affect measures of voice perturbation. Few studies, however, have been conducted to quantitatively justify the use or exclusion of certain types of recorders in voice perturbation studies. This study used sinusoidal and triangular waves and synthesized vowels to compare perturbation measures extracted from directly digitized signals with those recorded and played back through various tape recorders, including 3 models of digital audio tape recorders, 2 models of analog audio cassette tape recorders, and 2 models of video tape recorders. Signal contamination for frequency perturbation values was found to be consistently minimal with digital recorders (percent jitter = 0.01%-0.02%), mildly increased with video recorders (0.05%-0.10%), moderately increased with a high-quality analog audio cassette tape recorder (0.15%), and most prominent with a low-quality analog audio cassette tape recorder (0.24%). Recorder effect on amplitude perturbation measures was lowest in digital recorders (percent shimmer = 0.09%-0.20%), mildly to moderately increased in video recorders and a high-quality analog audio cassette tape recorder (0.25%-0.45%), and most prominent in a low-quality analog audio cassette tape recorder (0.98%). The effect of cassette tape material, length of spooled tape, and duration of analysis were also tested and are discussed.

Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

NASA Astrophysics Data System (ADS)

Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

2009-12-01

This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

The West End Revitalization Association (WERA)'s right to basic amenities movement: voice and language of ownership and management of public health solutions in Mebane, North Carolina.

PubMed

Wilson, Omega R; Bumpass, Natasha G; Wilson, Omari M; Snipes, Marilyn H

2008-01-01

The West End Revitalization Association (WERA) cultivated strategies for assessing environmental hazards, managing stakeholder participation, and implementing corrective actions in three low-income African American communities in Mebane, North Carolina. The community voices evolved into language to drive WERA's "Right to Basic Amenities Movement" as a way to address health, legal, and quality-of-life disparities. The sustainability of this movement depends on communicating a solutions process with funding equity. Disparities are a way of life for impacted residents: dusty dead-end streets, contaminated drinking water, failed backyard septic tanks, and putrid odors. WERA organized on "common knowledge" for effective use of public health statutes and Title VI of the Civil Rights Act of 1964. WERA's board, staff, and volunteers exercised their voices in the language of government, public health, university research, and legal agencies. WERA's best practices and lessons learned may influence public policy in comparable communities in North Carolina and throughout the nation.

The Effectiveness of Pitch-raising Surgery in Male-to-Female Transsexuals: A Systematic Review.

PubMed

Van Damme, Silke; Cosyns, Marjan; Deman, Sofie; Van den Eede, Zoë; Van Borsel, John

2017-03-01

This study aimed to review the evidence of the effectiveness of pitch-raising surgery performed in male-to-female transsexuals. A search for studies was performed in PubMed, Web of Science, Science Direct, EBSCOhost, Google Scholar, and the references in retrieved manuscripts, using as keywords "transsexual" or "transgender" combined with terms related to voice surgery. We included eight studies using cricothyroid approximation, six studies using anterior glottal web formation, and six studies using other surgery types or a combination of surgical techniques, leading to 20 studies in total. Objectively, a substantial rise in postoperative fundamental frequency was identified. Perceptually, mainly laryngeal web formation seems risky for decreasing voice quality. The majority of patients seemed satisfied with the outcome. However, none of the studies used a control group and randomization process. Further investigation regarding long-term results is necessary. Future research needs to investigate long-term effects of pitch-raising surgery using a stronger study design. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Feasibility of using a handheld electronic device for the collection of patient reported outcomes data from children.

PubMed

Vinney, Lisa A; Grade, John D; Connor, Nadine P

2012-01-01

The manner in which a communication disorder affects health-related quality of life (QOL) in children is not known. Unfortunately, collection of quality of life data via traditional paper measures is labor intensive and has several other limitations, which hinder the investigation of pediatric quality of life in children. Currently, there is not sufficient research regarding the use of electronic devices to collect pediatric patient reported outcomes in order to address such limitations. Thus, we used a cross-over design to compare responses to a pediatric health quality of life instrument (PedsQL 4.0) delivered using a handheld electronic device to those from a traditional paper form. Respondents were children with (n=9) and without (n=10) a speech or voice disorder. For paper versus the electronic format, we examined time to completion, number of incomplete or inaccurate question responses, intra-rater reliability, ease of use, and child and parent preference. There were no significant differences between children's scores, time to complete the measure, or ratings related to ease of answering questions. The percentage of children who made answering errors or omissions with paper and pencil was significantly greater than the percentage of children who made such errors using the device. This preliminary study demonstrated that use of an electronic device to collect QOL or patient-reported outcomes (PRO) data from children is more efficient than and just as feasible, reliable, and acceptable as using paper forms. The development of hardware and software applications for the collection of QOL and/or PRO data in children with speech disorders is likely warranted. The reader will be able to understand: (1) The potential benefits of using electronic data capture via handheld devices for collecting pediatric patient reported outcomes; (2) The Pediatric Quality of Life Inventory 4.0 is a measure of the perception of general health quality that has distinguished between healthy children and those with chronic health conditions; (3) Past research in communication disorders indicates that voice and speech disorders may impact quality of life in children; (4) Based on preliminary data, electronic collection of patient reported outcomes in children with and without speech/voice disorders is more efficient and equally feasible, reliable, and acceptable when compared to paper forms. Copyright © 2011 Elsevier Inc. All rights reserved.

[Therapy of adult-onset laryngeal papilloma: integrallty submucosal dissection of the tumor by CO2 laser].

PubMed

Lei, W B; Liu, Q H; Chai, L P; Zhu, X L; Wang, Z F; Li, Q M; Tang, H C; Jiang, A Y; Wen, Y H; Wen, W P

2016-10-07

Objective: To evaluate the feasibility and efficacy of the integrallty submucosal resection of adult-onset laryngeal papilloma by CO 2 laser. Methods: A group of 64 cases (36 males and 28 females, multipe lesions 54 cases and single lesion 10 cases, aged 18-75 years, mean age 43.13 years) with adult-onset laryngeal papilloma encountered in the first affliated hospital of Sun Yatsen university from 2009 to 2015 was retrospectively analyzed. All cases were treated with integrallty submucosal dissection of the tumor by CO 2 laser, and observed the changes of tumor integral scope, inter-operative, operative processes, postoperative voice quality, postoperative scarring, and the tracheotomy conditions, which were analysed and evaluated. Results: A total of 64 patients were followed up from 1 year to 5 years. Preoperative tumor integral scope of these patients averaged of 7.00. A total of 62 cases kept 0 score of the tumor integral scope for at least one year, which lead to a clinical cure rate of 96.9%. The inter-operative averaged of 25.7 months. The total operative processes of these patients were 87 times (mean time 1.36). Four cases resulted in postoperative scarring. However these was a good result in postoperative voice quality with a mean score 4.25. As to the changes of tumor integral scope, all cases got a declining score (mean score 6.72), which resulted in a remission rate of 100%. Conclusion: The integrallty submucosal dissection of adult-onset 1aryngeal papilloma by CO 2 laser was an effective way to reduce the tumor integral scope; lengthen their inter-operative; decrease the operative processes, avoid the occurrence of tracheotomy; and improve the postoperative voice quality. Most of the patients could even be cured ultimately.

Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fung, Kevin; Lyden, Teresa H.; Lee, Julia

2005-12-01

Introduction: Organ-preservation treatment approaches for advanced laryngeal cancer patients that use combination chemoradiotherapy result in cure rates similar to primary laryngectomy with postoperative radiotherapy. In the national VA Larynx Cancer Trial, successful organ preservation was associated with an overall improvement in quality of life but not in subjective speech compared with long-term laryngectomy survivors. As part of a Phase II clinical trial, a prospective study of speech and swallowing results was conducted to determine if larynx preservation is associated with improved voice and swallowing compared with results in patients who require salvage laryngectomy. Subjects: A total of 97 patients withmore » advanced laryngeal cancer (46 Stage III, 51 Stage IV) were given a single course of induction chemotherapy (cisplatin 100 mg/m{sup 2} on Day 1 and 5-FU 1,000 mg/m{sup 2}/day x 5 days), followed by assessment of response. Patients with less than 50% response underwent early salvage laryngectomy, and patients with 50% or better response underwent concurrent chemoradiation (72 Gy and cisplatin 100 mg/m{sup 2} on Days 1, 22, and 43), followed by two cycles of adjuvant chemotherapy (DDP/5-FU). Direct laryngoscopy and biopsy were performed 8 weeks after radiation therapy to determine final tumor response. Late salvage surgery was performed on patients with persistent or recurrent disease. Methods: Completed survey data on voice and swallowing utilizing the Voice-Related Quality of Life Measure (V-RQOL) and the List Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) were obtained from 56 patients who were alive and free of disease at the time of survey, with a minimum follow-up of 8 months. Comparisons were made between patients with an intact larynx (n = 37) vs. laryngectomy (n = 19), as well as early (n = 12) vs. late salvage laryngectomy (n = 7). Multivariate analysis was performed to determine factors predictive of voice and swallowing outcomes. Overall 3-year determinant survival was 87%, with median follow-up of 40 months. Results: Patients with an intact larynx demonstrated significantly higher (p = 0.02) mean V-RQOL scores (80.3) than did laryngectomy patients (65.4). This finding was consistent in the social-emotional (p = 0.007) and physical functioning domains (p = 0.03). No differences in V-RQOL scores were found in comparisons between early and late salvage laryngectomy. Multiple linear regression revealed that predictors of higher total V-RQOL scores include lower T stage (p = 0.03), organ preservation (p = 0.0007), and longer duration since treatment (p = 0.01). Understandability of speech was better in patients with an intact larynx (p = 0.001). Overall swallowing function was comparable between groups. Multiple logistic regression revealed that longer duration since treatment (p = 0.03, odds ratio = 1.1) and lower maximal mucositis grade (p = 0.03, odds ratio = 0.3) were predictive of higher likelihood of eating in public. Nutritional mode consisting of oral intake alone without nutritional supplements was achieved in 88.9% of patients with an intact larynx compared with 64.3% of laryngectomees (p = 0.09). Conclusions: Voice-related quality of life is better in patients after chemoradiation therapy compared with salvage laryngectomy. Earlier salvage, although known to be associated with fewer surgical complications, did not result in improved voice; however, the number of patients analyzed is small. Overall swallowing function is good in all patients; however, patients with an intact larynx are more likely to obtain nutrition with oral intake alone without supplements. Such measures of function and quality of life are important endpoints to help judge overall effectiveness as newer, more aggressive treatment protocols with added toxicities are developed and evaluated.« less

Smartphone Application for the Analysis of Prosodic Features in Running Speech with a Focus on Bipolar Disorders: System Performance Evaluation and Case Study.

PubMed

Guidi, Andrea; Salvi, Sergio; Ottaviano, Manuel; Gentili, Claudio; Bertschy, Gilles; de Rossi, Danilo; Scilingo, Enzo Pasquale; Vanello, Nicola

2015-11-06

Bipolar disorder is one of the most common mood disorders characterized by large and invalidating mood swings. Several projects focus on the development of decision support systems that monitor and advise patients, as well as clinicians. Voice monitoring and speech signal analysis can be exploited to reach this goal. In this study, an Android application was designed for analyzing running speech using a smartphone device. The application can record audio samples and estimate speech fundamental frequency, F0, and its changes. F0-related features are estimated locally on the smartphone, with some advantages with respect to remote processing approaches in terms of privacy protection and reduced upload costs. The raw features can be sent to a central server and further processed. The quality of the audio recordings, algorithm reliability and performance of the overall system were evaluated in terms of voiced segment detection and features estimation. The results demonstrate that mean F0 from each voiced segment can be reliably estimated, thus describing prosodic features across the speech sample. Instead, features related to F0 variability within each voiced segment performed poorly. A case study performed on a bipolar patient is presented.

Comminuted Laryngeal Fracture Following Blunt Trauma: A Need for Strict Legislation on Roads!

PubMed

Jain, Shraddha; Singh, Pragya; Gupta, Minal; Kamble, Bhavna; Phatak, Suresh S

2017-01-01

Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding. He presented with breathing difficulty, change in voice, surgical emphysema, and pneumomediastinum, but without any skin changes over the neck. His airway could be restored due to early tracheostomy and open reduction with internal fixation with sutures along with laryngeal stenting. He has no significant swallowing or breathing problem and reasonably good voice 6 months after surgery. This case highlights the need for strict legislation on roads in India and the importance of high level of suspicion for laryngeal fracture in acute trauma patient. Early identification and timely internal fixation not only restore the airway but also improve long-term voice and airway outcomes.

Smartphone Application for the Analysis of Prosodic Features in Running Speech with a Focus on Bipolar Disorders: System Performance Evaluation and Case Study

PubMed Central

Guidi, Andrea; Salvi, Sergio; Ottaviano, Manuel; Gentili, Claudio; Bertschy, Gilles; de Rossi, Danilo; Scilingo, Enzo Pasquale; Vanello, Nicola

2015-01-01

Bipolar disorder is one of the most common mood disorders characterized by large and invalidating mood swings. Several projects focus on the development of decision support systems that monitor and advise patients, as well as clinicians. Voice monitoring and speech signal analysis can be exploited to reach this goal. In this study, an Android application was designed for analyzing running speech using a smartphone device. The application can record audio samples and estimate speech fundamental frequency, F0, and its changes. F0-related features are estimated locally on the smartphone, with some advantages with respect to remote processing approaches in terms of privacy protection and reduced upload costs. The raw features can be sent to a central server and further processed. The quality of the audio recordings, algorithm reliability and performance of the overall system were evaluated in terms of voiced segment detection and features estimation. The results demonstrate that mean F0 from each voiced segment can be reliably estimated, thus describing prosodic features across the speech sample. Instead, features related to F0 variability within each voiced segment performed poorly. A case study performed on a bipolar patient is presented. PMID:26561811

An integrated tool for the diagnosis of voice disorders.

PubMed

Godino-Llorente, Juan I; Sáenz-Lechón, Nicolás; Osma-Ruiz, Víctor; Aguilera-Navarro, Santiago; Gómez-Vilda, Pedro

2006-04-01

A PC-based integrated aid tool has been developed for the analysis and screening of pathological voices. With it the user can simultaneously record speech, electroglottographic (EGG), and videoendoscopic signals, and synchronously edit them to select the most significant segments. These multimedia data are stored on a relational database, together with a patient's personal information, anamnesis, diagnosis, visits, explorations and any other comment the specialist may wish to include. The speech and EGG waveforms are analysed by means of temporal representations and the quantitative measurements of parameters such as spectrograms, frequency and amplitude perturbation measurements, harmonic energy, noise, etc. are calculated using digital signal processing techniques, giving an idea of the degree of hoarseness and quality of the voice register. Within this framework, the system uses a standard protocol to evaluate and build complete databases of voice disorders. The target users of this system are speech and language therapists and ear nose and throat (ENT) clinicians. The application can be easily configured to cover the needs of both groups of professionals. The software has a user-friendly Windows style interface. The PC should be equipped with standard sound and video capture cards. Signals are captured using common transducers: a microphone, an electroglottograph and a fiberscope or telelaryngoscope. The clinical usefulness of the system is addressed in a comprehensive evaluation section.

Vocal analysis of suicidal movie characters.

PubMed

Palinkas-Sanches, Elaine; Sanches, Marsal; Ferrari, Maria Cristina C; Oliveira, Gisele; Behlau, Mara

2010-12-01

The aim of this study was to describe the auditory-perceptive evaluation and the psychodynamic aspects of voice samples among suicidal movie characters. Voice samples of 48 characters (27 male, 21 female), extracted from 36 movies produced between 1968 and 2006, were analyzed. The samples were evaluated through a specific protocol focusing on the auditory-perceptive evaluation (voice quality, resonance, pitch, loudness, modulation, pauses, articulation and rhythm) and the psychodynamic aspects of voice. 85.5% of the samples exhibited abnormal findings in at least five parameters of the auditory-perceptive analysis, such as breathiness (n=42; 87.5% of the samples), hoarseness (n=39; 81.2%) and strain (n=29; 60.4%), as well as laryngopharingeal resonance (n=39; 81.2%), either high pitch (n=14; 29.2%), or decreased loudness (n=31; 64.6%). With respect to the psychodynamic aspects, dismay was detected in 50% (n=24) of the samples, hopelessness in 47.9% (n=23), resignation in 37.5% (n=18), and sadness in 33.3% (n=16). Our findings suggest the existence of specific patterns used by actors during the interpretation of suicidal characters. The replication of these findings among real patients may contribute to improvement in the evaluation of potential suicidal patients, as well as the implementation of preventive measures.

Neural Correlates of Explicit Social Judgments on Vocal Stimuli

PubMed Central

Hensel, Lukas; Bzdok, Danilo; Müller, Veronika I.; Zilles, Karl; Eickhoff, Simon B.

2015-01-01

Functional neuroimaging research on the neural basis of social evaluation has traditionally focused on face perception paradigms. Thus, little is known about the neurobiology of social evaluation processes based on auditory cues, such as voices. To investigate the top-down effects of social trait judgments on voices, hemodynamic responses of 44 healthy participants were measured during social trait (trustworthiness [TR] and attractiveness [AT]), emotional (happiness, HA), and cognitive (age, AG) voice judgments. Relative to HA and AG judgments, TR and AT judgments both engaged the bilateral inferior parietal cortex (IPC; area PGa) and the dorsomedial prefrontal cortex (dmPFC) extending into the perigenual anterior cingulate cortex. This dmPFC activation overlapped with previously reported areas specifically involved in social judgments on ‘faces.’ Moreover, social trait judgments were expected to share neural correlates with emotional HA and cognitive AG judgments. Comparison of effects pertaining to social, social–emotional, and social–cognitive appraisal processes revealed a dissociation of the left IPC into 3 functional subregions assigned to distinct cytoarchitectonic subdivisions. In total, the dmPFC is proposed to assume a central role in social attribution processes across sensory qualities. In social judgments on voices, IPC activity shifts from rostral processing of more emotional judgment facets to caudal processing of more cognitive judgment facets. PMID:24243619

Trial Vocal Fold Injection Predicts Thyroplasty Outcomes in Nonparalytic Glottic Incompetence.

PubMed

Dumberger, Lukas D; Overton, Lewis; Buckmire, Robert A; Shah, Rupali N

2017-04-01

Trial vocal fold injection (TVFI) may be used prior to permanent medialization when voice outcome is uncertain. We aimed to determine whether voice outcomes of TVFI are predictive of, or correlate with outcomes after type I Gore-Tex medialization thyroplasty (GMT) in patients with nonparalytic glottic incompetence (GI). Thirty-five patients with nonparalytic GI who underwent TVFI followed by GMT were retrospectively reviewed. Change in voice-related quality of life (VRQOL) after TVFI was compared to change in VRQOL 3 to 9 months after GMT. Similar comparisons were made for change in glottal function index (GFI) and change in grade, roughness, breathiness, asthenia, and strain (GRBAS). Sample correlation coefficients were calculated. Change in VRQOL after TVFI showed good correlation with change in VRQOL after GMT, r = 0.55. Change in GFI after TVFI showed strong correlation with change in GFI after GMT, r = 0.74. Change in GRBAS after TVFI showed excellent correlation with change in GRBAS after GMT, r = 0.90. The TVFI is a useful tool in nonparalytic GI when outcomes from glottic closure procedures are not clear. Voice outcome measures after TVFI strongly correlate with outcomes from GMT. These data may be used to more confidently counsel patients regarding their predicted outcomes of permanent medialization.

DIRECT operational field test evaluation natural use study. Part 4, Recommendations for expanded deployment

DOT National Transportation Integrated Search

1998-08-01

The DIRECT project compared four low-cost driver information systems. Of the four that were : compared, the RDS approach proved superior to the others in toggling reliability and voice quality. The DIRECT project planned to expand the implementation ...

Paralanguage and Kinesics (Nonverbal Communication).

ERIC Educational Resources Information Center

Key, Mary Ritchie

Nonverbal communication is an important and little-understood aspect of human communication. This book deals primarily with two aspects of nonverbal communication: paralanguage and kinesics. "Paralanguage" includes vocalizations such as hissing, shushing, and whistling, as well as speech modifications such as quality of voice (sepulchral, whiny,…

A Skype-Buddy Model for Blended Learning

ERIC Educational Resources Information Center

Macharaschwili, Carmen E.; Coggin, Linda Skidmore

2013-01-01

Online learning in higher education allows distance education students to complete degree requirements in virtual environments. Universities are challenged with providing quality education experiences for these students and meet the students' needs for engagement and challenge within a collaborative framework. This study proposes how Voice over…

The influence of reed curvature on the tone quality of lingual organ pipes

NASA Astrophysics Data System (ADS)

Plitnik, G. R.; Angster, J.

2002-11-01

Given certain design constraints, such as the type of stop being voiced and the desired tone quality, reed voicers must use consummate skill to curve each tongue so as to produce the best and most stable tone, as well as maintaining a consistent tone quality across an entire rank of pipes. The curvature given to a reed tongue influences not only the harmonic structure of the steady-state sound, but also the attack. Two fundamentally different types of curvature are typically employed, the chorus reed (trompette) curve (which yields a bright sound) and the smooth-toned curve employed for solo reeds such as the clarinet. This study investigated the effect of reed curvature on the vibration and tone of reed tongues of both types. Two F2 pipes (a trompette and a clarinet) were constructed and voiced with 6 different tongues each to produce a variety of tones. The reed's vibration was measured under typical conditions by laser vibrometer; the pressure waves in the boot and in the shallot were measured by means of one-eighth inch microphones and the emitted sound was recorded at the egress. By performing various measurements simultaneously, phase differences were also determined.

Perceptual aspects of singing.

PubMed

Sundberg, J

1994-06-01

The relations between acoustic and perceived characteristics of vowel sounds are demonstrated with respect to timbre, loudness, pitch, and expressive time patterns. The conditions for perceiving an ensemble of sine tones as one tone or several tones are reviewed. There are two aspects of timbre of voice sounds: vowel quality and voice quality. Although vowel quality depends mainly on the frequencies of the lowest two formants. In particular, the center frequency of the so-called singer's formant seems perceptually relevant. Vocal loudness, generally assumed to correspond closely to the sound pressure level, depends rather on the amplitude balance between the lower and the higher spectrum partials. The perceived pitch corresponds to the fundamental frequency, or for vibrato tones, the mean of this frequency. In rapid passages, such as coloratura singing, special patterns are used. Pitch and duration differences are categorically perceived in music. This means that small variations in tuning or duration do not affect the musical interval and the note value perceived. Categorical perception is used extensively in music performance for the purpose of musical expression because without violating the score, the singer may sharpen or flatten and lengthen or shorten the tones, thereby creating musical expression.

A Wicked Problem? Whistleblowing in Healthcare Organisations Comment on "Cultures of Silence And Cultures of Voice: The Role Of Whistleblowing in Healthcare Organisations".

PubMed

Hyde, Paula

2016-01-08

Mannion and Davies' article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While 'voice' is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain 'truths.' By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem. © 2016 by Kerman University of Medical Sciences.

Voice of the customer---a roadmap for service improvement.

PubMed

Uberoi, Ravinder S; Nayak, Yogamaya; Sachdeva, Pritindira; Sibal, Anupam

2013-01-01

Patient satisfaction surveys help a great deal in identifying ways of improving a hospital's services. Ultimately, that translates into better care and happier patients. Moreover, it shows the staff and the community that the hospital is serious about quality and is looking for ways to improve. This article describes how the Voice of the Customer (VOC) Survey can be used as a tool for improving services. Regular monitoring of VOC scores is essential for minimizing the gaps between service delivery and patient expectations. The present study showcases the various initiatives undertaken to improve the VOC scores from an original 4.40 to 4.77 (on a 5 point scale) at the hospital under study.

Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis

PubMed Central

Tomicic, Alemka; Martínez, Claudio; Pérez, J. Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane

2015-01-01

This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient–therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode. PMID:25932014

Unilateral Vocal Fold Paralysis: A Systematic Review of Speech-Language Pathology Management.

PubMed

Walton, Chloe; Conway, Erin; Blackshaw, Helen; Carding, Paul

2017-07-01

Dysphonia due to unilateral vocal fold paralysis (UVFP) can be characterized by hoarseness and weakness, resulting in a significant impact on patients' activity and participation. Voice therapy provided by a speech-language pathologist is designed to maximize vocal function and improve quality of life. The purpose of this paper is to systematically review literature surrounding the effectiveness of speech-language pathology intervention for the management of UVFP in adults. This is a systematic review. Electronic databases were searched using a range of key terms including dysphonia, vocal fold paralysis, and speech-language pathology. Eligible articles were extracted and reviewed by the authors for risk of bias, methodology, treatment efficacy, and clinical outcomes. Of the 3311 articles identified, 12 met the inclusion criteria: seven case series and five comparative studies. All 12 studies subjectively reported positive effects following the implementation of voice therapy for UVFP; however, the heterogeneity of participant characteristics, voice therapy, and voice outcome resulted in a low level of evidence. There is presently a lack of methodological rigor and clinical efficacy in the speech-language pathology management of dysphonia arising from UVFP in adults. Reasons for this reduced efficacy can be attributed to the following: (1) no standardized speech-language pathology intervention; (2) no consistency of assessment battery; (3) the variable etiology and clinical presentation of UVFP; and (4) inconsistent timing, frequency, and intensity of treatment. Further research is required to develop the evidence for the management of UVFP incorporating controlled treatment protocols and more rigorous clinical methodology. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

The power of your vocal image.

PubMed

McCoy, L A

1996-03-01

Your vocal image is the impression that listeners form of you based on the sound of your voice. In a dental office, where the initial patient contact usually occurs over the phone, your vocal image is vitally important. According to social psychologists, people begin to make relatively durable first impressions within six to 12 seconds of perceiving a sensory cue. This means that patients begin to form their impressions of a telephone speaker almost immediately. Based on the qualities of the speaker's voice and how it is used, they'll form impressions related to everything from the speaker's physical and personality characteristics to his or her intellectual ability, and eventually even generalize their impressions to include the office that the speaker represents. If you want to improve your vocal image, you must first be aware of exactly what that image is. There are two factors that combine to create a vocal impression--the speaker's physical vocal tools and the sound that is created by them. The five physical tools involved are the lungs, vocal cords, throat, mouth and ears. At each stage in the sound production process, we can easily fall into negative habits and lazy patterns if we're not careful. Although we can't do much about our physical voice mechanism, we can certainly exercise a great deal of control over how our voice is used. A strong, confident voice is an essential part of effective interpersonal communication. If you want to project an image of confidence and professionalism, don't overlook the subtle benefits of effective vocal power.

Amygdala and auditory cortex exhibit distinct sensitivity to relevant acoustic features of auditory emotions.

PubMed

Pannese, Alessia; Grandjean, Didier; Frühholz, Sascha

2016-12-01

Discriminating between auditory signals of different affective value is critical to successful social interaction. It is commonly held that acoustic decoding of such signals occurs in the auditory system, whereas affective decoding occurs in the amygdala. However, given that the amygdala receives direct subcortical projections that bypass the auditory cortex, it is possible that some acoustic decoding occurs in the amygdala as well, when the acoustic features are relevant for affective discrimination. We tested this hypothesis by combining functional neuroimaging with the neurophysiological phenomena of repetition suppression (RS) and repetition enhancement (RE) in human listeners. Our results show that both amygdala and auditory cortex responded differentially to physical voice features, suggesting that the amygdala and auditory cortex decode the affective quality of the voice not only by processing the emotional content from previously processed acoustic features, but also by processing the acoustic features themselves, when these are relevant to the identification of the voice's affective value. Specifically, we found that the auditory cortex is sensitive to spectral high-frequency voice cues when discriminating vocal anger from vocal fear and joy, whereas the amygdala is sensitive to vocal pitch when discriminating between negative vocal emotions (i.e., anger and fear). Vocal pitch is an instantaneously recognized voice feature, which is potentially transferred to the amygdala by direct subcortical projections. These results together provide evidence that, besides the auditory cortex, the amygdala too processes acoustic information, when this is relevant to the discrimination of auditory emotions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Teachers' voice use in teaching environments: a field study using ambulatory phonation monitor.

PubMed

Lyberg Åhlander, Viveka; Pelegrín García, David; Whitling, Susanna; Rydell, Roland; Löfqvist, Anders

2014-11-01

This case-control designed field study examines the vocal behavior in teachers with self-estimated voice problems (VP) and their age- and school-matched voice healthy (VH) colleagues. It was hypothesized that teachers with and teachers without VP use their voices differently regarding fundamental frequency, sound pressure level (SPL), and in relation to the background noise. Teachers with self-estimated VP (n = 14; two males and 12 females) were age and gender matched to VH school colleagues (n = 14; two males and 12 females). The subjects, recruited from an earlier study, had been examined in laryngeal, vocal, hearing, and psychosocial aspects. The fundamental frequency, SPL, and phonation time were recorded with an Ambulatory Phonation Monitor during one representative workday. The teachers reported their activities in a structured diary. The SPL (including teachers' and students' activity and ambient noise) was recorded with a sound level meter; the room temperature and air quality were measured simultaneously. The acoustic properties of the empty classrooms were measured. Teachers with VP behaved vocally different from their VH peers, in particular during teaching sessions. The phonation time was significantly higher in the group with VP, and the number of vibratory cycles differed between the female teachers. The F0 pattern, related to the vocal SPL and room acoustics, differed between the groups. The results suggest a different vocal behavior in subjects with subjective VP and a higher vocal load with fewer possibilities for vocal recovery. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Objective Identification of Prepubertal Female Singers and Non-singers by Singing Power Ratio Using Matlab.

PubMed

Usha, M; Geetha, Y V; Darshan, Y S

2017-03-01

The field of music is increasingly gaining scope and attracting researchers from varied fields in terms of improvising the art of voice modulation in singing. There has been a lot of competition, and young budding singers are emerging with more talent. This study is aimed to develop software to differentiate a prepubertal voice as that of a singer or a non-singer using an objective tool-singing power ratio (SPR)-as an objective measure to quantify the resonant voice quality. Recordings of singing and phonation were obtained from 30 singers and 30 non-singer girls (8-10 years). Three professional singers perceptually evaluated all samples using a rating scale and categorized them as singers or non-singers. Using Matlab, a program was developed to automatically calculate the SPR of a particular sample and classify it into either of two groups based on the normative values of SPR developed manually. Positive correlation for SPR of phonation or singing was found between perceptual and manual ratings, and objective values of SPR. Software could automatically give the SPR values for samples that are fed and could further differentiate them as singer or non-singer. Researchers need not depend on professional singers or musicians for the judgment of voice for research purposes. This software uses an objective tool, which serves as an instrument to judge singing talent using singing and phonation samples of children. Also, it can be used as a first line of judgment in any singing audition process, which could ease the work of professionals. Copyright © 2017 The Voice Foundation. All rights reserved.

Internet Voice Distribution System (IVoDS) Utilization in Remote Payload Operations

NASA Technical Reports Server (NTRS)

Best, Susan; Bradford, Bob; Chamberlain, Jim; Nichols, Kelvin; Bailey, Darrell (Technical Monitor)

2002-01-01

Due to limited crew availability to support science and the large number of experiments to be operated simultaneously, telescience is key to a successful International Space Station (ISS) science program. Crew, operations personnel at NASA centers, and researchers at universities and companies around the world must work closely together to perform scientific experiments on-board ISS. NASA has initiated use of Voice over Internet Protocol (VoIP) to supplement the existing HVoDS mission voice communications system used by researchers. The Internet Voice Distribution System (IVoDS) connects researchers to mission support "loops" or conferences via Internet Protocol networks such as the high-speed Internet 2. Researchers use IVoDS software on personal computers to talk with operations personnel at NASA centers. IVoDS also has the capability, if authorized, to allow researchers to communicate with the ISS crew during experiment operations. NODS was developed by Marshall Space Flight Center with contractors A2 Technology, Inc. FVC, Lockheed- Martin, and VoIP Group. IVoDS is currently undergoing field-testing with full deployment for up to 50 simultaneous users expected in 2002. Research is currently being performed to take full advantage of the digital world - the Personal Computer and Internet Protocol networks - to qualitatively enhance communications among ISS operations personnel. In addition to the current voice capability, video and data-sharing capabilities are being investigated. Major obstacles being addressed include network bandwidth capacity and strict security requirements. Techniques being investigated to reduce and overcome these obstacles include emerging audio-video protocols and network technology including multicast and quality-of-service.

Voice Outcomes of Adults Diagnosed with Pediatric Vocal Fold Nodules and Impact of Speech Therapy.

PubMed

Song, Brian H; Merchant, Maqdooda; Schloegel, Luke

2017-11-01

Objective To evaluate the voice outcomes of adults diagnosed with vocal fold nodules (VFNs) as children and to assess the impact of speech therapy on long-term voice outcomes. Study Design Prospective cohort study. Setting Large health care system. Subjects and Methods Subjects diagnosed with VFNs as children between the years 1996 and 2008 were identified within a medical record database of a large health care system. Included subjects were 3 to 12 years old at the time of diagnosis, had a documented laryngeal examination within 90 days of diagnosis, and were ≥18 years as of December 31, 2014. Qualified subjects were contacted by telephone and administered the Vocal Handicap Index-10 (VHI-10) and a 15-item questionnaire inquiring for confounding factors. Results A total of 155 subjects were included, with a mean age of 21.4 years (range, 18-29). The male:female ratio was 2.3:1. Mean VHI-10 score for the entire cohort was 5.4. Mean VHI-10 scores did not differ between those who received speech therapy (6.1) and those who did not (4.5; P = .08). Both groups were similar with respect to confounding risk factors that can contribute to dysphonia, although the no-therapy group had a disproportionately higher number of subjects who consumed >10 alcoholic drinks per week ( P = .01). Conclusion The majority of adults with VFNs as children will achieve a close-to-normal voice quality when they reach adulthood. In our cohort, speech therapy did not appear to have an impact on the long-term voice outcomes.

Reliability and validity of the Korean version of Pediatric Voice Handicap Index: in school age children.

PubMed

Park, Sung Shin; Kwon, Tack-Kyun; Choi, Seong Hee; Lee, Won Yong; Hong, Young Hye; Jeong, Nyun Gi; Sung, Myung-Whun; Kim, Kwang Hyun

2013-01-01

The aim of this study was to assess the reliability and validity of the Pediatric Voice Handicap Index (pVHI) for cross-cultural adaptation of the Korean version with school age children. The questionnaire was translated into Korean and was completed by 101 Korean parents who have children with or without disordered voice. The Korean version-pVHI scores were obtained with 60 parents of normal children and 41 parents who have children with voice problems. Content validity was verified by five experienced speech-language pathologists with clinical specialization in voice disorders. Internal consistency was calculated through Cronbach's α coefficient and test-retest reliability of the Korean version-pVHI score was determined using Pearson product-moment correlation coefficients. Mann-Whitney U test was used to compare GRBAS with the Korean version-pVHI scores between normal and dysphonia group. The relationship between the parent-reported the Korean version-pVHI total scores and perceptual ratings of voice quality from experts was investigated using Spearman correlation coefficients. The results showed that the Korean version-pVHI provided a high internal consistency (α=0.92) and test-retest reliability of its subscales: total (T) 0.97, functional (F) 0.90, physical (P) 0.95, emotional (E) 0.92. The Korean version-pVHI mean scores in normal group were 1.28 (T), 0.62 (F), 0.35 (P) and 0.32 (E), respectively whereas those of the Korean version-pVHI in children group with dysphonia were 23.13 (T), 8.90 (F), 9.54 (P) and 4.93 (E). Significant differences in the Korean version-pVHI (T, F, P, E) and perceptual evaluation (grade, rough, breathy) between normal and dysphonia group were revealed (P<0.05). Moreover, relatively moderate-to-high correlation between the Korean version-pVHI parameters (T) and perceptual measures (G) was exhibited in children with dysphonia. The subjective Korean version-pVHI can be applicable and useful supplementary tool for evaluating parents' perception of their children's voice dysfunction, identifying multifactors on daily life affecting their children's voice and measuring treatment efficacy before and after therapeutic intervention. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The Acoustic Correlates of Breathy Voice: a Study of Source-Vowel INTERACTION{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00} {00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}{00}.

NASA Astrophysics Data System (ADS)

Lin, Yeong-Fen Emily

This thesis is the result of an investigation of the source-vowel interaction from the point of view of perception. Major objectives include the identification of the acoustic correlates of breathy voice and the disclosure of the interdependent relationship between the perception of vowel identity and breathiness. Two experiments were conducted to achieve these objectives. In the first experiment, voice samples from one control group and seven patient groups were compared. The control group consisted of five female and five male adults. The ten normals were recruited to perform a sustained vowel phonation task with constant pitch and loudness. The voice samples of seventy patients were retrieved from a hospital data base, with vowels extracted from sentences repeated by patients at their habitual pitch and loudness. The seven patient groups were divided, based on a unique combination of patients' measures on mean flow rate and glottal resistance. Eighteen acoustic variables were treated with a three-way (Gender x Group x Vowel) ANOVA. Parameters showing a significant female-male difference as well as group differences, especially those between the presumed breathy group and the other groups, were identified as relevant to the distinction of breathy voice. As a result, F1-F3 amplitude difference and slope were found to be most effective in distinguishing breathy voice. Other acoustic correlates of breathy voice included F1 bandwidth, RMS-H1 amplitude difference, and F1-F2 amplitude difference and slope. In the second experiment, a formant synthesizer was used to generate vowel stimuli with varying spectral tilt and F1 bandwidth. Thirteen native American English speakers made dissimilarity judgements on paired stimuli in terms of vowel identity and breathiness. Listeners' perceptual vowel spaces were found to be affected by changes in the acoustic correlates of breathy voice. The threshold of detecting a change of vocal quality in the breathiness domain was also found to be vowel-dependent.

Improving Audio Quality in Distance Learning Applications.

ERIC Educational Resources Information Center

Richardson, Craig H.

This paper discusses common causes of problems encountered with audio systems in distance learning networks and offers practical suggestions for correcting the problems. Problems and discussions are divided into nine categories: (1) acoustics, including reverberant classrooms leading to distorted or garbled voices, as well as one-dimensional audio…

Health Instruction Packages: Dental Assisting.

ERIC Educational Resources Information Center

McEnery, Paula

Text, illustrations, and exercises are utilized in this set of four learning modules to instruct dental assisting students in various office skills. The first module, "Dental Office Telephone Techniques," examines the qualities of a good telephone voice and demeanor and provides guidelines for taking a message and handling various…