The accent method of voice therapy: Effect of accentuations on FO, SPL, and airflow

The effect of the increased flow rate (ΔU) in response to the Accent Method exercises on fundamental frequency (FO) and sound pressure level (SPL) was studied in three subjects (professionally trained, trained, and untrained in this method). In all the subjects, the rhythmic accentuated exercises produced a variable degree of increase in FO (ΔFO) and SPL (ΔSPL). The professionally trained subject showed greater ΔFO and ΔSPL in response to the ΔU in the fastest tempo, which requires higher skills. Both trained subjects showed a greater correlation between ΔU and both ΔSPL and ΔFO, as well as between ΔFO and ΔSPL, as compared to the untrained subject. The effects of the accentuated exercises on FO and SPL in response to the increased airflow rate (ΔU) thus appear to demonstrate the treating effectiveness of the Accent Method.     

The Towne-Heuer reading passage—A reliable aid to the evaluation of voice

The science of voice evaluation and assessment has profited from technological advancement and objective measurement of voice parameters has become an integral part of the voice examination, however, subjective voice evaluation remains a vital component of any voice examination. The Towne-Heuer Reading Passage was developed in 1970 to provide a reading sample that would facilitate subjective voice evaluation. The reliability of the passage was established using three judges listening to 15 normal Philadelphia speakers and 15 vocal abuse-misuse clients with verified vocal nodules. The frequency of hard glottal attack (HGA) was determined for the two groups and high interjudge and intrajudge correlation was found. A difference in the frequency of HGA was found between the two groups.     

Voice problems as side effects of inhaled corticosteroids in asthma patients—a prevalence study

Voice disturbances in asthma patients may be caused by inhaled corticosteroids. In order to study the prevalence of such voice disturbances, a questionnaire was delivered to asthma patients at three asthma and allergy departments in Stockholm. The questionnaire consisted of 25 questions concerning the asthma disease symptoms, medication, voice function, and voice disturbances. A total of 350 questionnaires were delivered. Response frequency was 80%. There was a significant positive correlation between inhalation of cortison and voice disturbances. Most of the patients complained about hoarseness, followed by throat clearing, a lump in the throat, loss of voice, and less frequently, throat pain. There were no significantly differences between men and women. Elderly had more voice problems than young persons. Patients with voice-demanding professions had more problems than patients who used their voice to a lesser extent during the working day. There was a significant positive correlation between high cortison doses and voice problems as well as between voice problems and acid regurgitation.     

The Voice Handicap of Student-Teachers and Risk Factors Perceived to Have a Negative Influence on the Voice

A cross-sectional questionnaire survey was performed. The objectives of the study were to assess the psychosocial impact of current voice complaints as perceived by student-teachers with voice complaints in comparison with student-teachers without voice complaints, and to observe the pattern of risk factors in relation to their voice handicap. Subjects in the general population without a voice-demanding profession were selected as a reference group for limited comparison with the total group of student-teachers (future professional voice users). The respondents to the questionnaires were anonymous. Among the student-teachers, 17.2% reported current voice complaints in comparison with 9.7% of the reference group, and the odds ratio was 1.94, which showed the relative risk. Student-teachers had significantly greater total Voice Handicap Index (VHI) scores than the reference group (P = 0.034). The VHI subscale scores were not significantly different (P > 0.05). Student-teachers who reported current voice complaints had a significantly higher total VHI and subscale scores than student teachers without voice complaints (P < 0.001). Of the student-teachers without voice complaints, 17.0% had VHI scores greater than the 75th percentile. These persons may be neglecting their voice handicap and probably represent the false-negative cases in the estimation of voice complaints. Logistic regression analysis of each of the given risk factors with the VHI as the independent variable showed that the perceived negative influence of the given risk factors on their voices was significantly greater with increasing VHI scores across the VHI range. A significant correlation was observed between the number of perceived risk factors and increasing VHI scores across the VHI range. An increased awareness of risk factors in relation to their voice handicap would serve to motivate student-teachers to change factors that contributed to their voice problem. Attention to all risk factors, which the subjects perceive to be a risk, would aid in effective management of their voice handicap.     

The influence of a minority magnetic phase on the field dependence of the magnetocaloric effect

The field dependence of the magnetic entropy change can be used to detect the existence of a minority magnetic phase without experimentally reaching its Curie temperature. In this work, we present results that could suggest a breakdown of the recently proposed universal behaviour of the magnetocaloric effect in materials with a second-order magnetic phase transition in some La-containing samples. The behaviour of the outlier La-containing materials is an evidence of the existence of minority phases, preventing the construction of the universal curve with a single reference temperature. However, the use of two reference temperatures avoids this difficulty and allows applying the universal curve for practical purposes even with the presence of the minority phase.     

Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report

The United States Bureau of Labor Statistics and other sources wereconsulted about the percentages of the working population that we identified as professional voice users. The largest percentage may be in sales and sales related occupations (13%), but the exact breakdown of those who approach their clients vocally rather than by mail is still uncertain. The second largest population is teachers, who comprise 4.2% percent of the U.S. workforce (1994 statistic). Teachers have been identified as having the greatest incidence of voice disorders. Population data are also given for professional voice users who could present a significant hazard to public safety if their vocal communication skills were severely impaired.     

Voice problems in a small swedish town: A retrospective study of the prevalence and a follow-up

The prevalence of voice problems among patients consulting the primary health care unit of a small Swedish town during 1984 was investigated. A study of the records of 11,606 patients indicated that 102 of them consulted their doctor mainly because of voice problems. The period prevalence of voice problems in the population of 20,049 people was 0.5%. A follow-up examination 1 year later indicated that 44% of these patients still had voice problems. Among the patients with a voice disorder diagnosis made by means of indirect laryngoscopy in 1984, 72% still had a voice disorder diagnosis at the follow-up. It is pointed out that the doctor who is seeing a patient with voice problems should make a thorough examination including indirect laryngoscopy. It is also important to discuss the patient's smoking habits and professional vocal strain to prevent recurrence.     

The Impact of Specific Exertion on the Efficiency and Ease of the Voice: A Pilot Study

Even though most singers and other professional voice users are encouraged to relax to optimize the quality and performance of the voice, observations of acclaimed singers, actors, and public speakers would suggest otherwise. These successful vocal performers appear to be energized, actively working and exerting themselves. For this reason, a study was designed to explore the role of exertion in maintaining and optimizing the voice. The focus of this study was the possibility that increasing exertion could improve the voice and might result in the voice user experiencing less strain and, therefore, more comfort and ease. Ten subjects were recorded before and after completing a workshop to develop their skills with precise use of effort involving selected parameters of the larynx and vocal tract. Self-reported ratings of degree of exertion and level of comfort were collected at the time of each recording. The preworkshop and postworkshop recordings were analyzed acoustically and perceptually to compare the degree of noise in the signal that corresponds with the efficiency of the voice. The results indicated that, for all subjects, the quality of the voice improved with an increase in the use of specific exertion. Furthermore, ease and comfort also significantly increased.     

Voice research: So What? A clearer view of voice production, 25 years of progress; the speaking voice

The past 25 years has yielded an impressive growth in our knowledge of vocal function. Interdisciplinary research cooperation in areas of laryngeal histology, vocal aerodynamics and acoustics, vocal fold vibratory characteristics, neurolaryngology, and phonatory models has led to a clearer view of voice production. This article offers a brief review of the progress that has been made in our understanding of the speaking voice and relates this knowledge to clinical practice. The importance of utilizing voice research to confirm traditional management techniques and to develop new physiologically based management approaches is also stressed.     

Communicative Suitability of Voice Following Radiotherapy for T1 Glottic Carcinoma: Testing the Reliability of a Rating Instrument

The objective of the study was to determine whether a communicative suitability rating instrument could be used in a meaningful way to assess functionality of voice following radiotherapy for T1 glottic cancer. Seventeen naive listeners judged the suitability of voice of a patient group with T1 glottic carcinoma (n = 20) just before treatment, a group of patients (n = 40) after radiotherapy, and a matched control group (n = 20) of normal speakers. Listeners rated suitability on a 10-point scale for 10 speaking situations, which supposedly make different demands. In order to validate scores on communicative suitability, ratings were related to perceptual voice quality evaluations and videolaryngostroboscopic evaluations. Results indicate that the concept of measuring listener judgments of communicative suitability of voice is basically sound. Raters are reliable and can discriminate between groups of normal and pathological voices. Patients with T1 glottic carcinoma (assessed before the start of treatment) have on average the least suitable voices. Following radiotherapy suitability is, on average, improved, but does not approach the suitability of normal voices. Ratings on communicative suitability were clearly related to perceptual voice quality aspects and videolaryngostroboscopic evaluations. A subset of three communicative suitability rating scales is recommended as part of the protocol for evaluating voice outcome after radiotherapy for early glottic cancer, besides perceptual evaluation of voice quality by trained and naive raters, videolaryngostroboscopy, acoustical analyses, and self-ratings of vocal performance.     

Evaluating the effectiveness and efficiency of voice therapy using transnasal flexible laryngoscopy: a randomized controlled trial

Transnasal flexible laryngoscopy (TFL) is an examination of laryngeal anatomy and physiology using continuous light. TFL is being used increasingly by voice pathologists in treatment but with little scientific evidence to support it. The purpose of this study was to evaluate the effectiveness and efficiency of TFL as a therapeutic tool. The study used a prospective randomized controlled trial. Fifty dysphonic subjects were recruited and randomly assigned to either a traditional treatment group or a TFL-assisted treatment group. The effectiveness of voice therapy in both treatment groups was measured with a package of voice outcome measures. Subjects in both treatment groups demonstrated statistically significant improvements after voice therapy (perceptual auditory rating of voice quality measurement p < 0.01; instrumental electroglottographic measurement p < 0.01; patient questionnaire measurement p < 0.01). The time taken to complete treatment in both groups was recorded. The average (median) time taken to complete voice therapy in the TFL-assisted treatment group was 2 hours less than in the traditional treatment group (p < 0.01). Voice therapy with TFL as a therapy tool was effective and more efficient than traditional voice therapy.     

The Effect of Noise on Computer-Aided Measures of Voice: A Comparison of CSpeechSP and the Multi-Dimensional Voice Program Software Using the CSL 4300B Module and Multi-Speech for Windows

The effect of noise on computer-derived samples of voice was compared across three different hardware/software configurations. The hardware/software systems included a stand-alone A/D converter (CSL Module 4300B) coupled to a custom Pentium PC used in conjunction with the Multi-Dimensional Voice Program (MDVP) software, and a Creative Labs A/D converter coupled to the same custom PC under software control of MDVP/Multispeech and CSpeechSP. Voice samples were taken from 10 female subjects, then mixed with computer fan noise creating three different signal-to-noise (S/N) levels. Mixed signals were analyzed on the three hardware/software systems. Results revealed that fundamental frequency was most resistant to the degradation effect of noise across systems; jitter and shimmer values, however, were more variable across all configurations. Jitter and shimmer values were significantly higher under certain S/N levels for the MDVP 4300B based system as compared to MDVP for Multi-Speech and CSpeechSP. The findings punctuate the need for sensitivity to recording environments, careful selection of hardware/software equipment arrays, and the establishment of minimal recording conditions (>25 dBA S/N) for voice sampling and analysis using computer-assisted methods.     

Test-retest study of the GRBAS scale: Influence of experience and professional background on perceptual rating of voice quality

Perceptual evaluation was performed by means of the GRBAS scalefor a series of nine pathological voice samples that were presented twice to a group of 23 judges, consisting of experienced and inexperienced otolaryngologists (ENTs) and speech-language pathologists (S/LPs). The time interval between ratings was 14 days. Test-retest reliability was moderate. The best agreement between the observers was obtained for the G (grade) parameter and the worst for the S (strained) parameter. Considering the medians of the GRBAS ratings, no significant influence was measured for level of experience or professional background. Yet, based on means, the results show that professional background has a greater impact on perceptual rating than experience.     

Analysis of the electric field behavior in the vicinity of a triple junction,using finite elements method computational simulations

The authors studied the electric field behavior in the vicinity of a triple junction, composed by metal, vacuum and dielectric parts, using computational simulations. A bi-dimensional model was constructed using ANSYS MAXWELL to analyze the magnitude of the electric field as a function of the contact angles of the materials. The results showed that a field enhancement or reduction could occur in vacuum for certain contact angles. The influence of the dielectric permittivity was also investigated, and the conclusions showed that the maximum electric field enhancement is proportional to the dielectric permittivity.     

Analysis of the temperature influence on the plasma reflectance by a new FDTD method

We apply the shift-operator FDTD (SO-FDTD) method for calculating dispersive media plasmas. We write the dielectric constant of a dispersive medium as a rational fractional function and derive the relation between D and E in the time domain. For a uniform, approximately isothermic, isotropic, warm-collision-plasma slab, the reflection coefficient of electromagnetic waves can be calculated using the SO-FDTD method. We study the influence of temperature on the collisions and absorption of electromagnetic waves in the plasma and discuss the regularity of the relationships obtained.     

Finite element simulation and analytical analysis for nano field emission sources that terminate with a single atom: A new perspective on nanotips

Nanotips are highly demanded for various applications in nanotechnology. For instance, nanotips with a single atom end can be used as a source of self collimated electron or ion beams. Such tips are usually characterized in the field ion microscope (FIM) or the field emission microscope (FEM), where only a top view can be captured and analyzed. We have noticed that single atom tips fabricated by different methods produce electrons in FEM mode, or ions in FIM mode, at a wide range of applied voltages for the respective mode. In this work we present numerical and analytical analyses to the distribution of the electric field in the vicinity of the nanotip apex that holds the topmost single atom. We demonstrate that although the electric field is relatively enhanced by the nano protrusion it is still significantly dominated by the tip base. The analyses explicitly show that nanotips with broad bases produce even less field than some modest tips, at the same applied voltage. This pronounced effect of the tip base accounts for the relatively high voltages needed at the imaging threshold field. The results reveal that single atom tips are not necessarily sharp at a mesoscopic scale and the tip sharpness has to be determined from the combination of the nanotip apex (FIM or FEM) image and the applied voltage.