A Pilot Survey of Vocal Health in Young Singers

The objective of this study was to determine the incidence of vocal problems in young choir singers and to correlate vocal problems with demographic and behavioral information. A questionnaire addressing vocal habits and hygiene was offered to 571 young choir singers, up to 25 years of age, who sing at least weekly; 129 (22.6%) responded. More than one-half of the respondents had experienced vocal difficulty, particularly older adolescents. Detrimental behaviors and circumstances surveyed were not reflective of the incidence of vocal difficulty, except for morning hoarseness, chronic fatigue, insomnia, and female gender after puberty. Voice care professionals should be aware that self-reported voice difficulties are common among young choral singers, especially postpubescent girls, and children with symptoms consistent with reflux (morning hoarseness) and emotional stress (insomnia). Laryngologists should communicate with choral conductors and singing teachers to enhance early identification and treatment of children with voice complaints, and to develop choral educational strategies that help decrease their incidence.     

Association between Social Frailty and Sleep Quality among Community-dwelling Older Adults: A Cross-sectional Study

Objective: We examined the association between social frailty and subjective sleep quality among community-dwelling adults. Methods: This cross-sectional study recruited Japanese adults over the age of 60 years from health check-ups held in a public townhall in a suburban area between 2018 and 2019. Social frailty was evaluated using five criteria (living alone, not visiting friends sometimes, going out less frequently than the last year, not feeling helpful to friends or family, and not talking to someone every day) and categorized into three groups: non-frailty, pre-frailty, and frailty. Sleep quality was assessed according to the Pittsburgh Sleep Quality Index (PSQI) by giving participants a self-reported questionnaire. We performed multivariable linear regression analysis, denoting social frailty as an independent variable, and the global PSQI score as a dependent variable. Results: Data from 300 older adults were analyzed, 51.0% of whom were female. The participants'' mean age was 73.0 years (standard deviation = 5.8). Multivariable analysis revealed the notable association between social frailty and a high global PSQI score (compared with non-frailty, frailty: β = 0.94, 95% CI = 0.08 to 1.80, p = 0.033). Of the five determiners of social frailty, not talking with someone every day was especially associated with a high global PSQI score (β = 1.57, 95% CI = 0.49 to 2.66, p = 0.005). Conclusion: The present study suggests that social frailty is associated with poor sleep quality among community-dwelling older adults. Our findings indicate the importance of social frailty on sleep quality among older adults.     

Harmonics-to-Noise Ratio: An Index of Vocal Aging

Distinguishing between vocal changes that occur with normal aging and those that are associated with disease is an important goal of research in voice. Several acoustic measures have been used in an attempt to illuminate the integrity of the vocal mechanism, including harmonics-to-noise ratio (HNR), jitter, and fundamental frequency (F₀). HNR is a measure that quantifies the amount of additive noise in the voice signal; jitter reflects the periodicity of vocal fold vibration. In this study, measures of HNR, jitter and F₀ were used to compare vocal function in three groups of normally speaking women: young adults, middle-aged adults, and elderly adults. Significant differences in HNR emerged between the elderly women and the other two groups. F₀ differences were also apparent between the elderly group and the two younger groups; there were no significant differences in jitter between the three groups. HNR was found to be a more sensitive index of vocal function than jitter. The significant lowering of HNR evident in the elderly speakers may be attributable in part to medications taken by the majority of these elderly subjects.     

A Second-Order High-Resolution Scheme for a Juvenile-Adult Model of Amphibians

In this article we consider a juvenile-adult population model of amphibians in which juveniles are structured by age and adults are structured by size. We develop a second-order explicit high-resolution scheme to approximate the solution of the model. Convergence of the finite difference approximation to the unique weak solution with bounded total variation is proved. Numerical examples demonstrate the high-resolution property and the achievement of the designed accuracy for the scheme. The scheme is then applied to understand the dynamics of an urban amphibian population.     

Effects of back extensor strengthening exercises on postural alignment,physical function and performance,self-efficacy,and quality of life in Japanese community-dwelling older adults: A controlled clinical trial

Objective: To examine the changes in postural alignment and kyphosis-correlated factors after 6 months of back extensor strengthening exercise in a group of community-dwelling older adults aged ≥65 years. Methods: We quasi-randomized 29 subjects into an intervention group treated with a back extensor strengthening program and a control group treated with a full-body exercise program. These groups completed 20-30 minutes of exercise directed by a physical therapist one or more times per week and were instructed to exercise at home as well. The participants were assessed prior to and after the intervention using the following criteria: postural alignment of “usual” and “best” posture, physical function, physical performance, self-efficacy, and quality of life. The differences between two factors (group and period) were compared for each of the measurement variables. Results: Subjects who adequately completed the exercises were analyzed. A reduced knee flexion angle was noted in the “best” posture of both groups, as were improved physical function and performance with the exception of one-leg standing time. Verifying the effect size in the post-hoc analysis, the body parts that showed changes to postural alignment after the intervention differed between groups. Conclusions: Back extensor strengthening exercises improved physical function and performance, but did not improve spinal alignment. The changes due to these interventions were not significantly different from changes observed in the full-body exercise group. However, post-hoc analysis revealed that the effect size of posture change was different, possible indicating that the two groups experienced different changes in the postural alignment.     

A snapshot of young adults’ noise exposure reveals evidence of ‘Binge Listening’

There have been several previous studies into daily noise exposure levels in modern urban communities, which typically report mean noise exposure levels (L_Aeq) for adults between 73 and 79 dB. In this study, rather than focus on group mean exposures across a wide age range, individual patterns of noise exposure over 4- and 5-day periods were examined in a group of 45 young adults aged 18–35 years. The main objective of the study was to determine the extent to which young adults exhibit a ‘binge listening’ pattern of noise exposure, i.e., high weekend leisure noise vs. low weekday work noise exposure. A secondary objective was to identify the types of activities that generate the highest noise exposures. The results showed that although most participants (60%) were exposed to low daily noise levels, 33% of participants exhibited a ‘binge listening’ exposure pattern characterized by one or two high-noise days, usually a Friday, Saturday or Sunday, preceded or followed by much quieter days. The most notable high-noise activities were playing an instrument solo or in a band; attending a nightclub; and attending a pop concert, each of which recorded average noise levels greater than 100 dB. Future research is needed to determine whether ‘binge listening’ is more or less harmful than the chronic exposure presupposed in traditional risk models, however, under the equal-energy principle, repeated ‘binge’ noise exposures from weekend visits to nightclubs, live music events and other high-noise events represent a significant risk to long-term hearing health.     

Voice Handicap Index Results for Older Patients with Adductor Spasmodic Dysphonia

Adductor spasmodic dysphonia (ADSD) adversely affects a speaker's ability to effectively communicate. For many individuals suffering with ADSD, botulinum toxin (Botox) is the chosen treatment to remediate the symptoms. Although Botox's effects on symptom remediation have been examined before, patient perception of improvement post-Botox has been examined less frequently. Further, no studies have addressed the symptomatic changes in older adults that occur after Botox treatment. The Voice Handicap Index (VHI) was used as the instrument to assess older patient's (>65 years) perception of how ADSD impacts certain areas of their life pre- and post-Botox injection. The outcome of the VHI was related to a clinical judgment of voice severity. Participants also completed the Social Readjustment Rating Scale (SRRS) to examine overall stress level, and the outcome of the SRRS was correlated to postinjection VHI scores. Results indicated no significant correlation between VHI scores and voice severity or SRRS ratings. The current study suggests further study of voice outcomes with older adults with ADSD is needed.     

Effect of a Combined Exercise and Cognitive Activity Intervention on Cognitive Function in Community-dwelling Older Adults: A Pilot Randomized Controlled Trial

Objective: The purpose of this study is to investigate the effect of an intervention combining exercise and cognitive activity on cognitive function in healthy older adults. Methods: This pilot randomized controlled trial recruited 33 eligible, healthy communitydwelling older adults (mean age, 77.1 years old; women, 51.5%), who were divided into intervention and waitlist control groups. The intervention group was engaged weekly in a group activity comprising exercise and discussions of homework, which included reading aloud, simple arithmetic, and simple activities, like spotting differences, for cognitive stimulation. They were also required to complete cognitive activity homework twice a week. The waitlist control group received no intervention. The main outcomes were cognitive function assessed using the Mini-Mental State Examination, delayed recall score on the Logical Memory IIA of the Wechsler Memory Scale Revised, Trail Making Test, and digit symbol substitution test. Results: According to the results, Mini-Mental State Examination scores were maintained in the intervention group but declined in the control group [Mean change in outcomes in control group (95% confidence interval): -1.68 (-2.89 to -0.48)]. Additional mean change in outcomes in intervention group were found [1.68 (0.02 to 3.35)]. Conclusions: Interventions combining exercise and cognitive activity can be helpful for preserving cognitive function in healthy older adults.     

Maximum Duration of Sustained /s/ and /z/ and the s/z Ratio With Controlled Intensity

SUMMARY: The purpose of this study was to compare maximum prolongations of controlled-intensity /s/ vs. /z/ in young healthy male and female adults and to compare the s/z ratio in young men and women. Twenty young adult men and 20 young adult women were included in this study. Participants produced 10 trials of /s/ and 10 of /z/ with a controlled intensity of 60-dB sound-pressure level (SPL). Maximum prolongations and s/z ratio were determined by three different methods: based on the longest out of 10 trials, the longest of 3 trials, and an average of the first 3 trials. Results revealed that based on averaged group data, /s/ and /z/ seemed to be prolonged for similar durations. Men consistently prolonged both phonemes significantly longer than women. There were no significant differences in s/z ratio between men and women. However, when individual data were reviewed, it seemed that some subjects consistently prolonged /s/ for a longer duration than /z/, some subjects prolonged /z/ longer than /s/, and some subjects actually produced approximately equal durations of the two phonemes. It was further noted that /s/ durations were more favorably impacted by practice than /z/ durations.     

Age-Related Change in Muscle Characteristics and Resistance Training for Older Adults

In older adults, muscle weakness contributes greatly to functional restrictions on daily living activities, increased risk of falls, and adverse physiological changes. It has been suggested that not only muscle mass but also muscular infiltration of noncontractile elements may influence muscular performance such as strength and rapid force production. It is proved that resistance training may provoke substantial increases in muscle size even if it is performed at low intensities in older individuals. Also, recent studies have demonstrated the effectiveness of resistance training on muscle quality such as muscular infiltration of noncontractile elements for older people. This review shows the age-related changes in muscle mass and muscle quality, which were measured by muscle echo intensity on ultrasound images, and low-intensity resistance training effects on muscle volume and muscle quality.