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Sharp E, Cook R. Voice Symptoms and Wellbeing in School Teachers in England. J Voice 2024; 38:1252.e1-1252.e10. [PMID: 35307220 DOI: 10.1016/j.jvoice.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Negative psychological factors such as depression and other common mental disorders have been found to be associated with voice problems in teachers. However, there is little research with teachers that investigates the relationship between positive psychological factors such as wellbeing and voice problems. Although negative and positive mental states are on a continuum of psychological health, research suggests negative and positive effects are not necessarily inversely correlated and therefore need to be investigated separately. OBJECTIVE/HYPOTHESIS To explore the relationship between voice symptoms and wellbeing in teachers working in primary and secondary schools in England. We hypothesise that as wellbeing increases voice symptoms will decrease. DESIGN Cross sectional study using a self-administered web-based questionnaire conducted with primary and secondary school teachers in England. METHODS The study included 1205 teachers from 608 primary and secondary schools, including state and fee paying, and mainstream and special schools. Voice symptoms were measured using The Voice Symptom Scale and wellbeing was measured using the Warwick Edinburgh Mental Wellbeing Scale. Information was also obtained on health, lifestyle, sociodemographic and environmental factors. Analysis was conducted using a linear multi-level regression model. RESULTS A statistically significant relationship between voice symptoms and wellbeing was identified (-0.31 95% CI -0.41, -0.20 P =< 0.001). Other factors found to be statistically significantly associated with voice symptoms were age, sex, gastroesophageal reflux, class size, background noise, speaking louder than normal and respiratory infection. Hours teaching per week, deprivation of school, voice training, teaching subject, smoking status and asthma were not associated with voice symptoms. CONCLUSIONS This study suggests that there is an association between vocal symptoms and wellbeing. Teachers with higher wellbeing had fewer voice symptoms.
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Affiliation(s)
- Emily Sharp
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK.
| | - Robert Cook
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
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Fujiki RB, Thibeault SL. Voice Disorder Prevalence and Vocal Health Characteristics in Adolescents. JAMA Otolaryngol Head Neck Surg 2024; 150:800-810. [PMID: 39052255 PMCID: PMC11273279 DOI: 10.1001/jamaoto.2024.2081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 05/22/2024] [Indexed: 07/27/2024]
Abstract
Importance Voice disorders impede communication and detract from quality of life, yet little is known about how voice problems present in adolescents. This study characterized the prevalence of voice problems and vocal health characteristics of adolescents throughout the US. Objective To determine the prevalence of adolescent voice problems in the US as well as the symptoms, voice use patterns, and risk factors associated with these problems. Design, Setting, and Participants This prospectively performed, cross-sectional survey study conducted from March to June 2023 included a probability sample of adolescents (aged 13-17 years) who were located across the US. Main Outcome and Measures Adolescents were surveyed concerning voice use, voice symptoms, demographic information, and substance use patterns. The Vocal Fatigue Index (VFI) was also completed. Fisher exact tests, χ2 tests, and logistic regression were used to compare those with and without reported voice problems. Results Five-hundred and two adolescents participated (51.6% participation rate), including 248 female (49.4%), 7 nonbinary (1.3%), 254 male (50.6%), 4 transfemale (0.7%), and 3 transmale individuals (0.5%) (mean [SD] age, 15.2 [1.3] years). The lifetime prevalence of voice problems was 24.3%, and current prevalence was 7.4%. Voice-related diagnoses included dysphonia associated with acute illness, vocal hyperfunction, benign lesions, and muscle tension. The mean (SD) VFI score was 4.7 (8.09) for part 1, 1.6 (3.2) for part 2, and 2.1 (3.2) for part 3. Adolescents with voice complaints presented with significantly higher VFI scores than those without voice problems (Cohen d for part 1 = 0.78, part 2 = 0.59, and part 3 = 0.79). Voice problems interfered with daily tasks, prevented participation in extracurricular activities, limited the ability to sing, and were associated with school absences. Voice use patterns associated with voice problems included frequent loud voice use, coughing, and/or throat clearing. Risk factors for increased voice problem prevalence included part-time employment in childcare (odds ratio [OR], 6.4; 95% CI, 1.6-26.3), singing (OR, 2.08; 95% CI, 1.3-3.1), performance-related extracurricular activities (ie, musical theater [OR, 2.67; 95% CI, 1.1-6.6 ], karaoke [OR, 3.08; 95% CI, 1.3-6.9]), vaping (OR, 1.99; 95% CI, 1.1-3.5), and/or secondhand smoke exposure (OR, 1.83; 95% CI, 1.2-2.7). Adolescents identifying as transgender were more than 4 times (OR, 4.44; 95% CI, 0.63-31.2) as likely to report voice problems compared with cisgender adolescents. Conclusions The results of this survey study illuminate the nature of voice problems in adolescents and may guide clinicians in preventing and treating voice disorders in this population. Future work may define the mechanisms through which these factors are associated with the risk for voice disorders in adolescents and determine whether observed relationships are causal or associative.
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Vaartio-Rajalin H, Lyberg Åhlander V, Nyholm L. Professional voice use in health and nursing care - Time for reconsideration? A scoping review. Scand J Caring Sci 2024; 38:550-567. [PMID: 38773887 DOI: 10.1111/scs.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/19/2024] [Accepted: 05/04/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND Communication is a key tool in the nursing profession. It is known that listeners are sensitive to the speaker's voice and interpret the speaker's intentions primarily from the non-verbal signal conveyed. AIM To map and discuss the current state of knowledge and research evidence on professional voice use in health and nursing care. DESIGN AND METHOD A scoping review adherent to the EQUATOR guidelines PRISMA-ScR. DATA SOURCES Searches in the EBSCO, CINAHL, Medline, PubMed, PsychInfo and PsycArticles databases were conducted between 1 and 28 February 2023. RESULTS According to the data (n = 23), health professionals use voice as a vital aspect of caring communication and caring relationships, and in leadership as well as inter-professional collaboration, to facilitate information exchange and understanding and promote shared decision-making. The data showed that there is also a rising tendency to explore vocal demands and problems among health professionals. No studies were found on the use of voice in digital health and nursing care services or by social robots. Most of the reviewed studies were cross-sectional, rather small, and focused primarily on the perspectives of healthcare professionals. CONCLUSION The use of voice should be explored as a vital aspect of caring communication and caring relationships from the patients' perspective, and the effects of voice use on listeners' emotions and actions should be examined in different contexts with modern, voice-specific data collection methods. Studies focusing on voice use in digital health care and by social robots are also needed. By integrating training programmes, education and technological innovations, health care can leverage the full potential of voice-based communication to promote a more coordinated and patient-centred care environment, true inter-professional collaboration and effective leadership. IMPACT Professional voice use is an essential part of all health and nursing care and an impressive method that should be used consciously. Therefore, the meaning and methods of voice use, including speech accommodation, should be systematically introduced into health and nursing care and included in nursing education.
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Affiliation(s)
- Heli Vaartio-Rajalin
- Master School, Turku University of Applied Sciences, Turku, Finland
- Faculty of Pedagogy and Welfare Studies, Department of Health Sciences, Åbo Akademi University, Vaasa, Finland
| | - Viveka Lyberg Åhlander
- Department of Speech Language Pathology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Åbo, Finland
- Department of Clinical Sciences, Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Linda Nyholm
- Department of Caring and Ethics, the Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Hauerslev LL, Lindegaard L, Printz T, Wistbacka GÖ. Cross-Cultural Adaptation and Validation of the Vocal Fatigue Index (VFI) to Danish. J Voice 2024:S0892-1997(24)00229-7. [PMID: 39183134 DOI: 10.1016/j.jvoice.2024.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 07/15/2024] [Accepted: 07/15/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVES The aim was to cross-culturally adapt and validate the Vocal Fatigue Index (VFI) to Danish (DK-VFI). STUDY DESIGN Cross-sectional design. METHODS The original American English VFI was cross-culturally adapted to Danish using a forward-backward translation procedure combined with focus group interviews. The DK-VFI was distributed to 26 patients with vocal fatigue (VF) and 103 vocally healthy controls. A matched subsample based on age and sex of the control group was included. Internal consistency was determined using Cronbach's alpha and test-retest reliability was determined using Spearman's Rho as well as Wilcoxon signed-rank tests. Validity was confirmed using the Wilcoxon rank-sum test. Sensitivity and specificity were assessed using the Receiver Operating Characteristics test and the discriminative ability was determined using the Area Under the Curve (AUC) test. The original VFI consists of three factors, and cutoff values were calculated for each separate factor in the DK-VFI. RESULTS Minor changes were made in the phrasing of specific questions in order to appropriate the VFI to the Danish language. The internal consistency for the DK-VFI was high, with a Cronbach's alpha of α = 0.95. The results showed statistically significant differences (P < 0.05) in mean scores of the DK-VFI between patients and controls. The cutoff values between patients and controls for each separate factor were ≥11.5 for factor 1, ≥2.5 for factor 2, and ≤5.5 for factor 3. The results of the AUC analysis showed that the DK-VFI has discriminative abilities of 0.94 for factor 1, 0.92 for factor 2, and 0.82 for factor 3. Analysis of test-retest reliability showed strong reliability for the patient group and acceptable reliability for the control group. CONCLUSION The DK-VFI is a valid and reliable tool for identifying symptoms of VF and can sensitively discriminate people with VF from vocally healthy controls.
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Affiliation(s)
- Laura Lily Hauerslev
- Department of Cultural and Linguistic Sciences, University of Southern Denmark, Odense, Denmark.
| | - Laura Lindegaard
- Department of Cultural and Linguistic Sciences, University of Southern Denmark, Odense, Denmark
| | - Trine Printz
- Department of Cultural and Linguistic Sciences, University of Southern Denmark, Odense, Denmark
| | - Greta Öhlund Wistbacka
- Acoustic Technology Group, Department of Electrical and Photonics Engineering, Technical University of Denmark, Denmark; Department of Public Health and Caring Sciences, Uppsala University, Sweden
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Piatek S, Voigt-Zimmermann S, Böckelmann I. Heart Rate Variability in a Vocal Stress Test with Special Consideration of the Objective Voice Function. J Voice 2024:S0892-1997(24)00230-3. [PMID: 39117518 DOI: 10.1016/j.jvoice.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Many employees, especially in voice-intensive professions, are under psychological stress at work, which is very difficult to objectify. The aim of the study was to analyze correlations between heart rate variability (HRV) parameters and objective voice function using weighted voice parameters (Dysphonia Severity Index [DSI]) in order to determine whether subjects with impaired vocal function show a predominance of sympathetic control during a vocal stress test. STUDY DESIGN Prospective. METHODS Fifty-three people of working age were examined. After asking for sociodemographic, occupational, and voice-related data, the objective voice function was determined using the DiVAS voice diagnostics system, and a 20-minute vocal stress test was performed. The electrocardiogram was recorded using medilog AR12plus during the vocal stress test and in a 5-minute rest phase before and a 5-minute recovery phase after the test. HRV was analyzed using the Kubios HRV Premium software. RESULTS HRV was reduced during the vocal stress test compared to the resting and recovery phase. A Spearman correlation analysis showed significant correlations, particularly between the frequency-related HRV parameters and the DSI. The DSI correlated positively with the high frequency (HF) band (the relative power and the normalized unit). The DSI correlated negatively with the quotient between low frequency and HF and the low frequency normalized unit. CONCLUSION During a vocal stress test, adults in working age show a correlation between parameters of objective vocal function and parameters of HRV. The more impaired the objective vocal function, the higher the predominance of sympathetic activation under vocal stress. The voice can therefore be seen as a "warning signal" for the processes in the autonomic nervous system. The use of preventive strategies for stress management and for voice health appears to be particularly beneficial in vocally stressful occupations in order to achieve a positive effect on parasympathetic activity.
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Affiliation(s)
- Stephanie Piatek
- Department of Occupational Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany.
| | - Susanne Voigt-Zimmermann
- Department of Speech Science and Phonetics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Irina Böckelmann
- Department of Occupational Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Naunheim MR, DeVore EK, Huston MN, Song PC, Franco RA, Bhattacharyya N. Increasing Prevalence of Voice Disorders in the USA: Updates in the COVID Era. Laryngoscope 2024; 134:3713-3718. [PMID: 38525993 DOI: 10.1002/lary.31409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/03/2024] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To estimate the current prevalence of voice disorders among adults in the United States; to determine the association of individual factors with voice disorders. METHODS The 2022 National Health Interview Survey (NHIS) was analyzed to identify adults reporting voice problems in the past 12 months. Demographics were assessed, as well as the duration, severity, and resolution of the voice problem. The relationship between voice problems, gender, lost workdays, and long COVID was investigated. A comparison to the 2012 NHIS was made to determine changes in voice disorder prevalence. RESULTS 29.9 million Americans (95%CI[28.3-31.5]) annually report a voice problem, representing 12.2% of the population (95%CI[11.7-12.8%]). Overall, 26.8% and 13.2% reported the severity of their voice problem as moderate or severe, respectively. Only 5.1% (95%CI[4.3-6.0%]) of respondents sought treatment. Most voice problems were resolved within 1 week (53.0%,95%CI[50.9-55.1%]). Females were more likely than males to report a voice problem (14.4% vs. 10.0%,95%CI[13.7-15.1] and [9.3-10.7], respectively). The 17.6 million Americans with long COVID symptoms were more likely to have voice complaints than those without (21.1% vs. 11.6%,95%CI[18.9-23.5%] and [11.1-12.1%], respectively). Lost workdays were not significantly higher for those with voice disorders compared to those without (17.1 vs. 12.9 days,95%CI[12.0-22.1] and [11.0-14.8], respectively). CONCLUSIONS Voice problems affect approximately 1 in 8 adults in the U.S. annually, demonstrating an alarming increased prevalence since 2012 using the same survey methodology. Relatively few individuals seek care for their voice problem, despite significant self-reported impact. Further study is required regarding the impact of COVID and changes in voice use patterns on voice disorders. LEVEL OF EVIDENCE 3 Laryngoscope, 134:3713-3718, 2024.
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Affiliation(s)
- Matthew R Naunheim
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Elliana K DeVore
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Molly N Huston
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, U.S.A
| | - Phillip C Song
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Ramon A Franco
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Neil Bhattacharyya
- Harvard Medical School, Boston, Massachusetts, U.S.A
- Department of Otolaryngology Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
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Aghajanzadeh M, Dabirmoghaddam P, Soleimani M, Saeedi S. Comparing five-factor personality traits and psychological distress between dysphonic patients and individuals with vocally healthy voices. Brain Behav 2024; 14:e3641. [PMID: 39099382 PMCID: PMC11298687 DOI: 10.1002/brb3.3641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024] Open
Abstract
INTRODUCTION It was reported that voice can carry information about personality and psychological distress. In the current study, the relationship between five-factor personality traits and psychological distress with voice was enlightened from diverse aspects. METHODS A total of 119 participants (55 with and 64 without dysphonia) sustained vowels /a/ and /i/, read six standard sentences, and answered a question. Three raters auditory-perceptually evaluated the vocal samples using the Persian version of CAPE-V. The participants were distributed into four groups (vocally healthy, mild, moderate, and severe dysphonia). They completed two questionnaires: NEO Five-Factor Inventory (NEO-FFI) and Depression, Anxiety, and Stress Scale-21. RESULTS Results showed that the conscientiousness (U = 1146.500, z = -3.27, p = .001) in the dysphonia group was significantly less than the vocally healthy group. Depression (U = 1381.000, z = -2.03, p = .042) and anxiety (U = 1181.000, z = -3.10, p = .002) in the dysphonia group were significantly higher than in the vocally healthy group. In comparing different abnormal overall voice qualities, the mild dysphonia group revealed significantly lower conscientiousness (p = .001) and significantly higher anxiety (p = .002) relative to the vocally healthy group. CONCLUSIONS Findings indicated that the conscientiousness trait could play an influential role in persons with dysphonia and its psychological status. The voice care team should consider conscientiousness and psychological distress during the assessment and treatment of dysphonic patients.
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Affiliation(s)
- Mahshid Aghajanzadeh
- Department of Speech Therapy, School of RehabilitationTehran University of Medical SciencesTehranIran
| | | | - Mehdi Soleimani
- Department of Psychiatry, School of MedicineTehran University of Medical SciencesTehranIran
| | - Saeed Saeedi
- Department of Speech Therapy, School of RehabilitationTehran University of Medical SciencesTehranIran
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Verduyckt I, Chang T, Creagh S, Taleb H. Self-reported voice difficulties in educational professionals during COVID-19 in Quebec: a cross-sectional mixed-methods study. LOGOP PHONIATR VOCO 2024; 49:66-74. [PMID: 36256890 DOI: 10.1080/14015439.2022.2121986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/11/2022] [Accepted: 09/02/2022] [Indexed: 10/24/2022]
Abstract
Background: The health measures imposed by COVID-19 on workplaces created adverse communication settings. Our cross-sectional study aimed to document the nature and severity of the vocal difficulties experienced by educational professionals a few weeks after the implementation of health measures in schools and early childhood settings in Quebec, Canada while teaching in class.Methods: To this end, we conducted a self-report survey containing nine close-ended questions and one open-ended question regarding self-reported vocal difficulties and the implementation of health measures. The survey was answered by 194 educational professionals in October 2020.Results: Since the introduction of the health measures, respondents reported often or always: having difficulty making themselves heard (66.5%), needing to strain their voice (68.1%), having throat pain after work (38.1%), and being concerned about their vocal health (25.2%). 35.6% perceived that their voice changed moderately or a lot and 75.3% did not feel equipped to take care of their vocal health. Fisher's exact tests revealed the difficulties overall were more present in women (p < 0.05).Discussion: The qualitative analysis of open-ended question answers shows a circular process at play, where the vocal responses to the COVID-19-induced communication barriers contribute to creating more problematic communication settings, thus increasing the challenges for vocal health. Better equipping the professionals to take care of their vocal health by developing resources in their professional settings to help them face vocal challenges in both every day as well as extreme situations, should be a priority.
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Affiliation(s)
- Ingrid Verduyckt
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain, Montréal, Canada
| | - Tiffany Chang
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain, Montréal, Canada
| | - Sinead Creagh
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal métropolitain, Montréal, Canada
- Faculty of Education, University of Hong Kong, Hong Kong, Hong Kong
| | - Hanaa Taleb
- École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Canada
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Brisson V, Fournier C, Pelletier A, Joyal M, Defoy L, Tremblay P. Vocal Health and Vocal Health Knowledge Among Occupational Voice Users in the Province of Quebec. J Voice 2024; 38:799.e15-799.e27. [PMID: 35082049 DOI: 10.1016/j.jvoice.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Abstract
Voice disorders are frequent among occupational voice users such as teachers. Although these disorders can have serious personal and professional consequences, they are not often recognized as occupational diseases and little attention is paid to their prevention. This study aimed to provide a portrait of the self-reported vocal health and vocal health knowledge of occupational voice users in Quebec, Canada, and to identify risk factors associated with voice disorder symptoms. We conducted an online survey targeting occupational voice users in the province of Quebec, Canada, with a focus on those involved in teaching or training. The final sample, after excluding incomplete surveys, included 808 respondents (665 women, M = 41.5 ± 10.4 years old). The survey responses were analyzed using descriptive and inferential statistics. Results indicated that 9.8% of the respondents had a history of a diagnosed voice disorder and 68.8% of the respondents experienced at least one voice symptom on a regular basis. Ordinal logistic regressions revealed that several personal and environmental factors are associated with an increased risk of developing voice disorders symptoms: being a woman, suffering from a breathing disorder, allergies, acid reflux and/or hearing impairment, having less work experience, working with elementary school children and/or with continuous or speech noise in the background. Most of the respondents (94.6%) had never received information regarding voice disorders during their academic training and less than half of them (47.7%) knew which professionals can treat voice disorders. These findings highlight the need for formal vocal health education among both occupational voice users and their employers to improve prevention and treatment for voice disorders in an at-risk population.
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Affiliation(s)
- Valérie Brisson
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada; CERVO Brain Research Center, Quebec City, Canada
| | - Constance Fournier
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada
| | - Alicia Pelletier
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada
| | | | - Lyne Defoy
- CHU de Quebec-Université Laval, Hôpital St-François d'Assise, Quebec City, Canada
| | - Pascale Tremblay
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada; CERVO Brain Research Center, Quebec City, Canada.
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Kim HB, Song J, Park S, Lee YO. Classification of laryngeal diseases including laryngeal cancer, benign mucosal disease, and vocal cord paralysis by artificial intelligence using voice analysis. Sci Rep 2024; 14:9297. [PMID: 38654036 DOI: 10.1038/s41598-024-58817-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
Voice change is often the first sign of laryngeal cancer, leading to diagnosis through hospital laryngoscopy. Screening for laryngeal cancer solely based on voice could enhance early detection. However, identifying voice indicators specific to laryngeal cancer is challenging, especially when differentiating it from other laryngeal ailments. This study presents an artificial intelligence model designed to distinguish between healthy voices, laryngeal cancer voices, and those of the other laryngeal conditions. We gathered voice samples of individuals with laryngeal cancer, vocal cord paralysis, benign mucosal diseases, and healthy participants. Comprehensive testing was conducted to determine the best mel-frequency cepstral coefficient conversion and machine learning techniques, with results analyzed in-depth. In our tests, laryngeal diseases distinguishing from healthy voices achieved an accuracy of 0.85-0.97. However, when multiclass classification, accuracy ranged from 0.75 to 0.83. These findings highlight the challenges of artificial intelligence-driven voice-based diagnosis due to overlaps with benign conditions but also underscore its potential.
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Affiliation(s)
- Hyun-Bum Kim
- Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, Seoul, South Korea
| | - Jaemin Song
- Department of Industrial and Data Engineering, Hongik University, Seoul, South Korea
| | - Seho Park
- Department of Industrial and Data Engineering, Hongik University, Seoul, South Korea
| | - Yong Oh Lee
- Department of Industrial and Data Engineering, Hongik University, Seoul, South Korea.
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Wang F, Yiu EML. Predicting Dysphonia by Measuring Surface Electromyographic Activity of the Supralaryngeal Muscles. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:740-752. [PMID: 38315579 DOI: 10.1044/2023_jslhr-23-00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
PURPOSE This study set out to investigate whether individuals with dysphonia, as determined by either self-assessment or clinician-based auditory-perceptual judgment, exhibited differences in perilaryngeal muscle activities using surface electromyography (sEMG) during various phonatory tasks. Additionally, the study aimed to assess the effectiveness of sEMG in identifying dysphonic cases. METHOD A total of 77 adults (44 women, 33 men, Mage = 30.4 years) participated in this study, with dysphonic cases identified separately using either a 10-item Voice Handicap Index (VHI-10) or clinician-based auditory-perceptual voice quality (APVQ) evaluation. sEMG activities were measured from the areas of suprahyoid and sternocleidomastoid muscles during prolonged vowel /i/ phonations at different pitch and loudness levels. Normalized root-mean-square value against the maximal voluntary contraction (RMS %MVC) of the sEMG signals was obtained for each phonation and compared between subject groups and across phonatory tasks. Additionally, binary logistic regression analysis was performed to determine how the sEMG measures could predict the VHI-10-based or APVQ-based dysphonic cases. RESULTS Participants who scored above the criteria on either the VHI-10 (n = 29) or APVQ judgment (n = 17) exhibited significantly higher RMS %MVC in the right suprahyoid muscles compared to the corresponding control groups. Although the RMS %MVC value from the right suprahyoid muscles alone was not a significant predictor of self-evaluated dysphonic cases, a combination of the RMS %MVC values from both the right and left suprahyoid muscles significantly predicted APVQ-based dysphonic cases with a 69.66% fair level. CONCLUSIONS This study found that individuals with dysphonia, as determined by either self-assessment or APVQ judgment, displayed more imbalanced suprahyoid muscle activities in voice production compared to nondysphonic groups. The combination of the sEMG measures from both left and right suprahyoid muscles showed potential as a predictor of dysphonia with a fair level of confidence. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25112804.
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Affiliation(s)
- Feifan Wang
- School of Humanities, Shanghai Normal University, Shanghai, China
- Voice Research Laboratory, The University of Hong Kong, Pokfulam
| | - Edwin M-L Yiu
- Voice Research Laboratory, The University of Hong Kong, Pokfulam
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12
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Huston MN, Puka I, Naunheim MR. Prevalence of Voice Disorders in the United States: A National Survey. Laryngoscope 2024; 134:347-352. [PMID: 37530584 DOI: 10.1002/lary.30929] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES The prevalence of voice disorders has not been explored in the context of recent trends in voice use, including voice assistant technology and increased use of teleconferencing for remote work. The objective of this research is (1) to determine the prevalence of voice disorders in the adult population of the United States, and (2) to understand the association of voice disorders with demographic and voice use factors, including vocal demands, and use of teleconferencing and voice assistant technology. METHODS A survey pertaining to voice disorders and voice use was developed and administered to a representative sample of US population. Demographics and information related to risk factors for voice disturbance, including high vocal demands, teleconferencing, and voice-assistant use were also analyzed. RESULTS A total of 1522 responses were included. Of these, 20.6% reported having had a voice disorder at some point in their life. This rate was higher in employed respondents, singers, and teachers (all p < 0.0001) and was notably higher in those who used teleconferencing technology and voice assistant technology (both p < 0.0001). Approximately 60% of this subset reported seeking medical care for their voice, 12.6% reported a current voice disorder, and 9.5% reported a voice problem that had recurred multiple times. CONCLUSIONS Approximately 1 in 5 Americans surveyed has had a voice disorder. Risk factors for voice disorders include use of teleconferencing technology, voice assistant use, and occupational factors. LEVEL OF EVIDENCE 3 Laryngoscope, 134:347-352, 2024.
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Affiliation(s)
- Molly N Huston
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Ira Puka
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA
| | - Matthew R Naunheim
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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13
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Silva MT, Occhi-Alexandre IGP, Teixeira LC. Association Between Vocal Symptoms, Communication, Work Environment, and Sense of Coherence in Hospital Health Professionals. J Voice 2023:S0892-1997(23)00370-3. [PMID: 38129270 DOI: 10.1016/j.jvoice.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study aimed to associate the presence of vocal symptoms with sociodemographic and occupational data, work environment self-perception, oral communication wearing a face mask, and the sense of coherence (SOC). METHOD This cross-sectional analytical observational study included 66 health professionals from a Brazilian hospital. They answered an online questionnaire on sociodemographic aspects, self-perception of the physical work environment, and oral communication at work. The Voice Symptom Scale (VoiSS) and Sense of Coherence Scale (SOC-13) were also applied. The significance level was set at 5% for the statistical analysis. RESULTS The self-perception of vocal symptoms was 62%. Professionals who considered the noise in their work environment unsatisfactory had more vocal symptoms (P = 0.005), especially in the limitation (P = 0.013) and physical (P = 0.028) domains of the VoiSS. Professionals with higher self-perceived vocal symptoms also reported incoordination between breathing, speech, and articulation (P = 0.041) and self-perceived difficulty being heard with a protective mask (P = 0.033). Professionals with a higher self-perceived score in the limitation domain of the VoiSS also had a higher self-perceived effort to speak with a mask (P = 0.035) and a higher self-perception that other people find it difficult to hear them with a face mask (P = 0.050). There was a weak negative correlation between VoiSS and SOC (P < 0.05) and between its domains (P < 0.05). CONCLUSION Self-perception of voice symptoms is high among health professionals in a Brazilian public hospital. The presence of these symptoms is related to the perception of a noisy work environment and communication difficulties due to the use of a face mask. The lower the ability to cope with stressful situations, the larger the presence of voice symptoms among health professionals.
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Affiliation(s)
- Melyssa Tamietti Silva
- School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
| | | | - Letícia Caldas Teixeira
- School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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14
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Lindström E, Öhlund Wistbacka G, Lötvall A, Rydell R, Lyberg Åhlander V. How older adults relate to their own voices: a qualitative study of subjective experiences of the aging voice. LOGOP PHONIATR VOCO 2023; 48:163-171. [PMID: 35446741 DOI: 10.1080/14015439.2022.2056243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
AIM The aim of this study was to investigate how otherwise healthy older adults with self-assessed voice problems relate to their voice and voice changes. METHOD Focus groups were conducted at an activity center to identify how older adults reflect on their own voice and the aging voice in general. The interviews were audio recorded and transcribed. The analysis was done using thematic content analysis. RESULTS The analysis resulted in three main themes: "communicational aspects of the aging voice," "consequences of deteriorating vocal and communicative capacity," and "attitudes, strategies, and ideas". The participants considered voice to be an important communication tool and presented what could be interpreted as awareness regarding their voice. Voice changes were considered a natural part of aging. This attitude was also an important reason why the participants had not sought medical care for their voice problems. The participants discussed ideas concerning extended voice use to maintain a functioning voice when aging. Simultaneously, voice changes due to aging were considered to have a negative effect on communication and social participation. CONCLUSIONS The voice is important for older adults, and an insufficient voice can affect communication and social participation. Information about aging voice and voice exercises, for example from speech language pathologists, could be of interest among older adults. Further studies on the voice of older adults are needed regarding how they experience their voice and the general aspects of a healthy aging voice.
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Affiliation(s)
- Emma Lindström
- Department of Speech Language Pathology, Faculty of Arts, Theology and Psychology, Åbo Akademi University, Turku, Finland
| | | | - Agnes Lötvall
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Roland Rydell
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Viveka Lyberg Åhlander
- Department of Speech Language Pathology, Faculty of Arts, Theology and Psychology, Åbo Akademi University, Turku, Finland
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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15
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Nudelman C, Udd D, Åhlander VL, Bottalico P. Reducing Vocal Fatigue With Bone Conduction Devices: Comparing Forbrain and Sidetone Amplification. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4380-4397. [PMID: 37844616 DOI: 10.1044/2023_jslhr-23-00409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
PURPOSE Altered auditory feedback research aims to identify methods to strengthen speakers' awareness of their own voicing behaviors, diminish their perception of vocal fatigue, and improve their voice production. This study aims to compare the effects of two bone conduction devices that provide altered auditory feedback. METHOD Twenty participants (19-33 years old, age: M [SD] = 25.5 [3.85] years) participated in a vocal loading task using a standard Forbrain device that provides filtered auditory feedback via bone conduction and a modified Forbrain device that provides only sidetone amplification, and a control condition with no device was also included. They rated their vocal fatigue on a visual analog scale every 2 min during the vocal loading task. Additionally, pre- and postloading voice samples were analyzed for acoustic voice parameters. RESULTS Across all participants, the use of bone conduction-altered auditory feedback devices resulted in a lower vocal fatigue when compared to the condition with no feedback. During the pre- and postvoice samples, the sound pressure level decreased significantly during feedback conditions. During feedback conditions, spectral mean and standard deviation significantly decreased, and spectral skew significantly increased. CONCLUSION The results promote bone conduction as a possible preventative tool that may reduce self-reported vocal fatigue and compensatory voice production for healthy individuals without voice disorders.
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Affiliation(s)
- Charles Nudelman
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign
| | - Daniela Udd
- Faculty of Arts, Psychology and Theology, Department of Speech and Language Pathology, Åbo Akademi University, Turku, Finland
| | - Viveka Lyberg Åhlander
- Faculty of Arts, Psychology and Theology, Department of Speech and Language Pathology, Åbo Akademi University, Turku, Finland
| | - Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign
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16
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Aldridge-Waddon L, Hiles C, Spence V, Hotton M. Clinical Psychology and Voice Disorders: A Meta-Analytic Review of Studies Assessing Psychological Characteristics Across Individuals With and Without Voice Disorders. J Voice 2023:S0892-1997(23)00287-4. [PMID: 37806904 DOI: 10.1016/j.jvoice.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES Clinical voice disorders are heterogenous conditions capturing problems with voice production and control. Psychological conceptualizations of voice disorders posit that mood, anxiety, and personality characteristics contribute to the development and maintenance of voice symptoms. This review brings together research comparing these psychological characteristics across groups with and without voice disorders, with the aim of profiling group differences. METHODS A systematic search of PubMed, CINAHL, Ovid (PsycInfo, MEDLINE, Embase), and Web of Science databases was conducted, with studies required to assess psychological characteristics between samples with and without voice disorders. Relative study quality and risk of bias were formally evaluated, synthesizing results via meta-analysis (estimating standardized mean difference; SMD) and narrative synthesis. RESULTS Thirty-nine studies (N = 4740) were reviewed. Marked psychological differences were observed between case-control groups, including significantly higher self-reported features of depression (SMD = 0.50), state anxiety (SMD = 0.58), trait anxiety (SMD = 0.52), health anxiety (SMD = 0.57), and neuroticism (SMD = 0.47) in voice disorder groups. However, less consistent patterns of difference were observed between voice disorder types, including minimal quantitative differences between functional and organic diagnoses. CONCLUSIONS Findings underline and formulate the psychological features associated with experiencing a voice disorder, indicating individuals with voice disorders present with considerable psychological needs that may benefit from clinical psychology input.
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Affiliation(s)
- Luke Aldridge-Waddon
- Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK.
| | - Chloe Hiles
- Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK
| | - Victoria Spence
- VoiceFit Specialist Speech Therapy Services, VoiceFit Specialist Speech Therapy Services, UK
| | - Matthew Hotton
- Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK; Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, UK
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17
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Perry TT, Brungart DS, Myers JR, Cord LL, Solomon NP. Prevalence of Self-Reported Voice Concerns and Associated Risk Markers in a Nonclinical Sample of Military Service Members. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3364-3381. [PMID: 37532245 DOI: 10.1044/2023_jslhr-23-00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Difficult communication environments are common in military settings, and effective voice use can be critical to mission success. This study aimed to estimate the prevalence of self-reported voice disorders among U.S. military service members and to identify factors that contribute to their voice concerns. METHOD A nonclinical sample of 4,123 active-duty service members was recruited across Department of Defense hearing conservation clinics. During their required annual hearing evaluation, volunteers provided responses to voice-related questions including a slightly adapted version of the Voice Handicap Index-10 (VHI-10) as part of a larger survey about communication issues. Changepoint detection was applied to age and years of service to explore cohort effects in the reporting of voice concerns. Logistic regression analyses examined multiple available factors related to communication to identify factors associated with abnormal results on the VHI-10. RESULTS Among the respondents, 41% reported experiencing vocal hoarseness or fatigue at least several times per year, and 8.2% (n = 336) scored above the recommended abnormal cut-point value of 11 on the VHI-10. Factors independently associated with the greatest risk for self-reported voice concerns were sex (female), cadmium exposure, vocal demands (the need for a strong, clear voice), and auditory health measures (frequency of experiencing temporary threshold shifts; self-reported hearing difficulties). CONCLUSIONS Based on self-reported voice concerns and false negative rates reported in the literature, the prevalence of dysphonia in a large sample of active-duty service members is estimated to be 11.7%, which is higher than that in the general population. Certain predictors for voice concerns were expected based on previous literature, like female sex and voice use, but frequency of temporary threshold shifts and exposure to cadmium were surprising. The strong link between voice and auditory problems has particular implications regarding the need for effective communication in high-noise military and other occupational environments.
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Affiliation(s)
- Trevor T Perry
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Oak Ridge Institute for Science and Education, APHC Research Participation Program, TN
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - Douglas S Brungart
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Jennifer Rae Myers
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Laura L Cord
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
| | - Nancy Pearl Solomon
- National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD
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18
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Song Z, Lee PJ, Jung H. Prevalence of voice handicap among nurses in intensive care units due to occupational noise during pandemic. Front Public Health 2023; 11:1250512. [PMID: 37727611 PMCID: PMC10505665 DOI: 10.3389/fpubh.2023.1250512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Background Healthcare workers have been identified as being at risk of occupational voice disorders. Among them, nurses working in intensive care units (ICUs) are particularly vulnerable due to the risk factors that are associated with their exposure to high levels of noise. Thus, this study aimed to determine the prevalence of voice disorders among ICU nurses. Methods A questionnaire was administered to 100 ICU nurses from four hospitals in China. The questionnaire assessed vocal-related symptoms, perceived voice handicap, frequently heard noise sources, and the quality of communications. Results Results indicate that the most frequently reported voice symptoms were 'voice tiredness' and 'voiceless'. Nurses working more than 50 h per week experienced voice symptoms more frequently than nurses working for 40-50 h per week. The median value of the perceived voice handicap score (VHI-30) was 23, indicating mild voice handicap, while 24% of the nurses reported severe voice handicap. Longer working hours and working at patient wards were significantly associated with higher VHI-30 scores. The nurses also reported that the quality of verbal communication with patients and colleagues and voice problems worsened during the COVID-19 pandemic. Conclusion More than 20% of nurses reported severe voice handicap, however, voice handicap among ICU nurses did not appear universally to all nurses. Further research is necessary to identify the risk factors associated with voice disorders and the mechanism behind such heterogeneity among ICU nurses.
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Affiliation(s)
- Ziwei Song
- Acoustics Research Unit, School of Architecture, University of Liverpool, Liverpool, United Kingdom
| | - Pyoung-Jik Lee
- Acoustics Research Unit, School of Architecture, University of Liverpool, Liverpool, United Kingdom
| | - HeeJung Jung
- Department of Management and Entrepreneurship, Imperial College London, London, United Kingdom
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Castillo-Allendes A, Cantor-Cutiva LC, Hunter EJ. Mapping the Landscape of Voice Complaints among Teachers: A Bibliometric Investigation. J Voice 2023:S0892-1997(23)00218-7. [PMID: 37648623 PMCID: PMC10899526 DOI: 10.1016/j.jvoice.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE With the significant and growing interest in voice disorders among teachers over the last several decades, there is value in having a comprehensive overview of the current state of the field and its related research productivity. This study aims to provide an updated and comprehensive mapping of the intellectual structure and research evolution in the field of occupational voice complaints among teachers. METHODS A systematic review of scientific articles on occupational voice complaints among teachers published in the last two decades was conducted using the preferred reporting items for systematic reviews and meta-analyses statements. A retrospective bibliometric analysis was then performed using the Web of Science core collection and VOSviewer to identify scientific productivity indicators, including publications per year, productivity by country, journals, and most cited articles. RESULTS Based on the search eligibility criteria, a total of 473 articles were initially screened, and from this selection, 157 articles were identified as meeting the inclusion criteria and therefore included in the analysis. The analysis revealed a strong trend in scientific productivity, with a 300% increase in the number of publications during the last decade. The leading countries in publications on this field were Brazil, the United States, and Finland. The Journal of Voice, CoDAS, and Folia Phoniatrica et Logopaedica were the most frequently published journals. Additionally, the literature on voice complaints among teachers primarily focused on five conceptual clusters: vocal demand response, voice disorders, vocal health promotion, individual-associated factors, and voice symptoms. CONCLUSION This study examines the growing literature on voice complaints among teachers over the past 20 years, identifying key countries, journals, and thematic clusters. The findings have important implications for researchers, policymakers, and practitioners, providing insights for collaboration and guiding future advancements in the field.
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Affiliation(s)
- Adrián Castillo-Allendes
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa.
| | - Lady Catherine Cantor-Cutiva
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa.
| | - Eric J Hunter
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan; Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa.
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Adriaansen A, Van Lierde K, Meerschman I, Claeys S, D'haeseleer E. The Occurrence of Laryngeal Pathologies in a Treatment-Seeking Pediatric Population. J Voice 2023:S0892-1997(23)00210-2. [PMID: 37524580 DOI: 10.1016/j.jvoice.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES The purpose of this study was to 1) describe the age- and sex-specific occurrence of laryngeal pathologies in a treatment-seeking pediatric population in the voice unit of Ghent University Hospital, Belgium, and 2) describe this population in terms of vocal parameters, vocal complaints, influencing factors, and treatment history and recommendation. STUDY DESIGN Retrospective, observational study. METHODS All patient records were analyzed for children (0-18 years) who consulted the ear, nose, and throat department of Ghent University Hospital for the first time between July 2015 and June 2021 with complaints of dysphonia. In total, 103 children (66 males, 37 females) with a mean age of 10.01 years (SD: 3.4, range 3.93-17.96) were included in this study. Laryngeal pathology was diagnosed using a flexible videolaryngo(strobo)scopy. The influence of age and sex on laryngeal etiology (organic/functional voice disorder) was examined using a Welch-modified t test and a Fisher's exact test, respectively. RESULTS Organic lesions were observed in 77.7% of the participants, with vocal fold nodules (VFNs) being the most common diagnosis (66.0%). A functional voice disorder was diagnosed in 22.3% of the children. Children with a functional voice disorder are significantly older than children with an organic voice disorder. There was no statistically significant difference between males and females in laryngeal etiology. Mean dysphonia severity index was -2.7 (SD: 3.2, range -9.3 to +3.7), the mean acoustic voice quality index 4.70 (SD: 1.5, range 2.35-8.27), and the mean pediatric voice handicap index 29.8 (SD: 13.6, range 5-60). The occurrence of vocal misuse was mentioned in 80.6% of the patient records. CONCLUSION Organic voice disorders, especially VFNs, are predominant in treatment-seeking children with dysphonia. Functional voice disorders become more common with increasing age during childhood. A disordered vocal quality, reduced vocal capabilities and reduced voice-related quality of life were found.
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Affiliation(s)
- Anke Adriaansen
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa.
| | - Iris Meerschman
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Sofie Claeys
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium.
| | - Evelien D'haeseleer
- Center for Speech and Language Sciences (CESLAS), Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Royal Conservatory Brussels, Musical Department, Brussels, Belgium.
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McGlashan J, Aaen M, White A, Sadolin C. A mixed-method feasibility study of the use of the Complete Vocal Technique (CVT), a pedagogic method to improve the voice and vocal function in singers and actors, in the treatment of patients with muscle tension dysphonia: a study protocol. Pilot Feasibility Stud 2023; 9:88. [PMID: 37226281 DOI: 10.1186/s40814-023-01317-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 05/02/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Muscle tension dysphonia (MTD) results from inefficient or ineffective voice production and is the cause of voice and throat complaints in up to 40% of patients presenting with hoarseness. Standard treatment is voice therapy (SLT-VT) delivered by specialist speech therapists in voice disorders (SLT-V). The Complete Vocal Technique (CVT) is a structured, pedagogic method which helps healthy singers and other performers optimise their vocal function enabling them to produce any sound required. The aim of this feasibility study is to investigate whether CVT administered by a trained, non-clinical CVT practitioner (CVT-P) can be applied to patients with MTD before progressing to a pilot randomised control study of CVT voice therapy (CVT-VT) versus SLT-VT. METHODS/DESIGN In this feasibility study, we use a mixed-method, single-arm, prospective cohort design. The primary aim is to demonstrate whether CVT-VT can improve the voice and vocal function in patients with MTD in a pilot study using multidimensional assessment methods. Secondary aims are to assess whether (1) a CVT-VT study is feasible to perform; (2) is acceptable to patients, the CVT-P and SLT-VTs; and (3) whether CVT-VT differs from existing SLT-VT techniques. A minimum of 10 consecutive patients with a clinical diagnosis of primary MTD (types I-III) will be recruited over a 6-month period. Up to 6 video sessions of CVT-VT will be delivered by a CVT-P using a video link. The primary outcome will be a change in pre-/post-therapy scores of a self-reported patient questionnaire (Voice Handicap Index (VHI)). Secondary outcomes include changes in throat symptoms (Vocal Tract Discomfort Scale), acoustic/electroglottographic and auditory-perceptual measures of voice. Acceptability of the CVT-VT will be assessed prospectively, concurrently and retrospectively both quantitatively and qualitatively. Differences from SLT-VT will be assessed by performing a deductive thematic analysis of CVT-P transcripts of therapy sessions. CONCLUSION This feasibility study will provide important data to support whether to proceed with a randomised controlled pilot study focusing on the effectiveness of the intervention compared to standard SLT-VT. Progression criteria will be based on demonstrating a positive outcome in treatment, successful delivery of the pilot study protocol, acceptability to all stakeholders and satisfactory recruitment rates. TRIAL REGISTRATION ClinicalTrials.gov website ( NCT05365126 Unique Protocol ID: 19ET004). Registered on 06 May 2022.
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Affiliation(s)
- Julian McGlashan
- Ear, Nose and Throat Department, Queen's Medical Centre Campus, Nottingham University Hospitals, Nottingham, NG7 2UH, UK.
| | - Mathias Aaen
- Complete Vocal Institute, Kompagnistraede 32A, 1208, Copenhagen K, Denmark
- Honorary Researcher, Ear, Nose and Throat Department, Queen's Medical Centre Campus, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
| | - Anna White
- Ear, Nose and Throat Department, Queen's Medical Centre Campus, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
| | - Cathrine Sadolin
- Complete Vocal Institute, Kompagnistraede 32A, 1208, Copenhagen K, Denmark
- Honorary Researcher, Ear, Nose and Throat Department, Queen's Medical Centre Campus, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
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Slagboom TNA, van Bunderen CC, De Vries R, Bisschop PH, Drent ML. Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly: a systematic review in accordance with PRISMA guidelines. Pituitary 2023:10.1007/s11102-023-01322-7. [PMID: 37210433 PMCID: PMC10397145 DOI: 10.1007/s11102-023-01322-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE Diagnostic delay is high in acromegaly and leads to increased morbidity and mortality. The aim of this study is to systematically assess the most prevalent clinical signs, symptoms and comorbidities of acromegaly at time of diagnosis. DESIGN A literature search (in PubMed, Embase and Web of Science) was performed on November 18, 2021, in collaboration with a medical information specialist. METHODS Prevalence data on (presenting) clinical signs, symptoms and comorbidities at time of diagnosis were extracted and synthesized as weighted mean prevalence. The risk of bias was assessed for each included study using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS Risk of bias and heterogeneity was high in the 124 included articles. Clinical signs and symptoms with the highest weighted mean prevalence were: acral enlargement (90%), facial features (65%), oral changes (62%), headache (59%), fatigue/tiredness (53%; including daytime sleepiness: 48%), hyperhidrosis (47%), snoring (46%), skin changes (including oily skin: 37% and thicker skin: 35%), weight gain (36%) and arthralgia (34%). Concerning comorbidities, acromegaly patients more frequently had hypertension, left ventricle hypertrophy, dia/systolic dysfunction, cardiac arrhythmias, (pre)diabetes, dyslipidemia and intestinal polyps- and malignancy than age- and sex matched controls. Noteworthy, cardiovascular comorbidity was lower in more recent studies. Features that most often led to diagnosis of acromegaly were typical physical changes (acral enlargement, facial changes and prognatism), local tumor effects (headache and visual defect), diabetes, thyroid cancer and menstrual disorders. CONCLUSION Acromegaly manifests itself with typical physical changes but also leads to a wide variety of common comorbidities, emphasizing that recognition of a combination of these features is key to establishing the diagnosis.
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Affiliation(s)
- Tessa N A Slagboom
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
| | - Christa C van Bunderen
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ralph De Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Peter H Bisschop
- Department of Endocrinology and Metabolism, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
| | - Madeleine L Drent
- Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
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Flock L, King SR, Williams J, Finlay E, Smikle H, Benito M, Benton-Stace F, Brown J, Mann-Daraz AJ, Hart L, Mclean K, Prucnal Z, Barry L, Lynes R, Toy M, Valentine K, Slattery S, Aldridge-Waddon L. Working Together to Find a Voice: Recommendations for Voice Healthcare Based on Expert-By-Experience and Practitioner Consensus. J Voice 2023:S0892-1997(23)00083-8. [PMID: 36959052 DOI: 10.1016/j.jvoice.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVES Voice care services aim to provide effective and meaningful voice care. Current practice guidance recommends a multidisciplinary voice care approach, supported by the evidence-base and practitioner experience. However, unlike other areas of physical and mental health, current voice care guidance does not explicitly include the voices of experts-by-experience, meaning those who have lived experience of voice difficulties. The perspectives of those working within nonclinical voice professions, such as vocal coaches, are also often omitted. There is therefore a need for updated practice guidance which prioritizes expert-by-experience and nonclinical perspectives. METHODS Vocal Health Education hosted a consensus meeting in London, UK. The meeting was coproduced with experts-by-experience, and attendees included those with lived experience of voice difficulties and practitioners across a range of disciplines within voice care. The content of the meeting was synthesized into themes and associated recommendations were drafted and agreed to by all attendees. RESULTS The consensus statement offers practical advice to those working in voice care. Recommendations are offered for multidisciplinary and biopsychosocial voice care, with a focus on person-centered practice and the valuing of lived experience. Through discussion, consensus was reached regarding recommendations for voice care assessment and treatment, practitioner approach, psychosocial considerations, and service design. The need for greater expert-by-experience involvement, coproduction, and co-construction was emphasized throughout. CONCLUSIONS This report emphasizes the voices of those with lived experience. It highlights ways of updating or improving current care, with the aim of informing clinical practice as well as research and service development. The consensus statement is the first in voice care to include experts-by-experience at the center of its recommendations, underlining the need for more coproduced and co-constructed research and practice within voice healthcare.
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Affiliation(s)
- Lydia Flock
- Vocal Manual Therapy, Oxford Vocal Massage, Oxford, UK; Voice Care Centre, Voice Care Centre, London, UK
| | - Stephen R King
- Voice Care Centre, Voice Care Centre, London, UK; Vocal Health Education, Vocal Health Education, London, UK
| | - Jenevora Williams
- Voice Care Centre, Voice Care Centre, London, UK; Vocal Health Education, Vocal Health Education, London, UK
| | - Emma Finlay
- Independent Researcher, VHE Meeting, London, UK
| | - Hannah Smikle
- Vocal Coaching, Hannah Smikle-Vocal Performance Coaching, Stockport, UK
| | | | | | - Jenna Brown
- Voice Study Centre, Voice Study Centre, Suffolk, UK
| | | | - Lydia Hart
- Voice Care Centre, Voice Care Centre, London, UK; Speech and Language Therapy, Frimley Health NHS Foundation Trust, Berkshire, UK
| | - Keesha Mclean
- Cairns Voice Studio and Cairns Voice Care, Cairns Voice Studio and Cairns Voice Care, Cairns, Australia
| | | | | | | | - Mel Toy
- Mel Toy Music, Mel Toy Music, London, UK
| | - Kate Valentine
- Voice Care Centre, Voice Care Centre, London, UK; Valentine Voice Care, Valentine Voice Care, Seaford/Glasgow/London, UK
| | - Sam Slattery
- Grace Bay Medical, Grace Bay Medical, Grace Bay, Turks and Caicos Islands
| | - Luke Aldridge-Waddon
- Oxford Institute of Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, UK.
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Presbyphonia as an Individual Process of Voice Change. J Voice 2023; 37:303.e1-303.e14. [PMID: 33495034 DOI: 10.1016/j.jvoice.2020.12.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to determine the individual variability of the severity of dysphonia in the population of older women and men using the initial perceptual voice assessment (GRBAS) and objective diagnosis of the clinical form of Presbyphonia with laryngeal visualization technique (High-Speed Digital Imaging [HSDI]) and acoustic voice analysis (Diagnoscope Specjalista). METHODS The study included 302 elderly women and men. Application of perceptual GRBAS scale allowed to extract 230 subjects with voice disorders (Group I). Remaining 72 elderly subjects without the symptoms of dysphonia consisted Group II. Group III included 50 subjects with euphonic voice. In the assessment of dysphonia, visualization technique (HSDI) as well as acoustic method (Diagnoscope Specjalista). The observation of real vibration of vocal folds using HSDI technique and HS camera allowed to examine symmetricity (Shaw-Deliyski scale), periodicity and amplitude of vibration, Mucosal Wave (MW) morphology, Glottal Closure Type, and value of Open Quotient (OQ). Acoustic analysis allowed to assess value of Fundamental Frequency (F0), Maximum Phonation Time (MPT) as well as Jitter, Shimmer, Noise-to-Harmonics Ratio (NHR) parameters. Narrowband Spectrography was performed. RESULTS HSDI technique allowed to register in elderly women with voice disorders a mild asymmetry and aperiodicity of vibrations, MW reduction, amplitude increase and glottal insufficiency in the posterior segment of glottis which indicated edematous changes in the larynx. In 90% of men in this group, moderate asymmetry and aperiodicity were observed as well as amplitude decrease, significant limitation of MW and glottal insufficiency in the middle segment of the glottis which indicated atrophic changes in the larynx. In remaining 10% of men, amplitude of vibration was increased which indicated the existence of hypofunctional dysphonia. Objective confirmation of glottal insufficiency in women with edematous changes was high value of OQ in posterior segment of the glottis registered with HSDI technique. In men with larynx atrophy, the value of OQ was the highest in the middle segment of the glottis. Glottal insufficiency, especially in the middle segment, coexisted with the increase of NHR parameter observed in acoustic examination and with numerous nonharmonic components in the scope of high frequencies revealed in narrowband spectrography, especially in men with larynx atrophy. What is more, in men, the increase of F0 and reduction of MPT was registered. In women with edematous changes of the larynx, acoustic analysis revealed decrease of F0 value, increase of Jitter, Shimmer, NHR as well as reduction of MPT. Narrowband sopectrography revealed not only harmonic components but also nonharmonics in the range of low, medium, and high frequencies. CONCLUSIONS The course of Presbyphonia varies individually in the elderly. In many subjects, the process of aging does not influence the quality of voice. Crucial importance in the diagnosis of Presbyphonia is assigned to High-Speed Digital Imaging technique which confirms the existence of edematous changes in the larynx in women as well as atrophy and hypofunctional dysphonia in men. The acoustic examination of voice confirmed the individual variability of the severity of Presbyphonia in the elderly depending on the clinical form of dysphonia determined by the gender of the diagnosed person.
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25
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Smith JD, McConville K, Tiner MK, Baldner EF, Rosenberg M, Kupfer RA, Hogikyan ND, Morrison RJ. Examining Use and Effectiveness of Teletherapy for Patients with Dysphonia. J Voice 2023:S0892-1997(23)00034-6. [PMID: 36863957 DOI: 10.1016/j.jvoice.2023.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE(S)/HYPOTHESIS Virtual therapy (teletherapy) for patients with dysphonia has become ubiquitous in the COVID-19 era. However, barriers to widespread implementation are evident, including unpredictable insurance coverage attributed to limited evidence supporting this approach. In our single-institution cohort, our objective was to show strong evidence for use and effectiveness of teletherapy for patients with dysphonia. STUDY DESIGN Single institution, retrospective cohort study. MATERIAL AND METHODS This was an analysis of all patients referred for speech therapy with dysphonia as primary diagnosis from 4/1/2020 to 7/1/2021 and in whom all therapy sessions were delivered in a teletherapy format. We collated and analyzed demographics and clinical characteristics and adherence to the teletherapy program. We assessed changes in perceptual assessments and vocal capabilities (GRBAS, MPT), patient-reported outcomes (V-RQOL), and metrics of session outcomes (complexity of vocal tasks, carry-over of target voice) pre- and post-teletherapy using student's t test and chi-square test. RESULTS Our cohort included 234 patients (mean [SD] age 52 [20] years) residing a mean (SD) distance of 51.3 (67.1) miles from our institution. The most common referral diagnosis was muscle tension dysphonia (n = 145, 62.0% patients). Patients attended a mean (SD) of 4.2 (3.0) sessions; 68.0% (n = 159) of patients completed four or more sessions and/or were deemed appropriate for discharge from teletherapy program. Statistically significant improvements were seen in complexity and consistency of vocal tasks with consistent gains in carry-over of target voice for isolated tasks and connected speech. CONCLUSIONS Teletherapy is a versatile and effective approach for treatment of patients with dysphonia of varying age, geography, and diagnoses.
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Affiliation(s)
- Joshua D Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Katherine McConville
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Margaret K Tiner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Ford Baldner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Marci Rosenberg
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Robbi A Kupfer
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Norman D Hogikyan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Robert J Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA.
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26
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Attitudes About Artificially Intelligent Interactive Voice Response Systems Using Amazon Alexa in Cardiovascular Clinics: Insights from the VOICE-COVID-19 Study. J Cardiovasc Transl Res 2023:10.1007/s12265-022-10289-y. [PMID: 36749563 PMCID: PMC9904249 DOI: 10.1007/s12265-022-10289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/25/2022] [Indexed: 02/08/2023]
Abstract
The acceptability of artificially intelligent interactive voice response (AI-IVR) systems in cardiovascular research settings is unclear. As a result, we evaluated peoples' attitudes regarding the Amazon Echo Show 8 device when used for electronic data capture in cardiovascular clinics. Participants were recruited following the Voice-Based Screening for SARS-CoV-2 Exposure in Cardiovascular clinics study. Overall, 215 people enrolled and underwent screening (mean age 46.1; 55% females) in the VOICE-COVID study and 58 people consented to participate in a post-screening survey. Following thematic analysis, four key themes affecting AI-IVR acceptability were identified. These were difficulties with communication (44.8%), limitations with available interaction modalities (41.4%), barriers with the development of therapeutic relationships (25.9%), and concerns with universality and accessibility (8.6%). While there are potential concerns with the use of AI-IVR technologies, these systems appeared to be well accepted in cardiovascular clinics. Increased development of these technologies could significantly improve healthcare access and efficiency.
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27
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Kim JS, Kim S, Moon TH, Park S, Kim SH, Kim S, Lee DH, Kim BG, Chang KH, Park JO. Effect of Occupational Noise Exposure on the Prevalence of Benign Vocal Fold Lesions: A Nationwide Population-Based Study. Clin Exp Otorhinolaryngol 2023; 16:87-94. [PMID: 36521487 PMCID: PMC9985988 DOI: 10.21053/ceo.2022.01298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Voice abuse in noisy environments can result in voice disorders. However, insufficient studies have sought to differentiate vocal cord lesions through laryngoscopic examinations among workers in noisy environments. This study investigated the relationship between a history of noise exposure in the workplace and benign vocal fold lesions (BVFLs). METHODS We used Korea National Health and Nutrition Examination Survey data from 2010 to 2012. The chi-square test was used to compare characteristics between two groups according to the presence or absence of BVFLs. To investigate the association between BVFLs and noise exposure in the workplace, we calculated adjusted odds ratios and 95% confidence intervals (CIs) using multiple logistic regression analysis. RESULTS In total, 10,170 participants with available laryngoscopy. RESULTS were enrolled. Smoking history, hypertension, diabetes, and exposure to noise for more than 3 months at the workplace were significantly more common in participants with BVFLs. After adjusting for age, sex, smoking, drinking, obesity, hypertension, diabetes, income, education, and occupation as confounders, we confirmed that BVFLs were 1.52 times more likely (95% CI, 1.157-1.990) to occur in individuals with occupational noise exposure. CONCLUSION Working in a noisy environment could induce BVFLs in workers through voice abuse. Social recognition that a noisy environment is a risk factor for BVFLs needs to be improved, and preventive measures should be implemented.
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Affiliation(s)
- Ji-Sun Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sukil Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tae-Hoon Moon
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soomin Park
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Hwa Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Subin Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Hyun Lee
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Guk Kim
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki-Hong Chang
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun-Ook Park
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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28
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Ng WC, Lokanathan Y, Baki MM, Fauzi MB, Zainuddin AA, Azman M. Tissue Engineering as a Promising Treatment for Glottic Insufficiency: A Review on Biomolecules and Cell-Laden Hydrogel. Biomedicines 2022; 10:3082. [PMID: 36551838 PMCID: PMC9775346 DOI: 10.3390/biomedicines10123082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Glottic insufficiency is widespread in the elderly population and occurs as a result of secondary damage or systemic disease. Tissue engineering is a viable treatment for glottic insufficiency since it aims to restore damaged nerve tissue and revitalize aging muscle. After injection into the biological system, injectable biomaterial delivers cost- and time-effectiveness while acting as a protective shield for cells and biomolecules. This article focuses on injectable biomaterials that transport cells and biomolecules in regenerated tissue, particularly adipose, muscle, and nerve tissue. We propose Wharton's Jelly mesenchymal stem cells (WJMSCs), induced pluripotent stem cells (IP-SCs), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF), insulin growth factor-1 (IGF-1) and extracellular vesicle (EV) as potential cells and macromolecules to be included into biomaterials, with some particular testing to support them as a promising translational medicine for vocal fold regeneration.
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Affiliation(s)
- Wan-Chiew Ng
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Yogeswaran Lokanathan
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Marina Mat Baki
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Ani Amelia Zainuddin
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mawaddah Azman
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Feng S, Weng C, Cai S, Yang Z, Wu M, Kang N. The prevalence and risk factors for perceived voice disorders in public school teachers. Laryngoscope Investig Otolaryngol 2022; 7:790-798. [PMID: 35734057 PMCID: PMC9195021 DOI: 10.1002/lio2.803] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/16/2022] [Accepted: 04/13/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this study was to explore the prevalence and risk factors in public kindergarten and elementary school teachers in the Jimei district in Xiamen. We took particular interest in the relationship between work-related factors and voice disorders. Study Design A cross-sectional investigation; a General Investigation. Methods This study was conducted from September 14 to 18, 2020 at public kindergarten and elementary schools in Xiamen, China. A total of 3140 teachers were separated into a perceived voice disorder group (PVD) and no perceived voice disorder group (NPVD) according to the Voice Handicap Index. The chi-square test was applied to explore the differences between the PVD and NPVD groups. The univariate logistic regression models were used to identify the risk factors in terms of unadjusted odds ratio and 95% confidence interval. Stepwise logistic regression was then used to ascertain independent determinants. Results We found that the prevalence of PVD was 47.52%. The results showed that risk factors of PVD included being female (OR = 1.574), middle-rank technical title and higher (OR = 2.199), continuous lecturing for more than 3 classes (OR = 3.034), lectured more than 10 classes a week (OR = 1.436) and taught art or physical education (OR = 1.742). Conclusions Teachers' work-related characteristics were associated with PVD. This proves that a preventive voice care program for teachers, administered by the school or education bureau, is urgent. This could include components such as the reasonable arrangement of timetables and recruitment of a sufficient number of kindergarten and elementary school teachers.Level of evidence: Case-series.
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Affiliation(s)
- Shuxiu Feng
- From the Second Affiliated Hospital of Xiamen Medical CollegeXiamenFujianChina
| | | | - Shaofang Cai
- From the Second Affiliated Hospital of Xiamen Medical CollegeXiamenFujianChina
| | - Zijiang Yang
- From the Second Affiliated Hospital of Xiamen Medical CollegeXiamenFujianChina
| | - Meina Wu
- From the Second Affiliated Hospital of Xiamen Medical CollegeXiamenFujianChina
| | - Ning Kang
- From the Second Affiliated Hospital of Xiamen Medical CollegeXiamenFujianChina
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30
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Buckley KL, Carey LB. Systems Approaches to Occupational Vocal Health: Considerations for Community Faith Leaders. JOURNAL OF RELIGION AND HEALTH 2022; 61:1183-1206. [PMID: 34694551 PMCID: PMC8544187 DOI: 10.1007/s10943-021-01444-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 05/12/2023]
Abstract
Systems thinking approaches can benefit the occupational vocal health of vocally reliant workers. This paper explores community faith leaders as an example of a highly vocally reliant occupation, who may benefit from systems thinking being used to support their vocal occupational health and safety. A scoping review of the current literature regarding faith leaders' occupational voice use and vocal health is detailed, including recognised occupational hazards. This article then discusses the unique and potential use of systems thinking for facilitating faith leaders' vocal occupational health and safety. Rather than using a solely clinical perspective, the sociotechnical systems approach and the biopsychosocial-spiritual approach are noted as particularly pertinent for this occupational group.
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Affiliation(s)
- Katie L. Buckley
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083 Australia
| | - Lindsay B. Carey
- Palliative Care Unit, Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083 Australia
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31
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Nieminen M, Aro K, Mäkitie A, Harlin V, Kainulainen S, Jouhi L, Atula T. Challenges in diagnosing head and neck cancer in primary health care. Ann Med 2021; 53:26-33. [PMID: 32746635 PMCID: PMC7877942 DOI: 10.1080/07853890.2020.1802060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/22/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Early diagnosis of head and neck cancer (HNC) will improve patient outcomes. The low incidence of HNC renders its detection challenging for a general practitioner (GP) in primary health care (PHC). PATIENTS AND METHODS To examine these challenges, our cohort consisted of all patients visiting PHC centres in the City of Helsinki in 2016. We chose 57 ICD-10 codes representing a sign or symptom resulting from a possible HNC and compared data for all new HNC patients. RESULTS A total of 242,211 patients (499,542 appointments) visited PHC centres, 11,896 (5%) of whom presented with a sign or symptom possibly caused by HNC. Altogether, 111 new HNCs were diagnosed within the Helsinki area, of which 40 (36%) were referred from PHC. The median delay from the initial PHC visit to the referral to specialist care was 5 days, whereby 88% of patients were referred within one month. CONCLUSIONS Despite the low incidence of HNC and the large number of patients presenting with HNC-related symptoms, GPs working in PHC sort out potential HNC patients from the general patient group in most cases remarkably effectively. KEY MESSAGES For every head and neck cancer (HNC) patient encountered in the primary health care, a general practitioner (GP) will meet approximately 6000 other patients, 100 of whom exhibit a sign or a symptom potentially caused by a HNC. Despite the low incidence of HNC, GPs referred patients to specialist care effectively, limiting the median delay from the initial appointment to referral to only 5 days.
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Affiliation(s)
- Markus Nieminen
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Aro
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Clinical Sciences, Intervention and Technology, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Vappu Harlin
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland
| | - Satu Kainulainen
- Department of Oral and Maxillofacial Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lauri Jouhi
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Atula
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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32
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[New developments in phonosurgery and laryngology]. HNO 2021; 69:693-694. [PMID: 34476517 DOI: 10.1007/s00106-021-01080-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 10/20/2022]
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33
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Nynäs P, Vilpas S, Kankare E, Karjalainen J, Lehtimäki L, Numminen J, Tikkakoski A, Kleemola L, Uitti J. Clinical Findings among Patients with Respiratory Symptoms Related to Moisture Damage Exposure at the Workplace-The SAMDAW Study. Healthcare (Basel) 2021; 9:1112. [PMID: 34574886 PMCID: PMC8466522 DOI: 10.3390/healthcare9091112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Respiratory tract symptoms are associated with workplace moisture damage (MD). The focus of this observational clinical study was patients with workplace MD-associated symptoms, to evaluate the usefulness of different clinical tests in diagnostics in secondary healthcare with a special interest in improving the differential diagnostics between asthma and laryngeal dysfunction. METHODS In patients referred because of workplace MD-associated respiratory tract symptoms, we sought to systematically assess a wide variety of clinical findings. RESULTS New-onset asthma was diagnosed in 30% of the study patients. Laryngeal dysfunction was found in 28% and organic laryngeal changes in 22% of the patients, and these were common among patients both with and without asthma. Most of the patients (85%) reported a runny or stuffy nose, and 11% of them had chronic rhinosinusitis. Atopy was equally as common as in the general population. CONCLUSIONS As laryngeal changes were rather common, we recommend proper differential diagnostics with lung function testing and investigations of the larynx and its functioning, when necessary, in cases of prolonged workplace MD-associated symptoms. Chronic rhinosinusitis among these patients was not uncommon. Based on this study, allergy testing should not play a major role in the examination of these patients.
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Affiliation(s)
- Pia Nynäs
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.L.); (L.K.); (J.U.)
| | - Sarkku Vilpas
- Department of Phoniatrics, Tampere University Hospital, 33520 Tampere, Finland; (S.V.); (E.K.)
| | - Elina Kankare
- Department of Phoniatrics, Tampere University Hospital, 33520 Tampere, Finland; (S.V.); (E.K.)
| | - Jussi Karjalainen
- Allergy Centre, Tampere University Hospital, 33520 Tampere, Finland; (J.K.); (J.N.)
| | - Lauri Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.L.); (L.K.); (J.U.)
- Allergy Centre, Tampere University Hospital, 33520 Tampere, Finland; (J.K.); (J.N.)
| | - Jura Numminen
- Allergy Centre, Tampere University Hospital, 33520 Tampere, Finland; (J.K.); (J.N.)
| | - Antti Tikkakoski
- Department of Clinical Physiology and Nuclear Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Leenamaija Kleemola
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.L.); (L.K.); (J.U.)
| | - Jukka Uitti
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland; (L.L.); (L.K.); (J.U.)
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Printz T, Godballe C, Grøntved ÅM. The Dual-Microphone Voice Range Profile Assessment—Interrater Reliability. J Voice 2021; 35:521-529. [DOI: 10.1016/j.jvoice.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/19/2019] [Accepted: 12/19/2019] [Indexed: 11/26/2022]
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The German Restructured Vocal Fatigue Index and Characteristics of Dysphonic and Vocally Healthy Populations. J Voice 2021; 37:469.e11-469.e18. [PMID: 33663908 DOI: 10.1016/j.jvoice.2021.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The Vocal Fatigue Index (VFI), a 19-item psychometric self-report questionnaire, enables individuals with vocal fatigue (VF) to be identified and their complaints to be characterized. The purpose of this study was to improve the German-language version (VFI-G) and to evaluate further vocal fatigue-related characteristics of dysphonic and control populations. METHODS The VFI-G was restructured by replacing the three factors that structured the original: (1) tiredness of voice and voice avoidance; (2) physical discomfort; and (3) improvement of symptoms with rest, with two clusters developed on the basis of the results of a factor analysis by Nanjundeswaran et al. (2019). The two new clusters are: (1) tiredness and avoidance plus physical discomfort; and (2) symptom improvement through rest. One hundred one (101) individuals with voice disorders and 100 vocally healthy controls from a previous study that cross-validated the VFI-G participated in this study. In order to assess the validity of our newly adjusted VFI-G, independent samples t test, receiver operating characteristic curve, likelihood ratios and the Youden Index were calculated. The association of the two VF clusters with subject characteristics such as age, sex, type of voice disorder, and level of vocal usage was also analyzed using either a Pearson correlation or a one-way ANOVA for each of the two populations. RESULTS Significantly higher scores were obtained in voice-disordered subjects in both clusters (all P values < 0.001) than in healthy-voice subjects. The threshold for cluster 1 of the VFI-G was determined as ≥17.5 (74.3% sensitivity and 88.0% specificity). The results of cluster 2 are identical to that of factor 3 of the previous cross-validation study of the VFI-G. Most subject characteristics show no significant association with cluster 1 of the VFI-G, but cluster 2 seems to be moderately associated with age, type of voice disorder and level of vocal usage in the dysphonic population. CONCLUSIONS The restructured VFI-G showed improved validity and can be recommended for use in the assessment of VF. Cluster 2 is also moderately associated with several vocal fatigue-related subject characteristics of the dysphonic population.
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Prieto Farias P, Campo Rivas MND. Profile of patients undergoing speech-language therapy in a physical and rehabilitation medicine hospital service. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212340721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Purpose: to analyze the profile and risk factors of patients attended by speech therapists in a hospital service of physical and rehabilitation medicine (P&RM) of the public health system. Methods: a retrospective cohort study was carried out. The variables were summarized using frequencies, proportions, and measures of central tendency. Relative risks (RR) were estimated, using the incidence ratio (IC:95%) and the bilateral Fisher's exact test. A level of significance was considered p <0.05. Results: 23,365 speech therapy activities distributed in 8,416 sessions were carried out between September 2016 to September 2018, with patients admitted to a P&RM service. The activities focused people over 60 years in the areas of swallowing (28.6%) and cognition (11.7%). Age equal to or greater than 60 years was identified as a risk factor for admission, due to cerebrovascular disease of 1.36 (95% CI: 1.24-1.49; p = 0.001), and belonging to section B of the National Health Fund (FONASA), 1.37 (95% CI: 1.29-1.46, p = 0.001). The RR for respiratory pathology was greater in the winter period: 1.63 (95% CI: 1.50-1.76; p = 0.001). Conclusion: elderly and low-income people are more likely to need speech therapy rehabilitation in the context of P&RM service.
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Affiliation(s)
- Paulo Prieto Farias
- Universidad San Sebastián, Chile; Hospital Clínico Dra. Eloísa Díaz I, Chile
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Kenny C. Dysphonia and Vocal Tract Discomfort While Working From Home During COVID-19. J Voice 2020; 36:877.e1-877.e8. [PMID: 33223124 PMCID: PMC7566822 DOI: 10.1016/j.jvoice.2020.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 01/22/2023]
Abstract
Objective During COVID-19, government measures to prevent disease spread included advice to work from home. In addition to occupational risk factors, the increased use of telecommunication and changed work environment may contribute to voice and vocal tract discomfort (VTD). This study established the prevalence, incidence, characteristics and impact of self-perceived dysphonia and VTD in those working from home during COVID-19. Methods A cross-sectional, observational study using an online survey recruited 1575 participants. It captured information about dysphonia and VTD presence, onset, and severity. Those with dysphonia completed the voice-related quality of life to measure impact. Regression analyses identified risk factors for voice and vocal tract problems. Results Dysphonia and VTD prevalence rates were 33% and 68%, respectively, incidences were 28% and 50%. Perceived dysphonia severity was mild in 72% of cases. Dry throat was the most common VTD symptom at 66%. Mean voice-related quality of life score was 82.4 (standard deviation ± 13.2). Raising or straining the voice while working predicted new onset dysphonia and VTD. Increasing telecommunication use was associated with worse dysphonia and VTD onset. Conclusion Those working from home have seen a rise in dysphonia and VTD, which were associated with communication modality and change in environment. If home offices become the ‘new normal’ post-COVID, workplaces should consider voice training for employees to limit potential difficulties.
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Affiliation(s)
- Ciarán Kenny
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Ireland.
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Abdelhamid A, Hassan M, Youssef G. The Nature and Risk Factors of Minimal Associated Pathological Lesions of Vocal Folds at Two Hospitals in the Gulf Area. J Voice 2020; 36:438.e25-438.e31. [PMID: 32919830 DOI: 10.1016/j.jvoice.2020.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify the possible risk factors related to etiology of the minimal associated pathological lesions (MAPLs) of the vocal folds and their impacts on the recurrence of lesion. METHODS This analytical cross-sectional study included 200 subjects presented with dysphonia to the Phoniatrics/Voice Clinics in two hospitals in Gulf region (KSA and UAE). Same number of matched voluntaires from the same hospitals (hospital staffs, employees and their relatives) and relatives of subjects with typical voice quality were included as well. Both groups underwent a simple questionnaire consists of 15 items related to previously accused risk factors of MAPLs. RESULTS The bivariant analysis by Fisher's exact test showed that male gender, presence of kids, misuse of voice, alcohol, gastroesophageal reflux diseases and voice handicapping are associated with significant risk to have MAPLs with P values < 0.001 for all except for alcohol (P = 0.015). Welch's t test revealed higher smoking index in subject than control groups with significant difference (P < 0.001). In contrast, spices, family shouting and nearby industry were not potent risk factors in our study group. CONCLUSION Vocal trauma especially in females and children is a potent risk factor for vocal fold nodules and cysts. The gastroesophageal reflux is a suggested risk factor for Reinke's edema and contact granuloma. Smoking is the risk factor for MAPLs particularly polyp, contact granuloma, and Reinke's edema. Also, alcohol consumption is a possible risk factors for Reinke's edema. Identification of risk factors of the MAPLs is an important step in planning therapy. Risk factors which are highly related to a specific type of MAPLs should be involved in any planned program for protection, voice rehabilitation and/or prevention of recurrence of that lesion.
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Affiliation(s)
- Ahmed Abdelhamid
- Department of Otolaryngology, College of Medicine, Imam Abdulrahman Bin Faisal University, Damman, Saudi Arabia
| | - Megahed Hassan
- Phoniatrics Clinic, Erada Complex for Mental Health, Minstry of Health, Tabuk, Saudi Arabia; Otolaryngology Department, Faculty of Medicine, Sohag University, Egypt.
| | - Gamal Youssef
- Dubai Hospital, DHA, UAE; ENT Department, Alexandria University, Egypt
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Brännström KJ, Lyberg-Åhlander V, Sahlén B. Perceived listening effort in children with hearing loss: listening to a dysphonic voice in quiet and in noise. LOGOP PHONIATR VOCO 2020; 47:1-9. [PMID: 32696707 DOI: 10.1080/14015439.2020.1794030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The present study investigates the effect of signal degradation on perceived listening effort in children with hearing loss listening in a simulated class-room context. It also examines the associations between perceived listening effort, passage comprehension performance and executive functioning. METHODS Twenty-four children (aged 06:03-13:00 years) with hearing impairment using cochlear implant (CI) and/or hearing aids (HA) participated. The children made ratings of perceived listening effort after completing an auditory passage comprehension task. All children performed the task in four different listening conditions: listening to a typical (i.e. normal) voice in quiet, to a dysphonic voice in quiet, to a typical voice in background noise and to a dysphonic voice in background noise. In addition, the children completed a task assessing executive function. RESULTS Both voice quality and background noise increased perceived listening effort in children with CI/HA, but no interaction with executive function was seen. CONCLUSION Since increased listening effort seems to be a consequence of increased cognitive resource spending, it is likely that less resources will be available for these children not only to comprehend but also to learn in challenging listening environments such as classrooms.
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Affiliation(s)
- K Jonas Brännström
- Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Viveka Lyberg-Åhlander
- Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden.,Speech Language Pathology, Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Birgitta Sahlén
- Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Sheyona V, Devadas U. The Prevalence and Impact of Voice Problems in Nonprofessional Voice Users: Preliminary Findings. J Voice 2020; 36:383-388. [PMID: 32660848 DOI: 10.1016/j.jvoice.2020.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Studies reporting the prevalence of voice problems in the non-professional voice users are rare. Thus, the objective of this preliminary investigation was to explore; (1) the prevalence of self-reported voice problems, and (2) its impact on the nonprofessional voice users. METHOD This was a cross-sectional survey that was distributed to 500 nonprofessional voice users working in different educational institutions in the Manipal city of Karnataka state, India. The results of the study are discussed based on the 426 qualified questionnaire responses. RESULTS The lifetime prevalence of voice problem was 21.6% (n = 92), with 4.9% (n = 21) of the participants reporting it on the day of the survey. The self-reported prevalence of voice problems was significantly higher (P = 0.001) in female (64%, n = 59) as compared to male participants (35.8%, n = 33). Voice problems affected job performance by 34.7% (n = 32) and caused work absenteeism in 11.9% (n = 11). CONCLUSIONS The results of this preliminary study indicated that a significant number of nonprofessional voice users suffer from voice problems, and it has a significant impact on their job performance. Hence, in future large scale, epidemiological studies are needed with randomly selected samples of different age groups, gender, income status, educational level, area of residence to understand the possible risk factors, and impact of voice problem on the quality of life in general working and not working nonprofessional voice users in India.
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Affiliation(s)
- Valson Sheyona
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Usha Devadas
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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KYRIAKOU K, THEODOROU E, PETINOU K, PHINIKETTOS I. Risk factors for voice disorders in public school teachers in Cyprus. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2020; 61:E221-E240. [PMID: 32803009 PMCID: PMC7419129 DOI: 10.15167/2421-4248/jpmh2020.61.2.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 05/12/2020] [Indexed: 12/01/2022]
Abstract
AIMS The purpose of this study was to investigate risk factors for self-perceived voice disorders in teachers in Cyprus in order to determine the necessity for a preventative vocal hygiene education program which could improve their work performance. METHODS An online questionnaire was completed by 449 teachers. The questionnaire extracted data regarding risk factors that may contribute to the development of voice disorders, occupational consequences of voice disorders and vocal hygiene education, as well as, a self-perceived severity of a participant's voice problem. Subjects were split into two groups, teachers with Voice Disorder Index (VDI) ≤ 7 and teachers with VDI > 7. The chi-squared test was used to explore the differences in responses for each voice risk factor, occupational consequence and vocal hygiene education between the two groups. RESULTS Teachers in the VDI > 7 group were more likely to frequently experience nasal allergies and respiratory infections, coughing, throat clearing, stress and yelling, have shorter breaks between classes, use loud voice, use their voice to discipline students, teach above students talking, etc. than teachers in the VDI ≤ 7 group. Moreover, teachers in the VDI > 7 group were more likely to limit their ability to perform certain tasks at work and reduce their activities or interactions "3-5 or more days" annually due to voice problems. CONCLUSIONS Health, voice use, lifestyle, and environmental factors may play a part in the development of voice disorders in teachers and have an impact on their job. Therefore, a preventative vocal hygiene education program is suggested.
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Affiliation(s)
- K. KYRIAKOU
- Correspondence: Kyriaki Kyriakou, Cyprus University of Technology, Department of Rehabilitation Sciences Vragadinou 15, 3036 Limassol, Cyprus - E-mail:
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Combined Generative Adversarial Network and Fuzzy C-Means Clustering for Multi-Class Voice Disorder Detection with an Imbalanced Dataset. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10134571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The world has witnessed the success of artificial intelligence deployment for smart healthcare applications. Various studies have suggested that the prevalence of voice disorders in the general population is greater than 10%. An automatic diagnosis for voice disorders via machine learning algorithms is desired to reduce the cost and time needed for examination by doctors and speech-language pathologists. In this paper, a conditional generative adversarial network (CGAN) and improved fuzzy c-means clustering (IFCM) algorithm called CGAN-IFCM is proposed for the multi-class voice disorder detection of three common types of voice disorders. Existing benchmark datasets for voice disorders, the Saarbruecken Voice Database (SVD) and the Voice ICar fEDerico II Database (VOICED), use imbalanced classes. A generative adversarial network offers synthetic data to reduce bias in the detection model. Improved fuzzy c-means clustering considers the relationship between adjacent data points in the fuzzy membership function. To explain the necessity of CGAN and IFCM, a comparison is made between the algorithm with CGAN and that without CGAN. Moreover, the performance is compared between IFCM and traditional fuzzy c-means clustering. Lastly, the proposed CGAN-IFCM outperforms existing models in its true negative rate and true positive rate by 9.9–12.9% and 9.1–44.8%, respectively.
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Cantarella G, Barillari MR, Lechien JR, Pignataro L. The Challenge of Virtual Voice Therapy During the COVID-19 Pandemic. J Voice 2020; 35:336-337. [PMID: 32660845 PMCID: PMC7301088 DOI: 10.1016/j.jvoice.2020.06.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otolaryngology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosaria Barillari
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Jerome R Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; Department of Otolaryngology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Occupational voice is a work in progress: active risk management, habilitation and rehabilitation. Curr Opin Otolaryngol Head Neck Surg 2020; 27:439-447. [PMID: 31651425 PMCID: PMC6867679 DOI: 10.1097/moo.0000000000000584] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The current article reviews recent literature examining occupational voice use and occupational voice disorders (January 2018–July 2019).
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Karjalainen S, Brännström JK, Christensson J, Sahlén B, Lyberg-Åhlander V. A Pilot Study on the Relationship between Primary-School Teachers' Well-Being and the Acoustics of their Classrooms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062083. [PMID: 32245168 PMCID: PMC7142460 DOI: 10.3390/ijerph17062083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/30/2022]
Abstract
Although teachers’ well-being and vocal health are affected by noise, research on classroom sound environment from the teachers’ perspective is scarce. This study investigated the relationship between teachers’ well-being and classroom acoustics. The possible influence of teachers’ age, experience, teaching grade and class size on the relationship was also investigated. In this study, well-being refers to self-reported vocal health, stress, burnout and self-efficacy. Twenty-three primary-school teachers answered questionnaires on well-being. In each teacher’s classroom, the acoustical properties were measured with the variables reverberation time, clarity of speech (C50) and ventilation system noise (VSN). A series of non-parametric correlations were run to determine the relationship between teachers’ well-being and classroom acoustics. Initially, there was a significant bivariate correlation between burnout and VSN, as well as voice symptoms correlated with VSN and teaching grade. Although the results became not significant after correction for multiple tests, the findings indicate that higher degree of burnout is associated with higher levels of VSN in classrooms, and voice symptoms increase with higher VSN. Teachers working in lower grades had more voice symptoms than those working in higher grades.
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Affiliation(s)
- Suvi Karjalainen
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, 221 85 Lund, Sweden
| | - Jonas K Brännström
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, 221 85 Lund, Sweden
| | | | - Birgitta Sahlén
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, 221 85 Lund, Sweden
| | - Viveka Lyberg-Åhlander
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, 221 85 Lund, Sweden
- Logopedics, Faculty of Arts, Psychology and Theology, Åbo Akademi University, 20 500 Turku, Finland
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Byeon H, Cha S. Evaluating the effects of smoking on the voice and subjective voice problems using a meta-analysis approach. Sci Rep 2020; 10:4720. [PMID: 32170174 PMCID: PMC7069957 DOI: 10.1038/s41598-020-61565-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 01/14/2020] [Indexed: 11/09/2022] Open
Abstract
The objectives of this study were to identify the effects of smoking on the voice of smokers and present the baseline data for establishing the basis for preventing voice disorders. This study was evaluated using a meta-analysis from studies published between Jan 1, 2000, and Nov 15, 2018. As a result, the final meta-analysis was conducted using nine papers. The standard mean difference was analyzed after dividing the effects of smoking on voice into the pitch (F0), sound quality (jitter, shimmer, and noise to harmonic ratio; NHR), Maximum Phonation Time (MPT), and subjective voice problem. The results showed that there was a significant difference in F0 and MPT. On the other hand, the jitter, shimmer, NHR, and Voice Handicap Index (VHI) had different mean effect size but they were not significantly different. The analysis by sub-function of VHI results showed that the mean effect size was significantly different only in VHI-P (Physical). This study evaluated the effects of smoking on voice using meta-analysis. It was confirmed that smoking had significant and moderate effects on the F0 of voice, MPT, VHI, and physical functions. It is necessary for future meta-analysis studies to conduct randomized controlled experiments or longitudinal studies to confirm the effect sizes of variables.
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Affiliation(s)
- Haewon Byeon
- Department of Speech Language Pathology, College of Health Science, Honam University, Gwangju, Republic of Korea. .,Department of Speech Language Pathology, School of Public Health, Honam University, 417, Eodeung-daero, Gwangsan-gu, Gwangju, Republic of Korea.
| | - Seulki Cha
- Department of Rehabilitation, Graduate School, Honam University, Gwangju, Republic of Korea
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Karjalainen S, Sahlén B, Falck A, Brännström J, Lyberg-Åhlander V. Implementation and evaluation of a teacher intervention program on classroom communication. LOGOP PHONIATR VOCO 2019; 45:110-122. [DOI: 10.1080/14015439.2019.1595131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Suvi Karjalainen
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Birgitta Sahlén
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Andreas Falck
- Department of Psychology, Lund University, Lund, Sweden
- Institut Jean Nicod, Département d’études cognitives, ENS, EHESS, PSL University, CNRS, Paris, France
| | - Jonas Brännström
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Viveka Lyberg-Åhlander
- Department of Clinical Sciences/Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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