Cell Yell!: Health Risks in Telehealth

2019 ◽  
Vol 4 (3) ◽  
pp. 538-541
Author(s):  
Jessica S. Kisenwether ◽  
Denis Anson
Keyword(s):  
Visual Feedback ◽  
Voice Quality ◽  
Health Issues ◽  
Audiovisual Communication ◽  
Vocal Health ◽  
Face To Face ◽  
Vocal Intensity ◽  
Average Face ◽  
Vocal Quality ◽  
Acoustical Data

Purpose The purpose of this study was to determine if the use of visual feedback can overcome the absence of side tone to control for vocal quality changes, specifically loudness, with speakerphone use. Method Ten men and 10 women held two 5-min conversations in pairs under audio-only and audiovisual communication conditions. Acoustical data and a number of conversational collisions (communication partners trying to speak at the same time) under each condition were compared. Results There were no statistically significant differences in acoustical measures of voice quality between audio-only and audiovisual conversations; however, vocal intensity was consistently 4 times more powerful than average face-to-face conversational intensity during both conditions. The number of conversational collisions was significantly less for the audiovisual condition as compared to the audio-only condition. Conclusion Results suggest that visual feedback did allow for modulation of conversational flow (fewer conversational collisions) but did not allow for modulation of vocal quality. Visual feedback did not overcome the absence of side tone and resulted in the same increased conversational loudness observed during the audio-only condition. As a result, remote conversational partners such as clients and telehealth practitioners are more susceptible to developing vocal health issues.

scholarly journals Use of alternative consultation forms in Danish general practice in the initial phase of the COVID-19 pandemic – a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tina Drud Due ◽  
Thorkil Thorsen ◽  
Julie Høgsgaard Andersen
Keyword(s):  
Patient Care ◽  
Initial Phase ◽  
Health Care Systems ◽  
Qualitative Interviews ◽  
Clinical Work ◽  
Health Issues ◽  
Short Term ◽  
Diagnostic Uncertainty ◽  
Face To Face ◽  
Care Systems

Abstract Background Attempts to manage the COVID-19 pandemic have led to radical reorganisations of health care systems worldwide. General practitioners (GPs) provide the vast majority of patient care, and knowledge of their experiences with providing care for regular health issues during a pandemic is scarce. Hence, in a Danish context we explored how GPs experienced reorganising their work in an attempt to uphold sufficient patient care while contributing to minimizing the spread of COVID-19. Further, in relation to this, we examined what guided GPs’ choices between telephone, video and face-to-face consultations. Methods This study consisted of qualitative interviews with 13 GPs. They were interviewed twice, approximately three months apart in the initial phase of the pandemic, and they took daily notes for 20 days. All interviews were audio recorded, transcribed, and inductively analysed. Results The GPs re-organised their clinical work profoundly. Most consultations were converted to video or telephone, postponed or cancelled. The use of video first rose, but soon declined, once again replaced by an increased use of face-to-face consultations. When choosing between consultation forms, the GPs took into account the need to minimise the risk of COVID-19, the central guidelines, and their own preference for face-to-face consultations. There were variations over time and between the GPs regarding which health issues were dealt with by using video and/or the telephone. For some health issues, the GPs generally deemed it acceptable to use video or telephone, postpone or cancel appointments for a short term, and in a crisis situation. They experienced relational and technical limitations with video consultation, while diagnostic uncertainty was not regarded as a prominent issue Conclusion This study demonstrates how the GPs experienced telephone and video consultations as being useful in a pandemic situation when face-to-face consultations had to be severely restricted. The GPs did, however, identify several limitations similar to those known in non-pandemic times. The weighing of pros and cons and their willingness to use these alternatives shifted and generally diminished when face-to-face consultations were once again deemed viable. In case of future pandemics, such alternatives seem valuable, at least for a short term.

The effect of visual feedback and training in auditory-perceptual judgment of voice quality

2015 ◽  
Vol 42 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Ben Barsties ◽  
Mieke Beers ◽  
Liesbeth Ten Cate ◽  
Karin Van Ballegooijen ◽  
Lilian Braam ◽  
...  
Keyword(s):  
Visual Feedback ◽  
Voice Quality ◽  
Perceptual Judgment ◽  
And Training

scholarly journals Telemedicine and mental health: coming of age?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Ohannessian ◽  
A Scardoni ◽  
L Bellini ◽  
S Salvati ◽  
A Amerio ◽  
...  
Keyword(s):  
Mental Health ◽  
Massachusetts General Hospital ◽  
Coming Of Age ◽  
Global Scale ◽  
Mobile App ◽  
Mental Wellbeing ◽  
Health Issues ◽  
Implementation Challenges ◽  
Face To Face ◽  
Remote Patient

Abstract Telemedicine is the practice of medicine from distance using information technology and include mainly teleconsultation via video and/or chat, teleexpertise to request the opinion of a specialist, and remote patient monitoring to improve the follow-up of patients. The use of telemedicine in mental health and most specially psychiatry has been one of the first use case described in the scientific literature, via video teleconsultation, due to the absence of physical patient examination. One of the oldest telepsychiatry case from the literature was published in 1973 for patients assessed from 1968 with the Massachusetts General Hospital in Boston, USA. Despite its medical and technical ease, telepsychiatry is still not widely spread and integrated into healthcare systems due to organisational and implementation challenges. More recently, telepsychology and other telemedicine interventions in mental health have been growing across the globe, including for mental wellbeing promotion and prevention of mental health conditions in specific environments. The rise of consumer digital healthcare directly through mobile app and dedicated websites is also to be considered in the wide opportunities of telemedicine opportunities to address mental health issues at a global scale. Various models needs thus to be considered between digital only care and blended approach mixing face-to-face and digital ways, as well as telemental health delivered only via the existing healthcare system or via new private digital players. The objective of the presentation is to describe the spectrum of existing telemedicine interventions in mental health, the digital features enabling its adoption and the assessment of its impact on clinical and public health outcomes.

Student Voice Use and Vocal Health During an All-State Chorus Event

2010 ◽  
Vol 58 (4) ◽  
pp. 346-367 ◽  
Author(s):  
James F. Daugherty ◽  
Jeremy N. Manternach ◽  
Kathy K. Price
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Health Perceptions ◽  
Singing Voice ◽  
Vocal Health ◽  
Close Proximity ◽  
Rest Time ◽  
Field Notes ◽  
Voice Use

This field-based case study documented students’ ( N = 256) voice use and voice health perceptions during a 3-day all-state high school chorus event through daily surveys, phonation duration data, analysis of rehearsal voice use behaviors, and field notes. Among the primary results are the following: (a) First and final day survey comparisons indicated significant declining changes in 5 of 7 voice health indicator statements and in self-perceptions of singing voice quality, yet (b) most students (78.8%) believed they had taken good care of their voices; (c) self-reported sleep hours decreased significantly; (d) vocal fold contact time measured with two students ranged from 15% to 38% during rehearsal periods, 1% to 27% during on-site non-rehearsal times, and 3% to 17% during measured pre- and post-event activities, but (e) overall percentages of vocal fold contact varied little between regular rehearsal and on-site non-rehearsal events (female: 19.37% rehearsal, 20.11% non-rehearsal; male: 22.89% rehearsal, 20.54% non-rehearsal); (f) rehearsal voice rest time (63%) exceeded voice use time (37%); (g) students sat in close proximity to other choristers for approximately 73% of rehearsal time; and (h) the two compositions ranked highest relative to demands on adolescent voices consumed 61% of rehearsal time.

Ultrasonography applied to the description of voice quality settings in adult speakers of Brazilian Portuguese

Revista CEFAC ◽  
2021 ◽  
Vol 23 (6) ◽  
Author(s):  
Tamar Vieira de Jesus ◽  
Aline Neves Pessoa Almeida ◽  
Zuleica Camargo
Keyword(s):  
Data Analysis ◽  
Instructional Material ◽  
Profile Analysis ◽  
Voice Quality ◽  
Brazilian Portuguese ◽  
Ultrasound Images ◽  
Perceptual Judgments ◽  
Analysis Scheme ◽  
Vocal Quality

ABSTRACT Purpose: to relate ultrasound images with auditory-perceptual data on vocal quality settings in adult speakers of Brazilian Portuguese. Methods: the corpus consisted of speech samples (sentences contained in the instructional material of the Vocal Profile Analysis Scheme - VPAS-PB) from seven adult subjects of both genders, recorded simultaneously by acoustic and ultrasonographic means. Data analysis was based on auditory-perceptual judgments of vocal quality and ultrasound images generated by the AAA software. Results: vocal quality settings related to the position of the tongue body and the extension of the tongue and jaw found correspondences to the contours of ultrasound images of the tongue in selected key segments (oral vowels), especially those with greater degrees of manifestation. Conclusion: there were correspondences between vocal quality settings detected in the perceptual sphere and their respective tongue body and jaw ultrasound images.

scholarly journals Observing Supreme Court Oral Argument: A Biosocial Approach

1992 ◽  
Vol 11 (1) ◽  
pp. 35-52 ◽  
Author(s):  
James N. Schubert ◽  
Steven A. Peterson ◽  
Glendon Schubert ◽  
Stephen Wasby
Keyword(s):  
Content Analysis ◽  
Supreme Court ◽  
Language Use ◽  
Voice Quality ◽  
Systematic Observation ◽  
Face To Face ◽  
Political Interaction ◽  
Oral Argument ◽  
Level Of Analysis ◽  
The U.S

Supreme Court oral argument (OA) is one of many face-to-face settings of political interaction. This article describes a methodology for the systematic observation and measurement of behavior in OA developed in a study of over 300 randomly selected cases from the 1969-1981 terms of the U.S. Supreme Court. Five sources of observation are integrated into the OA database at the speaking turn level of analysis: the actual text of verbal behavior; categorical behavior codes; aspects of language use and speech behavior events; electro-acoustical measurement of voice quality; and content analysis of subject matter. Preliminary data are presented to illustrate the methodology and its application to theoretical concerns of the research project.

Tradition and Culture: An Important Determinant of Inuit Women’s Health

2013 ◽  
Vol 4 (1) ◽  
pp. 25 ◽  
Author(s):  
Gwen K. Healey
Keyword(s):  
Teenage Pregnancy ◽  
Social Inclusion ◽  
Well Being ◽  
Health Issues ◽  
Face To Face ◽  
Arctic Regions ◽  
Illness Prevention ◽  
Women’S Perceptions ◽  
Health And Well Being

This exploratory qualitative study used a case study method to explore Inuit women’s perspectives on their health and well-being. Data were gathered using face-to-face interviews from a purposive sample of women in one Nunavut community who self-identified as Inuit. Data analysis and interpretation were guided by an established approach in qualitative research called “immersion/crystallization.” Various strategies, including methods of verification and validition, were employed to ensure the scientific rigour and reliability of the study’s findings. The mechanisms through which culture and tradition affected women’s perceptions of health and well-being were clearly illustrated and clearly significant to the interview subjects. Women used examples of teenage pregnancy and parenting issues to illustrate traditional practices in Nunavut communities and their significance in an increasingly non-traditional society. Women stressed the importance of speaking Inuktitut and teaching it to their children. Many associated their ability to speak Inuktitut with their ties to Inuit traditions. Women described the grief experienced from loss of culture leading to problems related to identity, social inclusion and wellness. Culture and traditional knowledge were identified as key determinants of health for Canadian Inuit women. This study provides important information to inform and guide health promotion and illness prevention planning. The study will also help decision-makers and health professionals address some of the health issues affecting Inuit women by providing them with some insight into Inuit women’s local and contemporary circumstances. The results of this work can support local efforts to identify priorities for policy and program development relevant to Inuit women’s specific needs. Finally, the relevance of insight gained through the health perspectives of Inuit women in Nunavut deserves further investigation in relation to other Arctic regions, both in Canada and in the larger circumpolar community.

The Dysphonia Severity Index

2000 ◽  
Vol 43 (3) ◽  
pp. 796-809 ◽  
Author(s):  
Floris L. Wuyts ◽  
Marc S. De Bodt ◽  
Geert Molenberghs ◽  
Marc Remacle ◽  
Louis Heylen ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Voice Quality ◽  
Severity Index ◽  
Voice Handicap Index ◽  
Objective Measures ◽  
Maximum Phonation Time ◽  
Vocal Quality ◽  
The Voice ◽  
Weighted Combination

The vocal quality of a patient is modeled by means of a Dysphonia Severity Index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following selected set of voice measurements: highest frequency (F 0 -High in Hz), lowest intensity (I-Low in dB), maximum phonation time (MPT in s), and jitter (%). The DSI is derived from a multivariate analysis of 387 subjects with the goal of describing, purely based on objective measures, the perceived voice quality. It is constructed as DSI=0.13 x MPT + 0.0053 x F 0 -High – 0.26 x I-Low – 1.18 x Jitter (%) + 12.4. The DSI for perceptually normal voices equals +5 and for severely dysphonic voices –5. The more negative the patient's index, the worse is his or her vocal quality. As such, the DSI is especially useful to evaluate therapeutic evolution of dysphonic patients. Additionally, there is a high correlation between the DSI and the Voice Handicap Index score.

scholarly journals Acoustic and hearing-perceptual voice analysis in individuals with idiopathic Parkinson's disease in "on" and "off" stages

2010 ◽  
Vol 68 (5) ◽  
pp. 706-711 ◽  
Author(s):  
Luiza Lara M Santos ◽  
Larissa Oliveira dos Reis ◽  
Iara Bassi ◽  
Clara Guzella ◽  
Francisco Cardoso ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Control Group ◽  
Idiopathic Parkinson’S Disease ◽  
Acoustic Parameters ◽  
Perceptual Analysis ◽  
Idiopathic Parkinson's Disease ◽  
Vocal Quality

OBJECTIVE: To evaluate the voice quality of patients with idiopathic Parkinson's disease, at the "on" and "off" moments of the disease. METHOD: Five individuals with Parkinson's disease and five of the control group were assessed. All of them underwent the recording of voice and speech. The acoustic parameters analyzed were: fundamental frequency, jitter, shimmer, harmonic noise proportion and index of tremor, besides performing the hearing-perceptual analysis by means of GRBASI scale. The findings were analyzed using statistics through t test and the level of significance adopted was p<0.05. RESULTS: There was no difference in the acoustic parameters in the three analyzed groups. In the hearing-perceptual analysis, patients with idiopathic Parkinson's disease showed altered voice quality and the ones from the control group, neutral vocal quality. CONCLUSION: Patients with idiopathic Parkinson's disease present rough, breathy and unstable vocal quality in both stages. In the acoustic analysis, there are no differences in the studied parameters.

scholarly journals The Impact of Communication Modality on Voice Production

2020 ◽  
Vol 63 (9) ◽  
pp. 2913-2920
Author(s):  
Lauren F. Tracy ◽  
Roxanne K. Segina ◽  
Manuel Diaz Cadiz ◽  
Cara E. Stepp
Keyword(s):  
Technology Use ◽  
Voice Quality ◽  
Voice Therapy ◽  
Social Environments ◽  
Audiovisual Communication ◽  
Remote Communication ◽  
Voice Production ◽  
Vocal Effort ◽  
Communication Modalities ◽  
The Impact

Purpose Communicating remotely using audio and audiovisual technology is ubiquitous in modern work and social environments. Remote communication is increasing in medicine and in voice therapy delivery, and this evolution may have an impact on speakers' voices. This study sought to determine whether these communication modalities impact the voice production of typical speakers. Method The speech acoustics of 12 participants with healthy voices were recorded as they held standardized conversations with a single investigator using three communication modalities: in-person, remote-audio, and remote-audiovisual. Participants rated their vocal effort on a 100-mm visual analog scale. Results Compared to in-person communication, self-ratings of vocal effort were statistically significantly increased for remote-audiovisual communication; vocal effort during remote-audio and in-person communication were not significantly different. In comparison to in-person communication, vocal intensity and smoothed cepstral peak prominence (CPPS) were statistically significantly higher during remote-audio and remote-audiovisual communication. Effect sizes for CPPS changes were larger than for sound pressure level (SPL), and changes in CPPS and SPL between in-person and remote-audiovisual communication were not significantly correlated. Conclusions Vocal effort and SPL were increased when using remote-audio and remote-audiovisual communication in comparison to in-person communication. Voice quality was also impacted by technology use, with changes in CPPS that were consistent with, but not fully explained by, increases in SPL. This may impact the telepractice delivery of voice therapy, and further investigation is warranted.

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