PHYSIOLOGICAL VOCAL WARMING UP PROGRAM IN RELIGIOUS SINGERS

Purpose: To analyze the effectiveness of a physiological vocal warm-up program focused on religious singers. Method: longitudinal study involving 39 subjects male and female, aged at least 18 and at most 50, the participants underwent an evaluation vocal pre-warm-up and vocal post-warm-up, results being compared to both evaluations. The evaluation was applied questionnaire vocal habits and symptoms, acoustic analysis and auditory perceptual analysis. The study was conducted in Catholic Churches of Várzea Grande City in the state Mato Grosso. Results: They said participants to use the corner of a median of 87.3 months with weekly frequency of 2.4 times per week. However, 89.7% of the singers reported not warm up the voice before the corner and not desaquecerem 94.9% after the corner. In inadequate vocal habits most said talking aplenty. Already in vocal symptoms the three most prevalent were: voice worse in the morning (59.0%), loss of treble (54.4%) and hoarseness constant (51.3%). After application of vocal warm-up program improvement was observed in vocal self assessment and auditory perceptual analysis. There was also a significant increase in the fundamental frequency of the sustained vowel, but for the singing voice there was no change in acoustic parameters analyzed. Conclusion: The vocal heating program was effective with positive changes in voice adjustments, providing a more comfortable voice output this being noticed by singers themselves.

Unilateral Vocal Fold Paralysis: The “Trifecta”—Dysphonia, Dysphagia, and Dyspnea

Purpose: A clinical case of unilateral vocal fold paralysis is presented with case history, auditory-perceptual analysis and accompanying audio files and ratings, videostroboscopic files and ratings, and acoustic analysis, as well as impressions and plan for treatment. Method: A single clinical case of unilateral vocal fold paralysis is presented for learning purposes. Results: Clinical keys are provided for learning. Conclusion: Learners will be able to follow a clinical case to aid in perceptual, videostroboscopic, acoustic, and voice assessment and goal and treatment planning. Supplemental Material https://doi.org/10.23641/asha.16799563

Chromatic Discrimination Thresholds as a Function of Color Differences and Cone Excitations

In this paper, Just Noticeable Differences (JNDs) of color-normal subjects measured towards the Protan, Deutan, and Tritan confusion points are presented as a function of the chromaticity of the reference points. Measurements were executed with the Cambridge Colour Test Trivector test in equidistant reference points towards eight directions equally spaced and centered on the neutral reference point in the CIE 1976 UCS diagram.Results were evaluated as the function of the distance between the reference points and the neutral point. The reference points were the chromaticities of the backgrounds of the pseudoisochromatic plates in the test, and the neutral point was defined as equal energy white. The evaluation was performed considering ∆Eu'v' differences and L/(L + M) and S/(L + M) ratios of the cone-excitations.Chromatic discrimination thresholds exceeded the normative upper limit of color normal subjects in ∆Eu'v' units at extreme reference points. Shifting the reference points from the neutral point towards the confusion points indicated an increase of Just Noticeable Differences measured towards the confusion points following second-order polynomials. Based on our results a model estimating the JNDs expressed in ∆Eu'v' units towards the confusion points was recommended.Even though CIE 1976 UCS diagram is not a perceptually uniform color space, the Just Noticeable Differences measured with the CCT correlate with the corresponding L' and S' cone excitations. This confirms the basic applicability of the CIE 1976 UCS diagram for characterizing Just Noticeable Differences. For complete perceptual analysis, the use of cone-excitation-based metrics is still essential and recommended.

Does the Acoustic Voice Quality Index (AVQI) Correlate with Perceived Creak and Strain in Normophonic Young Adult Finnish Females?

<b><i>Background:</i></b> The Acoustic Voice Quality Index (AVQI) is a correlate of dysphonia. It has been found to differentiate between dysphonic and normophonic speakers and to indicate the effects of voice therapy. This study investigates how the AVQI reacts towards creak and strain, which are common in normophonic speakers. <b><i>Methods:</i></b> The material was obtained from an earlier study on 104 Finnish female university students (mean age 24.3 years, SD 6.3 years) with no known pathology of voice or hearing and a perceptually normal voice (G = 0 in GRBAS), who were recorded while reading aloud a standard text and sustaining the vowel [a:]. Perceptual analysis for the amount of creak and strain was carried out by 2 expert listeners. In this study, the AVQI v03.01 was analyzed and correlated with perceptual evaluations. Samples with low and high amounts of creak and strain were compared with <i>t</i> tests. <b><i>Results:</i></b> On average, the AVQI was below the threshold value of dysphonia in the Finnish population. The AVQI (ρ = 0.35, <i>p</i> = 0.000) and its subparameters, smoothed cepstral peak prominence (CPPS; ρ = –0.35, <i>p</i> = 0.000) and harmonics-to-noise ratio (HNR; ρ = –0.30, <i>p</i> = 0.002) showed low but significant correlations with creak. Strain had low but significant correlations with spectral Slope (ρ = 0.38, <i>p</i> = 0.000) and Tilt (ρ = –0.40, <i>p</i> = 0.009). The AVQI was lower (better) in samples that were evaluated as having a high amount of strain, but the difference was not significant. Only CPPS differentiated significantly between low and high amounts of creak. <b><i>Conclusion:</i></b> The AVQI does not seem to differentiate between high and low amounts of creak and strain in normophonic speakers.

Prospective cohort study of voice outcomes following secondary tracheoesophageal puncture in gastric pull-up reconstruction after total laryngopharyngoesophagectomy

Background Gastric pull-up is a reconstructive option for circumferential defects after resection of advanced laryngopharyngeal malignancy. Voice loss is expected and vocal rehabilitation remains a challenge. Our study objectives were to investigate the feasibility of secondary tracheoesophageal puncture following gastric pull-up and to analyze voice outcomes. Methods This was a prospective cohort study of patients with advanced laryngopharyngeal malignancies who underwent gastric pull-up and secondary tracheoesophageal puncture between 1988 and 2017 at a tertiary-care academic institution. Objective acoustic measures included fundamental frequency and vocal intensity. Perceptual analysis was performed using voice recordings (“Rainbow Passage”) randomly presented in a blinded fashion to four clinicians using the validated GRBAS scale. Speech intelligibility was assessed in a blinded fashion using a validated 7-point scale. Additionally, the Voice Handicap Index-10 was administered as a validated patient self-reporting tool. Results Ten patients (7 male, 3 female) were included, all of whom preferentially used tracheoesophageal puncture for communication. These patients had abnormal median fundamental frequency of 250 (interquartile range (IQR) 214–265) Hz and a limited median vocal intensity of 65.8 (IQR 64.1–68.3) dB. Perceptual analysis (GRBAS) revealed a median ‘moderate’ degree of impairment [grade 2 (IQR 2–3), roughness 2 (IQR 2–3), breathiness 3 (IQR 2–3), asthenia 2 (IQR 1–2), strain 2 (IQR 1–2)] as did median intelligibility scores [median 5 (IQR 4–7)]. Most patients self-reported an abnormal voice handicap-10 [median 26.5 (IQR 22.8–35.0)]. Conclusion Secondary tracheoesophageal puncture is a safe and feasible option for voice rehabilitation after gastric pull-up. Although analyses demonstrated moderate subjective and objective impairment, tracheoesophageal puncture provided patients with a self-reported means of functional verbal communication and was their preferred method of communication. Graphical abstract

Sports Facilities and Utilities: A Perceptual Analysis of Secondary School Students

Kant stated that education is to develop a sound mind in a sound body. Following a descriptive survey in a quantitative framework, the current study aimed to analyze the perception of students at Khyber Pakhtunkhwa about the availability of sports facilities and their utilization. A multi-stage sample of 300 students was taken from12 urban Secondary schools of district Peshawar. A questionnaire was used for the collection of quantitative data having five-point Likert scales. Kruskale Wallace H test and Mann-Whitney U test were used as inferential statistics for finding the differences in the groups. The study found that most of the secondary school students participated in sports activities. The majority of schools were having sports facilities, however, fewer students were having sports facilities outside their schools. It was suggested that if students are provided with proper sports facilities and proper guidelines, it will have a significant impact on their physical development and academic achievements.