The clinical implication of the vocal cords-carina distance in anaesthetized Chinese adults during orotracheal intubation

Background. Previous studies have identified no strong correlation between patients' height and tracheal length in anaesthetized patients. We have attempted to compare vocal cords-carina distance (VCD) in Chinese patients with the dimensions of five commonly used tracheal tubes. In addition, we attempted to find a surface anatomy measurement that would identify patients with 'short tracheas'. Methods. We measured VCD in 130 anaesthetized Chinese patients with a fibreoptic bronchoscope. Also measurements were obtained of the distal ends of five commonly used tracheal tubes. We undertook various surface anatomy measurements on the patients' chest and neck region to predict those patients with short tracheas. Results. VCD averaged 12.6 ((SD) 1.4) cm. In seven patients (5%) this distance was particularly short (between 8.8 and 10.4 cm). Many of the commonly used tracheal tubes would be placed close to or beyond the carina when the black intubation guide mark(s) is (are) at the level of the vocal cords. The VCD of

Extended program notes for a recital of selected vocal literature

The purpose of these extended program notes is to provide information that will assist the listening audience in comprehending the historical and biographical significance of the each vocal selection. A brief analysis of each selection, a historical interpretation of the work, a translation of the texts and a CD of the recital are included. The contents of the recital comprise of several selections from the soprano repertoire: The Georg Phillip Telemann cantata Lauter Wonne, lauter Freude; the Wolfgang Amadeus Mozart Laudate Dominum from the Vesperae solemnes de confessore; the Joaquin Nin y Castellano Diez Villancicos de Noel; Gabriel Faurd's art songs Dans le ruines d'une abbay, Les Berceaux, and Au bord e l'eau; Sergei Rachmaninov's three songs Oni otvechali, Zdes Khorosho, and Vocalise; and Libby Larsen's Cowboy Songs.

Prevalência e fatores associados à alteração vocal em idosos institucionalizados com capacidade cognitiva preservada

Voice disorders (VD) in the elderly can interfere negatively in communication, emotional well-being and quality of life, conditions that correspond to greater exposure to illness and social isolation bringing consequent economic impact for the health system. It is assumed that institutionalized confinement, weakness and morbidity associated to nursing home (NH) contribute to transform VD an especially prevalent condition in institutionalized elderly, including those without cognitive impairment. Thus, the aim of this study was to determine the prevalence and associated factors of VD in NH elderly residents without cognitive impairment. There is no epidemiological diagnostic instruments of VD for elderly populations, so the first step of this study was dedicated to prepare and analyze the psychometric properties of a short, inexpensive and easy to use questionnaire named Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos—RAVI). The methodological procedures of this step followed the guidelines of the Standards for Educational and Psychological Testing and contemplated validity evidence based on test content, based on response processes, based on internal structure and based on relations with other variables, as well as reliability analysis and clinical consistency. The result of the validation process showed that the RAVI final score generate valid and reliable interpretations for the epidemiological diagnosis of VD in the elderly, which endorsed the use of the questionnaire in the second stage of the study, performed in ten NH located in the city of Natal, Rio Grande do Norte. At this stage, data from socioeconomic and demographic variables, lifestyle, general health conditions and characterization of the institution were collected. It was performed a bivariate analysis and it was calculated the prevalence ratio as a magnitude association measure, with a confidence interval of 95%. The variables with p-value less than 0.20 were included in the multiple logistic regression model that followed the Forward selection method. The odds ratio found in the multivariate model was converted into prevalence ratio and the level of significance was 5%. The sample consisted of 117 subjects with predominance of females and average of 79.68 (± 7.92) years old. The prevalence of VD was 39.3% (95% CI: 30.4-48.1%). The multivariate model showed statistically significant association between VD and depressive symptoms, smoking for a year or more and selfreported hearing loss. In conclusion, VD is a prevalent health condition in NH elderly residents without cognitive impairment and is associated with factors involving psychosocial, lifestyle and communicative disability that require attention of managers and professionals involved with NH environment. Strategies to encourage communication and social integration, actions to combat smoking and minimizing the effects of hearing loss could stimulate the physical well-being, emotional and mental health of institutionalized elderly population, contributing to the vocal and communicative maintenance, a more effective social inclusion and better overall health condition.

Sociophonetic deception: the elements of vocal disguise

The focus of my research is vocal disguise within forensic linguistics. Specifically, I answer the question of what individuals are most likely to do with their voice when they do not want to be recognized by a listener. I also focus on whether specific sociolinguistic characteristics – gender and place of origin – have an effect on the disguise choices that individuals make. My research has found that participants show a preference for altering pitch and/or duration across conditions, as well as taking on a foreign accent. Gender and origin were found to be significant for respect to differences in duration, and significance was also found between origin and pitch. These results suggest that disguise might contain elements of style shifting, and that a speaker's choice is more systematic than random.

The sound of whiteness: early music vocal performance practice in Britain

American Musicological Society annual meeting, San Francisco, 10 Nov. 2011

Investigating Multiple Roles of Vocal Confidence in Persuasion

Although persuasion often occurs via oral communication, it remains a comparatively understudied area. This research tested the hypothesis that changes in three properties of voice influence perceptions of speaker confidence, which in turn differentially affects attitudes according to different underlying psychological processes that the Elaboration Likelihood Model (ELM, Petty & Cacioppo, 1984), suggests should emerge under different levels of thought. Experiment 1 was a 2 (Elaboration: high vs. low) x 2 (Vocal speed: increased speed vs. decreased speed) x 2 (Vocal intonation: falling intonation vs. rising intonation) between participants factorial design. Vocal speed and vocal intonation influenced perceptions of speaker confidence as predicted. In line with the ELM, under high elaboration, confidence biased thought favorability, which in turn influenced attitudes. Under low elaboration, confidence did not bias thoughts but rather directly influenced attitudes as a peripheral cue. Experiment 2 used a similar design as Experiment 1 but focused on vocal pitch. Results confirmed pitch influenced perceptions of confidence as predicted. Importantly, we also replicated the bias and cue processes found in Experiment 1. Experiment 3 investigated the process by which a broader spectrum of speech rate influenced persuasion under moderate elaboration. In a 2 (Argument quality: strong vs. weak) x 4 (Vocal speed: extremely slow vs. moderately slow vs. moderately fast vs. extremely fast) between participants factorial design, results confirmed the hypothesized non-linear relationship between speech rate and perceptions of confidence. In line with the ELM, speech rate influenced persuasion based on the amount of processing. Experiment 4 investigated the effects of a broader spectrum of vocal intonation on persuasion under moderate elaboration and used a similar design as Experiment 3. Results indicated a partial success of our vocal intonation manipulation. No evidence was found to support the hypothesized mechanism. These studies show that changes in several different properties of voice can influence the extent to which others perceive them as confident. Importantly, evidence suggests different vocal properties influence persuasion by the same bias and cue processes under high and low thought. Evidence also suggests that under moderate thought, speech rate influences persuasion based on the amount of processing.

Anthropogenic noise affects vocal interactions

Animal communication plays a crucial role in many species, and it involves a sender producing a signal and a receiver responding to that signal. The shape of a signal is determined by selection pressures acting upon it. One factor that exerts selection on acoustic signals is the acoustic environment through which the signal is transmitted. Recent experimental studies clearly show that senders adjust their signals in response to increased levels of anthropogenic noise. However, to understand how noise affects the whole process of communication, it is vital to know how noise affects the receiver’s response during vocal interactions. Therefore, we experimentally manipulated ambient noise levels to expose male European robins (Erithacus rubecula) to two playback treatments consisting of the same song: one with noise and another one without noise. We found that males responding to a conspecific in a noise polluted environment increased minimum frequency and decreased song complexity and song duration. Thus, we show that the whole process of communication is affected by noise, not just the behaviour of the sender.

Validade e fiabilidade do protocolo de avaliação da qualidade vocal da Universidade de Aveiro

O presente estudo teve como principal objetivo rever a versão original do Protocolo de Avaliação da Qualidade Vocal da Universidade de Aveiro (PAQVUA), criar o respetivo manual, comprovar a validade de conteúdo do PAQVUA assim como a sua fiabilidade inter e intra avaliador. Para rever a versão original do PAQVUA, foi efetuada uma revisão narrativa da literatura, com o objetivo de encontrar informação que revelasse a pertinência, da versão original do protocolo, para assim se efetuarem as alterações necessárias. Para analisar a validade de conteúdo recorreu-se a um painel de peritos, num total de seis, especialistas na área da voz que avaliaram as provas do PAQVUA, folha de registo e manual. Os peritos avaliaram todos os componentes do PAQVUA através do preenchimento de um questionário com o objetivo de se comprovar a relevância, clareza e precisão de cada uma das provas de avaliação e também o conteúdo do seu manual. Para além disso pretendeu-se também comprovar a fiabilidade inter e intra avaliador do PAQVUA. Para isso, o mesmo protocolo foi aplicado duas vezes por duas avaliadoras diferentes e também foi aplicado em dois momentos temporais diferentes por uma só avaliadora. A amostra teve um total de doze participantes. Para analisar estatisticamente os resultados da validade de conteúdo utilizou-se o método gráfico Bland e Altman modificado e o Coeficiente de Correlação Intraclasses (CCI). Para a fiabilidade inter e intra avaliador recorreu-se ao Coeficiente de Correlação de Spearman (ρ) e ao Kappa de Cohen (k). Relativamente aos resultados obtidos com o método Bland e Altman modificado, verificou-se a existência de concordância entre os peritos através da análise dos gráficos, sendo que a maioria dos pontos se encontrou dentro dos limites esperados de concordância. Quanto aos valores do CCI (entre 0.379 e 0.479), estes revelaram uma correlação regular. No que concerne à fiabilidade inter avaliador, os resultados de correlação e concordância apresentaram-se relevantes, com valores de ρ (de Spearman) superiores a 0.700 e valores de k (de Cohen) superiores a 0.600, na maioria dos casos. O mesmo foi constatado para a fiabilidade intra avaliador. Desta forma pode concluir-se que a nova versão do PAQVUA apresenta validade de conteúdo sendo tal comprovado pelo método de Bland-Altman modificado e pelos valores do CCI. Quanto à fiabilidade inter e intra avaliador, pode afirmar-se que o PAQVUA é fiável, porém como a amostra em estudo é pequena, o que a torna pouco representativa, esta conclusão carece de fundamento com base num estudo mais alargado. Apesar da limitação referida, acredita-se que este protocolo é uma mais-valia para o estudo da patologia vocal em ambiente clínico, assim como para a investigação científica nesta área, pois através do PAQVUA podem-se recolher diversas informações relacionadas com a voz, úteis para uma intervenção terapêutica baseada em evidências científicas.

W.A. Mozart's Die Zauberflöte An Arrangement and Performance Edition for Wind Instruments and Vocal Soloists

The purpose of this dissertation is to produce a new Harmonie arrangement of Mozart’s Die Zauberflöte suitable for modern performance, bringing Joseph Heidenreich’s 1782 arrangement—one of the great treasures of the wind repertoire—to life for future performers and audiences. I took advantage of the capabilities of modern wind instruments and performance techniques, and employed other instruments normally found in the modern wind ensemble to create a work in the tradition of Heidenreich’s that restored as much of Mozart’s original thinking as possible. I expanded the Harmonie band to include flute and string bass. Other instruments provide special effects, a traditional role for wind instruments in the Classical opera orchestra. This arrangement is conceived to be performed with the original vocal soloists, making it a viable option for concert performance or for smaller staged productions. It is also intended to allow the wind players to be onstage with the singers, becoming part of the dramatic action while simultaneously serving as the “opera orchestra.” This allows creative staging possibilities, and offers the wind players an opportunity to explore new aspects of performing. My arrangement also restores Mozart’s music to its original keys and retains much of his original wind scoring. This arrangement expands the possibilities for collaboration between opera studios, voice departments or community opera companies and wind ensembles. A suite for winds without voices (currently in production) will allow conductors to program this major work from the Classical era without dedicating a concert program to the complete opera. Excerpted arias and duets from this arrangement provide vocalists the option of using chamber wind accompaniment on recitals. The door is now open to arrangements of other operas by composers such as Mozart, Rossini and Weber, adding new repertoire for chamber winds and bringing great music to life in a new way.

Acoustic analysis of vocal dysphonia

Voice acoustic analysis is becoming more and more usefúl in diagnosis of voice disorders or laryngological pathologies. The facility to record a voice sigiial is an advantage over other invasive techniques. This paper presents the statistical analyzes ofa set of voice parameters like jitter, shimmer and HNR over a 4 groups of subjects vvith dysphonia, fünctional dysphonia, hyperfünctional dysphonia, and psychogenic dysphonia and a control group. No statistical signifícance differences over pathologic groups were found but clear tendencies can be seen between pathologic and control group. The tendencies indicates this parameters as a good features to be used in an intelligent diagnosis system, moreover the jitter and shimmer parameters measured over different tones and vowels.

Parálisis de cuerda vocal unilateral: estudio de la calidad vocal después del tratamiento logopédico

Fundamento. Describir los factores sociodemográficos de pacientes con parálisis de cuerda vocal unilateral (PCVU) a los que se aplica un tratamiento logopédico y analiza el impacto en la calidad vocal tras la terapia. Metodología. Se incluyeron 47 pacientes con PCVU diagnosticada mediante vídeo-laringoscopia. Todos recibieron intervención logopédica repartida en 15 sesiones y estructurada en tres etapas progresivas. Se instruyó al paciente en técnicas vocales, coordinación fono-respiratoria, control del soplo, tonificación glótica e impostación vocal. Los parámetros incluidos en el estudio antes y después de la terapia fueron: cierre glótico, Voice Handicap Index-10 (VHI-10) para medir la autopercepción de calidad vocal y escala GRABS para la calidad vocal. Resultados. La edad media fue 51 años (rango 20-80), 60% mujeres. La causa quirúrgica fue la más frecuente (72%). El 40% desempeñaban una profesión relacionada con la voz. El tiempo medio desde el diagnóstico hasta el inicio del tratamiento fue 5 meses (2-12). El cierre glótico completo aumentó de 34 a 80% (p<0,001), la puntuación en VHI-10 descendió de 24,24 a 16,09 puntos (p<0,001) y los valores de GRABS mejoraron en todas las cualidades de la voz (p<0,001). Solo un 8,5% requirió cirugía post-tratamiento. Conclusiones. La terapia de reeducación vocal es eficaz como primera indicación terapéutica en pacientes con PCVU, reservando la medialización con material no reabsorbible o cirugía de tiroplastia a aquéllos con mala evolución. No obstante, es necesario reducir el tiempo que se demora el paciente en llegar a la Unidad de Voz tras el diagnóstico laringoscópico.