Vocal fold vibratory and acoustic features in fatigued Karaoke singers

Session 3aMU - Musical Acoustics and Speech Communication: Singing Voice in Asian CulturesKaraoke is a popular singing entertainment particularly in Asia and is gaining more popularity in the rest of world. In Karaoke, an amateur singer sings with the background music and video (usually guided by the lyric captions on the video screen) played by Karaoke machine, using a microphone and an amplification system. As the Karaoke singers usually have no formal training, they may be more vulnerable to vocal fatigue as they may overuse and/or misuse their voices in the intensive and extensive singing activities. It is unclear whether vocal fatigue is accompanied by any vibration pattern or physiological changes of vocal folds. In this study, 20 participants aged from 18 to 23 years with normal voice were recruited to participate in an prolonged singing task, which induced vocal fatigue. High speed laryngscopic imaging and acoustic signals were recorded before and after the singing task. Images of /i/ phonation were quantitatively analyzed using the High Speed Video Processing (HSVP) program (Yiu, et al. 2010). It was found that the glottis became relatively narrower following fatigue, while the acoustic signals were not sensitive to measure change following fatigue. © 2012 Acoustical Society of Americapublished_or_final_versio

Exploring the Context, Roles and Experiences of Mothers in Caring for their Inpatient Sick Newborns in Nairobi, Kenya: An Ethnographic Approach

Little progress has been made in reducing deaths among newborns. Newborn morbidity and mortality can be prevented through the timely provision of combined health systems interventions and access to high-quality inpatient and supportive care. Additionally, recent evidence has demonstrated the importance of social factors to the survival of sick newborns. The involvement of parents through family centred care, as well as maternally delivered interventions, have been shown to have positive outcomes for mother and baby, but in debates around the quality of care for newborns the voices of mothers, particularly in low and middle-income countries, are rarely heard. Using an ethnographic approach, this study critically examines the roles and experiences of mothers of hospitalized sick newborns in two newborn units in Nairobi, Kenya. Data collection involved non-participant observations, discharge in-depth interviews and narrative interviews with mothers 2-6 weeks post-discharge. Data were collected over 3 years and analysed iteratively using a grounded approach. The study revealed striking differences in the structural, cultural and socio-economic context of the two newborn units and their clientele. In both hospitals, the mothers played a role in providing care for their babies but with marked differences in the timing of onset, preparation and supervision of these roles. Despite these differences, the mothers narrated similar experiences of shock, fear and confusion in coping with their sick newborn, exacerbated by inadequate communication and information sharing between staff and mothers and a lack of psychosocial support. The inequities in care observed in the Nairobi newborn units are barely visible in the mothers’ own stories, instead they narrate a shared experience of their encounters with a biomedical model of care delivery. Advocacy for structural changes to reduce inequities in neonatal care are necessary. However, focusing on technological improvements risks further embedding a biomedical paradigm that ignores the needs of mothers

System for audio capture and classification of baby cry samples

We explore multiclass classification of infants' cries and the relation between the age of the infant and the accuracy of classification. Additionally we explore secure cloud storage and cloud data processing. We compare several state-of-the-art multiclass classification models with recurrent neural networks. Classification accuracy was obtained on data from infants of various ages. For data storage and processing we used the Django Rest API and the opensource cloud platform OpenStack. Multiclass classification models successfully differentiated between different classes of crying, but no age effect has been found. We have demonstrated the aptness of the Django Rest API and OpenStack platform for data storing and processing in the cloud

Prospective study to explore changes in quality of care and perinatal outcomes after implementation of perinatal death audit in Uganda

Objective To assess the effects of perinatal death (PND) audit on perinatal outcomes in a tertiary hospital in Kampala. Design Interrupted time series (ITS) analysis. Setting Nsambya Hospital, Uganda. Participants Live births and stillbirths. Interventions PND audit. Primary and secondary outcome measures Primary outcomes: perinatal mortality rate, stillbirth rate, early neonatal mortality rate. Secondary outcomes: case fatality rates (CFR) for asphyxia, complications of prematurity and neonatal sepsis. Results 526 PNDs were audited: 142 (27.0%) fresh stillbirths, 125 (23.8%) macerated stillbirths and 259 (49.2%) early neonatal deaths. The ITS analysis showed a decrease in perinatal death (PND) rates without the introduction of PND audits (incidence risk ratio (IRR) (95% CI) for time=0.94, p<0.001), but an increase in PND (IRR (95% CI)=1.17 (1.0 to –1.34), p=0.0021) following the intervention. However, when overdispersion was included in the model, there were no statistically significant differences in PND with or without the intervention (p=0.06 and p=0.44, respectively). Stillbirth rates exhibited a similar pattern. By contrast, early neonatal death rates showed an overall upward trend without the intervention (IRR (95% CI)=1.09 (1.01 to 1.17), p=0.01), but a decrease following the introduction of the PND audits (IRR (95% CI)=0.35 (0.22 to 0.56), p<0.001), when overdispersion was included. The CFR for prematurity showed a downward trend over time (IRR (95% CI)=0.94 (0.88 to 0.99), p=0.04) but not for the intervention. With regards CFRs for intrapartum-related hypoxia or infection, no statistically significant effect was detected for either time or the intervention. Conclusion The introduction of PND audit showed no statistically significant effect on perinatal mortality or stillbirth rate, but a significant decrease in early neonatal mortality rate. No effect was detected on CFRs for prematurity, intrapartum-related hypoxia or infections. These findings should encourage more research to assess the effectiveness of PND reviews on perinatal deaths in general, but also on stillbirths and neonatal deaths in particular, in low-resource settings

Mother-Infant Relationships in the NICU: A Multiple Case Study Approach

Parent-child relationships consist of both external and internal components. The external component is the behavioral interaction between mother and child, while the internal components are expectations each member of the dyad has for the both the relationship and of the other partner. These expectations are called internal working models (IWMs) and are blueprints that have been developed from an individual’s childhood experience of sensitive or insensitive parenting. A mother’s IWMs influence how she perceives her child, her relationship with her child and herself as a mother, the sensitivity of her caregiving, and ultimately her child’s IWM of him or her self. Premature birth presents several challenges to the parent-child relationship and clearly impacts the external relationship features. Labor and delivery are often traumatic and are followed by abrupt separation of the dyad. The baby is taken into an environment that imposes physical separation, and is physiologically unable to participate in typical parent-child interactions. Until now there have been no studies that investigate the internal and external components of the relationship while in the NICU. Cross-case findings from the study included three themes: (1) mothers experienced trauma; (2) the act of caregiving built the relationship; and (3) protocol-based caregiving at Midwest NICU interfered with the mother-infant relationship. While the research questions yielded the following findings: (1) a larger percentage of distorted internal working models was found in the present study than in previous studies that used the WMCI with preterm samples (Borghini, 2006; Korja, 2009; Meijsen, 2011; Tooten, 2014); (2) the quality of the behavioral interaction between mothers and their preterm infants during feeding was intrusive, regardless of the WMCI rating; (3) meeting the infant’s attachment needs (e.g. successfully providing comfort during distress) in the NICU is what contributed to the participant’s understanding of themselves as “good enough.

Epidemiology of perinatal mortality in rural Burkina Faso: A community-based prospective cohort study

Background: Perinatal mortality is one of the major public health problems in Sub-Saharan Africa. It is estimated that over 6 millions infant deaths occur each year during the perinatal period either as stillbirths or early neonatal deaths. However, the accurate estimates on this burden are rare, especially in Africa where over 40% of all perinatal deaths take place. The lack of reliable data on PNMR in developing countries could be one of the reasons that make it invisible and therefore getting little attention from the funding agencies. We took the opportunity of the PROMISE-EBF trial, a randomized community-based study that aimed at assessing the effect of the promotion of exclusive breastfeeding by peer-counsellors on EBF rates and child morbidity at 12 weeks of age, to describe the magnitude of PNMR in Banfora health district, a rural area, South of Burkina Faso. Study objectives: To measure the PNMR in the EBF cohort in Banfora health district To identify potential risk factors for perinatal death in this cohort. Methods: We performed a secondary analysis on the datasets of the EBF study which was a cluster-randomized trial in 24 villages of Banfora with an intervention package consisting of one antenatal and 6 postnatal individual counselling sessions on EBF. Data of the two arms were considered as those of a single cohort and the PNMR, the stillbirth and the early neonatal mortality rates were estimated. In a multivariable logistic regression using baseline characteristics of the study participants as exposures and the perinatal death as outcome, we calculated crude and adjusted OR for perinatal death, stillbirth and early neonatal death. Covariates with an OR statistically significant (p<0.05) were considered as risk factors for PNMR. Results: 900 pregnant women were sampled for data collection in the EBF trial. Five women were excluded later (wrong inclusions) and 20 women got multiple births (20 pairs of twins), and were excluded from further follow-up. 875 women with a single birth were followed up to day 7 postpartum and included in the final analysis. The PNMR, the stillbirth and the early neonatal mortality rates, were 73.1‰ [95% CI: 55.8-90.4], 56‰ [95% CI:40.7-71.2], and 18.1‰ [95% CI:9-27.2], respectively. In the crude analysis, the young age of the mother (<20 years), the parity (nulliparous women), the season of birth (dry season), and the intervention appeared as the main risk factors for PNMR. In a multivariable logistic regression adjusting for all variables that were found to be important in the occurrence of perinatal deaths, we found that the young age of the mother (OR=2.93 95% CI:1.54-5.57), a birth during the dry season (OR=1.85 95% CI: 1.19-2.87), and the intervention (OR=2.16 95% CI:1.20-3.89) were factors that increased significantly the risk of perinatal death. The intention of the mother to not EBF the future baby had a marginal effect on PNMR (OR=1.55 95% CI:0.97-2.49) but a statistically significant effect on the risk of stillbirth (OR=1.90 95% CI:1.04-3.47). Conclusion: Our study showed the burden of perinatal deaths in a rural area in Burkina with the highest PNMR ever reported in this country. The risk factors identified in this study have been reported in previous studies except the intention of the mother to EBF that need further investigations.Master of philosophy in international healthMAMD-INTHINTH39