Electromyographic control of prosthetic voice after total laryngectomy

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2008.Includes bibliographical references (p. 41-43).The electrolarynx (EL) is a common rehabilitative speech aid for individuals who have undergone laryngectomy, but typical devices lack pitch control and require the exclusive use of one hand. This study investigated the viability of surface electromyography (sEMG) to control the onset and offset of an EMG-controlled EL (EMG-EL) while attending to real-time sEMG biofeedback using sEMG collected from seven locations across the ventral neck and face surface in eight individuals at least 1 year past total laryngectomy.Speech performance was assessed as the percentage of fully voiced words and successfully produced pauses. During use of the EMG-EL with biofeedback participants increased the sEMG during words and decreased the sEMG during pauses. Electrodes on the superior ventral neck, submental surface, and below the comer of the mouth showed consistently high performance across all participants. These results indicate promise for the applicability of the EMG-EL across a large segment of the laryngectomy population.by Cara Elizabeth Stepp.S.M

Nurse Executives\u27 Lived Experience of Incorporating Caring Leadership

The link between compassion and caring at all levels of nursing practice and the enhancement of the patient experience is well-documented. However, the techniques nurse executives use to incorporate caring into their daily practice while coping with competing organizational priorities is poorly understood. The purpose of this qualitative phenomenological study, guided by Watson\u27s theory of human caring, was to examine detailed accounts of the experiences of nurse executives incorporating compassion and caring into their daily practice, including techniques they use to build and sustain compassion and caring while balancing competing priorities. A purposive sample of 10 nurse executives participated in the study. Audio recordings of each participant\u27s face-to-face interview were transcribed and coded using NVivo 12 software while the demographic surveys were analyzed using SurveyMonkey. The data analysis was performed using the interpretive phenomenological analysis (IPA) process. Four themes emerged from the analysis: (a) preparation for executive role, (b) execution of responsibilities, (c) demonstration of caring, and (d) balancing influences. The key findings revealed that caring permeates the nurse executive\u27s practice and nurse executives require mentorship to effectively execute their function. Based on these results, nurse executives should focus on welcoming guidance from other experienced mentors and nurse leaders. Nursing administrators, educators, and researchers can use these findings to design further research exploring the experience of nurse executives from additional settings, cultures, and ethnicities. Positive social change may result from this work by providing direction to nurse executives seeking to successfully navigate corporate culture while improving the staff work environment, quality of care, staff retention, and patient outcomes through compassion and caring

Characterization and Improvement of the Clinical Assessment of Vocal Hyperfunction

Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2009.Cataloged from PDF version of thesis.Includes bibliographical references (p. 165-180).Vocal hyperfunction refers to "conditions of abuse and/or misuse of the vocal mechanism due to excessive and/or 'imbalanced' muscular forces" (Hillman, Holmberg, Perkell, Walsh, & Vaughan, 1989), characterized by excessive laryngeal and paralaryngeal tension (Aronson, 1980; M. D. Morrison, Rammage, Belisle, Pullan, & Nichol, 1983; N. Roy, Ford, & Bless, 1996). There is no widely accepted diagnostic measure of the presence and degree of vocal hyperfunction, and currently, assessment during diagnosis is often primarily based on subjective impressions given the patient's history and presentation of symptoms such as auditory-perceptual and visual or tactile discrimination of muscle tension (e.g., laryngeal palpation). Clinical care is hindered by the lack of a "gold standard" objective measure for the assessment of vocal hyperfunction. The first study in this thesis evaluated a novel experimental design for the study of vocal hyperfunction, making use of the established clinical procedure of injection laryngoplasty. This work found that the use of injection laryngoplasty as a platform for the study of some types of vocal hyperfunction is limited, but may offer a convenient opportunity to study selected associated parameters. Particular promising objective measures were investigated in the remaining four studies: kinematics of the vocal folds, root-mean-squared (RMS) measures of surface electromyography (sEMG), and spectral characteristics of sEMG. Kinematic features of vocal fold abduction and adduction were shown to discriminate between individuals with muscle tension dysphonia and controls.(cont.) RMS measures of sEMG were investigated through correlation with current clinical neck palpation techniques in voice therapy patients and via a cross-sectional study of individuals with vocal fold nodules. Correlations between RMS neck sEMG and palpation ratings were low, and although some individuals with nodules displayed RMS neck sEMG patterns that were inconsistent with those seen in controls, overall the RMS measures were unable to discriminate between disordered and control groups. Mean coherence between two neck sEMG locations in individuals with vocal nodules was significantly lower in the 15 - 35 Hz band relative to controls, possibly agreeing with past subjective accounts of "imbalanced" muscle activity.by Cara Elizabeth Stepp.Ph.D

Manual of high risk pregnancy and delivery

viii+727hlm.;23c

The Inverse Galois Problem

(Statement of Responsibility) by Lorelei Elizabeth Stepp(Thesis) Thesis (B.A.) -- New College of Florida, 1996(Electronic Access) RESTRICTED TO NCF STUDENTS, STAFF, FACULTY, AND ON-CAMPUS USE(Bibliography) Includes bibliographical references.(Source of Description) This bibliographic record is available under the Creative Commons CC0 public domain dedication. The New College of Florida, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.(Local) Faculty Sponsor: Poimenidou, Eirin

Manual of high risk pregnancy and delivery

viii+727hlm.;23c

Manual of high risk pregnancy and delivery, 5th ed./ Gilbert

viii, 727 hal.: ill., tab.; 23 c

Manual of high risk pregnancy and delivery, 5th ed./ Gilbert

viii, 727 hal.: ill., tab.; 23 c

Manual of high risk pregnancy and delivery, 5th ed./ Gilbert

viii, 727 hal.: ill., tab.; 23 c

Manual High Risk Pregnancy & Delivery

xii, 740 p.; 24 x 18 c