Perceived vocal morbidity in a problem asthma clinic

<p>Aims: Asthma treatment has the potential to affect patients' voices. We undertook detailed characterisation of voice morbidity in patients attending a problem asthma clinic, and we determined how patients' perceptions related to objective assessment by an experienced observer.</p> <p>Methods: Forty-three patients took part in the study. Subjects completed the self-administered voice symptom score (VoiSS) questionnaire and underwent digital voice recording. These voice recordings were scored using the grade–roughness–breathiness–asthenicity–strain system (GRBAS). Laryngoscopy was also performed.</p> <p>Results: The median VoiSS was 26 (range three to 83). VoiSS were significantly lower in the 17 patients with normal laryngeal structure and function (range four to 46; median 22), compared with the 26 patients with functional or structural laryngeal abnormality (range three to 83; median 33) (95 per cent confidence intervals for difference 0.0–21.0; p = 0.044). The overall grade score for the GRBAS scale did not differ between these two groups, and only 13 patients had a GRBAS score of one or more, recognised as indicating a voice problem. There were positive correlations between related GRBAS score and voice symptom score subscales. Although voice symptom scores were significantly more abnormal in patients with structural and functional abnormalities, this score performed only moderately well as a predictive tool (sensitivity 54 per cent; specificity 71 per cent). Nevertheless, the voice symptom score performed as well as the more labour-intensive GRBAS score (sensitivity 57 per cent; specificity 60 per cent). Patients' inhaled corticosteroid dose (median dose 1000 µg beclomethasone dipropionate or equivalent) had a statistically significant relationship with their overall grade score for the GRBAS scale (r = 0.56; p < 0.001), but not with their VoiSS. Only one patient had evidence of laryngeal candidiasis, and only two had any evidence of abnormality suggesting steroid-induced myopathy.</p> <p>Conclusions: Vocal morbidity is common in patients with asthma, and should not be immediately attributed to steroid-related candidiasis. The VoiSS merits further, prospective validation as a screening tool for ENT and/or speech and language therapy referral in patients with asthma.</p&gt

Rewritable routines in human interaction with public technology

In this paper, the cognitive ergonomics of using public technology is investigated. A methodology for predicting human error with technology has been developed. Predictions from the method (combined with observation of user performance) form the foundation of the concept of ‘rewritable routines’. This is in keeping with the tradition of building models of user cognition on the basis of observed and predicted errors. The concept is introduced and illustrated with examples. Implications for cognitive ergonomics are discussed

Multiple man-machine interfaces

The multiple man machine interfaces inherent in military pilot training, their social implications, and the issue of possible negative feedback were explored. Modern technology has produced machines which can see, hear, and touch with greater accuracy and precision than human beings. Consequently, the military pilot is more a systems manager, often doing battle against a target he never sees. It is concluded that unquantifiable human activity requires motivation that is not intrinsic in a machine

Reliability of perceptions of voice quality: evidence from a problem asthma clinic population

<p>Introduction: Methods of perceptual voice evaluation have yet to achieve satisfactory consistency; complete acceptance of a recognised clinical protocol is still some way off.</p> <p>Materials and methods: Three speech and language therapists rated the voices of 43 patients attending the problem asthma clinic of a teaching hospital, according to the grade-roughness-breathiness-asthenicity-strain (GRBAS) scale and other perceptual categories.</p> <p>Results and analysis: Use of the GRBAS scale achieved only a 64.7 per cent inter-rater reliability and a 69.6 per cent intra-rater reliability for the grade component. One rater achieved a higher degree of consistency. Improved concordance on the GRBAS scale was observed for subjects with laryngeal abnormalities. Raters failed to reach any useful level of agreement in the other categories employed, except for perceived gender.</p> <p>Discussion: These results should sound a note of caution regarding routine adoption of the GRBAS scale for characterising voice quality for clinical purposes. The importance of training and the use of perceptual anchors for reliable perceptual rating need to be further investigated.</p&gt

Comparing verbal media for alarm handling: Speech versus textual displays

The rise of computers in command and control domains has meant that control operations can be performed via desk-based visual display terminals. This trend has also produced the potential to display information to operators in a variety of formats. Of particular interest has been the use of text-based displays for alarm presentation. There are possible limitations to the use of text for alarm presentation, not least of which is the need for a dedicated alarms display screen (or, at least, a display page). Given the capability of computers to synthesize speech, it is possible that speech-based alarms could generate the same information as text-based displays without the need for dedicated screen space. In this paper an experimental comparison of speech-based and text-based displays for presentation of alarms is reported. The findings show that speech leads to longer response times than text displays, but that it has minimal effect on the efficacy of fault handling. The results are discussed within the alarm initiated activities framework and implications for alarm system design are outlined

THE POLITICAL ECONOMY OF THE URUGUAY ROUND NEGOTIATIONS: A VIEW FROM GENEVA

International Relations/Trade,

A measurement of the vibrational band strength for the upsilon sub 3 band of the HO2 radical

The HO2 radicals generated in a discharge-flow system were observed with tunable diode laser absorption in the P-branch of the nu(3) vibrationall band at 1080/cm. The observed line positions agree with those calculated from the molecular constants for the nu(3) bland obtained from a previous study using laser magnetic resonance spectroscopy. The band strength was determined by observing line center absoptions when HO2 is produced in the reaction F + H2O2 yields HO2 + HF (k1) with a measured concentration of atomic fluorine and excess hydrogen peroxide. F-atom concentrations are measured by diode laser absorption of the spin-orbit transition at 404/cm. The analysis accounts for HO2 losses due to the reactions of HO2 + HO2 yields H2O2 + O2 (k3) and F + HO2 yields HF + O2 (k4). The line strength for the 6(15) 7(16) F(1) transition is 2.9 x 10 to the 21st power sq cm/molecule/cm which corresponds to a nu(3) band strength of 34 +/- 9 sq/cm(STP atm). This value is a factor of 6 lower than previous ab initio calculations. These results will be useful in assessing the feasibility of atmospheric measurements of HO2 using infrared absorption techniques

Some determinants of path generating functions

We evaluate four families of determinants of matrices, where the entries are sums or differences of generating functions for paths consisting of up-steps, down-steps and level steps. By specialisation, these determinant evaluations have numerous corollaries. In particular, they cover numerous determinant evaluations of combinatorial numbers - most notably of Catalan, ballot, and of Motzkin numbers - that appeared previously in the literature.Comment: 35 pages, AmS-TeX; minor corrections; final version to appear in Adv. Appl. Mat