It Sounds like It Feels: Preliminary Exploration of an Aeroacoustic Diagnostic Protocol for Singers

To date, no established protocol exists for measuring functional voice changes in singers with subclinical singing-voice complaints. Hence, these may go undiagnosed until they progress into greater severity. This exploratory study sought to (1) determine which scale items in the self-perceptual Evaluation of Ability to Sing Easily (EASE) are associated with instrumental voice measures, and (2) construct as proof-of-concept an instrumental index related to singers’ perceptions of their vocal function and health status. Eighteen classical singers were acoustically recorded in a controlled environment singing an /a/ vowel using soft phonation. Aerodynamic data were collected during a softly sung /papapapapapapa/ task with the KayPENTAX Phonatory Aerodynamic System. Using multi and univariate linear regression techniques, CPPS, vibrato jitter, vibrato shimmer, and an efficiency ratio (SPL/PSub) were included in a significant model (p < 0.001) explaining 62.4% of variance in participants’ composite scores of three scale items related to vocal fatigue. The instrumental index showed a significant association (p = 0.001) with the EASE vocal fatigue subscale overall. Findings illustrate that an aeroacoustic instrumental index may be useful for monitoring functional changes in the singing voice as part of a multidimensional diagnostic approach to preventative and rehabilitative voice healthcare for professional singing-voice users

Speaking up in Healthcare: An Exploration of the Allied Health New Graduate Workforce

Introduction: All healthcare workers are responsible for patient safety and quality improvement and need to “speak up” to communicate issues. As healthcare systems strain under the impact of reduced staffing and workloads increase, allied health new graduates are feeling under pressure and unsupported. Understanding their experiences of speaking up as they transition into the workforce will identify what support they require to fulfil their patient safety and quality improvement responsibilities. Method: An exploratory study was conducted to investigate how new graduates in allied health speak up. Informed by a realist theoretical position, this study was interested in what contexts and resources support new graduates to speak up or not. Two different focus groups with allied health new graduates were used to collect data. Reflexive thematic analysis was employed to draw out key themes and sub-themes. Results: Three main themes were generated –advocacy drives speaking up, scaffolding, and transition impact. Further analysis identified context-mechanism-outcome configurations which were then developed into an initial programme theory. Conclusion: Further in-depth exploration of speaking up behaviour with allied health new graduates will inform leaders within education and workplace settings about ways to develop confident and competent professionals who can speak up for patient safety and quality improvement

Assessment of occupational noise-induced hearing loss for ACC: A practical guide for otolaryngologists

Several people have shared their expertise and support in developing this guideline. The first version was developed and published in 2011. ACC, occupational medicine specialists and otorhinolaryngologists (ORLs) collaborated to provide practical guidance on how to assess whether noised-induced hearing loss (NIHL) was caused by occupational exposure. ACC’s Audiology Advisor requested that the 2011 guideline be updated. We convened an expert advisory group and, alongside evidence-based research updated since 2011, provided expert consensus knowledge in this area. This 2018 version of the guideline is now presented to you to inform your specialist assessments of ACC ONIHL clients. The New Zealand Society of Otolaryngology, Head and Neck Surgery endorsed the guideline on 5 October 2018.The guideline includes summaries of ACC-commissioned systematic literature reviews on key aspects of ONIHL, and references to resources to assist you to provide robust, evidence- based reports. Background information on relevant legislation and specific details of the New Zealand context, including useful guidance on carrying out assessments for third parties, are also included. See Appendix A for the 2018 Otolaryngologist Report (ACC723)

Increasing Tumor Volume Is Predictive of Poor Overall and Progression-Free Survival: Secondary Analysis of the Radiation Therapy Oncology Group 93-11 Phase I-II Radiation Dose-Escalation Study In Patients With Inoperable Non-Small-Cell Lung Cancer

Purpose Patients with non–small-cell lung cancer (NSCLC) in the Radiation Therapy Oncology Group (RTOG) 93-11 trial received radiation doses of 70.9, 77.4, 83.8, or 90.3 Gy. The locoregional control and survival rates were similar among the various dose levels.We investigated the effect of the gross tumor volume (GTV) on the outcome. Methods and Materials The GTV was defined as the sum of the volumes of the primary tumor and involved lymph nodes. The tumor response, median survival time (MST), and progression-free survival (PFS) were analyzed separately for smaller (≤45 cm3) vs. larger (\u3e45 cm3) tumors. Results The distribution of the GTV was as follows: ≤45 cm3 in 79 (49%) and \u3e45 cm3 in 82 (51%) of 161 patients. The median GTV was 47.3 cm3. N0 status and female gender were associated with better tumor responses. Patients with smaller (≤45 cm3) tumors achieved a longer MST and better PFS than did patients with larger (\u3e45 cm3) tumors (29.7 vs. 13.3 months, p \u3c 0.0001; and 15.8 vs. 8.3 months, p \u3c 0.0001, respectively). Increasing the radiation dose had no effect on the MST or PFS. On multivariate analysis, only a smaller GTV was a significant prognostic factor for improved MST and PFS (hazard ratio [HR], 2.12, p = 0.0002; and HR, 2.0, p = 0.0002, respectively). The GTV as a continuous variable was also significantly associated with the MST and PFS (HR, 1.59, p \u3c 0.0001; and HR, 1.39, p \u3c 0.0001, respectively). Conclusions Radiation dose escalation up to 90.3 Gy did not result in improved MST or PFS. The tumor responses were greater in node-negative patients and women. An increasing GTV was strongly associated with decreased MST and PFS. Future radiotherapy trials patients might need to use stratification by tumor volume. Int. J. Radiation Oncology Biol. Physics, Volume 70, No. 2, pp. 385-390, 200

Contested childhoods across borders and boundaries: Insights from curriculum provisions in Northern Ireland and the Irish Free State in the 1920s

Conceptualisations and constructs of children and childhood are temporally and contextually grounded. Historical documents are rich sources of insight and understanding regarding how children were understood, valued and treated at various times by particular societies. This article explores the conceptualisation of children and childhood in the 26-county Irish Free State (South) and the 6-county Northern Ireland (North) in the 1920s following the partition of Ireland, through the lens of educational documentation, primarily national primary school curricula. The focus on both jurisdictions is interesting in the context of partition, exploring the sometimes divergent and often convergent ways in which children were conceptualised across borders and boundaries. This article reveals, using Sorin and Galloway’s framework as a conceptual and analytical tool, that conceptualisations of children were broadly similar in the North and South but differed in their focus and enactment in both fledgling states. These disparities are largely attributable to the very different political, social and religious orientations of both jurisdictions and the use of education as a vehicle for nation-building, as well as identity and gender formation. The article also explores alternative conceptualisations of children in education policy in the North and South by presenting case study ‘outliers’ of educational provision. A century since partition, conclusions and implications are noted that resonate with contemporary elements of convergence and divergence on educational policy and the conceptualisation of children across the island of Ireland

“Knowledge Is Power”: A Mixed-Methods Study Exploring Adult Audience Preferences for Engagement and Learning Formats Over 3 Years of a Health Science Festival

© 2015, © 2015 SAGE Publications. Science festivals enable scientists to engage with publics, but format design reflecting different engagement models is contested. This study gathered mixed-methods data over 3 years (2011-2013) from on-site surveys (N = 661) of a health science festival, exploring audience preferences for dissemination or dialogue formats (lectures, discussions, community expo, lab experiments, and day out). Irrespective of time, age–group, or gender, lectures were significantly ranked the main attraction (76.8%), most highly attended (89.1%), and most useful format (83.8%). Thematic analysis revealed five themes exploring nonformal learning motivations for audiences, highlighting that knowledge/understanding acquisition is perceived as empowering greater health literacy

Upper crustal evolution across the Juan de Fuca ridge flanks

Author Posting. © American Geophysical Union, 2008. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geochemistry Geophysics Geosystems 9 (2008): Q09006, doi:10.1029/2008GC002085.Recent P wave velocity compilations of the oceanic crust indicate that the velocity of the uppermost layer 2A doubles or reaches ∼4.3 km/s found in mature crust in <10 Ma after crustal formation. This velocity change is commonly attributed to precipitation of low-temperature alteration minerals within the extrusive rocks associated with ridge-flank hydrothermal circulation. Sediment blanketing, acting as a thermal insulator, has been proposed to further accelerate layer 2A evolution by enhancing mineral precipitation. We carried out 1-D traveltime modeling on common midpoint supergathers from our 2002 Juan de Fuca ridge multichannel seismic data to determine upper crustal structure at ∼3 km intervals along 300 km long transects crossing the Endeavor, Northern Symmetric, and Cleft ridge segments. Our results show a regional correlation between upper crustal velocity and crustal age. The measured velocity increase with crustal age is not uniform across the investigated ridge flanks. For the ridge flanks blanketed with a sealing sedimentary cover, the velocity increase is double that observed on the sparsely and discontinuously sedimented flanks (∼60% increase versus ∼28%) over the same crustal age range of 5–9 Ma. Extrapolation of velocity-age gradients indicates that layer 2A velocity reaches 4.3 km/s by ∼8 Ma on the sediment blanketed flanks compared to ∼16 Ma on the flanks with thin and discontinuous sediment cover. The computed thickness gradients show that layer 2A does not thin and disappear in the Juan de Fuca region with increasing crustal age or sediment blanketing but persists as a relatively low seismic velocity layer capping the deeper oceanic crust. However, layer 2A on the fully sedimented ridge-flank sections is on average thinner than on the sparsely and discontinuously sedimented flanks (330 ± 80 versus 430 ± 80 m). The change in thickness occurs over a 10–20 km distance coincident with the onset of sediment burial. Our results also suggest that propagator wakes can have atypical layer 2A thickness and velocity. Impact of propagator wakes is evident in the chemical signature of the fluids sampled by ODP drill holes along the east Endeavor transect, providing further indication that these crustal discontinuities may be sites of localized fluid flow and alteration.This research was supported by National Science Foundation grants OCE-00-02488, OCE-00-02551, and OCE-00- 02600

Consensus proposals for classification of the family hepeviridae

The family Hepeviridae consists of positive-stranded RNA viruses that infect a wide range of mammalian species, as well as chickens and trout. A subset of these viruses infects humans and can cause a self-limiting acute hepatitis that may become chronic in immunosuppressed individuals. Current published descriptions of the taxonomical divisions within the family Hepeviridae are contradictory in relation to the assignment of species and genotypes. Through analysis of existing sequence information, we propose a taxonomic scheme in which the family is divided into the genera Orthohepevirus (all mammalian and avian hepatitis E virus (HEV) isolates) and Piscihepevirus (cutthroat trout virus). Species within the genus Orthohepevirus are designated Orthohepevirus A (isolates from human, pig, wild boar, deer, mongoose, rabbit and camel), Orthohepevirus B (isolates from chicken), Orthohepevirus C (isolates from rat, greater bandicoot, Asian musk shrew, ferret and mink) and Orthohepevirus D (isolates from bat). Proposals are also made for the designation of genotypes within the human and rat HEVs. This hierarchical system is congruent with hepevirus phylogeny, and the three classification levels (genus, species and genotype) are consistent with, and reflect discontinuities in the ranges of pairwise distances between amino acid sequences. Adoption of this system would include the avoidance of host names in taxonomic identifiers and provide a logical framework for the assignment of novel variants

Choral singing therapy following stroke or Parkinsons disease: An exploration of participants experiences

© 2015 Informa UK Ltd. Purpose: People with stroke or Parkinsons disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use is of increasing interest. This article explores the experiences of and factors influencing participation in choral singing therapy (CST) by people with stroke or PD and their significant others. Method: Participants (eight people with stroke, six with PD) were recruited from a community music therapy choir running CST. Significant others (seven for stroke, two for PD) were also recruited. Supported communication methods were used as needed to undertake semi-structured interviews (total N = 23). Results: Thematic analysis indicated participants had many unmet needs associated with their condition, which motivated them to explore self-management options. CST participation was described as an enjoyable social activity, and participation was perceived as improving mood, language, breathing and voice. Conclusions: Choral singing was perceived by people with stroke and PD to help them self-manage some of the consequences of their condition, including social isolation, low mood and communication difficulties.Implications for RehabilitationChoral singing therapy (CST) is sought out by people with stroke and PD to help self-manage symptoms of their condition.Participation is perceived as an enjoyable activity which improves mood, voice and language symptoms.CST may enable access to specialist music therapy and speech language therapy protocols within community frameworks

Upper crustal structure and axial topography at intermediate spreading ridges : seismic constraints from the southern Juan de Fuca Ridge

Author Posting. © American Geophysical Union, 2005. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 110 (2005): B12104, doi:10.1029/2005JB003630.We use multichannel seismic reflection data to image the upper crustal structure of 0-620 ka crust along the southern Juan de Fuca Ridge (JdFR). The study area comprises two segments spreading at intermediate rate with an axial high morphology with narrow (Cleft) and wide (Vance) axial summit grabens (ASG). Along most of the axis of both segments we image the top of an axial magma chamber (AMC). The AMC along Cleft deepens from south to north, from 2.0 km beneath the RIDGE Cleft Observatory and hydrothermal vents near the southern end of the segment, to 2.3 km at the northern end near the site of the 1980’s eruptive event. Along the Vance segment, the AMC also deepens from south to north, from 2.4 km to 2.7 km. Seismic layer 2A, interpreted as the basaltic extrusive layer, is 250-300 m thick at the ridge axis along the Cleft segment, and 300-350 m thick along the axis of the Vance segment. However off-axis layer 2A is similar in both segments (500-600 m), indicating ~90% and ~60% off-axis thickening at the Cleft and Vance segments, respectively. Half of the thickening occurs sharply at the walls of the ASG, with the remaining thickening occurring within 3-4 km of the ASG. Along the full length of both segments, layer 2A is thinner within the ASG, compared to the ridge flanks. Previous studies argued that the ASG is a cyclic feature formed by alternating periods of magmatism and tectonic extension. Our observations agree with the evolving nature of the ASG. However, we suggest that its evolution is related to large changes in axial morphology produced by small fluctuations in magma supply. Thus the ASG, rather than being formed by excess volcanism, is a rifted flexural axial high. The changes in axial morphology affect the distribution of lava flows along the ridge flanks, as indicated by the pattern of layer 2A thickness. The fluctuations in magma supply may occur at all spreading rates, but its effects on crustal structure and axial morphology are most pronounced along intermediate spreading rate ridges.This study was supported by the National Science Foundation grants OCE-0002551 to Woods Hole Oceanographic Institution, OCE-0002488 to Lamont-Doherty Earth Observatory, and OCE-0002600 to Scripps Institution of Oceanography