Strengthening the integration of midwifery in health systems; a leader-to-leader collaboration

Barriers and facilitators for quality midwifery care exist on different levels in the health systems. After decades of challenges and varied degrees of success, a stakeholder leader-to-leader collaboration could provide added value through knowledge sharing on how to integrate the midwifery cadre into an existing health system. Initiated by The Midwifery Society of Nepal, Dalarna University Sweden and MAMTA - Health Institute for Mother and Child India, a research network focusing midwifery has been formed. The background, purpose and activities of this network has been described in this News and Events paper

Pregnancy related anxiety and general anxious or depressed mood and the choice for birth setting:A secondary data-analysis of the DELIVER study

BACKGROUND: In several developed countries women with a low risk of complications during pregnancy and childbirth can make choices regarding place of birth. In the Netherlands, these women receive midwife-led care and can choose between a home or hospital birth. The declining rate of midwife-led home births alongside the recent debate on safety of home births in the Netherlands, however, suggest an association of choice of birth place with psychological factors related to safety and risk perception. In this study associations of pregnancy related anxiety and general anxious or depressed mood with (changes in) planned place of birth were explored in low risk women in midwife-led care until the start of labour. METHODS: Data (n = 2854 low risk women in midwife-led care at the onset of labour) were selected from the prospective multicenter DELIVER study. Women completed the Pregnancy Related Anxiety Questionnaire-Revised (PRAQ-R) to assess pregnancy related anxiety and the EuroQol-6D (EQ-6D) for an anxious and/or depressed mood. RESULTS: A high PRAQ-R score was associated with planned hospital birth in nulliparous (aOR 1.92; 95% CI 1.32–2.81) and parous women (aOR 2.08; 95% CI 1.55–2.80). An anxious or depressed mood was associated with planned hospital birth (aOR 1.58; 95% CI 1.20–2.08) and with being undecided (aOR 1.99; 95% CI 1.23–2.99) in parous women only. The majority of women did not change their planned place of birth. Changing from an initially planned home birth to a hospital birth later in pregnancy was, however, associated with becoming anxious or depressed after 35 weeks gestation in nulliparous women (aOR 4.17; 95% CI 1.35–12.89) and with pregnancy related anxiety at 20 weeks gestation in parous women (aOR 3.91; 95% CI 1.32–11.61). CONCLUSION: Low risk women who planned hospital birth (or who were undecided) more often reported pregnancy related anxiety or an anxious or depressed mood. Women who changed from home to hospital birth during pregnancy more often reported pregnancy related anxiety or an anxious or depressed mood in late pregnancy. Anxiety should be adequately addressed in the process of informed decision-making regarding planned place of birth in low risk women

Cantor Digitalis: chironomic parametric synthesis of singing

Cantor Digitalis is a performative singing synthesizer that is composed of two main parts: a chironomic control interface and a parametric voice synthesizer. The control interface is based on a pen/touch graphic tablet equipped with a template representing vocalic and melodic spaces. Hand and pen positions, pen pressure, and a graphical user interface are assigned to specific vocal controls. This interface allows for real-time accurate control over high-level singing synthesis parameters. The sound generation system is based on a parametric synthesizer that features a spectral voice source model, a vocal tract model consisting of parallel filters for vocalic formants and cascaded with anti-resonance for the spectral effect of hypo-pharynx cavities, and rules for parameter settings and source/filter dependencies between fundamental frequency, vocal effort, and formants. Because Cantor Digitalis is a parametric system, every aspect of voice quality can be controlled (e.g., vocal tract size, aperiodicities in the voice source, vowels, and so forth). It offers several presets for different voice types. Cantor Digitalis has been played on stage in several public concerts, and it has also been proven to be useful as a tool for voice pedagogy. The aim of this article is to provide a comprehensive technical overview of Cantor Digitalis

Dept. for Speech, Music and Hearing Quarterly Progress and Status Report Intonation analysis of a multi-channel choir recording Intonation analysis of a multi-channel choir recording

Abstrac

Data for: Effects of the lung volume on the electroglottographic waveform in some trained female singers

Supplementary figure files A-D for the article Ternström S, D'Amario S, Selamtzis A. Effects of the lung volume on the electroglottographic waveform in some trained female singers. Submitted to Journal of Voice

Perception and acoustic measurement of good voice quality for radio

Speech-Language Pathology Session IB: abstract no. SLP28Theme: Care of the Professional VoicePURPOSE: Significant differences between voices of radio performers and controls have been reported in previous literature. Despite this, listener responses to voices on radio are likely to vary as voices need to suit the station/product. This paper examined whether a) voices could be reliably categorised based on how good they were for radio and b) these perceptual categories could be predicted using acoustic measures. METHOD: Twenty-four male radio performers (mean age = 36 years, range = 20-52 years) and 24 agematched male controls performed the 'Rainbow Passage' as if presenting on radio. In Study 1, the voice samples were perceptually rated using a three-stage paired-comparison paradigm by 51 naive listeners. Reliability data (Cronbach’s Alpha/ICCs) were used in forming perceptual groups. In Study 2, the same voice samples were analysed for measures of: Fundamental Frequency, Long Term Average Spectrum, Cepstral Peak Prominence and pause/spoken-phrase duration. RESULTS: In Study 1, Good inter-judge reliability was found for the perceptual ratings of best 15 voices (good for radio group, 14/15=radio performers) however agreements for ratings of remaining 33 voices (unranked group) were poor. Discriminant function analyses in Study 2 showed that Standard Deviation of Sounded Portion Duration, Equivalent Sound Level and smoothed Cepstral Peak Prominence predicted membership of good for radio and unranked groups with moderate accuracy (R2=0.328). DISCUSSION: Although some voices on radio could be perceived and agreed upon as having good quality for radio, current acoustic analyses can detect only some of the acoustic signal properties of these voices. Further research on perception of good voice quality for radio and acoustic measures that sensitively reflect good voice quality is warranted