INVESTIGATING THE EFFICACY OF VOCAL FUNCTION EXERCISES IN IMPROVING VOCAL FUNCTION IN ADULTS IRRADIATED FOR LARYNGEAL CANCERS: A THREE PART DISSERTATION

Deterioration in voice quality following radiation therapy for the treatment of laryngeal cancers (LC) is well documented in literature. The majority of studies show that these voice problems are long term and in some cases permanent. Deterioration in voice quality, especially over a period of time could lead to significant communication difficulties in daily life or in some cases could even result in loss of profession. Despite the negative effects of radiation therapy on voice quality being well documented, few studies have focused on the efficacy of voice therapy in the irradiated LC population. The purpose of this study was to investigate the efficacy of a well researched, evidence based voice therapy approach, known as Vocal Function Exercises (VFEs) in improving vocal function in patients who have been irradiated for LCs. The present study conducted in three systematic stages with distinct and related study aims. The first involved characterizing the head and neck cancer treatment seeking population at the University of Kentucky (UK). Stage 2 involved characterizing vocal function following irradiation for LC using a multidimensional assessment approach. Stage 3 was a phase 2 clinical trial aimed at treating these deficits in vocal function identified through stage 2 using a systematic evidence based voice therapy approach, Vocal Function Exercises. For the phase 2 clinical trial, the comparison group received vocal hygiene (VH) counseling. Observations from stage 1 showed that majority of patients from the treatment seeking population at UK between a 3 year time period from 2008 to 2010 were diagnosed with laryngeal cancers and were treated with chemoradiation therapy. Stage 2 demonstrated a multidimensional deterioration in vocal function following radiation therapy for laryngeal cancers. Stage 3 demonstrated a significant improvement in vocal function across the primary outcome measure (Voice Handicap Index) as a result of VFE+VH. Improvements were also seen in select parameters across the five domains of voice assessment in the VFE group. No significant improvements were observed in the vocal hygiene group in any parameters in each domain of voice assessment. Our study demonstrated adults irradiated for laryngeal cancers demonstrated a multi-dimensional deterioration of vocal function. These changes were long term since study participants were 2- 7 years post radiation therapy. Implementation of VFE+VH demonstrated a significant improvement in voice related quality of life and select parameters across the five domains of voice assessment. The present study demonstrated promising preliminary evidence for the use of VFE+VH to improve vocal function in patients irradiated for laryngeal cancers

Defining Roles and Responsibilities for School-Based Tele-Facilitators: Intraclass Correlation Coefficient (ICC) Ratings of Proposed Competencies

The primary purpose of this study was to craft and validate a set of core competencies necessary for a tele-facilitator to possess in the school setting.  Competencies were created through literature review and qualitative analysis. Following expert review, the competencies were revised and formatted into an online survey which was sent to respondents in four target groups: (a) school administrators who had adopted telepractice as a service delivery model; (b) speech-language pathologists (SLPs) experienced in telepractice within a school setting; (c) current tele-facilitators, and (d) scholars experienced in telepractice. Fifty-seven percent (20 out of 35) of the competencies were rated as “Essential Skills.” The remaining competencies could be more or less important depending on workplace requirements

Enhancement of Aging Rat Laryngeal Muscles with Endogenous Growth Factor Treatment

Clinical evidence suggests that laryngeal muscle dysfunction is associated with human aging. Studies in animal models have reported morphological changes consistent with denervation in laryngeal muscles with age. Life‐long laryngeal muscle activity relies on cytoskeletal integrity and nerve–muscle communication at the neuromuscular junction (NMJ). It is thought that neurotrophins enhance neuromuscular transmission by increasing neurotransmitter release. We hypothesized that treatment with neurotrophin 4 (NTF4) would modify the morphology and functional innervation of aging rat laryngeal muscles. Fifty‐six Fischer 344xBrown Norway rats (6‐ and 30‐mo age groups) were used to evaluate to determine if NTF4, given systemically (n = 32) or directly (n = 24), would improve the morphology and functional innervation of aging rat thyroarytenoid muscles. Results demonstrate the ability of rat laryngeal muscles to remodel in response to neurotrophin application. Changes were demonstrated in fiber size, glycolytic capacity, mitochondrial, tyrosine kinase receptors (Trk), NMJ content, and denervation in aging rat thyroarytenoid muscles. This study suggests that growth factors may have therapeutic potential to ameliorate aging‐related laryngeal muscle dysfunction

Developing and Testing a Smartphone Application to Enhance Adherence to Voice Therapy: A Pilot Study

The present study aimed to develop a smartphone application (app) that addressed identified barriers to success in voice therapy; accessibility, and poor adherence to home practice. The study objectives were (1) to investigate if app use enhanced adherence to the home practice of voice therapy and (2) to test app usability. Maximizing the effectiveness of voice therapy is vital as voice disorders are detrimental to personal and professional quality of life. A single-blinded randomized clinical trial was completed for the first objective. Participants included normophonic individuals randomly assigned to the app group or the traditional group. The primary outcome measure was adherence measured as the number of missed home practice tasks. The second objective was completed through usability testing and a focus group discussion. The app group (n = 12) missed approximately 50% less home practice tasks as compared to the traditional group (n = 13) and these results were statistically significant (p = 0.04). Dropout rates were comparable between the two groups. Usability results were positive for good usability with high perceived usefulness and perceived ease of use. App use resulted in improved adherence to home practice tasks. App usability results were positive, and participants provided specific areas of improvement which are achievable. Areas for improvement include app engagement and willingness to pay

Does a systematic vocal exercise program enhance the physiologic range of voice production in classical singing graduate-level students?

Purpose: The purpose of this study was to assess the effects of vocal function exercises (VFEs) on the physiologic range of the operatic voice. The primary outcome measure was total voice range profile (VRP) area. Method: Forty graduate-level opera majors were randomly assigned to experimental (training with VFE + vocal hygiene) and control (vocal hygiene only) groups. All participants underwent an acoustic voice assessment (modified VRP) pre and post 10 weeks of the assigned intervention. VRP total area was calculated and compared between and within the two groups. The total VRP area was subsequently divided into three area thirds (low, medium, and high). Results: A significant improvement (increase) was observed in the VFE group for the primary outcome measure of VRP area when pre- and postvoice conditions were compared for total area, upper third, and middle third. No significant improvement was found in the vocal hygiene-only group. Conclusion: Vocal training with VFEs over a 10-week period demonstrated positive effects on physiologic voice range as evidenced by an increase in the total VRP area and therefore may enhance the potential of those who already have professional voice training.Comisión Nacional de Investigación Científica y Tecnológica (CONICYT) FONDECYT 1118029

Abstracts of National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020

This book presents the abstracts of the papers presented to the Online National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020 (RDMPMC-2020) held on 26th and 27th August 2020 organized by the Department of Metallurgical and Materials Science in Association with the Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, India. Conference Title: National Conference on Research and Developments in Material Processing, Modelling and Characterization 2020Conference Acronym: RDMPMC-2020Conference Date: 26–27 August 2020Conference Location: Online (Virtual Mode)Conference Organizer: Department of Metallurgical and Materials Engineering, National Institute of Technology JamshedpurCo-organizer: Department of Production and Industrial Engineering, National Institute of Technology Jamshedpur, Jharkhand, IndiaConference Sponsor: TEQIP-