Does a Voice Disorder Exist in Individuals with Cystic Fibrosis?

Cystic Fibrosis (CF) is a genetic disease of the exocrine gland (Gardner, 2007). The disease is characterized by thick secretion in organs (Lorenco, Costa and da Silva Filho, 2014). Chronic coughing can also be seen due to the thick secretions accumulating (Gardner, 2007). The transmembrane regulator gene is responsible for encoding an epithelial chloride channel (Lorenco, Costa and da Silva Filho, 2014).Thick viscous secretions through the respiratory tract and other organs, occur because the channel does not properly transport chloride and sodium to the epithelial membranes (Lorenco, Costa and da Silva Filho, 2014). The secretion in the respiratory system leads to decrease lung function (Lorenco, Costa and da Silva Filho, 2014). Many of the characteristics that are seen in CF are factors that affect voice, for example optimal respiration is required as a power source for phonation. Vocal fold thickness and the excessive mucus that covers them as a result of the disease are known to change vibratory patterns and voice abnormalities. Chronic coughing can also contribute to voice disorders (Gibson and Vertigan, 2009). This study utilizes the Voice-Handicap Index and the Voice-Related Quality of Life, as well as Qualtrics Survey Software to understand the perception of one’s voice in those living with Cystic fibrosis

The Role Of Local Authorities In Health Issues: A Policy Document Analysis

Prior to the passing of the Health and Social Care Act 2012 the Communities and Local Government (CLG) Select Committee conducted an investigation into the proposed changes to the Public Health System in England. The Committee considered 40 written submissions and heard oral evidence from 26 expert witnesses. Their report, which included complete transcripts of both oral and written submissions, provided a rich and informed data on which to base an analysis of the proposed new public health system. This report analyses the main themes that emerged from the evidence submissions and forms part of our preliminary work for PRUComm’s PHOENIX project examining the development of the new public health system

PACE: Program of All-inclusive Care for the Elderly

Educational Objectives 1. Describe the Program of Allinclusive Care for the Elderly model of care for frail seniors with chronic health care needs. 2. Demonstrate how PACE benefits providers in the delivery of services. 3. Explain how the PACE concept complements Virginia’s Long Term Care Reform, as well as initiatives to develop further the PACE program in Virginia

Nausea and vomiting in pregnancy (NVP) is not just 'Morning Sickness' : data from a prospective cohort study

Background: Nausea and vomiting in pregnancy is usually called ‘morning sickness’. This is felt by sufferers to trivialise the condition. Symptoms have been described as occurring both before and after noon, but daily symptom patterns have not been clearly described and statistically modelled to enable the term ‘morning sickness’ to be accurately analysed. Aim: To describe the daily variation in nausea and vomiting symptoms during early pregnancy in a group of sufferers. Design and setting: A prospective cohort study of females recruited from 15 May 2014 to 17 February 2017 by Swiss Precision Diagnostics (SPD) Development Company Limited, which was researching hormone levels in early pregnancy and extended its study to include the description of pregnancy symptoms. Method: Daily symptom diaries of nausea and vomiting were kept by females who were trying to conceive. They also provided daily urine samples, which when analysed enabled the date of ovulation to be determined. Data from 256 females who conceived during the first month of the study are included in this article. Daily symptom patterns and changes in daily patterns by week of pregnancy were modelled. Functional data analysis was used to produce estimated symptom probability functions. Results: There was a peak probability of nausea in the morning, a lower but sustained probability of nausea throughout the day, and a slight peak in the evening. Vomiting had a defined peak incidence in the morning. Conclusion: Referring to nausea and vomiting in pregnancy as simply ‘morning sickness’ is inaccurate, simplistic, and therefore unhelpful

Territoriality and breeding biology of the coot (fulica atra (l)) at Attenborough

Field work was carried out from August 1972 until August 1974 on an area of 119 ha. Of the Attenborough Gravel Pits in Nottinghamshire. A total of 135 territorial pairs were monitored with reference to size of territory, length of laying season, clutch size, egg size, hatching and fledging success and relationship with other waterfowl. Territory size varied from 0.08 ha. To 1.37 ha. with a mean of 0.46 ha. It was not correlated with clutch size or bredding success. Both members of a pair defended the territory. A minimum of 19 pairs are believed to have remained on their territories for the whole of the study period. In both years the laying season lasted approximately 2.5 months: peak laying season lasted approximately 2.5 months: peak laying occurring from 24 April to 7 May. It is confirmed that Fulica atra in Europe is normally single brooded. No correlation was found between egg size and clutch size. In both years egg laid early in the breeding season were found to be significantly larger than all other eggs. The incubation period was 23/24 days. The mean clutch size of the 124 completed clutches was 6.1 ± 0. 14 eggs. In Britain as a whole the overall mean clutch size was calculated to be 6.0 ± 0.08 eggs which is significantly smaller (d = 23.006, P<0.001) than the mean clutch size (7.9 ± 0.03) of the coot in continental Europe. A hatching rate of 49.3% was recorded and of those chicks that hatched 41.0% fledged at approximately eight weeks. Breeding success averaged 20.2% with a mean of 1.3 young fledged per breeding pair. Both parents build the nest, incubate the eggs and feed and care for the young. Some young were still on territory, with their parents, at Il| weeks of age. Intraspecific aggression was noted throughout the year, but interspecific aggression, apart from that towards the moorhen, only occurred in the breeding season. It is concluded that interspecific aggression is unlikely to harm other waterfowl in the area

Electroanalgesia: Historical and Contemporary Developments

Aims and Objectives: This thesis makes an in-depth examination of the historical, including the eighteenth-century pioneering electrical treatments of the Rev John Wesley, together with contemporary developments in electroanalgesia from the late twentieth-century, including the author's own pilot study, in order to provide a sound, scientific basis for their continuing use. The problem and the hypothesis: Controversy still surrounds the effectiveness of electrical treatments, even after 250 years of application. This is seen in its most researched form as TENS (transcutaneous electrical nerve stimulation) and ALTENS (acupuncture-like transcu taneous electrical nerve stimulation) for chronic back pain. The empirical research making up the main part of the thesis sets out to provide clear evidence to reject the null hypothesis, i.e. that there are no significant clinical effects from the use of electrical treatments for chronic back pain. Methods and findings: The empirical tertiary research centred on a systematic review and meta-analysis, within the framework of the Cochrane Collaboration, of all randomised controlled trials of TENS/ ALTENS for chronic back pain found during rigorous searches of the medical literature. Pooling their results in a meta-analysis established that effective clinical benefits are to be found in the use of ALTENS/TENS for chronic back pain, at least in the short term. Conclusions and recommendations: This wide ranging PhD thesis demonstrates for the first time significant clinical benefits of TENS/ ALTENS for treating patients with chronic back pain and if implemented on a global basis, then considerable numbers of chronic back pain sufferers could benefit