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

“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

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

What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis

Background Globally, the rate of emergency hospital admissions is increasing. However, little evidence exists to inform the development of interventions to reduce unplanned Emergency Department (ED) attendances and hospital admissions. The objective of this evidence synthesis was to review the evidence for interventions, conducted during the patient’s journey through the ED or acute care setting, to manage people with an exacerbation of a medical condition to reduce unplanned emergency hospital attendance and admissions. Methods A rapid evidence synthesis, using a systematic literature search, was undertaken in the electronic data bases of MEDLINE, EMBASE, CINAHL, the Cochrane Library and Web of Science, for the years 2000–2014. Evidence included in this review was restricted to Randomised Controlled Trials (RCTs) and observational studies (with a control arm) reported in peer-reviewed journals. Studies evaluating interventions for patients with an acute exacerbation of a medical condition in the ED or acute care setting which reported at least one outcome related to ED attendance or unplanned admission were included. Results Thirty papers met our inclusion criteria: 19 intervention studies (14 RCTs) and 11 controlled observational studies. Sixteen studies were set in the ED and 14 were conducted in an acute setting. Two studies (one RCT), set in the ED were effective in reducing ED attendance and hospital admission. Both of these interventions were initiated in the ED and included a post-discharge community component. Paradoxically 3 ED initiated interventions showed an increase in ED re-attendance. Six studies (1 RCT) set in acute care settings were effective in reducing: hospital admission, ED re-attendance or re-admission (two in an observation ward, one in an ED assessment unit and three in which the intervention was conducted within 72 h of admission). Conclusions There is no clear evidence that specific interventions along the patient journey from ED arrival to 72 h after admission benefit ED re-attendance or readmission. Interventions targeted at high-risk patients, particularly the elderly, may reduce ED utilization and warrant future research. Some interventions showing effectiveness in reducing unplanned ED attendances and admissions are delivered by appropriately trained personnel in an environment that allows sufficient time to assess and manage patients

A Case study of an 11-year-old with auditory processing disorder

The article presents a case study of a child ('Sally') with multiple risk factors for auditory processing disorder (APD), including low birth weight and a history of otitis media. Sally presented for auditory processing assessment at age 7 years 9 months due to learning difficulties, despite normal intelligence. Sally had persistent mild hearing loss associated with repeated middle ear infections and hearing aids were trailed at 22 months. Mother reported increased vocalisations and improved listening with hearing aids. Three years later, hearing aids were withdrawn, as Sally's hearing thresholds had improved. Following diagnosis of APD an FM device was trailed successfully, but Sally is no longer using the device. Trial of more discrete FM devices is recommended. Despite using hearing aids as a preschooler and using an FM device for a year, Sally has continued to have auditory difficulties. An inter-disciplinary approach involving the family and other professionals such as teachers, educational psychologists, speech pathologists, and audiologists, might have ensured better outcomes for Sally.13 page(s

Management of auditory processing disorder for school-aged children : applying the ICF (International Classification of Functioning, Disability and Health) framework

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Are cortical auditory evoked potentials useful in the clinical assessment of adults with cochlear implants?

Cochlear implant (CI) trends are changing as more recipients are receiving bilateral implantation. Also more pre-lingually deafened adults are choosing to be implanted. Clinical assessment after cochlear implantation is usually based on speech perception tests. Such tests, however, may not be a realistic outcome measure for some of these cases, creating a need for more objective measures of CI performance. Cortical auditory evoked potentials (CAEPs) recorded in the sound field may be a fast and reliable procedure for the clinical audiologist to determine CI outcomes. This paper presents two case studies illustrating CAEP findings in an adult CI user who was pre-lingually deafened and a bilateral CI user.7 page(s

Behavioural and electroacoustic calibration of air-conducted click and toneburst auditory brainstem response stimuli

Although auditory brainstem response (ABR) audiometry is widely used to assess hearing sensitivity in infants and young children, normal calibration values vary across clinics. This study was undertaken to determine normal hearing thresholds for tonebursts and clicks with insert earphones. Techniques for performing electroacoustic and behavioural calibration of brief ABR stimuli are described. The average insert earphone thresholds for 25 young adults with normal hearing for 500, 1000, 2000, 4000 and 8000 Hz, 2-1-2 cycle tonebursts presented at 41 per second were: 24, 20, 23, 23 and 34 dB peak to peak equivalent (ppe) SPL (re 20 μPa), respectively. Average thresholds were about 30 dB ppeSPL for 100 μs clicks. Results were generally consistent with normative values reported in the literature.7 page(s

A Randomized control trial of interventions in school-aged children with auditory processing disorders

Objective: The primary purpose of the study was to compare intervention approaches for children with auditory processing disorder (APD): bottom-up training including activities focused on auditory perception, discrimination, and phonological awareness, and top-down training including a range of language activities. Another purpose was to determine the benefits of personal FM systems. Design: The study is a randomized control trial where participants were allocated to groups receiving one of the two interventions, with and without personal FM, or to the no intervention group. The six-week intervention included weekly one-hour sessions with a therapist in the clinic, plus 12 hours per week of parent-directed homework. Study sample: 55 children (7 to 13 years) with APD participated in the study. Intervention outcomes included reading, language, and auditory processing. Results: Positive outcomes were observed for both training approaches and personal FM systems on several measures. Pre-intervention nonverbal IQ, age, and severity of APD did not influence outcomes. Performance of control group participants did not change when retested after the intervention period. Conclusions: Both intervention approaches were beneficial and there were additional benefits with the use of personal FM. Positive results we re not limited to the areas specifically targeted by the interventions.13 page(s