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Background Professional voice users are a group of people using their voice for earning of their income. One such important profession is that of the Imams of mosques who excessively recite Quran, especially during Ramadan. This excessive reciting during Ramadan puts them in a great risk for vocal problems. The Imams need an assessment and management for their voice to protect them from the expected voice disorders. Aim The aim of this study was to assess the voice of Imams before and after Ramadan and to study the effect of following the voice hygiene advices during Ramadan on their voice. Study design This was a cross-sectional study conducted to assess the voice of Imams before and after Ramadan. Patients and methods The study included 34 Imams. They were divided into two groups: the first group included 17 Imams who received voice hygiene advices before Ramadan, and the second group included 17 Imams who did not receive voice hygiene advices (the control group). All candidates were subjected to two types of assessment: examination using the VHI (the Arabic modification of voice handicapped index) and multidimensional voice program. Results The group that received voice hygiene advices showed better scores of multidimensional voice program and VHI compared with the control group voice parameters, and some parameters were significantly better or toward normal in post-Ramadan compared with pre-Ramadan assessment. Conclusion and recommendation Voice hygiene advices should be given to a wide scale of Imams as a protective tool for their voices. Voice hygiene advices should be included in any program of voice therapy.

Drought-related disasters are among the natural disasters that are able to cause large economic and social losses. In recent years, droughts have affected different regions of Brazil, impacting water, food, and energy security. In this study, we used the Integrated Drought Index (IDI), which combines a meteorological-based drought index and remote sensing-based index, to assess the drought events from 2011 to 2019 over Brazil. During this period, drought events were observed throughout the country, being most severe and widespread between the years 2011 and 2017. In most of the country, the 2014/15 hydrological year stands out due to the higher occurrence of severe and moderate droughts. However, drought intensity and observed impacts were different for each region, which is shown by the different case studies, assessing different types of impacts caused by drought in Brazil. Thus, it is fundamental to evaluate the impacts of droughts in a continental country such as Brazil, where a variety of vegetation, soil, land use, and especially different climate regimes predominate.

Turzyński Dominik, Sulikowski Piotr. Comparison of teachers’ and vocalists’ awareness of voice functioning, voice emission therapy and physiotherapy. Journal of Education, Health and Sport. 2019;9(9):372-377. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3402556 http://ojs.ukw.edu.pl/index.php/johs/article/view/7412 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2019; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 25.08.2019. Revised: 30.08.2019. Accepted: 09.09.2019. Comparison of teachers’ and vocalists’ awareness of voice functioning, voice emission therapy and physiotherapy Dominik Turzyński1, Piotr Sulikowski2 1 Faculty of Health Sciences, Pomeranian Medical University in Szczecin 2 Faculty of Computer Science and Information Technology, West Pomeranian University of Technology in Szczecin Corresponding author: Dominik Turzyński, e-mail: turzynski.d@edu.pum.edu.pl Abstract Introduction Voice seems to us inalienable, although the lack of proper voice hygiene can result in that we may be excluded from professional activity for a long time or even completely. Therefore, it was decided to check voice functioning awareness of people who professionally speak or sing. Material and methods The research was based on a survey on a sample of 135 people from the target group. The form consisted of 28 items, including detailed questions about the type and degree of occupational exposure to voice effort, as well as the level of physical activity, occurrence of possible disorders, addiction to stimulants such as cigarettes or alcohol, and questions regarding participation in classes of correct voice emission, awareness of the existence of physiotherapeutic assistance in the field of voice rehabilitation and many others. Results The results presented and discussed in detail include the analysis of answers to questions posed in the survey, as well as the results of the Voice Handicap Index test in the group of teachers and vocalists. Conclusions Significant differences in awareness of voice functioning between teachers and vocalists were noticed. It can be stated that among teachers the deteriorating voice correlates with the increase in age. On the other hand, among vocalists, the level of perceived voice fatigue remains relatively constant while aging. Teachers who participated in the study show significantly less awareness of the principles of proper voice emission and hygiene than vocalists, as demonstrated by the Voice Handicap Index. Key words: voice, disorder, VHI, voice emission, teachers, vocalists, physiotherapy, rehabilitation

For Sri Lanka, as an agricultural country, a methodical drought monitoring mechanism, including spatial and temporal variations, may significantly contribute to its agricultural sustainability. Investigating long-term meteorological and agricultural drought occurrences in Sri Lanka and assessing drought hazard at the district level are the main objectives of the study. Standardized Precipitation Index (SPI), Rainfall Anomaly Index (RAI), and Vegetation Health Index (VHI) were used as drought indicators to investigate the spatial and temporal distribution of agriculture and meteorological droughts. Climate Hazards Group Infrared Precipitation with Stations (CHIRPS) data from 1989 to 2019 was used to calculate SPI and RAI. MOD13A1 and MOD11A2 data from Moderate Resolution Imaging Spectroradiometer (MODIS) from 2001 to 2019, were used to generate the Vegetation Condition Index (VCI) and Temperature Condition Index (TCI). Agricultural drought monitoring was done using VHI and generated using the spatial integration of VCI and TCI. Thus, various spatial data analysis techniques were extensively employed for vector and raster data integration and analysis. A methodology has been developed for the drought declaration of the country using the VHI-derived drought area percentage. Accordingly, for a particular year, if the country-wide annual extreme and severe drought area percentage based on VHI drought classes is ≥30%, it can be declared as a drought year. Moreover, administrative districts of Sri Lanka were classified into four hazard classes, No drought, Low drought, Moderate drought, and High drought, using the natural-beak classification scheme for both agricultural and meteorological droughts. The findings of this study can be used effectively by the relevant decision-makers for drought risk management (DRM), resilience, sustainable agriculture, and policymaking.

خشکسالی پدیده ای است طبیعی که تقریباً در تمامی اقالیم جهان رخ می‌دهد. اثرات این پدیده خزنده و آرام در مناطق خشک و نیمه خشک به دلیل بارندگی سالانه کمتر شان، بیشتر است. در تحقیق حاضر برای پایش مکانی خشکسالی، از سری‌های زمانی NDVIو LSTسنجنده MODISماهواره Terraدر ماه‌های فصول رشد (فروردین تا شهریور) سال‌های 1379 الی 1393 در استان مرکزی استفاده شد. برای این منظور، شاخص VCIو TCIبترتیب بر اساس سری‌های زمانی 15 ساله NDVIو LSTبه صورت ماهانه ایجاد گردید و در ادامه شاخص VHIبر اساس ترکیب دو شاخص مذکور استخراج شد. درنتیجه نقشه‌های درجات شدت خشکسالی بر اساس شاخص VHIدر پنج طبقه:1- خیلی شدید 2- شدید 3- متوسط 4- ملایم 5- بدون خشکسالی، استخراج گردیده و تغییرات این طبقات در سری‌های زمانی VHIمورد بررسی قرار گرفت. بررسی سری‌های زمانی حاصل از VCIو TCIنشان داد که ارتباط معنی داری میان تغییرات NDVIو LSTوجود دارد. مطابق نتایج نقشه‌های طبقه بندی شدت خشکسالی، شاخص VHI، سال 1379 و 1380 دارای بیشترین شدت و سال‌های 1383 و 1386 دارای کمترین شدت خشکسالی بوده اند. همچنین ماه اردیبهشت دارای بیشترین شدت خشکسالی و شهریور دارای کمترین شدت خشکسالی بوده است. بیشترین درصد مساحت طبقات خشکسالی بترتیب مربوط به طبقه بدون خشکسالی (56%)، ملایم (19%)، متوسط (%15)، شدید (8%) و خیلی شدید (2%) بوده است. مقایسه نتایج حاصل از این تحقیق و گزارش سازمان هواشناسی، دقت بسیار خوب روش استفاده از شاخص سنجش از دوری VHI درپایش خشکسالی کشاورزی را نشان می‌دهد. نتیجه آنکه شاخص‌های سنجش از دوری پایش خشکسالی (مانند VHI) می‌توانند با برطرف کردن نقاط ضعف روش‌های نقطه‌ای، در پایش خشکسالی کشاورزی به تصمیم سازان و برنامه ریزان کمک شایانی نمایند.

Agricultural drought monitoring is paramount in order to maintain food security in Indonesia, particularly in Subang and Karawang as the national rice production centers. In this paper, satellite-borne remote sensing data are tested for monitoring drought extent in about 184.486 ha of both regencies. Vegetation Health Index (VHI), a vegetative drought indices based on remote sensing data, is studied in this case using long term sequence of 2000, 2005, 2010, and 2015 dry season Landsat data. VHI collates overall vegetation health, which in turn suitable to indicate agricultural drought extent. It measures either moisture vegetation/vegetation condition (VCI) or thermal condition of vegetation (TCI). Both indices were derived from Normalized Difference Vegetation Index (NDVI) and land surface temperature (LST) data respectively. The results revealed that VHI decreased more than 50 percent, from 30.86 in 2000 to 14.66 in 2015. This figure indicated drought extent intensified in research area, from mild drought to severe drought. The severity was mainly triggered by the rising LST from 27°C in 2000 to 40°C in 2015. In addition, there was a decreasing tendency of NDVI values in recent years, leading agricultural fields more susceptible to drought.

OBJECTIVE: The aim of this multicentric cross-sectional study was to examine the permanency of Montgomery thyroplasty (MTIS) results from a patient's perspective. DESIGN: The study consisted of collecting Voice Handicap Index (VHI-30) questionnaires from patients who had previously been operated with MTIS between 2 and 12 years before. Very long-term (>2 years) postoperative data were compared with the previously acquired preoperative and early postoperative VHI results. Influence of factors such as age, gender, size/side of the prosthesis and length of the follow-up were also analysed. SETTING: Multicentric study involving three tertiary European voice centres. PARTICIPANTS: Forty-nine unilateral vocal fold paralysis (UVFP) patients, treated by MTIS, were included in the study. MAIN OUTCOME MEASURES: The Voice Handicap Index-30 score. RESULTS & CONCLUSIONS: The median VHI was significantly different over time-points (Friedman's test P < .001), with a significant difference between preoperative and early postoperative time-points (median VHI: 70 vs 21, respectively; P < .001) and between preoperative and very long-term postoperative time-points (median VHI: 70 vs 16, respectively; P < .001). The median VHI did not differ for the early and very long-term postoperative time-points (median VHI: 21 vs 16; P = .470). Age differences, gender differences and size/side differences of the prostheses, centres where surgery took place and length of the follow-up showed no significant influence. Medialisation thyroplasty (MT) overall and MTIS, in particular, should be considered as a possible standard of care for UVFP when permanency of voice results is sought.

OBJECTIVE: The aim of this thesis is to study the link between perceived vocal handicap and perceptual and instrumental evaluations in patients with bilateral paralysis in vocal cord closure. METHOD: The speech evaluations of 36 patients are analyzed before and 12 months after laryngeal reinnervation. Correlation levels are measured between the VHI-10, a voice self-assessment analogue scale, the GRBASI scale and acoustic and aerodynamic measurements. RESULTS: In pre- and post-operative, the VHI-10 is correlated to voice self-assessment, GRBASI scale and maximum intensity. VHI-10 and TMP are also preoperatively linked. Correlation levels between the VHI-10 and GRBASI indices vary between pre- (G, B, A and I) and post-operative (G, I, S, A and R) assessments. CONCLUSION: The vocal handicap felt and the pneumophonic alteration are linked in bilateral laryngeal paralysis in closure. As breathing improves, the VHI-10 decreases and further translates the vocal gesture. The restoration of respiratory function must therefore be at the centre of treatment for laryngeal paralysis during closure. VHI-10 should also be interpreted with caution as it is partly related to respiratory disability when dyspnea is present; OBJECTIF : L’objectif de ce mémoire est d’étudier le lien entre le handicap vocal ressenti et les évaluations perceptives et instrumentales chez des patients présentant une paralysie bilatérale en fermeture des cordes vocales. MÉTHODE : Les bilans vocaux de 36 patients sont analysés avant et 12 mois après la réinnervation laryngée. Les niveaux de corrélation sont mesurés entre le VHI-10, une échelle analogique d’auto-évaluation vocale, l’échelle GRBASI et les mesures acoustiques et aérodynamiques. RÉSULTATS : En pré- et post-opératoire, le VHI-10 est corrélé à l’auto-évaluation de la voix, à l’échelle GRBASI et à l’intensité maximale. Le VHI-10 et le TMP sont également liés en préopératoire. Les niveaux de corrélation entre le VHI-10 et les indices de l’échelle GRBASI varient entre les évaluations pré- (G, B, A et I) et post-opératoire (G, I, S, A et R). CONCLUSION : Le handicap vocal ressenti et l’altération pneumo-phonique sont liés dans les paralysies laryngées bilatérales en fermeture. Lorsque la respiration s’améliore, le VHI-10 diminue et traduit davantage le geste vocal. La restauration de la fonction respiratoire doit donc être au centre des traitements des paralysies laryngées en fermeture. Le VHI-10 doit par ailleurs être interprété avec prudence car il est en partie lié au handicap respiratoire lorsqu’une dyspnée est présente.

Cilj ovog diplomskog rada je bio opisati utjecaj alergija na glas kroz objektivne i subjektivne mjere procjene te usporedba kvalitete glasa osoba oboljelih od inhalacijskih alergija s onima koji ne pate od alergija. Ispitanice su bile sve ženskog spola (n=30), kao i kontrolna skupina (n=30). Ispitivanje se provodilo tijekom sezone alergija. Procjena se sastojala od Indeksa vokalnih teškoća (VHI), snimanja fonacije glasa /a/, snimanja čitanja istog teksta svih ispitanica te mjerenja vremena proizvodnje glasova /s/ i /z/. Subjektivnu procjenu je činila perceptivna procjena kvalitete glasa provedena od strane iskusne logopedice te bodovanje Indeksa vokalnih teškoća. Objektivnu procjenu činila je akustička obrada i analiza fonacije glasa /a/ pomoću programa PRAAT. Promatrane su sljedeće varijable: jitter, shimmer, omjer šumnog i harmoničnog dijela spektra (HNR), maksimalno vrijeme fonacije, omjer glasova /s/ i /z/, rezultati svih triju podskala Indeksa vokalnih teškoća te njegov ukupan rezultat. Statističkom obradom dobivena je razlika između ispitanica i kontrolne skupine na svim trima podskalama VHI-ja: funkcionalnoj, fizičkoj i emocionalnoj kao i na ukupnom rezultatu. Također je dokazano da se omjer šumnog i harmoničnog dijela spektra statistički značajno razlikuje između skupine bez i skupina s alergijama. Dobivena je statistička povezanost između godina trajanja alergije i rezultata na VHI-ju te HNR-a i to na način da što veći broj godina osoba pati od alergija njen glas postaje šumniji, a rezultat na Indeksu vokalnih teškoća viši. Dobiveni rezultati djelomično se slažu s prethodno provedenim istraživanjima ove problematike te upućuju na važnost informiranja javnosti kao i struke o alergijama i njihovom mogućem nepoželjnom utjecaju na glas., The aim of this research paper was to describe effect of allergies on voice using objective as well as subjective measures and to compare voice quality of persons with no allergies to persons with inhalant allergies. All participants were female (n=30), as well as the control group (n=30). Evaluation was performed during allergy season, which comprised The Voice Handicap Index, acoustic and phonation analyses of the sound /a/ using the PRAAT programme, text reading and measurement of the ability to sustain sounds /s/ and /z/. Subjective analysis included perceptual evaluation of voice that was done by experienced SLP and the Voice Handicap Index. The observed variables consisted of: jitter, shimmer, harmonics to noise ratio (HNR), maximum phonation time, s/z ratio, results of all three subscales and total result of the VHI. A statistical analyses showed statistically significant difference between two groups on all VHI variables. The results also showed statistically significant difference on harmonics to noise ratio. A statistical analysis also showed correlation between number of years of duration of allergy and the observed acoustic variable HNR and results of the Voice Handicap Index, which means that the more years person suffers from allergies, her voice loses more quality. The ensuing results speak partly in favor of existing research. This research emphasises importance of informing public as well as the profession on allergies and their possible negative effect on voice.

OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

Voice disorders can have major impact on quality of life. Problems caused by these disorders can be experienced in different domains. The Voice Handicap Index (VHI) is a well-known voice-related quality of life instrument to measure physical, emotional and functional complaints. VHI change after treatment in seven separate benign laryngeal disorders was studied. In addition, correlation between the three domains was examined. VHI forms were completed before and 3 months after treatment. In a 5-year-period, 143 patients with seven specific diagnoses were retrospectively included. VHI improved for six diagnoses polyp (p

Cilj ovoga diplomskog istraživačkog rada bio je ispitati kvalitetu glasa kazališnih glumaca te utvrditi povezanost samoprocjene i objektivne procjene vokalnog statusa. Ispitanici su bili akademski obrazovani glumci (n=37), a ispitivanje je provedeno na području grada Zagreba. Samoprocjena se sastojala od Indeksa vokalnih teškoća (VHI) te posebno sastavljenog Upitnika za samoprocjenu glasa kod glumaca. Objektivnu procjenu činila je akustička obrada i analiza fonacija glasa /a/ pomoću PRAAT Programa. Promatrane akustičke varijable bile su jitter, shimmer i omjer šumnog i harmoničnog dijela spektra (HNR). Statističkom obradom dobivena je statistički značajna pozitivna povezanost između ukupnog rezultata F podskale upitnika VHI i akustičke varijable HNR te statistički značajna povezanost između ukupnog rezultata Upitnika za samoprocjenu glasa kod glumaca i akustičkih varijabli JITT (negativna korelacija) i HNR (pozitivna korelacija). Također, utvrđena je statistička povezanost između upitnika VHI i Upitnika za samoprocjenu glasa kod glumaca. Dobiveni rezultati idu u korist prijašnjih istraživanja koja naglašavaju potrebu za nezavisnom interpretacijom subjektivnih i objektivnih metoda procjene glasa. Također se postavlja pitanje daljnjeg dorađivanja i metrijskog testiranja Upitnika za samoprocjenu glasa kod glumaca kao mjernog instrumenta namijenjenog isključivo populaciji elitnih vokalnih profesionalaca., The aim of this research paper is to examine the voice quality of theater actors and determine the link between self-assessment and objective vocal evaluation. A total of 37 educated actors from the city of Zagreb participating in the study were subject to self-assessment, which comprised the Voice Handicap Index (VHI) and a specialized Vocal Self-assessment Questionnaire for Actors, and to objective evaluation, which included acoustic and phonation analyses of the sound /a/ using the PRAAT Program. The observed acoustic variables consisted of jitter, shimmer and the harmonics-to-noise ratio (HNR). Phonations of the sound /a/ were recorded using a TASCAM DR-05. A statistical analysis showed a statistical positive correlation between overall score on F subscale of the VHI and the observed acoustic variable HNR and a statistical correlation between the Vocal Self-assessment Questionnaire for Actors and the observed acoustic variables of jitter (negative correlation) and HNR (positive correlation). Moreover, a statistical correlation was established between the Voice Handicap Index and the Vocal Self-assessment Questionnaire for Actors. The ensuing results speak in favor of existing research which emphasize the need for an independent interpretation of subjective and objective vocal assessment methods. Furthermore, the issue was raised about the further development and psychometric testing of the Vocal Self-assessment Questionnaire for Actors to turn it into a measuring instrument intended exclusively for this population of elite vocal professionals.

O objetivo foi identificar nas histórias de vida das mães, as estratégias desenvolvidas para conviver com o HIV e com a criança soropositivo para o HIV. Utilizou abordagem qualitativa e teve como método de coleta a História de Vida. Os sujeitos foram três mães HIV positivo no contexto de um Hospital-dia em Florianópolis-SC. A partir da análise temática de Bardin emergiram três categorias: memórias da infância; adolescência e maturidade. Os resultados enfocam estratégias desenvolvidas pelas mães para conviver com HIV, dentre estas, apoio familiar, religioso, prevenção, assim como, as estratégias das mesmas no convívio com a criança também com HIV, das quais temos, tratamento medicamentoso; revelação do diagnóstico à criança; cuidados diários, entre outros. Concluímos que tais estratégias desenvolvidas/adaptadas pelas mães no convívio com o HIV em si e na criança foram influenciadas pela sua cultura e experiências ao longo da sua história de vida. The objective of this study was to identify strategies of living with HIV in the life histories of HIV-positive mothers and children. It uses the qualitative approach and the Life History as a source of data collection. The subjects were three HIV-positive mothers within the context of a Day-Hospital in Florianópolis - SC - Brazil. Based on the Bardin's thematic analysis, three categories emerged: childhood, adolescence, and maturity memories. The results pointed out strategies developed by the mothers for living with HIV, among which were family, religious, prevention, and support. It also pointed out strategies developed for living with an HIV-positive child, such as as medical treatment, revealing the diagnosis to the child, daily care, and others. We concluded that these strategies developed/adapted by the mothers in living with HIV itself and the child were influenced by their cultures and experiences throughout their life history. El objetivo del estudio fue identificar en las historias de vida de las madres, las estrategias desarrolladas para convivir con el VIH, y con el niño seropositivo para el VIH. Se utilizó el abordaje cualitativo, y el método para la recolección de datos fue la Historia de Vida. Los sujetos fueron tres madres con VIH positivo. Los sujetos fueron tres madres con VIH positivo, en el contexto de un Hospital-Día en Florianópolis-SC. Se utilizó el análisis temático de Bardin, del cual emergieron tres categorías: memorias de la infancia, adolescencia, y madurez. Los resultados focalizan las estrategias desarrolladas por las madres para convivir con VIH: apoyo familiar, religioso, prevención, así como, las estrategias de las mismas en su convivencia con el niño con VIH: tratamiento medicamentoso; revelación del diagnóstico al niño; cuidados diarios, entre otras. Concluimos que tales estrategias desarrolladas/ adaptadas por las madres en su convivencia con el VIH, en sí mismas y en el niño, fueron influenciadas por su cultura y por sus experiencias a lo largo de su historia de vida.

Odstranjenje grkljana (larinksa) nosi doživotne posljedice koje su funkcionalnog, psihološkog i socijalnog karaktera, a jedna od najtežih je gubitak sposobnosti glasnog govora. Zbog toga rehabilitacija glasa poslije totalne laringektomije predstavlja važan aspekt funkcionalne rehabilitacije laringektomirane osobe. Dvije najčešće korištene metode usvajanja alaringealnog govora su ezofagealni i traheoazofagealni govor. Cilj rada bio je usporediti kvalitetu glasa laringektomiranih osoba koje koriste ezofagealni govor i onih koje koriste traheoezofagealni govor. Pritom se htjelo utvrditi kojim se načinom nadomjesnog govora postiže bolja kvaliteta glasa. Istraživanje je provedeno na prigodnom uzorku koji se sastojao od pacijenata na Klinici za bolesti uha, nosa i grla i kirurgiju glave i vrata KBC-a Zagreb te članova Hrvatske zajednice laringektomiranih. U istraživanju je sudjelovalo 38 ispitanika prosječne dobi 65, 16 godina (raspon od 41 do 88 godina). Za procjenu kvalitete glasa korištene su subjektivne i objektivne metode procjene glasa. Kao objektivna metoda korištena je akustička analiza glasa u koju su bili uključeni parametri: broj prekida u fonaciji, jitter, shimmer i HNR. Za subjektivnu procjenu korišten je upitnik Indeks vokalnih teškoća (VHI) te perceptivna procjena kojom se dala opća ocjena disfonije. Rezultati istraživanja su pokazali da ne postoje statistički značajne razlike između ispitanika koji koriste ezofagealni govor i onih koji koriste traheoezofagealni govor na akustičkim parametrima glasa, perceptivnim parametrima glasa i rezultatima VHI-a.

Promjene glasa mogu biti uzrokovane disfunkcijom štitnjače, ali mogu biti i posljedica oštećenja laringealnihživacatijekom tireoidektomije. Takve komplikacije tireoidektomije se javljaju u 1 od 10 pacijenata. Cilj ovog istraživanja bio je utvrditi dolazi li do promjene kvalitete glasa nakon tireoidektomije. U tu svrhu koristila su se dva oblika procjene glasa: subjektivna metoda (samoprocjena glasa koristeći Indeks vokalne teškoće/VoiceHandicapIndex-VHI) te objektivna metoda (akustička analiza glasa). Ispitivanje se provelo u dvije vremenske točke: neposredno prije tireoidektomije i dva do tri mjeseca poslije tireoidektomije. Rezultati su pokazali da je poslije tireoidektomije došlo do razlika na subjektivnoj procjeni, ali se te razlike nisu pokazale statistički značajne. Akustičkom analizom je utvrđeno da je došlo do statistički značajne razlike samo na varijabli shimmer (SHIMM).

Short, self-report symptom questionnaires are often used in clinical setting for assessing patient’s perception of voice problems or to monitor the efficacy of the treatment. Voice Handicap Index is a questionnaire developed in the USA for self- assessment of voice difficulties. Aside from American questionnaire, there are several VHI adaptations in Europe (Dutch, Flemish, British, French, German, Italian and Portuguese) compared in several previous researches. The results confirm validity of all questionnaires and are considered appropriate for cross-linguistic comparisons. Also, adaptations for pediatric use and for singers were also developed supporting the quality and practicality of VHI and indicating the necessity for validation of the questionnaire for special groups. Therefore the aim of this paper was to make Croatian adaptation of VHI and validate it for general population but in groups of vocal professionals. This research included several groups of vocal professionals with frequent voice problems: actors, anchors and journalists, teachers, coaches, and kindergarden teachers. Statistical analysis indicated high levels of reliability and validity and also sensitivity of the VHI questionnaire. Controls (general population) showed lower results than voice professionals for the entire questionnaire and on each scale (functional, physical and emotional) confirming the validity of VHI. It can be concluded that Croatian VHI is valid and reliable measure for use in Croatian clinical context and for coparison with similar research.

A disfonia espasmódica de adução é um distúrbio vocal grave, caracterizado por espasmos dos músculos laríngeos durante a fonação, produzindo voz quebrada, tensa, forçada e estrangulada. Seus sintomas decorrem da contração intermitente e involuntária dos músculos tireoaritenóideos durante a fonação, o que resulta em pregas vocais tensas, pressionadas uma contra a outra, e no aumento da resistência glótica. OBJETIVO: Apresentar os resultados preliminares do impacto na qualidade vocal da cirurgia de Neurectomia do ramo tireoaritenóideo do laríngeo inferior, via endoscópica, associada à miectomia parcial do músculo tireoaritenóideo com laser de CO2. MATERIAL E MÉTODO: A cirurgia foi realizada em 7 pacientes (6 mulheres e 1 homem), com idades variando entre 22 e 75 anos, com diagnóstico de disfonia espasmódica de adução. Os pacientes foram submetidos ao VHI (Voice Handicap Index) no pré e pós-operatório. RESULTEDOS E CONCLUSÃO: A melhora vocal foi conseguida em todos os pacientes estudados não ocorrendo deterioração da qualidade vocal ao longo do período pós-operatório. Houve uma diferença evidente no VHI antes e após a cirurgia. Essa técnica cirúrgica mostrou-se eficaz e inovadora no tratamento da disfonia espasmódica de adução.Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia the adductor spasmodic dysphonia is a severe vocal disorder characterized by muscle laryngeal spasms during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms come from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold strain, pressed one against another and increased glottic resistance. AIM: report the results in the impact in vocal quality in neurectomy of the thyroarytenoid branch of the inferior laryngeal nerve by endoscopic route associated with partial myectomy of the thyroarytenoid muscle with co2 laser. MATERIAL E METHODS: the surgery was done in 07 patients ( 06 females and 01 male), aged 22 to 75, with adductor spasmodic dysphonia. They were submitted to vhi (voice handicap index) before and after surgery. RESULTS AND CONCLUSIONS: the vocal improvement was obtained in all studied patients, deterioration in vocal quality after surgery was not noticed. There was evident difference in the vhi before and after surgery. This surgical thecnique proved to be efficient and innovative in the treatment of adductor spasmodic dysphonia.

OBJETIVOS: avaliar a qualidade de vida das pessoas vivendo com o vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida e suas associações com características clínicas e adesão ao tratamento. MÉTODO: estudo transversal, realizado em um hospital do Estado da Paraíba. Utilizou-se questionário para caracterização sociodemográfica e clínica, escala de qualidade de vida (proposta pela Organização Mundial da Saúde) e escala de adesão ao tratamento (Questionário para Avaliação da Adesão ao Tratamento Antirretroviral). RESULTADOS: dos 314 entrevistados, 190 (60,5%) eram do sexo masculino, idade média de 43 anos, 121(38,5%) contavam com até cinco anos de estudo, 108 (34,4%) recebiam até dois salários-mínimos e 112 (35,7%) estavam afastados das atividades laborais. Quanto às variáveis clínicas, identificou-se que os indivíduos com carga viral indetectável apresentaram maiores escores em todos os domínios de qualidade de vida, com diferença estatisticamente significante em três domínios. Sobre a adesão ao tratamento, 235 (73,8%) apresentaram adesão insuficiente, os que apresentaram adesão estrita obtiveram melhores escores de qualidade de vida. Os resultados mostraram que a qualidade de vida é melhor para os aderentes ao tratamento antirretroviral. Apoiar as pessoas em tratamento para melhorar a adesão aos antirretrovirais deve ser tarefa constante dos profissionais de saúde e de outras pessoas que participam do tratamento, como familiares e amigos. OBJETIVOS: evaluar la calidad de vida de las personas viviendo con VIH/Sida y sus asociaciones con características clínicas y adhesión al tratamiento. MÉTODO: estudio transversal, realizado en un hospital del estado de Paraíba. Se utilizó un cuestionario para caracterización sociodemográfica y clínica, la Escala de Calidad de Vida (propuesta por la Organización Mundial de la Salud) y la Escala de Adhesión al Tratamiento (Cuestionario para Evaluación de la Adhesión al Tratamiento Antirretroviral). RESULTADOS: de los 314 entrevistados, 190 (60,5%) eran del sexo masculino, edad promedio de 43 años, 121(38,5%) contaban con hasta cinco años de estudio, 108 (34,4%) recibían hasta dos salarios mínimos y 112 (35,7%) no realizaban actividades laborales. En cuanto a las variables clínicas, se identificó que los individuos con carga viral indetectable presentaron mayores puntajes en todos los dominios de calidad de vida, con diferencia estadísticamente significativa en tres dominios. Sobre la adhesión al tratamiento, 235 (73,8%) presentaron adhesión insuficiente, los que presentaron adhesión estricta obtuvieron mejores puntajes de calidad de vida. Los resultados mostraron que la calidad de vida es mejor para los adherentes a la TARV. Apoyar a personas en tratamiento para mejorar la adhesión a los antirretrovirales debe ser una tarea constante de los profesionales de la salud y de otras personas que participan del tratamiento, como familiares y amigos. OBJECTIVES: to assess the quality of life of people living with HIV/AIDS and verify its association with clinical characteristics and treatment adherence. METHOD: cross-sectional study conducted in a hospital in the state of Paraíba, Brazil. A questionnaire was used to collect socio-demographic and clinical data. The quality of life scale proposed by the World Health Organization and a questionnaire to measure treatment adherence were used. RESULTS: of the 314 interviewees, 190 (60.5%) were male, aged 43 years on average, 121 (38.5%) had attended up to five years of schooling, 108 (34.4%) received up to two times the minimum wage, and 112 (35.7%) were on sick leave. In regard to clinical variables, individuals with an undetectable viral load scored higher in all the domains concerning quality of life, with statistically significant differences in three domains. Regarding treatment adherence, 235 (73.8%) presented poor adherence and those who strictly adhered to treatment obtained better scores in quality of life. The results show that quality of life is better among individuals adherent to ART. Supporting people to adhere to the antiretroviral treatment should be a persistent task of healthcare workers and other people participating in the treatment, such as family members and friends.

Promjene glasa mogu biti uzrokovane disfunkcijom štitnjače, ali mogu biti i posljedica oštećenja laringealnih struktura tijekom tireoidektomije. Takve komplikacije tireoidektomije se javljaju u 1 od 10 pacijenata podvrgnutih tireoidektomiji. Cilj ovog istraživanja je utvrditi dolazi li do promjene kvalitete glasa nakon tireoidektomije. U tu svrhu koristila su se dva oblika procjene glasa: subjektivna metoda (samoprocjena glasa koristeći Indeks vokalnih teškoća-VHI) te objektivna metoda (akustička analiza glasa). Ispitivanje se provelo u dvije vremenske točke: neposredno prije tireoidektomije i dva do tri mjeseca poslije tireoidektomije. Snimke fonacije svakog ispitanika su obrađene programom Audacity i analizirane pomoću programa PRAAT. Svi podaci su obrađeni deskriptivnom statistikom i neparametrijskim statističkim metodama. Analizom rezultata došlo se do zaključka da su promjene glasa, u nešto manjoj mjeri, postojale i prije tireoidektomije. Rezultati su pokazali da je poslije tireoidektomije došlo do značajnijih razlika na subjektivnoj procjeni, ali se te razlike nisu pokazale statistički značajne. Akustičkom analizom je utvrđeno da je došlo da statistički značajne razlike samo na varijabli SHIMM, dok ostale varijable nisu pokazale statistički značajnu razliku.

Several studies in recent years have already reported good oncologic results with laser microsurgery in the treatment of early glottic carcinoma. We conducted a longitudinal voice evaluation, in patients with early glottic cancer who underwent transoral laser cordectomy, in order to assess the voice quality outcome and its relationship with objective and subjective (voice handicap index questionnaire and GIRBAS scale) means. Twenty-four previously untreated patients underwent transoral laser cordectomy for early glottic cancer. All patients underwent subjective and objective voice assessment according to the multidimensional voice protocol recommended by the European Laryngological Society including acoustic, perceptual and stroboscopic analysis combined to patient self assessment of voice (voice handicap index-VHI). These evaluations were performed before treatment and 6 months after the treatment. Vocal fold healing was complete in all cases by 6 months following surgery. Main voice parameters (subjective and objective) resulted improved at the 6-month control after surgery. In particular, voice handicap index (VHI) and GIRBAS scale resulted reliable for voice assessment and for the postoperative follow-up. In conclusion, VHI, GIRBAS, multidimensional voice program (MDVP) and spectroacoustic parameters showed a close trend in the present study, and this confirms the validity of the voice analysis performed by each tool.

The aim of this research was to determine the relations between the results of objective voice analysis, perceptive voice analysis, and the results of self-assessment of vocal problems in persons with dysphonia, in order to examine the possibility to express and grade the influence of voice disorder on its acoustic features, perceived quality and social efficiency with one general measure based on unique set of variables. Thirty eight subjects (males and females) with diagnosed dysphonia participated in the research, as well as 30 control subjects, all between 20 and 64 years of age. Self-assessment was made by using the VHI. Objective voice analysis (16 variables) included analysis of sustained phonations of the vowel /a/ with MDVP (Key Elemetrics Co.) Perceptive voice assessment (3 variables) was carried out by two clinically experienced SLPs. The results of canonical analysis revealed significant relations between three different types of voice assessment. With the goal to investigate the possibility to rang the subjects by the severity of their vocal problems (mild, moderate or severe), tacsonomic analysis was used. This included 11 of original variables (5 self- assessment variables, 5 acoustic variables, and one perceptive variable) with most prominent canonical coefficients. Tacsonomic analysis showed that the subjects could be grouped into 3 separated clusters in a meaningful manner, without regard to the diagnosis.

Parkinsonova bolest degenerativni je i progresivni poremećaj središnjega živčanog sustava koji zahvaća bazalne ganglije i uzrokuje njihovo propadanje. Bolest se najčešće javlja u starijoj životnoj dobi, a kao posljedica bolesti javlja se tremor u mirovanju, rigor, bradikineza, ukočenost, demencija i druge teškoće među kojima je i poremećaj glasa. Cilj ovog rada jest procijeniti obilježja glasa osoba oboljelih od Parkinsonove bolesti i usporediti ih s obilježjima glasa osoba bez poremećaja te izvršiti ispitivanje vokalnog hendikepa u obje skupine ispitanika. Istraživanje je provedeno na uzorku od 28 ispitanika starosti od 48 do 82 godine. 18 ispitanika bile su osobe s Parkinsonovom bolesti, a deset ispitanika su bile osobe bez poremećaja. Ispitanici su ispunjavali upitnik Indeks vokalnih teškoća (VHI), a zatim je sniman njihov glas. Snimanje glasa obuhvaćalo je snimanje fonacije glasa /a/, a akustička analiza je rađena pomoću programa Praat. Rezultati su pokazali da se osobe s Parkinsonovom bolesti statistički značajno razlikuju u samoprocjeni glasa od osoba bez M. 104 Pušić, A. Bonetti, V. Vuletić: Glas osoba s Parkinsonovom bolesti 103-116 poremećaja, a akustička analiza pokazuje statistički značajne razlike u intenzitetskim oscilacijama titranja glasnica i odnosu intenziteta harmonika i šuma (HNR).

Cilj ovog istraživanja bio je ispitati bio-psiho- socijalne aspekte poremećaja glasa dvije skupine žena vokalnih profesionalaca – nastavnica i odgojiteljica – samoprocjenom utjecaja kvalitete glasa na svakodnevne aktivnosti pomoću upitnika Index vokalnih teškoća. U istraživanju je ispitano 70 nastavnica i odgojiteljica u dobi od 22 do 59 godine (srednja dob 38, 16 god) te 20 ispitanica izjednačenih po dobi, koje nisu vokalni profesionalci. Rezultati samoprocjene glasa upitnikom Indeks vokalnih teškoća (Voice Handicap Index – VHI) pokazali su da između ispitanica koje su vokalni profesionalci i ispitanica kontrolne skupine postoji statistički značajna razlika (p