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Valsalva maculopathy (VM) induced by the Valsalva maneuver may cause a sudden, painless, and dramatic loss of vision in healthy individuals due to a premacular location of the hemorrhage and rupture of retinal capillaries. The prognosis is generally good. The hemorrhage usually clears spontaneously without any treatment. Presently described are clinical findings from a case evaluated as VM resulting from a sudden, forceful shout during a quarrel. A 43-year-old female was admitted to the clinic with a 1-day history of sudden, painless loss of vision in the right eye after sudden, strong shout during an argument. There was no history of trauma or any systemic disease. On examination, the visual acuity was finger count at 1 meter in her right eye, and a central subhyaloid and subinternal limiting membrane premacular hemorrhage was noted. Her intraocular pressure values were 14 mmHg in the right eye and 13 mmHg in the left eye. Her blood pressure measurement was 130/80 mmHg. At 1 month, her vision had improved to 20/25 (LogMAR 0.10) and there was resolution of the hemorrhage without treatment. Although VM is considered to be rare, the events and activities with which it is associated are relatively common in daily life. A sudden, forceful shout and Valsalva stress can lead to dangerous, sudden vision loss due to a premacular hemorrhage.

This paper’s starting point is the famous passage from Leonardo da Vinci’s A Treatise on painting concerning the description of battle. In the text, da Vinci evokes the “sound” of violence. We wonder whether this notion, as described by da Vinci, was already part of a well-established iconographic and literary tradition. Surprisingly, the study of the battle painting genre has revealed that open mouths revealing bared teeth, so as to express a cry of desperate violence, are rare. In the past, these expressive attitudes were sometimes given to animals, and to humans only when the artist wished to express their animal nature (in depicting the enemy, for example). In this sense, the cross-study of education manuals has allowed us to better define how the social and cultural connotations of the wide-open mouth displaying dentition to demonstrate a strong connotation of human degradation. The semiotic value of this facial expression therefore perfectly illustrates da Vinci’s idea of war as “pazzia bestialissima” (bestial madness).

This research was carried out to study how shouts, shinai (bamboo kendo sword) contact, and fumikomi(step-in foot-stamping) sounds accompanying shinai strikes are perceived by collegiate-level kendo fencers both when fencing and when refereeing. As part of this study, a questionnaire survey was administered to individuals involved in collegiate-level kendo, with survey questions distinguishing between perceptions of such sounds both when fencing and when refereeing. Our survey results revealed the following findings: (1) In referee evaluations of ki-ken-tai-icchi, sounds are perceived as being equal in importance to the visual aspects of a fencer's physical movements. (2) Sounds created during the execution of a shinai strike are considered important by fencers while competing in a match. (3) Sounds created during the execution of a shinai strike are considered even more important when refereeing other fencers' matches than during one's own match. (4) Foot-stamping sounds during step-in probably influence referee scoring of shinai strikes. [ABSTRACT FROM AUTHOR]

Valsalva maculopathy (VM) induced by the Valsalva maneuver may cause a sudden, painless, and dramatic loss of vision in healthy individuals due to a premacular location of the hemorrhage and rupture of retinal capillaries. The prognosis is generally good. The hemorrhage usually clears spontaneously without any treatment. Presently described are clinical findings from a case evaluated as VM resulting from a sudden, forceful shout during a quarrel. A 43-year-old female was admitted to the clinic with a 1-day history of sudden, painless loss of vision in the right eye after sudden, strong shout during an argument. There was no history of trauma or any systemic disease. On examination, the visual acuity was finger count at 1 meter in her right eye, and a central subhyaloid and subinternal limiting membrane premacular hemorrhage was noted. Her intraocular pressure values were 14 mmHg in the right eye and 13 mmHg in the left eye. Her blood pressure measurement was 130/80 mmHg. At 1 month, her vision had improved to 20/25 (LogMAR 0.10) and there was resolution of the hemorrhage without treatment. Although VM is considered to be rare, the events and activities with which it is associated are relatively common in daily life. A sudden, forceful shout and Valsalva stress can lead to dangerous, sudden vision loss due to a premacular hemorrhage. [ABSTRACT FROM AUTHOR]

This essay argues that African American writing emerged as a consequence of slave evangelicalism’s ecstatic worship practices, the frenzied, uncontrollable, and unrehearsed behaviors that are commonly referred to as “shouting.” Persons shout when they are seized by God through the Holy Spirit, and the affective and intellectual qualities slaves acquired while shouting disposed them to take up written discourse and literary culture more broadly as viable enterprises with which to express political dissent and pursue aesthetic fulfillment. This essay establishes shouting’s conceptual formations and contextual features, then reads Richard Allen’s “Spiritual Song” (c. 1800) as well as Jupiter Hammon’s An Address to the Negroes in the State of New-York (1786/7) and “The Kind Master and the Dutiful Servant” (n.d.) as works that exemplify how shouting shaped the figural, ideological, and rhetorical dimensions of early black literary and textual productions. [ABSTRACT FROM AUTHOR]

Background People experiencing strong feelings of fatigue during exercise sometimes subconsciously yell to refocus their efforts and, thus, maintain exercise performance. The present study examined the influence of yelling during high-intensity exercise by analysing cardiorespiratory reactions and integrated electromyography (iEMG) changes in the vastus lateralis during a cycle ergometer test. Methods A total of 23 moderately trained people were recruited. The cycling test began with a resistance of 25 W/min, which was gradually increased. During the experimental trial, the participants were required to yell at least 3 times when they felt exhausted; during the controlled trial, they were not allowed to produce any yelling sounds. The testing order was randomly assigned and the 2 trials were completed within an interval between 3–10 days. Two-way repeated measures ANOVA was applied to analyse the differences within and between the trials, and interaction of trial and time. Results The peak power and time to exhaustion ( p  < 0.01) in the yelling trial were higher than those in the control trial. However, the vastus lateralis iEMG values of both trials at peak power were not significantly different. During the yelling period at 90%–100% of the maximal effort, a significant time-by-trial interaction ( p  < 0.05) was observed in oxygen consumption (VO 2 ), CO 2 production, O 2 pulse, ventilation, and respiratory rate. All the above measures showed a significant between-trial difference ( p  < 0.02). However, heart rate, respiratory exchange ratio, end-tidal oxygen pressure, and ventilatory equivalent for oxygen showed only significant between-trial difference ( p  < 0.05), but without interaction of trial and time. Conclusion Yelling enhances the peak O 2 pulse and VO 2 and maintains CO 2 -exclusion efficiency during high-intensity exercise. It may enable maintaining muscle activation without stronger EMG signals being required during high-intensity exercise. [ABSTRACT FROM AUTHOR]

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Accessible summary Verbal aggression is a common feature of life on a psychiatric ward., This study reports on how frequently patients were involved in incidents of verbal abuse, shouting, making threats, showing anger or making racist comments., Verbally aggressive patients tended to have a history of violence or drug misuse, but some patient characteristics were more strongly associated with particular types of verbal aggression., Abstract Verbally aggressive behaviour on psychiatric wards is more common than physical violence and can have distressing consequences for the staff and patients who are subjected to it. Previous research has tended to examine incidents of verbal aggression in little detail, instead combining different types of aggressive behaviour into a single measure. This study recruited 522 adult psychiatric inpatients from 84 acute wards. Data were collected from nursing and medical records for the first 2 weeks of admission. Incidents of verbal aggression were categorized and associations with patient characteristics examined. There were 1398 incidents of verbal aggression in total, reported for half the sample. Types of verbal aggression were, in order of prevalence: abusive language, shouting, threats, expressions of anger and racist comments. There were also a large number of entries in the notes which did not specify the form of verbal aggression. Staff members were the most frequent target of aggression. A history of violence and previous drug use were consistently associated with verbal aggression. However, there were also some notable differences in patient variables associated with specific types of verbal aggression. Future studies should consider using multidimensional measures of verbal aggression. [ABSTRACT FROM AUTHOR]

Two experiments were carried out to assess the ability of lay listeners to identify familiar voices from shouted samples. The experiments were conducted after a murder case in which a witness claimed to recognise the voice of a masked gunman based on two shouted words: get him! Our experiments were designed to explore the extent to which a listener can identify a known voice from a shouted sample, and also whether a two word sample is sufficient for identification. Recordings were obtained from a group of nine females who formed a close social network, plus six foils. Two shouted utterances were extracted for listening tests: for Test 1, 'get him!', and for Test 2, 'face down on the ground and hands behind your back now!' Thirteen listeners from the same social network participated in the tests. Listeners correctly identified familiar speakers in 52% of cases in Test 1 and 81% in Test 2. There was considerable variation in results across listeners, and also with respect to individual voices. The results suggest that recognition of shouted voices is far from perfect, even in closed tests carried out among a close network. The variability in performance emphasises the need to subject a witness's ability to identify a voice in a forensic case to formal testing wherever this is feasible. [ABSTRACT FROM AUTHOR]

Abstract: Because of the rise in life expectancy and in the prevalence of age-related diseases, the population in long-term care institutions is increasing. Among them are patient who shout. These put to the test the nursing staff. A quarter of the patients in long-term care institutions shout at least 4 times a week. The shouting and screaming may be intense and represent a real burden for the staff. In spite of this, shouting remains little studied while it is recognized as a disturbing phenomenom. The quiritachronometer is a detecting system, which records the duration of the shouting and restlessness of a bed-ridden patient. On one hand, a microphonical sensor is set to detect when a sound threshold is crossed and on the other hand, a passive infrared dispositive registers the movements in the bed. The artificial intelligence of the analysing software treats the data and displays the results in the shape of a circular 24-hours''diagram. The data thus collected are transmitted to the medical staff who can then adapt the treatment to the patient''s state. The quiritachronometer has been compared to the evaluation results put forward by the specialized staff of a long term-care hospital unit. Confronting results from both methods, experts have agreed and validated, unanimously, the quiritachronometer. Through the example of a medical case, we could show the praticality and medical interest of the quiritachronometer in the evaluation of the treatment and the diagnosis of the shouting in a patient with cognitive impairments and communication hindrance. [Copyright &y& Elsevier]

This study aimed at exploring vocal activity in severely demented patients with vocally disruptive behaviour as identified by nurses. Continuous tape-recordings (07.00 am-07.00 pm) of the vocal activity of 33 residents in psychogeriatric wards were analysed regarding duration, level, number, type, content and direction. The activity lasted for a mean of 338.7 minutes/patient and the longest episode of each patient had a mean duration of 103.5 minutes and turned into shouting in 17 cases. The vocal activity consisted of (1) inarticulate sounds or syllables; (2) predominance of inarticulate vocal activity; (3) articulate, words or sentences; (4) predominance of articulate vocal activity; and lastly (5) ‘dialogue vocal activity’. No significant relationships emerged when a multiple regression analysis with type as dependent and demographic data as independent variables was applied. The vocal activity was: impossible to interpret, directed to others, responsive, or non-directed utterances. The communicative function of the words used related to need for someone, incompetence, protest, need for help, in pain and despair/fear—hence, relating to an emotionally negative content, and less often to a positive emotional content. The vocal activity seemed possible to interpret as a ‘language’ stemming from strong emotion mostly of a negative nature And a ‘language’ used in monologues which could represent a self-stimulating ‘language’, thus meeting the need for activity. The results indicated that patients' emotional state must be attended to. [ABSTRACT FROM AUTHOR]

This study aimed at identifying patterns or clusters of functional impairment and behavioural disturbances in vocally disruptive patients compared with controls. Identified vocally disruptive patients (37) from psychogeriatric wards (264 patients) were included and compared with controls (37) matched fro sex and wards. Assessment of the degree of orientation and functional performance (physical and psychosocial) was made using a newly developed rating scale, Organic Brain Syndrome Scale, consisting of two subscales, a 16-item scale measuring orientation and a 39-item scale measuring functional performance and orientation in the ward, fluctuations in mental state and emotional disturbances, speech performance and psychomotor slowing, mobility, hostility, presence of delusions and hallucinations, sensitivity and euphoric state). Discriminant analysis revealed that vocally disruptive behaviour related significantly to physical dependence and disorientation in the ward, confusional reactions, delusions, hallucinations and a more preserved speech performance compared with control. Suggestions have been made that vocally disruptive behaviour develops when environmental factors such as sensory deprivation interact with the effect of the brain damage. [ABSTRACT FROM AUTHOR]