Audible Voice Research Articles

O-36 Listening the sound of neuromuscular junction during voluntary contraction

Background Sound is an indispensable component of electromyography. Although neurophysiologists are familiar with the end-plate noise and spikes, it is preferred to measure the neuromuscular transmission during voluntary contraction in time domain that is expressed in microseconds (jitter). Present study is aimed to create an audible voice of jitter and enable the physician to notice the difference between a healthy and a diseased neuromuscular transmission by hearing. Material and methods During voluntary contraction of frontalis muscle, single-fiber-like action potential pairs were recorded by using smallest concentric needle with 1 kHz high-pass filtering. Traces harboring potential pairs acquired from healthy participants and myasthenia patients were transferred. Signals were de-noised, locations of the two highest peak’s amplitude and the difference between them were determined. The average of these differences was calculated (jitter). “The sound of jitter” can be composed from the difference values of the locations of two highest peak’s amplitude. These values are duplicated in same amount proportionally up to 48,000 samples for achieving a 5 s length of sound. Then, they were sampled with 8 kHz. “The sound of jitter” was heard by using a function in “Matlab”. Results Sound of a healthy junction is soft; but in patients, it’s louder and contains more high frequency components. Conclusions Increased jitter reflects high variability of neuromuscular transmission. Converting it to an audible sound serves a different perspective. By doing so, the only irregularity that is heard would be the failure in junction transmission rather than the irregular firing of motor unit.

Contact Improvisation and Dance Narratives – Body Memory and Embodied Knowledge

This article concerns embodied knowledge closely connected to dance experience. I position my research project primarily on three autobiographic dance narratives concerning my involvement with the dance genre known as contact improvisation (CI). In making the argument that practicing CI creates experience and knowledge that become embedded in the body, I attempt to give the dancing body an “audible voice”, and apply theoretical concepts that are helpful in interpreting and elaborating my narratives. Key words: Dance-based research, autoethnography, body archive, intercorporeality, contact improvisation

Ocena dojrzałości szkolnej dzieci z wadą słuchu. Kontrowersje i wyzwania związane z diagnozą psychologiczno-pedagogiczną

The start of school education is an important and difficult phase in every child’s life. However with each one of them, we have to deal with the individual pace and specificity of development in each sphere, and even so it is difficult to recognize every child as equally mature as a pupil. Both the evaluation of child progress in the education process and the readiness for school education are made through the prism of linguistic proficiency. In the case of child’s hearing loss, especially when it is congenital or acquired at a very early stage, the development of speech and language is delayed. The determinant of this situation is the lack of access to the audible voice of the guardians. In a slightly different situation there are children with hearing impairment, having deaf parents. These people, from their earliest years, develop their sign language skills, which are primary to them. An increasing number of hearing impaired children go to integration classes in public schools. Does this mean that the psychological and pedagogical diagnosis procedure of the aforementioned group of children, including the study of their school maturity, can be considered appropriate?

Out of Time: The Experience of Speech-Generating Device Users

This article presents a phenomenological investigation into speech-generating device (SGD) use in the school context. Derived from a larger study on the experience of speaking through a SGD, this article focuses particularly on the experience of time and timing of speaking for one who must use a SGD to give audible voice to their words. Themes explored in this article include the challenge of time, the untimely rate of speech, which can be silencing, planning to talk tomorrow, and finally text time and how this time may lift the burden of time from SGD users. Implications for educators and others who support children and youth who use SGD are brought forward through reflection and discussion of this unique experience of voice and time.

Safety and feasibility of above cuff vocalisation for ventilator-dependant patients with tracheostomies

Temporary tracheostomy is commonly used in patients admitted to intensive care units. Cuffed tubes prevent laryngeal airflow, preventing vocalisation. Sub-glottic suction tubes such as the 'Blue Line Ultra Suctionaid™' are used primarily to remove sub-glottic secretions, but retrograde gas flows via the suction port can facilitate above cuff vocalisation. The aims were to assess whether patients could achieve an audible voice using above cuff vocalisation, to demonstrate the safe use of the Blue Line Ultra Suctionaid™ tracheostomy tube for above cuff vocalisation, and to assess potential benefits of above cuff vocalisation for communication, secretion management and swallowing. Our study (Reference 15/NW/0464, IRAS 178997) recruited adult intensive care unit patients who were alert, able to participate in an above cuff vocalisation trial and dependent on an inflated Blue Line Ultra Suctionaid™ cuff for ventilatory support. Consenting participants underwent fibreoptic endoscopic assessment of swallow by experienced Speech & Language Therapy staff with and without above cuff vocalisation. Clinical and fibreoptic endoscopic assessment of swallow, assessment of voice quality, swallowing and secretion management were recorded and scored. Median differences between paired observations and scores were analysed with and without above cuff vocalisation. Adverse events were identified by follow up fibreoptic endoscopic assessment of swallow and patient accounts. Ten patients completed the study. Above cuff vocalisation was used for a median of 15 min, during a median of nine episodes, over a median of three days. Above cuff vocalisation resulted in an audible voice in eight of the 10 patients, during 66 out of 91 above cuff vocalisation attempts. There improvements in unstimulated dry cough and swallow frequency and aspiration ratings measured by fibreoptic endoscopic assessment of swallow. No complications were reported or observed in 66 attempts with only one episode terminated prematurely. Above cuff vocalisation can achieve effective, safe, well-tolerated vocalisation in ventilator-dependant intensive care unit patients. Above cuff vocalisation has the potential to aid earlier, more effective communication and may improve laryngeal function and rehabilitation.

Smart Wearable Hand Device for Sign Language Interpretation System With Sensors Fusion

Gesturing is an instinctive way of communicating to present a specific meaning or intent. Therefore, research into sign language interpretation using gestures has been explored progressively during recent decades to serve as an auxiliary tool for deaf and mute people to blend into society without barriers. In this paper, a smart sign language interpretation system using a wearable hand device is proposed to meet this purpose. This wearable system utilizes five flex-sensors, two pressure sensors, and a three-axis inertial motion sensor to distinguish the characters in the American sign language alphabet. The entire system mainly consists of three modules: 1) a wearable device with a sensor module; 2) a processing module; and 3) a display unit mobile application module. Sensor data are collected and analyzed using a built-in embedded support vector machine classifier. Subsequently, the recognized alphabet is further transmitted to a mobile device through Bluetooth low energy wireless communication. An Android-based mobile application was developed with a text-to-speech function that converts the received textinto audible voice output. Experiment results indicate that a true sign language recognition accuracy rate of 65.7% can be achieved on average in the first version without pressure sensors. A second version of the proposed wearable system with the fusion of pressure sensors on the middle finger increased the recognition accuracy rate dramatically to 98.2%. The proposed wearable system outperforms the existing method, for instance, although background lights, and other factors are crucial to a vision-based processing method, they are not for the proposed system.

#ThisFlag and #ThisGown Cyber Protests in Zimbabwe: Reclaiming Political Space

ABSTRACTRecently there has been an increasing appropriation of and research on social media technologies in public protests. Thus, taking the #ThisFlag and #ThisGown movements in Zimbabwe, this article examines the role of social media as a mobilising tool in social movements and the creative appropriation of social media technologies by citizens to reclaim their political voices and spaces. I argue that social media continues to be central in mobilising protests for various online and offline activities. Further, it is also argued in this article that social media provided a discursive space for ordinary citizens’ voices to articulate their problems and to challenge the excesses of the government, which is epitomised by endemic corruption and bad governance and has caused massive unemployment and plummeted the Zimbabwean economy. In fact, social media technologies created a virtual community of dissent that actively fostered counter-hegemonic discourses, hence affording the hitherto supressed voices an audible voice against the authoritarian Mugabe government. I conclude that social media was an instrumental tool for protesters to organise, strategise and congregate regardless of their temporal and spatial locations. The article is based on qualitative data collected through in-depth interviews with 15 activists, participant observation, as well as secondary sources and Netnography.

Is it Colonial DDJJ Vu? Indigenous Peoples and Climate Injustice

Indigenous peoples are among the most audible voices in the global climate justice movement. Yet, as I will show in this chapter, climate injustice is a recent episode of a cyclical history of colonialism inflicting anthropogenic (human-caused) environmental change on Indigenous peoples (Wildcat). Indigenous peoples face climate risks largely because of how colonialism, in conjunction with capitalist economics, shapes the geographic spaces they live in and their socio-economic conditions. In the North American settler colonial context, which I focus on in this chapter, U.S. settler colonial laws, policies and programs are ‘both’ a significant factor in opening up Indigenous territories for carbon-intensive economic activities and, at the same time, a significant factor in why Indigenous peoples face heightened climate risks. Climate injustice, for Indigenous peoples, is less about the spectre of a new future and more like the experience of deja vu.

Central bank capitalism: Visible hands, audible voices

Central bankers can create money out of thin air; they can stop the misbehaviour of some of the most powerful institutions in the contemporary world – financial markets – in a matter of hours, if not minutes. In the era of central bank capitalism virtually every aspect of economic life has come under the sway of financial and monetary concerns. The author has focused on a particularly uncanny aspect of this regime: how central bankers endow the future with discernible features that we – the public – can reflect and act upon, animating or curtailing our propensity to produce, consume, borrow, and lend. Central bankers – rather than predicting the future – seek to create elements of a tractable future. They do this with words. They use language to sustain not merely the ideas that animate our economic future, but also the structures of feeling, the sentiments, and expectations that make them real. This article examines a series of communicative experiments that transformed the dynamics of contemporary capitalism, imparting its powerful capabilities to the visible hands and audible voices of a tiny group of government appointees – central bankers.

Folie à Trois: Prescribers', Pharmacists', and Patients' Shared Delusion of Medication Reconciliation.

Folie à Trois: Prescribers', Pharmacists', and Patients' Shared Delusion of Medication Reconciliation.

A Note on the Silent Canon in the Missal of Paul VI and Cardinal Ratzinger

A Note on the Silent Canon in the Missal of Paul VI and Cardinal Ratzinger Matthew S. C. Olver (bio) The use of the vernacular is usually considered the most obvious and noticeable of the liturgical reforms to appear after the Second Vatican Council in the implementation of the Constitution on the Sacred Liturgy Sacrosanctum Concilium. But just as significant and noticeable was the permission to say the Eucharistic prayer in a clear and audible voice, a permission that was soon followed by the explicit expectation that the canon be said in a voice that is audible to the faithful.1 Strangely, in spite of this clarity, the sacramentaries and missals approved for use in the United States of America contained a rubric for over forty years that appears to give official sanction to the recitation of the canon in the so-called [End Page 40] “mystic voice” that is inaudible to the faithful.2 This brief note traces this story and attempts to provide a bit of context to this extraordinary anomaly. The history of post-conciliar liturgical reforms is well known and easily accessible.3 And debate continues to rage on the propriety of the nature of the reform in the Latin rite.4 No less than the Benedict XVI, when he was still Cardinal Ratzinger, wrote regarding the Missal of Paul VI: “I regret certain deficiencies and do not consider each of the decisions made the best possible” ones. Nonetheless, he holds to the liturgical norms “with an inner conviction.”5 The debate over the content and forms of the current Missal issued under Pope Paul VI was further complexified [End Page 41] when Pope Benedict XVI issued Summorum Pontificum, the Motu Proprio that lifted any restrictions that had been in place regarding the use of the 1962 Missal.6 Before he was elevated to the papacy, Cardinal Ratzinger published his only book-length treatment on the liturgy, The Spirit of the Liturgy.7 The title consciously recalls the work of a nearly identical title in 1918 by Roman Guardini,8 a fact that Ratzinger highlights in the introduction to his volume.9 The eminent French liturgist Pierre-Marie Gy, however, argues that Ratzinger’s approach may actually be in tension with Guardini, (rather ironically) St. Pius X, and even Vatican II itself.10 Both Guardini and Pope Pius X advocated (in Gy’s words) a “spirituality integrated with liturgical life.”11 Gy goes on to suggest that one of the differences between them and Ratzinger is that the latter’s work demonstrates “an attempt to separate anew spirituality and celebration,” a serious charge indeed. Specifically, [End Page 42] Gy argues that Ratzinger’s approach to spirituality and piety is that “of his Christian childhood and of his priestly ordination” (which includes “an attachment to the priestly prayers said in a low voice” and a Mass with a silent canon). This, Gy maintains, is in tension with both “the liturgical rules currently in place” and also “the liturgical values affirmed by the Council.”12 Sacrosanctum Concilium says nothing specifically about how the canon is to be said. But in the revised rites that followed its promulgation there are at least three points that make it clear that intention is for the canon to be said in an audible voice. Most obviously, the rubrics that directly precede the Te igitur at the beginning of the canon in the missals that stem from the reforms of Trent all state clearly that the priest “dicit secreto” the text of the prayer.13 The adverb “secreto” disappears in the revised missals. Then, there are two paragraphs in both the 1970 and 2002 editions of the General Instructions that speak directly to how the canon is to be said. And when they are considered together, they appear to preclude the possibility of both the canon said inaudibly and the playing of any music during the canon. First: “Among the parts assigned to the priest, the eucharistic prayer has precedence; it is the high point of the celebration.” And second: “The presidential prayers should be spoken in a loud and clear voice so that everyone present can hear and pay attention. While the...

Improving Accessibility for Students with Visual Disabilities in the Technology-Rich Classroom

ABSTRACTAs higher education has increasingly embraced digital technologies, we have been too slow to acknowledge accessibility issues for students with visual disabilities. One of the earliest promises of information and communication technology was increased accessibility to content. In theory, digitized content should be as equally accessible as the printed word on a screen, a braille keyboard, or an audible voice on a speaker. In the majority of educational technology, this promise has gone unfulfilled, and faculty members are largely unaware of the myriad obstacles that students with visual disabilities confront while navigating the technology-rich classroom. The principles of Universal Design in Instruction (UDI) provide guidance for developing curriculum that maximizes accessibility and usability of course content for all learners, including those with disabilities. This article examines the development of political science courses through the lens of UDI.

The voiceless Acousmêtre

Paranormal Activity’s (2007) ‘found footage’ horror conceit hinges upon the efforts of yuppie Micah to use his digital video camera to capture proof of his girlfriend’s supernatural visitations. Micah concentrates on capturing visual evidence but the demon remains elusive. Only ephemeral effects of its presence are captured visually – instead, the invisible demon is embodied sonically. This article will concentrate on this sonic embodiment within the broader context of found footage horror’s cultural significance. Though Paranormal Activity mainly employs a screen-centred 2.0 stereo sound mix in keeping with its ‘home movie’ sound aesthetic, it later uses the surround channels so that the eerie, demonic sound ‘creeps’ into the full 5.1 surround sound field. Referring to Michel Chion’s and Randolph Jordan’s theorisations of the acousmetre as an unseen diegetic character whose audible voice is imbued with mysterious power, and Mark Kerins’ work on digital surround sound, this article argues that Paranormal ...

Whose Voice is it Anyway? Implications of Free Writing

This essay surveys a number of different interpretations of the metaphor of “voice”. It begins by exploring the use of free writing exercises as a means of nurturing the emergence of physical (audible) voice in creative writing classes before assessing some of the ramifications and implications of the trope, both diachronically and synchronically. A key issue of this discussion is whether voice is regarded as individual or social.

The Spectra of Soundless Voices and Audible Thoughts: Towards an Integrative Model of Auditory Verbal Hallucinations and Thought Insertion

Patients with psychotic disorders experience a range of reality distortions. These often include auditory-verbal hallucinations (AVHs), and thought insertion (TI) to a lesser degree; however, their mechanisms and relationships between each other remain largely elusive. Here we attempt to establish a integrative model drawing from the phenomenology of both AVHs and TI and argue that they in fact can be seen as ‘spectra’ of experiences with varying degrees of agency and ownership, with ‘silent and internal own thoughts’ on one extreme and ‘fully external and clearly audible voices’ in the absence of a speaker on the other. We believe a spectral model will add emphasis to the continuity of experience and help to better understand how one type of psychotic symptom may interact with another, and put forward the argument that the experience of TI itself is not sufficient to classify as a delusion. In addition we aim to discuss some of the conceptual issues surrounding AVHs and TI with first-person accounts and current philosophical and neuropsychological theories in mind. We propose that the mechanisms behind AVHs and TI are more complex than source-monitoring deficits; indeed, to understand such phenomena one must appreciate that their very ‘existence’ and ‘reality’ as experienced by the individual have much deeper implications and meaning, both philosophically and clinically.

The End of The Holocaust

The End of The Holocaust

Journal of Rare Cardiovascular Diseases: After one year of life we are growing out from infancy

Dear Readers, Dear Friends and Colleagues, The fifth issue of the Journal of Rare Cardiovascular Diseases is now ready. At the end of the year 2013, being at the same time, the very first year of the Journal’s life, I want to give thanks first to all the authors and reviewers, who shared their time and resources to support this idea of creating a comprehensive mean for exchanging knowledge and experience on orpahn cardiovascular diseases. By your invaluable contribution the Journal is becoming a more and more audible voice in this field, the field of neglected diseases. Special thanks I direct to the team of the editorial office. Your dedication and enthusiasm make it all happening, and happening outstandingly. After this year of various ups and downs, turns and twists we are stronger and ready… for the next one to come. Introducing to you this issue containing a great deal of interesting articles and case reports, we are hopeing it will not only be a good way to expand your knowledge on rare cardiovascular dieseases but will also inspire you to share your experience in this Journal. First dr Marcin Waligóra et al. in the review article is focusing on the rythm disorders in the group of patients with pulmonary hypertension. It introduces an important topic, which is otherwise insubstantially represented in the literature. To highlight the importance of this article one should realize that as many as 80% of clinical deteriorations in patients with PAH are related to various types of arrhythmia. Dr Leszek Wrotniak et al. present a study of 20 patients with Takayasu arteritis undergoing endovascular procedures. They show that up to 70% of these patients have significant stenosis or occlusion in more than one major arterial territory. Majority of this lesions can safely be treated percutaneously, however close follow‑up has to be maintained since the restenosis may occure. Four case reports including: cavernous hemangioma of the heart in a 37‑years‑old patient, successful reversal of advanced heart failure in preipartum cardiomyopathy with aggressive pharmacotheraphy and continuous‑flow left ventricular assist device from the Scottish National Advanced Heart Failure Unit, Golden Jubilee National Hospital, Glasgow, desmin – related restrictive cardiomyopathy and anomalous left coronary originating from the pulmonary artery from the Institute of Cardiology in Warsaw provide a wide range of know‑how regarding rare clinical cases. Every case is assigned the RCD code according to the Classification of Rare Cardiovascular Diseases which was presented to the international audience for the first time during the ESC Congress in Amsterdam 2013. Following professor Ottavio Alfieri’s opinion (San Rafaele Hospital in Milan) as well as our classification consultant’s conviction expressed during the ESC presentation, it is a milestone in understanding and moving the important topic of rare cardiovascular diseases forward. At the end of this issue you will find a report from the biggest workshop on interventional cardiology in Central and Eastern Europe – the “New Frontiers in Interventional Cardiology”. It was organized for the fourteenth time this year, since 1999 in Krakow, Poland. With ca. 1200 participants from all over the World, live transmissions, EAPCI Fellow courses and many up‑to‑date discussions, it became a valuable event at the end of each year in Krakow. We look forward to your submissions in all available forms. Please visit our web page www.jrcd.eu to find more details about submissions of articles and find all issues of JRCD with free access including the most recent one. Piotr Podolec Editor‑in‑Chief Journal of Rare Cardiovascular Diseases

Tunisian women in the twenty-first century: past achievements and present uncertainties in the wake of the Jasmine Revolution

The recent and dramatic changes in Tunisia since the Jasmine Revolution have brought new challenges for its citizens and for its women in particular. Tunisian women, long considered the most liberated in the Arab-Muslim world, are now seeing a growing conservative mind-set spreading across the country. The more frequent appearance of women wearing headscarves and men sporting beards in public, if only an outward symbol of Islam, is unusual behaviour in the traditionally secular, post-independent Tunisia. This more conservative phenomenon, although not the primary driver of the recent revolution, has secured a legitimate place in Tunisian society since January 2011. Many Tunisian feminists and NGOs fear that this legitimacy will eventually threaten women's active participation in public and private life, legally guaranteed through the 1956 Code of Personal Status (CPS). In this paper, we examine pre- and post-revolutionary Tunisia to understand the importance and influence of the rising tide of conservatism and its potential impact on women's rights. Two principle questions frame this study: (1) what factors have prompted the re-emergence of the more religiously based conservatism in secular Tunisia in recent years? and (2) will the new Tunisia safeguard the CPS through its transitional period and thereafter? The authors use an interdisciplinary approach in their study, integrating Tunisia's unique past – grounded in historical, political, and socio-economic events and conditions – with the interviews of 33 citizens prior to January 2011, and then evaluate the post-revolutionary events in light of the former. The analyses reveal that before January 2011, the more conservative behaviour was linked to the present-day challenges and global developments, and not necessarily to a deep-rooted Islamic practice and/or religiosity. Since the revolution, however, the legitimate acknowledgement of certain Islamic practices and movements, previously banned over a period of 50 years, has created an audible voice in the public arena which, in turn, has created a renewed and heightened concern about the possible deterioration of women's rights.

Effectiveness of using automated external defibrillator by trained healthcare professionals on survival outcomes among adult patients after in-hospital cardiac arrest: a systematic review.

Review question/objective The objective of this review is to synthesise the best available evidence of the effectiveness of using automated external defibrillator by trained healthcare professionals on survival outcomes in adult patients after in-hospital cardiac arrest. More specifically, the objectives are to identify: the effectiveness of using automated external defibrillator by trained healthcare professionals on return of spontaneous circulation and survival to hospital discharge in adult patients after in-hospital cardiac arrest. Inclusion criteria Types of participants This review will consider studies that include adults 18 years old and above; suffering from cardiac arrest requiring chest compression in in-patient wards, emergency department and out-patient procedures in hospital; presenting with an initial index pulseless (for example, but not limited to, ventricular fibrillation and pulseless ventricular tachycardia, asystole or pulseless electrical activities); presence or absence of co-morbidities such as congestive heart failure, myocardial infarction, diabetes mellitus, renal, hepatic or respiratory insufficiency, motor, cognitive or functional deficits, acute stroke, acute non-stroke neurological disorder, pneumonia, hypotension, sepsis, major trauma, metabolic or electrolyte abnormality, metastatic or haematology malignancy. The exclusion criteria are any age group who suffered out-of-hospital cardiac arrest or adults 18 years old and above suffered in-hospital cardiac arrest with a ‘do not resuscitate’ order (DNR). Types of intervention(s) This review will consider as interventions any use of commercially available automated external defibrillator by trained healthcare professionals for in-hospital cardiac arrest. The comparator of interest is use of manual/standard external defibrillator by trained healthcare professionals for in-hospital cardiac arrest. Types of outcomes This review will consider studies that include the following outcome measures: 1. survival with a return of spontaneous circulation for at least 20 minutes during resuscitation 2. survival to hospital discharge regardless of time to discharge 3. initial cardiac arrest rhythms

A Simple Strategy Improves Prehospital Electrocardiogram Utilization and Hospital Treatment for Patients with Acute Coronary Syndrome (from the ST SMART Study)

Although the American Heart Association recommends a prehospital electrocardiogram (ECG) be recorded for all patients who access the emergency medical system with symptoms of acute coronary syndrome (ACS), widespread use of prehospital ECG has not been achieved in the United States. A 5-year prospective randomized clinical trial was conducted in a predominately rural county in northern California to test a simple strategy for acquiring and transmitting prehospital ECGs that involved minimal paramedic training and decision making. A 12-lead ECG was synthesized from 5 electrodes and continuous ST-segment monitoring was performed with ST-event ECGs automatically transmitted to the destination hospital emergency department. Patients randomized to the experimental group had their ECGs printed out in the emergency department with an audible voice alarm, whereas control patients had an ECG after hospital arrival, as was the standard of care in the county. The result was that nearly 3/4 (74%) of 4,219 patients with symptoms of ACS over the 4-year study enrollment period had a prehospital ECG. Mean time from 911 call to first ECG was 20 minutes in those with a prehospital ECG versus 79 minutes in those without a prehospital ECG (p <0.0001). Mean paramedic scene time in patients with a prehospital ECG was just 2 minutes longer than in those without a prehospital ECG (95% confidence interval 1.2 to 3.6, p <0.001). Patients with non-ST-elevation myocardial infarction or unstable angina pectoris had a faster time to first intravenous drug and there was a suggested trend for a faster door-to-balloon time and lower risk of mortality in patients with ST-elevation myocardial infarction. In conclusion, increased paramedic use of prehospital ECGs and decreased hospital treatment times for ACS are feasible with a simple approach tailored to characteristics of a local geographic region.