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Objective: The aim of this study was to validate the Acoustic Voice Quality Index 03.01 (AVQIv3) and the Acoustic Breathiness Index (ABI) in the Spanish language. Method: Concatenated voice samples of continuous speech (cs) and sustained vowel (sv) from 136 subjects with dysphonia and 47 vocally healthy subjects were perceptually judged for overall voice quality and breathiness severity. First, to reach a higher level of ecological validity, the proportions of cs and sv were equalized regarding the time length of 3 seconds sv part and voiced cs part, respectively. Second, concurrent validity and diagnostic accuracy were verified. Results: A moderate reliability of overall voice quality and breathiness severity from 5 experts was used. It was found that 33 syllables as standardization of the cs part, which represents 3 seconds of voiced cs, allows the equalization of both speech tasks. A strong correlation was revealed between AVQIv3 and overall voice quality and ABI and perceived breathiness severity. Additionally, the best diagnostic outcome was identified at a threshold of 2.28 and 3.40 for AVQIv3 and ABI, respectively. Conclusions: The AVQIv3 and ABI showed in the Spanish language valid and robust results to quantify abnormal voice qualities regarding overall voice quality and breathiness severity. [ABSTRACT FROM AUTHOR]

Introduction: Professional activities of university lecturers involve continued and sustained use of the voice, leading in many cases to increased risk of developing voice disorders. Risk identification followed by the fast application of preventive or corrective measures is a key issue in this context., Objective: Define and implement a preventive program for the vocal health of university lecturers by using acoustic features automatically extracted from voice recordings to identify risk groups and manage preventive or corrective actions MATERIAL AND METHODS: A total of 170 subjects, aged between 18 and 65, were recruited at the San Pedro de Alcántara Hospital and at the University of Extremadura in Cáceres (Spain). They formed three groups-one of 25 people suffering from vocal fold nodules, another of 25 healthy people, and the third of 120 university lecturers. Medical history and voice status assessment was performed, and voice recordings were made following a research protocol. A feature extraction, selection, and classification procedure was applied to the voice recordings to provide the best predictors for discriminating between pathological and healthy voices. The model parameters were then used to determine the lecturers' probability of suffering vocal fold nodules or other pathologies with similar dysphonic speech. These probabilities were used to classify the lecturers into three risk groups-low, medium, and high. These groups were taken as the basis to assign the lecturers to a primary, secondary, or tertiary prevention level. Different preventive or corrective actions were applied for each prevention level., Results: The best set of predictors comprised sample entropy, correlation dimension, pitch period entropy, glottal noise excitation, and sex, achieving an overall accuracy of 92% with a random forest classifier. They all showed statistically significant differences between vocal fold nodules and healthy groups (P < 0.05). Three out of the four best acoustic features were nonlinear, showing the importance of nonlinear dynamics for clinical practice. The model parameters were applied to the predictors of the lecturers so as to assign them to the different risk groups, leading to 60.8% (73 out of 120) of the lecturers in the low-risk group, 29.2% (35 out of 120) in the medium-risk group, and 10% (12 out of 120) in the high-risk group. The prevention levels were assigned on the basis of this classification and the medical history and laryngological evaluation of some specific subjects. A statistically significant association was found between the voice status and the assigned prevention level (P < 0.001), with there being a clear dependence relationship (Cramér's V = 0.630)., Conclusion: It is feasible to develop and apply a preventive voice program for university lecturers that is aided by features automatically extracted from voice recordings. As the program progresses, it is expected that the information automatically provided for the assignment to prevention levels will become ever more precise. The method proposed can be extended to other voice professionals and other voice disorders., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: The voice in the academic context is a determining factor in the life of the teaching staff. The objective of this study was to evaluate the index vocal inability of in-service teachers and check your involvement the occupational conditions., Methods: For it, a descriptive-inferential study is done of cross-section to 480 teachers (average age: 45.14 ± 9.22), applying the questionnaire of vocal disability index (HIV-30). Using descriptive statistical techniques (mean and standard deviation) and inferential techniques (ANOVA). Statistical analysis was performed using SPSS v.23.0., Results: When applying the Voice Handicap Index (VHI-30) evidenced that teachers present a moderate vocal disability (41.2 rating), with increased risk in physical ability and own vocal function. Moreover, it was found that gender, educational stage, teaching load, antique, daily and weekly hours, student ratio and level of noise in the classroom, significantly affect the disturbance of the voice. It also shows more presence of dysphonia in teachers who perceive a progressive worsening of her voice throughout the day or week, and is absent in the work due to disorders of the voice., Conclusions: In conclusion, teachers attributed their laryngeal discomfort mainly to factors of the teaching context., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objectives: This study aimed to analyze the psychometric properties of the Spanish version of the Voice Activity and Participation Profile (SVAPP) questionnaire., Study Design: A randomized, cross-sectional sampling strategy with controls was used., Methods: Two samples with a total of 169 participants were analyzed, specifically 61 men (mean age 37.02) and 108 women (mean age 37.78). Of these participants, 112 were patients and 57 were controls. The instrument was submitted to reliability (internal consistency and corrected item-total correlations) and reproducibility analyses. Validation assessment was based on the construct validity, convergent validity, discriminant validity, and concurrent validity., Results: The global internal consistency was excellent (Cronbach's α = 0.976), corrected item-total correlations were satisfactory and ranged 0.63-0.89, and factor loadings were above 0.50. The different subscales showed good internal consistency (alpha coefficients ranged 0.830-0.956) and test-retest values were consistently associated. The exploratory factor analysis evidenced a strongly defined five factors internal structure, with factors loadings ranging 0.51-0.86. Convergent validity demonstrated that all subscales and scores were very strongly correlated (Pearson r above 0.735) and significantly associated. The discriminant validity analysis showed that SVAPP had good specificity to distinguish dysphonic from healthy voice subjects. Concurrent validity with Voice Handicap Index Spanish version (SVHI) showed very strong correlations between total scores, and between SVHI total score and SVAPP Daily and Social Communication subscales; correlations between both tests subscales were strong; only between SVAPP Work and SVHI Physical sections correlations were moderate., Conclusions: The findings of the present study demonstrated evidence for the SVAPP questionnaire reliability and validity, and provided insightful implications of voice disorders on Spanish patients' quality of life. However, further investigations are required., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction and Objectives: Perceptual rating of overall voice quality and other more specific perceptual dimensions is difficult, as such judgments depend on the listener's subjectivity. Thus, finding objective, valid, and accessible clinical measures to include in comprehensive voice evaluation protocols is a priority. The purposes of this study were to 1) determine the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from sustained vowels and connected speech samples using the software Praat; 2) to determine the relationship between measures of CPPS and perceptual ratings of vocal quality; and 3) describe the normative values of CPPS., Method: Measures of CPPS were obtained from connected speech and sustained vowel recordings of 72 Spanish-speaking subjects with voice disorders and 52 nondysphonic Spanish-speaking subjects with no vocal disorders using freely downloadable Praat software. IBM SPSS Statistics software version 23 was used to complete the statistical analyses., Results: results revealed a 70% sensitivity rate, a specificity rate of 85%. Estimated severity for sustained vowels and connected speech were strongly correlated and significantly associated with listener ratings of dysphonia severity., Conclusions: A single acoustic measure of CPPS was highly predictive of voice disorder status using Praat software. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols., (Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: This study aimed to perform translation, cross-cultural adaptation, and validation of the Spanish version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (TVQ MtF )., Study Design: This is a prospective study., Setting: The study was conducted by the Gender Identity Unit and the Voice Unit of a tertiary hospital referral center for surgical feminization of the voice., Subjects and Methods: The study had two parts: translation and adaptation of the TVQ MtF with the following actions: translation (with authorization and consensus of the authors of the original questionnaire), back-translation, pretesting, and final version; and preliminary study of the psychometric properties (feasibility, internal consistency, test-retest reliability, construct validity, discriminant validity, and ceiling and floor effects). Thirty male-to-female transsexual women filled out the questionnaire, and 18 of the 30 filled out the questionnaire approximately 2 weeks after filling it out for the first time., Results: Feasibility was 100%. Cronbach α was 0.976. The intraclass correlation coefficient was 0.885. The Spearman correlation coefficient between TVQ MtF and the physical component of SF-12 v2 was 0.102 (P value = 0.592) and between TVQ MtF and the mental component was -0.263 (P value = 0.161). A ceiling effect was not found. A floor effect was found in two questionnaires (6.7%)., Conclusion: Feasibility, internal consistency, and reliability outcomes in our study support the validity of the authorized Spanish version of the TVQ MtF ., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

This paper investigates the role of intonation in the marking of directly-perceived information in Majorcan Catalan polar questions. We conducted a perception experiment in which a total of 72 participants were introduced to a set of twins who were exposed to different types of evidence for a given p(roposition). One twin inferred p based on direct sensory information (via one of the five senses), while the other had been told that p by a third party, that is, reported information. Participants listened to a set of discourse contexts that ended in critical stimuli with three attested combinations of particle/intonation in this variety of Catalan: (1) polar questions produced with a falling nuclear contour ¡H+L* L%; (2) polar questions headed with the particle que 'that' produced with ¡H+L* L%; and (3) polar questions headed with the particle que and produced with a rise-fall L+H* L%. After hearing the stimulus, participants had to decide which of the twins had uttered the question-the one who inferred a proposition ( p) based on direct sensory information or the one who had been told p by a third party. The results show that listeners very consistently associate the que + L+H* L% combination with inferences drawn from direct sensory evidence as opposed to reported evidence. This shows that particles may work in tandem with intonation to convey the information source. Importantly, we show that intonation is a part of grammar that may be recruited for evidential strategies.

Three different nuclear pitch accents can be found in Castilian Spanish polar interrogatives. In addition to the 'canonical' low-rise pattern, there are two marked interrogative contours featuring high-rise and rise-fall pitch accents. The aim of this paper is to explain how each contour contributes to the interpretation of the utterance in which they occur. I argue that this contribution is to be sought at the semantic, not at the pragmatic-illocutionary, attitudinal-level. My proposal is that the low-rise contour is the expression of unspecified sentence polarity (corresponding to the interrogative operator), whereas the two marked contours add indications about the information source-that is, they encode evidential distinctions. The high-rise pattern indicates that the Self is the source of the information; the rise-fall tone indicates that Other is the source. The whole range of pragmatic interpretations that have been described in the literature can be easily accommodated into the present proposal as inferential developments of the encoded meaning together with contextual information. This view has implications for a theory of interrogatives, for the phonology of intonation and for the articulation of the semantics/pragmatics interface.

The aim of this research project was to carry out an epidemiological study on the voice health of the teaching population in Granollers (Barcelona) using the EVES questionnaire and to relate the collected data to the VHI results. The study sample consisted of 233 teachers from Granollers (Barcelona). The EVES questionnaire, which includes the VHI-10, was conducted online. A high percentage of the teachers consulted suffered voice disorders, which ranged from minor to more serious cases. In regard to the data obtained using the VHI, in 28.77% of the cases there was a moderate or a serious perception of voice problems. Out of these cases only one person, who had a moderate perception of their problem, was undergoing voice therapy with a speech therapist. There are three questions in the EVES questionnaire that can efficiently indicate the existence of a voice disorder in a straightforward manner, and the results for these were similar to those recorded for the VHI group of questions. Therefore, it may be argued that questions that refer to the perception of the degree of pleasantness of one's own voice should be included, because they would provide a useful way to indicate whether there is a voice problem at a preliminary screening stage.

Objectives: The aim of this research was to know the protective and risk factors associated with voice strain in teachers., Method and Study Design: A total of 675 teachers from Castille and León, Spain took part in the research within an age range between 23 and 66 years (from nursery school to university). A cross-sectional, descriptive, and analytic design was applied to data from a self-administered questionnaire., Results: The research showed that 16.4% had suffered some voice disorder and a remarkable percentage had never received any kind of voice training. The bivariate and multivariate analyses show that the size of the classroom, being a primary school teacher, teaching physical education, the noise caused by the students in the classroom, the struggle to keep the order within the class, raising the voice, and bad sleep are risk factors in the voice disorders. Each learning stage features a different risk factor, namely in nursery school, the noise caused by the pupils; in primary education, raising the voice; and in secondary education, the struggle to keep the order within the class. All these risk factors are linked with each other., Conclusions: The preventive measures must provide adequate answers to the voice requirements for every subject and stage, and these preventive measures must be based on the educational psychology principles to help the teachers deal with the problems originated by the lack of authority or the noise made by the students, using the proper voice techniques., (Copyright © 2015. Published by Elsevier Inc.)

This paper investigates the production of English unstressed vowels by two groups of early (ESp) and late Spanish (LSp) bilinguals and a control group of native English (NE) monolinguals. Three acoustic measurements were obtained: duration and intensity ratios of unstressed to stressed vowels, normalized vowel formants and euclidean distances. Both groups of bilinguals showed significantly fewer differences in duration between stressed and unstressed vowels than the NE monolinguals. Intensity differences depended on whether the stress pattern of the target English words matched the stress pattern of their Spanish cognates. As for vowel quality, the early bilinguals reduced the unstressed vowels, which clustered around the midcenter area of the vowel space, in the same fashion as the NE monolinguals, suggesting that vowel reduction might be operating at the phonological level. However, the late bilinguals showed a context-dependent, phonetic-level pattern with vowels that were more peripheral in the vowel space., (© 2015 S. Karger AG, Basel.)

Objective: The current study describes the collection of a new phonemically-balanced Spanish sentence resource, known as the Sharvard Corpus., Design: The resource contains 700 sentences inspired by the original English Harvard sentences along with speech recordings from a male and female native peninsular Spanish talker. Sentences each contain five keywords for scoring and are grouped into 70 lists of 10 sentences using an automatic phoneme-balancing procedure., Study Sample: Twenty-three native Spanish listeners identified keywords in the Sharvard sentences in speech-shaped noise., Results: Psychometric functions for the Sharvard sentences indicate mean speech reception thresholds of -6.07 and -6.24 dB, and slopes of 10.53 and 11.03 percentage points per dB at the 50% keywords correct point for male and female talkers respectively., Conclusions: The resulting open source collection of Spanish sentence material for speech perception testing is available online.

Background: To determine whether oropharyngeal dysphagia is a risk factor for readmission for pneumonia in elderly persons discharged from an acute geriatric unit., Methods: Observational prospective cohort study with data collection based on clinical databases and electronic clinical notes. All elderly individuals discharged from an acute geriatric unit from June 2002 to December 2009 were recruited and followed until death or December 31, 2010. All individuals were initially classified according to the presence of oropharyngeal dysphagia assessed by bedside clinical examination. Main outcome measure was readmission for pneumonia. Clinical notes were reviewed by an expert clinician to verify diagnosis and classify pneumonia as aspiration or nonaspiration pneumonia., Results: A total of 2,359 patients (61.9% women, mean age 84.9 y) were recruited and followed for a mean of 24 months. Dysphagia was diagnosed in 47.5% of cases. Overall, 7.9% of individuals were readmitted for pneumonia during follow-up, 24.2% of these had aspiration pneumonia. The incidence rate of hospital readmission for pneumonia was 3.67 readmissions per 100 person-years (95% CI 3.0-4.4) in individuals without dysphagia and 6.7 (5.5-7.8) in those with dysphagia, with an attributable risk of 3.02 readmissions per 100 person-years (1.66-4.38) and a rate ratio of 1.82 (1.41-2.36). Multivariate Cox regression showed an independent effect of oropharyngeal dysphagia, with a hazard ratio of 1.6 (1.15-2.2) for hospitalization for pneumonia, 4.48 (2.01-10.0) for aspiration pneumonia, and 1.44 (1.02-2.03) for nonaspiration pneumonia., Conclusion: Oropharyngeal dysphagia is a very prevalent and relevant risk factor associated with hospital readmission for both aspiration and nonaspiration pneumonia in the very elderly persons.

This study analyses the scaling and alignment of low and high intonational targets in the speech of 27 children - nine English-speaking, nine Catalan-speaking and nine Spanish-speaking - between the ages of two and six years. We compared the intonational patterns of words controlled for number of syllables and stress position in the child speech to the adult target speech provided by their mothers, and to a dataset of adult-directed speech recorded at a later stage for the purpose of measuring pitch height. A corpus of 624 utterances was elicited using a controlled naming task and analysed within the Autosegmental Metrical framework. Measuring the pitch height and pitch timing of nuclear pitch accents, we found that once the effects of syllable duration are accounted for, young children reach tonal targets with remarkable precision. Overall, the results indicate that the phonetic aspects of intonation are acquired from a very early age. Even the youngest children show adult-like alignment of the low target, although mastery of the high target increases with age. Young Spanish-speaking children, however, show a more precise attainment of pitch scaling and alignment of their (high) tonal targets than do Catalan and English children; where the ambient language lies within a general prosodic typology appears to influence the acquisition of tonal targets.

Recent studies in the field of intonational phonology have shown that information-seeking questions can be distinguished from confirmation-seeking questions by prosodic means in a variety of languages (Armstrong, 2010, for Puerto Rican Spanish; Grice & Savino, 1997, for Bari Italian; Kügler, 2003, for Leipzig German; Mata & Santos, 2010, for European Portuguese; Vanrell, Mascaró, Prieto, & Torres-Tamarit, 2010, for Catalan). However, all these studies have relied on production experiments and little is known about the perceptual relevance of these intonational cues. This paper explores whether Majorcan Catalan listeners distinguish information- and confirmation-seeking questions by means of two distinct nuclear falling pitch accents. Three behavioral tasks were conducted with 20 Majorcan Catalan subjects, namely a semantic congruity test, a rating test, and a classical categorical perception identification/discrimination test. The results show that a difference in pitch scaling on the leading H tone of the H+L* nuclear pitch accent is the main cue used by Majorcan Catalan listeners to distinguish confirmation questions from information-seeking questions. Thus, while a iH+L* pitch accent signals an information-seeking question (i.e., the speaker has no expectation about the nature of the answer), the H+L* pitch accent indicates that the speaker is asking about mutually shared information. We argue that these results have implications in representing the distinctions of tonal height in Catalan. The results also support the claim that phonological contrasts in intonation, together with other linguistic strategies, can signal the speakers' beliefs about the certainty of the proposition expressed.

Unlabelled: Teachers' voice problems are widely recognized as a consequence of their work. The measurement of vocal demands and risk factors is essential for adjusting occupational safety and health services to this population's needs., Objectives: To correlate vocal behavior and symptomatology with risk factors and voice disorders, and to further analyze gender influence on these variables., Subjects and Methods: 282 kindergarten and elementary education teachers were surveyed in a cross-sectional study using a self-administered questionnaire. For the purpose of this study, voice disorder prevalence was estimated based on the presence of a vocal effort plus 2 frequent symptoms., Results: 81.5% of teachers reported some degree of vocal effort; more than 60% of subjects evidenced frequent throat paresthesias or vocal fatigue at the end of a working day, and about 55% reported hoarseness. Voice disorder prevalence was 59%. Multivariate logistic regression analysis revealed that female gender, time required to alleviate vocal symptoms, perceived general state of health, prolonged use of the voice, and pupils' indiscipline significantly increased the odds of having vocal problems., Conclusions: Voice disorders affected most teachers and had a multifactorial nature. Vocal health care is particularly necessary for those subjects reporting vocal effort and more than 2 frequent symptoms., (Copyright © 2010 S. Karger AG, Basel.)

Objective: Examination of the vocal function and acoustic analysis in 905 teachers in La Rioja., Design: A case control study: 576 cases and 329 controls., Patients: 905 teaching staff of La Rioja: 589 female and 316 male., Methods: All teachers filled in a standard questionnaire, ENT and vocal function examination, videolaryngostroboscopy and acoustic analysis with MDVP., Results: The prevalence of voice disorders among teaching staff was 57%. The most prevalent lesions were: vocal overeffors (18%) nodular lesions (14%) and hyperfunctional dysphonia (8%). The prevalence of vocal symtoms was 79%. A pathological vocal function was found more frequent among dysphonic teachers than among normals. Frequency perturbations and amplitude perturbations were bigger among dysphonic teachers than among normals. Poor correlations were found between algorithms of acoustic análisis with MDVP and perceptual evaluation GRBAS., Conclusions: It is advisable to carry out a yearly clinical evaluation of all teaching staff because of the high prevalence of voice disorders among them.

The vocal pathology is very frequent among the teaching professionals. We have selected 140 teachers, 70 normals, and 70 with dysphonia. To all of them we have realised a complete voice exploration: aerodyinamic tests, tone and extension of the voice, perceptual evaluation of the voice with the GRBAS scale and also a videolaringostroboscopy to diagnose the teachers. Among the dysphonic teachers there is a poor neumophonologic coordination, a major use or an inadequate use of the respiratory and/or laryngeal musculature. The dysphonic teachers present a more pathological voice in the GRBAS scale than the normal teachers.