The effects of transcutaneous electrical nerve stimulation on muscle activity pattern in professional voice users with muscle tension dysphonia using surface electromyography data: A pilot study.

OBJECTIVES: Muscle Tension Dysphonia is a voice disorder, which results in stiffness in the laryngeal extrinsic muscles, intense collision, painful contractions, and vibrations of the vocal cords. Due to the multifactorial identity of Muscle Tension Dysphonia, its therapeutic approach must be multidisciplinary. METHODS: The participants were divided into two groups: a control group (5participants) that received Circumlaryngeal Manual Therapy (CMT) + Placebo Transcutaneous Electrical Nerve Stimulation and an experimental group (5participants) that received Transcutaneous Electrical Nerve Stimulation + CMT. Both groups received 10 sessions of treatment, twice a week, for 40 min each. Before and after treatment, participants were assessed using the Dysphonia Severity Index (DSI) and surface electromyography for their ability to sustain the vowels /e& u/and count from 20 to30. RESULT: After therapy, there were substantial improvements in the DSI (2.72 ± 0.55, P < 0.05) and muscle electrical activity in the control group. The DSI (3.66 ± 0.63, P < 0.05) and muscle electrical activity were also significantly improved in the experimental group after treatment. The findings of the between-group comparison after treatment revealed a significantly greater increase in the Dysphonia Severity Index in the experimental group compared with the control group (P = 0.037). Although there was no significant difference between the two groups in terms of muscle electrical activity, clinically significant changes were more noticeable in the experimental group when compared with the control group. CONCLUSIONS: Positive results were seen in both groups. The results demonstrate that both approaches relax vocal tract muscles. As a result, Transcutaneous Electrical Nerve Stimulation was recommended as a complementary treatment for clients with Muscle Tension Dysphonia.

Relation Between Dysphonia Severity Index (DSI) and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).

OBJECTIVES: This study aims to conduct a relationship survey between subjective voice assessment (the Persian version of consensus auditory perceptual evaluation of voice (called ATSHA)) and the Dysphonia Severity index (DSI). STUDY DESIGN: Cross-sectional, methodological study. METHODS: Our sample included 144 adults; 48 patients with different voice disorders and 96 volunteers without voice disorders, hearing complaints or any auditory-perceptual voice disorders. The vocal tasks included in the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the DSI were performed and recorded. We used subjective and objective assessments to investigate the correlation between the CAPE-V perceptual-auditory assessment parameters and the DSI. Finally, through using the univariate-linear regression and other statistical analyses, we examined the correlation and prediction value of subjective assessment by the DSI. RESULTS: The result of correlation of the total DSI value and individual items with the CAPE-V parameters demonstrated the strongest correlation between the DSI and breathiness (R = 0/563) in the second sentence of the CAPE-V scale, and the weakest correlation between the DSI and overall severity (R = 0/202) in the sixth sentence. The results of the univariate linear regression model indicated that the highest predictive power was obtained for the DSI and breathiness (R2 = 0/427) in the sixth sentence in the dysphonic group, while the lowest predictive power was found for low intensity and strain (R2 = 0/025) in the connected speech in the control group. CONCLUSION: This study found a significant relationship between the target objective and subjective voice assessment scales in most parameters. Furthermore, the findings of the current study show that the DSI scale, as an objective tool, can predict some auditory-perceptual parameters.

Cross-Cultural Adaptation and Validation of the Speech Handicap Index into Persian.

PURPOSE: The aim of the present study was to adapt and validate the Speech Handicap Index (SHI) into the Persian language. PATIENTS AND METHODS: The original published English version of the SHI was translated into Persian using the translation protocol and guidelines of the International Quality of Life Assessment. One hundred participants with oral and oropharyngeal cancer and 40 healthy participants completed the Persian SHI. Forty participants of the patient group completed the Persian SHI a second time after a 2-weeks period to evaluate test-retest reliability. Content validity (content validity index and content validity ratio), internal consistency (Cronbach α coefficient), test-retest reliability (intraclass correlations), and construct validity (confirmatory factor analysis) were examined. Control group and patient group values were compared to determine the clinical validity. RESULTS: A significant discrimination coefficient was found across all items, and the content and clinical validity were found to be acceptable. The Persian SHI showed a high internal consistency and test-retest reliability. The construct validity was within the acceptable range. CONCLUSIONS: The P-SHI is considered to be a valid and reliable questionnaire for speech assessment in Persian-speaking patients with head and neck cancer.

Dysphonia Characteristics and Vowel Impairment in Relation to Neurological Status in Patients with Multiple Sclerosis.

PURPOSE: In this study, we attempted to assess the phonation and articulation subsystem changes in patients with multiple sclerosis compared to healthy individuals using Dysphonia Severity Index and Formant Centralization Ratio with the aim of evaluating the correlation between these two indexes with neurological status. MATERIALS AND METHODS: A sample of 47 patients with multiple sclerosis and 20 healthy speakers were evaluated. Patients' disease duration and disability were monitored by a neurologist. Dysphonia Severity Index and Formant Centralization Ratio scores were computed for each individual. Acoustic analysis was performed by Praat software; the statistical analysis was run using SPSS 21. To compare multiple sclerosis patients with the control group, Mann-Whitney U test was used for non-normal data and independent-samples t test for normal data. Also a logistic regression was used to compare the data. Correlation between acoustic characteristics and neurological status was verified using Spearman correlation coefficient and linear regression was performed to evaluate the simultaneous effects of neurological data. RESULTS: Statistical analysis revealed that a significant difference existed between multiple sclerosis and healthy participants. Formant Centralization Ratio had a significant correlation with disease severity. CONCLUSION: Multiple sclerosis patients would be differentiated from healthy individuals by their phonation and articulatory features. Scores of these two indexes can be considered as appropriate criteria for onset of the speech problems in multiple sclerosis. Also, articulation subsystem changes might be useful signs for the progression of the disease.

Ambient particulate matter concentration levels of Ahvaz, Iran, in 2017.

Dust storm in Khuzestan region is strongly influenced by transportation and influx of large amount of particulate matter from internal sources (Hawizeh Marshes and East Ahwaz) and external sources (the Arabian Desert in Saudi Arabia, Jordan, Syria and the Sahara Desert). Particulate matter is one of the main components of indoor and outdoor air quality that can be very dangerous for human. The principal objective of this study was the pinpoint of the source of airborne particulate matter by the NOAA HYSPLIT model in Ahvaz City, southwest of Iran. The investigation of dust storm and their origin was performed by the GFSG Meteorological Data (backward trajectories ending analysis of the NOAA HYSPLIT model) and collecting particulate samples with high-volume air samplers during the fall and winter seasons. The results showed the average ambient particulate matter concentration in the cold and warm seasons was 158 and 161 µg/m3, respectively. Moreover, the average particulate matter concentration in the cold season was significantly higher than the standard level as presented in the National Ambient Air Quality Standard. Consequently, it seems essential to develop green space, decrease particulate emission from source and make determined efforts to control dust at governmental and international scales.

Biosurfactant production and its effects on solubilization activity of phenanthrene: a longitudinal study.

Pseudomonas facilis and Pseudomonasspp., isolated on the basis of its ability to grow on polycyclic aromatic hydrocarbon, was assayed for biosurfactant production (BP) potentials by measuring the surface tension (ST) of the culture supernatant at different time intervals. The strains in three levels of initial inoculum size (OD600 nm = 0.5, 1, 1.5) were added to medium to determine if bacterial inoculum size affects solubilization of phenanthrene (PHE).The result showed that although the two strains reduced the mean ST to less than 34.12 mN m(-1) at the end of day 6, mean solubilization activity of PHE reached 77.05 mg L(-1) on the sixth day. There was a significant increase in BP over time (P = 0.008); reaching its peak, 157.84 mg L(-1), at the end of the sixth day. Mean solubilization activity of PHE was not significantly different for the two strains (P = 0.216). The time-course study revealed that the ST reduction and BP potential was enhanced as inoculation size increased, leading to higher PHE solubility during the incubation time. However, the trend of increase in PHE solubility was not totally in the same way to cell growth and BP. It may be suggested that more bacterial density needs to be inoculated for practical application of effective bioremediation.

The effect of health promoting intervention on healthy lifestyle and social support in elders: a clinical trial study.

BACKGROUND: Many of the problems pertaining to old age originate from unhealthy lifestyle and low social support. Overcoming these problems requires precise and proper policy-making and planning. OBJECTIVES: The aim of the current research is to investigate the effect of health promoting interventions on healthy lifestyle and social support in elders. PATIENTS AND METHODS: This study was conducted as a clinical trial lasting for 12 months on 464 elders aged above 60 years who were under the aegis of health homes in Tehran, Iran. Participants were selected through double stage cluster sampling and then divided into intervention and control groups (232 individuals in each). Tools for gathering data were a demographic checklist and two standard questionnaires called Health-Promoting Lifestyle Profile version 2 and personal resource questionnaire part 2. Data were analyzed using descriptive and analytical tests including paired t test, analysis of covariance (ANCOVA) and Pearson correlation coefficient. RESULTS: The average age of elders in this study was 65.9 ± 3.6 years (ranging between 60 and 73 years old). Results showed that the differences between the mean post-test scores of healthy lifestyle and its six dimensions as well as perceived social support and its five dimensions in the control and intervention groups were statistically significant (P value < 0.0001). CONCLUSIONS: Aging is an inevitable stage of life. However, effective health promoting interventions can procrastinate it, reduce its consequences and problems, and turn it into a pleasant and enjoyable part of life.

The impact of educational intervention based on empowerment model in preventing violence against women.

BACKGROUND: One of the most obvious forms of violence in today's society is violence against women. In Iran, along with other countries, violence against women has become a problematic issue. OBJECTIVES: The present research aims to investigate the impact of educational intervention based on empowerment model in preventing violent behaviors against women. PATIENTS AND METHODS: The present study is an intervention research done through the random selection of 91 women under the aegis of Imam Khomeini Relief Foundation in Gorgan. Tools for data gathering included demographics checklist, Rosenberg Self-Esteem, general self-efficacy, awareness and attitude questionnaires. Three ninety-minute educational sessions were held for each group to enhance their awareness, change their attitudes, and train them life skills to increase self-esteem so that they can express their vicarious experiences to increase their self-efficacy toward violent behavior. Following the post-test, data were analyzed with SPSS software (version 20). Tests for analyzing data included descriptive and analytical tests (chi-square, Pearson's correlation, independent samples t-test, One-way ANOVA and paired t test). RESULTS: Results indicated that the frequency of domestic violence against participating women was significant after educational intervention, as compared to pre-intervention period. Paired t-test showed that average scores of awareness, attitude, self-esteem, and self-efficacy constructs, and total power were statistically higher after educational intervention as compared to the period prior to intervention. CONCLUSIONS: As one of the manifestations and the moving force of empowerment, education is the first major strategy in codifying, designing, and implementing empowerment programs. For women to be empowered, the active participation of all people in education is required.

Effect of combination exercise therapy on walking distance, postural balance, fatigue and quality of life in multiple sclerosis patients: a clinical trial study.

BACKGROUND: Multiple Sclerosis (MS) is a demyelinating disease of the nervous system which has numerous disabling effects on patients. OBJECTIVES: This study aimed at investigating the short- and long-term effects of a period of combination exercise therapy on walking distance, balance, fatigue and quality of life in multiple sclerosis patients referred to the physiotherapy clinic of Iran's Multiple Sclerosis Society in 2013. PATIENTS AND METHODS: This study was a randomized controlled clinical trial on 59 patients divided into the intervention (n = 39) and control groups (n = 20). The intervention group received 10 weeks of combination therapy including aerobic, strengthening, balancing and stretching exercises. A week before, a week later and a year after the beginning of the exercises, both groups of patients received BBSS, six minute walking, Family Support Services (FSS), Expanded Disability Status Scale (EDSS) and quality of life tests. The scores of two groups were then compared using statistical tests such as repeated measures ANOVA test. RESULTS: THE RESULTS INDICATED SIGNIFICANT CHANGES IN THE INTERVENTION GROUP IN COMPARISON TO THE CONTROL GROUP IN THE SECOND PHASE OF THE STUDY COMPARING TO THE FIRST ONE FOR ALL TESTS EXCEPT EDSS (MEAN DIFFERENCE SCORES OF EDSS: -0.13), P-value = 0.60; FSS: -6.9, P-value = 0.02, Mental Quality of Life (QOL): 16.36, P-value = 0.001; Physical QOL: 12.17, P-value = 0.001, six minute walking: 137.2, P-value < 0.0001; and Berg: 3.34, P-value < 0.0001. These changes were not significant in the second phase of the study comparing to the third one; however, they were again significant in the third phase comparing to the first phase of the study (P < 0.05). CONCLUSIONS: Exercise has significant effect on improving symptoms of multiple sclerosis, and cessation of exercise may cause recurrence of symptoms in the intervention group with a slope similar to that of the control group. Therefore, continuous rather than short period exercises have valuable symptomatic and supportive relief effects in patients.

Effects of family-centered empowerment model based education program on quality of life in methamphetamine users and their families.

BACKGROUND: Nowadays there are more concerns about drug treatment of methamphetamine abusers whereas quality of life (QOL) related supportive psychotherapy is less credited. OBJECTIVES: This study aimed to evaluate the effects of family-centered empowerment model on social support and QOL of methamphetamine users and their families. PATIENTS AND METHODS: This study was a randomized clinical trial; individuals were randomly allocated to three groups: a group for educating methamphetamine users in recovery (95 subjects), a group for educating a family member of methamphetamine users in recovery (95 subjects) and a control group (95 subjects). Data collecting instruments were standard questionnaires of social support and health-related quality of life (HRQOL). Data were analyzed using χ2-test, t-test, paired t-test, Pearson's correlation and ANOVA. RESULTS: Mean scores of QOL and social support dimensions changed significantly in two intervention groups (P < 0.0001), but didn't change in the control group (P > 0.05). Also, there was a positive significant relation (P < 0.05) between total social support and all dimensions of QOL for all study groups. CONCLUSIONS: Family-centered empowerment model, easily adapted to methamphetamine users and their families, leads to improved social supports and QOL.

Validity and Reliability of the Iranian Version of the HIV/AIDS Stigma Instrument-PLWHA (HASI-P).

BACKGROUND: HIV/AIDS disease has remained highly stigmatized all over the world even though the increasing accessibility of its treatment. This study was designed to adapt the HIV/AIDS Stigma Instrument (HASI) to the Iranian People Living with HIV/AIDS (PLWHA). METHODS: Translation -back translation of the scale into Persian was done. Then, the validity and reliability of the instrument were evaluated. The validity of the translated scale was assessed in three ways: evaluating its linguistic validity, assessing its content validity by a panel of nine experts, and exploring its construct validity by factor analysis. The internal con-sistency of the translated scale was evaluated by Cronbach's Alpha. RESULTS: HASI showed a good Content Validity Index (CVI value >0.75) and Content Validity Ratio (CVR >0.78). The internal consistency of the instrument regarding the total score was α=0.89. The three stigma sub-scales that were dis-tancing and blaming (8 items, α=0.87), fear (3 items, α=0.82), and discrimination (5 items, α=0.83). CONCLUSION: This article reports the development and validation of a new measure of stigma, i.e. HIV/AIDS Stigma Instrument in PLWHA (HASI-P), and pro-vides evidence to support its content validity and internal consistency.