Anxiolytic Effect of Citrus aurantium L. on Patients with Chronic Myeloid Leukemia.

The bone marrow aspiration procedure is used in hematological diseases and consists of a painful, invasive procedure causing anxiety-associated symptoms. The present study assessed the effect of Citrus aurantium L. essential oil on the treatment of anxiety, in the moment that precedes the collection of medullary material in patients with chronic myeloid leukemia (CML). Volunteers from both sexes were divided into groups receiving either the C. aurantium essential oil through inhalation, diazepam (10 mg), or the placebo. The evaluation was performed through psychometric scales [State-Trait Anxiety Inventory (STAI)] and physiological measurements (blood pressure and cardiac and respiratory frequency). Inhalation of C. aurantium was associated with a decrease in the STAI-S scores, suggesting an anxiolytic effect. In support of these results, a change in all the physiological measurements was observed in the group exposed to C. aurantium. In the diazepam group, only the diastolic pressure decreased, and no effect was observed in the placebo group. Therefore, the results showed that C. aurantium exhibits an anxiolytic effect and reduces the signs and symptoms associated with anxiety in patients with CML.

Vocal characteristics during child development: perceptual-auditory and acoustic data.

OBJECTIVE: To analyze perceptual-auditory and acoustic characteristics of children's voices of different age ranges. PATIENTS AND METHODS: Ninety-three 3- to 10-year-old children grouped from 3 to 5, 6 to 7, and 8 to 10 years served as participants. The severity of vocal deviation and the parameters of roughness, breathiness, strain, and instability were assessed using a visual analog scale. We calculated the mean and standard deviation of fundamental frequency (F0), jitter, shimmer, and glottal-to-noise excitation ratio for the sustained vowel, and the mean of F0 variability for connected speech. RESULTS: The most affected voices were in the age range 8-10 years, and only the phonation tension level was reduced as a result of aging. There were significant differences between children aged 3-5 years and the other age ranges for F0 mean for sustained vowels and F0 variability. CONCLUSION: Children aged 8-10 years had the highest severity of vocal deviation. There was a significant reduction of phonation tension and measure of F0, jitter, and shimmer after the age of 5 years.

Validation of the Self-assessment of Communication Competence (SACCom) in Brazilian Portuguese Through Item Response Theory.

OBJECTIVE: To evaluate the validity of the Self-assessment of Communication Competence - SACCom by analyzing the communication competency of adult individuals using the item response theory (IRT). METHODS: Overall, 778 individuals who responded to SACCom participated in this study. The initial version consisted of 20 polytomous items regarding communication skills. Polytomous answer keys to each item were ordered as follows: 1 - no, 2 - more or less, and 3 - yes. The IRT and the gradual response model, a 2-parameter logistic model for polytomous items, were used for validation. RESULTS: Due to problems in the preliminary analysis using the item characteristic curve (ICC), answer keys to SACCom items were reorganized in an ordinal dichotomous way. Response 1 was coded as 0 - no, while responses 2 and 3 were coded as 1 - yes. Item 9 of the ICC was problematic and did not add information to the instrument; hence, this item was excluded. SACCom, in its dichotomous format with 19 items, was unidimensional according to the eigenvalues graph and tetrachoric correlation analysis. The Cronbach's alpha coefficient showed an internal consistency value of 0.711. All item-total correlations were greater than 0.284. Item discrimination parameters ranged from a = 0.563 to a = 1.505, and the difficulty of the items ranged between b = -2.725 and b = 0.612. The likelihood ratio test showed that the model without restrictions best fit the data. ICC gleaned more information for individuals with lower communication skills. CONCLUSION: The 19-item, dichotomous SACCom is valid for the analysis of communication skills according to the IRT.

Auditory Perception of Roughness and Breathiness by Dysphonic Women.

OBJECTIVE: To investigate the auditory perception of roughness and breathiness by dysphonic women. METHODS: Twenty-two dysphonic native Brazilian Portuguese women participated in this research. All participants underwent audiological evaluation and laryngeal examination to confirm the diagnosis. During the tests, they recorded the sustained vowel /Ɛ/. A speech-language pathologist performed the auditory-perceptual judgment of voice quality for these vocal samples, categorizing the general degree of vocal deviation (mild, moderate, and severe degree) and the predominant type of deviation (roughness or breathiness). Thirty-two (32) stimuli were selected from a voice database, including twenty-four (24) dysphonic voice samples and eight (8) voice samples from vocally healthy women. The authors conducted five perception experiments, being three categorization tasks (normal vs. deviated, breathy vs. nonbreathy, rough vs. nonrough) and two tasks for discriminating the degree of deviation (roughness degree and breathiness degree). RESULTS: The experiments showed a difference between the answers for presence/absence of deviation, presence/absence of breathiness, and presence/absence of roughness in the stimuli, and a difference in the proportion of similar answers of dysphonic women (P < 0.001) regarding the identification of the deviation. Participants classified a large part of the deviated (57.9%), breathy (63.13%), and rough (65.31%) voices as normal. The degree of vocal deviation (P = 0.008) and the degree of roughness in the stimuli correlated positively with the proportion of similar answers of the participants. As for the discrimination of breathiness degrees, less deviated (normal and mild) voices were less discriminated, and more deviated (moderate and severe) voices were better discriminated. Regarding the discrimination of roughness degrees, only the voices with severe deviations showed good discrimination. CONCLUSION: Dysphonic women had a high rate of not similar answers in the identification of normal and deviated voices. They identified more than half of the deviated voices as normal. Samples with more severe deviations were proportionally more identified as deviated by the participants. The greater the vocal deviation of the participants' voices, the smallest the number of similar answers. Participants had a high rate of not similar answers in the identification of normal and breathy voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants had a high rate of similar answers in the identification of normal and rough voices. Dysphonic women show less ability to perceive mildly and moderately breathy voices in the breathy category. Participants show less ability to perceive only mildly roughness voices with similar responses. Dysphonic women could discriminate between voices with adjacent degrees of roughness but had a low percentage of similar answers for discrimination between voices with adjacent degrees of breathiness.

Prosodic Differences in the Voices of Transgender and Cisgender Women: Self-Perception of Voice - An Auditory and Acoustic Analysis.

INTRODUCTION: The voice is an important parameter for identifying the speaker's gender. Transgender people seek to adapt their bodies to gender identity, and transgender women have greater difficulties in achieving vocal acceptance. In this context, the evaluation of the various parameters of the voice of transgender and cisgender women is essential to make it possible to propose appropriate intervention measures. OBJECTIVES: To identify the differences in vocal characteristics of transgender and cisgender women. METHODS: An sectional study was conducted. The sample comprised 20 transgender women and 20 cisgender women who underwent evaluation of acoustic parameters, emotional prosody, self-perception, and perception of gender by lay listeners. RESULTS: The vocal characteristics of transgender and cisgender women differ in terms of the following parameters: f0, glottal noise excitation (GNE), vocal intensity, speech range profile (SRP), the first three formants of the vowel /a/, and in terms of emotional prosody, including duration and melodic contour. Higher values ​​were mostly found in the cisgender population, except for noise level and vocal intensity. In addition, in most cases lay listeners identified the voices of transgender women as belonging to the male gender. There was a negative correlation between vocal dissatisfaction and f0 among transgender women. CONCLUSIONS: Even though they perform vocal adjustments, the voices of transgender women are different from cisgender women in terms of acoustic parameters, vocal extension, and emotional prosody including duration and melodic contour. These differences have repercussions on the perception of gender by listeners.

Severity of voice disorders in children: correlations between perceptual and acoustic data.

OBJECTIVES: The aims of this study were to verify whether there is correlation between perceptual and acoustic data and to verify which measures are useful to identify the severity of voice deviation in children. METHODS: The participants were 71 children aged 3-9 years. The severity of voice deviation, roughness, breathiness, strain, and instability was evaluated by three speech therapists, experts on perceptual voice evaluation. A visual analog scale was used; speech material consisted of a sustained vowel sound /ε/ and the counting of numbers from one to 10. The means and standard deviations of fundamental frequency (F(0)), jitter, shimmer, and glottal-to-noise excitation (GNE) ratio were extracted from the sustained vowel, and the mean and variability of F(0) were extracted from automatic speech (counting). Perceptual and acoustic data were correlated. RESULTS: Most children had mild voice deviation, with strain, instability, and breathiness as predominant voice qualities. F(0) measures correlate with strain to phonate. Shimmer and GNE correlate with general degree of voice deviation and with the roughness, breathiness, and instability parameters. GNE and F(0) mean in connected speech were the only measures that distinguished voices regarding severity of voice deviation. CONCLUSIONS: There was a correlation between perceptual and acoustic measures from these children's voices. Children with high-pitched voices had higher voice deviations. GNE is a measure that reliably distinguishes the severity of voice deviation and may be useful in the screening and evaluation of children's voices.