Justyna Wiktorowicz

Applicability of the Polish Vocal Tract Discomfort (VTD) scale in the diagnostics of occupational dysphonia

Abstract Occupational dysphonia is mainly of hyperfunctional origin, expressed by complaints experienced in the vocal tract. The aim of the paper was to evaluate the applicability of the Polish Vocal Tract Discomfort (VTD) scale in the diagnostics of occupational dysphonia. Patients with occupational dysphonia (n = 218) and controls (n = 140) were subjected to the VTD scale, VHI evaluation, and maximum phonation time (MPT) measurement. The patients also underwent videostroboscopy. The comparison of the frequency and severity of VTD symptoms showed that the results of the study group were significantly higher (P = 0.000). The VTD scale is characterized by high values of Cronbachs alpha. This study results indicatethat the VTD scale can be a valuable tool, useful in the diagnostics of occupational dysphonia.

Quantitative assessment of videolaryngostroboscopic images in patients with glottic pathologies

Abstract Introduction: Digital imaging techniques enable exploration of novel visualization modalities of the vocal folds during phonation and definition of parameters, facilitating more precise diagnosis of voice disorders. Aim: Application of computer vision algorithms for analysis of videolaryngostroboscopic (VLS) images aimed at qualitative and quantitative description of phonatory vibrations. Materials and methods: VLS examinations were conducted for 45 females, including 15 subjects with vocal nodules, 15 subjects with glottal incompetence, and 15 normophonic females. The recorded VLS images were preprocessed, the glottis area was segmented out, and the glottal cycles were identified. The glottovibrograms were built, and then the glottal area waveforms (GAW) were quantitatively described by computing the following parameters: open quotient (OQ), closing quotient (CQ), speed quotient (SQ), minimal relative glottal area (MRGA), and a new parameter termed closure difference index (CDI). Results: Profiles of the glottal widths assessed along the glottal length differentiated the study groups (P < 0.001). Moreover, it was shown that the OQ, CQ, CDI, and MRGA indices can be considered as viable parameters for quantifying kinematics of the vocal folds for normophonic subjects and patients with diagnosed vocal nodules and glottal incompetence (P < 0.001). Conclusions: Computer image processing and analysis methods applied to videolaryngostroboscopic images allow for their quantitative assessment. Computation of the size-related and time-related parameters characterizing glottic pathologies is of interest for evidence-based voice diagnostics. Results of the performed ROC curve analysis suggest that the evaluated parameters can distinguish patients with voice disorders from normophonic subjects.

Extending Working Life: Which Competencies are Crucial in Near-Retirement Age?

Nowadays, one of the most important economic and social phenomena is population ageing. Due to the low activity rate of older people, one of the most important challenges is to take various actions involving active ageing, which is supposed to extending working life, and along with it—improve the competencies of older people. The aim of this paper is to evaluate the relevance of different competencies for extending working life, with limiting the analysis for Poland. The paper also assesses the competencies of mature Polish people (aged 50+, but still in working age). In the statistical analysis, I used logistic regression, as well as descriptive statistics and appropriate statistical tests. The results show that among the actions aimed at extending working life, the most important are those related to lifelong learning, targeted at improving the competencies of the older generation. The competencies (both soft and hard) of people aged 50+ are more important than their formal education.

Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia

BACKGROUND The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE). MATERIAL AND METHODS The examinations were performed in a study (dysphonic) group of professional voice users who had developed voice disorders (N = 51) and in the control group of normophonic subjects (N = 50). All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index) questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained) perceptual evaluation, maximum phonation time (MPT) measurement and videostroboscopy was performed in the study group. RESULTS The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001). In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05), perceptual evaluation by the GRBAS (p < 0.05) and the objective parameter MPT (p < 0.05). CONCLUSIONS The study has proven that the LMTPE scale is characterized by the high score of Cronbachs α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2):179-188.

Screening value of V-RQOL in the evaluation of occupational voice disorders.

BACKGROUND Given the growing number of occupational voice users, easy and quick broad-scale screening is necessary to provide prophylaxis of voice disorders. The aim of the study was to assess applicability of the Voice Related Quality of Life questionnaire (V-RQOL) to screening occupational voice disorders. MATERIAL AND METHODS The research comprised 284 subjects divided into 3 groups: 0 - the control group of normophonic subjects, non-professional voice users (N = 60), 1 - occupational voice users with objectively confirmed voice disorders (N = 124), 2 - the non-randomized group of occupational voice users with and without voice problems (N = 100). Self-assessment of voice was performed by means of the V-RQOL in comparison to the Voice Handicap Index (VHI). The relation between the V-RQOL and VHI was determined by means of linear regression. Receiver Operating Characteristic (ROC) curves were constructed and the cut-off point of the VRQOL was determined to discriminate between normophonic and dysphonic subjects. RESULTS The relationship between the VHI and V-RQOL scores indicated a satisfactory coefficient of determination: R2 = 0.7266. High values of Cronbachs α confirmed high reliability of the V-RQOL test (0.867). Voice-Related Quality of Life questionnaire (V-RQOL) results were significantly worse in the study group than for normophonic controls (p < 0.001). The cut-off point for the test was set at 79 points. The determined area under the curve (AUC) = 0.910 (p < 0.001) showed high diagnostic accuracy of the V-RQOL. Results of the VRQOL differed for diagnose-based subgroups of dysphonic patients. CONCLUSIONS The study gives grounds for application of the V-RQOL as a reliable tool for screening occupational voice disorders. Med Pr 2018;69(2):119-128.

Support for Economic Activity of People Aged 50+ in Poland: The Best Solutions of the Government’s Programme Solidarity of Generations

Abstract The article aims to assess some selected solutions of the Polish government’s programme “Solidarity of generations” [SG] designed to support economic activity among people aged 50+. It presents the results of a national survey conducted in the first half of 2012, mainly the outcomes of questionnaire interviews carried out with representative samples of people aged 45+ and employers. Studies under the name ‘Diagnosis of the current situation of females and males 50+ on the labour market in Poland [D50+]’ were conducted within the project “Equal Opportunities in the Labour Market for People Aged 50+”. In addition to standard methods of descriptive analysis and the assessment of relations, factor analysis is also used to identify the main types of activities advancing opportunities for people aged 45+. Some solutions of the government’s programme, such as the protection of employees from dismissal during the last four years before their retirement, were sometimes evaluated very differently by employers and people aged 45+. At the same time, both employers and people aged 45+ were favourable about free training and public subsidies to set up jobs for an unemployed persons aged 50+. According to the factor analysis results, the most important activities for people aged 45+ to have equal opportunities in the labour market are those activities that directly improve their qualifications. Although this finding is endorsed by both employers and people aged 45+, the insufficient systemic support for life-long learning limits the number of opportunities they could use to increase their employment activity. The variety of evaluations presented by the beneficiaries of the government programme should be taken into account in planning its modification. Streszczenie Celem artykułu jest ocena skuteczności wybranych rozwiązań zaproponowanych w rządowym programie Solidarność pokoleń [SG] dedykowanym wsparciu aktywności zawodowej osób 50+. W artykule zaprezentowano wyniki ogólnokrajowych badań przeprowadzonych w I poł. 2012 r., w tym przede wszystkim badań kwestionariuszowych przeprowadzonych na reprezentatywnych próbach osób w wieku 45+ oraz pracodawców. Badania pt. Diagnoza obecnej sytuacji kobiet i mężczyzn 50+ na rynku pracy w Polsce [D50+] zostały zrealizowane w ramach projektu Wyrównywanie szans na rynku pracy dla osób 50+. Poza standardowymi metodami analizy deskryptywnej i oceny współzależności, zastosowano analizę czynnikową celem wskazania głównych kierunków działań sprzyjających wyrównywaniu szans osób w wieku 45/50+ na rynku pracy w Polsce. Rozwiązania ujęte w programie rządowym, jak np. wprowadzenie okresów ochronnych przez zwolnieniem z pracy pracowników na 4 lata przed nabyciem praw do emerytury, spotykały się niekiedy z krańcowo różną oceną przez pracodawców i osoby 50+. Zarówno pracodawcy, jak i osoby w wieku 45+ wysoko oceniają bezpłatne szkolenia czy dofinansowanie ze środków publicznych wyposażenia miejsca pracy dla bezrobotnego 50+. W świetle analizy czynnikowej, dla wyrównywania szans osób w wieku 45/50+ na rynku pracy zasadnicze znaczenie odgrywają te działania, które bezpośrednio przyczyniają się do zwiększenia kwalifikacji osób w wieku 45/50+. Pracodawcy i osoby w niemobilnym wieku produkcyjnym są zgodni w tym zakresie, lecz niedostatek systemowego wsparcia edukacji ustawicznej dla osób w wieku 50+ osłabia możliwości wzrostu ich aktywności zawodowej. Zróżnicowane oceny mogą być wzięte pod uwagę przy modyfikacji programów wsparcia aktywności zawodowej 50+.