ABSTRACT
BACKGROUND: The influence of functional mass lesions on vocal fold oscillation patterns in vocally challenging tasks is not yet understood in detail. MATERIALS UND METHODS: Glissandi on the vowel [a:] from 220 to 440 Hz and 440 to 880 Hz were analyzed in three groups of four professional female singers: without a mass lesion or dysphony (group A), with a functional mass lesion (swellings without a great impact on oscillation patterns during stroboscopy; group B), and with organic dysphony (group C). High-speed digital imaging (HSDI; 20,000 fps), and acoustic and electroglottographic (EGG) signals were used for analysis. Based on the EGG sample entropy, time windows for analysis of register transition phenomena were constructed. The voice signals (glottal area waveform, GAW; acoustic and EGG signals) were perceptually rated in terms of the noticeability of registration events. RESULTS: The absolute sample entropy revealed maxima in fundamental frequency regions where register transitions typically occur. Groups A and B could be distinguished neither by perceptual rating nor based on sample entropy values. In comparison to the other two groups, the absolute sample entropy values of group C were greater in the lower glissando. However, the larger vocal fold oscillatory irregularities were observable for the upper glissando in this group. CONCLUSION: Functional mass lesions do not influence biomechanics adversely in vocally challenging tasks such as register transitions. The use of sample entropy as a criterion for detection of register transitions is promising, but needs further validation.
Subject(s)
Singing , Vocal Cords , Female , Glottis , Humans , Laryngoscopy , Phonation , Vibration , Vocal Cords/physiopathology , Voice QualityABSTRACT
A classification of suicidal behaviour was derived by cluster analysis from descriptive data on parasuicide patients. The grouping was meaningful in terms of clinical interpretation and had both therapeutic and prognostic implications. The sample was broken down into three groups, identified as repeated, serious and non-serious attempts. The repeated attempters had the worst prognosis at 1-year follow-up. When the sample was classified into five groups according to seriousness of the attempts, the repeater and non-serious groups were retained, while the serious attempts were split into three subtypes, which differed on nosological characteristics, treatment disposal and outcome. An excessively high successful suicide rate was found in a small group of elderly attempters.
Subject(s)
Suicide, Attempted/psychology , Behavior , Female , Humans , Male , Prognosis , Psychotherapy , Recurrence , Self-Injurious Behavior , Sex FactorsABSTRACT
In a review of 70 follow-up studies of patients hospitalised after attempted suicide, those follow-up studies were listed which tried to find predictors of further suicidal behaviour by statistical methods. The following predictors for patients with attempted suicide hospitalised in different institutions were found: "Previous attempted suicide" (risk of repetition of attempted suicide as well as of suicide), "previous psychiatric treatment" (risk of repeated attempted suicide), addiction (suicide or repetition of attempted suicide), personality disorder (repetition of attempted suicide), old age and male sex (suicide). There is only small evidence for the predictive power of other variables. Possibilities of improving the prognosis of suicide attempts are discussed.
Subject(s)
Suicide Prevention , Suicide, Attempted/psychology , Follow-Up Studies , Hospitalization , Humans , Mental Disorders/psychology , Motivation , Risk , Suicide/psychologySubject(s)
Referral and Consultation , Suicide, Attempted , Adolescent , Adult , Female , Germany, West , Hospitalization , Humans , Male , Mental Health Services , Middle Aged , Self-Injurious Behavior , Suicide, Attempted/psychologyABSTRACT
Fifteen rating scales for the estimation of suicide risks are reviewed. The report focuses on methods of scale development and validation. Problems of predictive accuracy, and ways of improving the prediction of suicidal behaviour are discussed.