Persona: Ardura Martínez, Diego
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Ardura Martínez
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Diego
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Publicación Menopausal Voice-Related Work Limitation Scale (MenoVWL): development and validation(Elsevier, 2022-11-30) Filipa M.B., Lã; Mateos Ramírez, Ana; Ardura Martínez, Diego; Barro Fiuza, Mauro; Polo Cano, Nuria; Filipa M.B., LãObjectives Menopause has been reported to affect the voice of female professional voice users (FPVUs). The present study aims at the development and validation of a scale to measure self-perceived menopausal voice-related limitation to work in FPVUs, henceforth the Menopausal Voice-Related Work Limitation Scale (MenoVWL). Methods Items were drawn from previous studies on impacts of sex steroid hormones on voice, available validated scales, and in-depth interviews with post-menopausal FPVUs. A preliminary version with 16 items was evaluated by a panel of 15 voice experts. The resulting revised version was filled in online, together with questions on current endocrinological reproductive status and related symptoms, history of amenorrhea, professional occupation, and demographic information. Responses concerning only professional voice users were selected and inclusive and exclusive criteria were applied for correct allocation of participants into pre- and post-menopausal stages within a restrict age range;192 responses were subject to factorial analysis for MenoVWL validation. Cronbach's alpha measured internal reliability. The scale was tested by comparing MenoVWL scores between pre- and post-menopausal FPVUs (98 and 94, respectively). Results Thirteen items were retained from the expert panel evaluation. Items presented a high Content Validity Index (.94 out of 1) and high Item Acceptance Ratio (86.25 %). Both exploratory and confirmatory factorial analysis rendered one dimension scale with an excellent internal consistency (Cronbach's alpha = .9). The results of a Mann-Whitney test showed a higher MenoVWL score for post- as compared to pre-menopausal FPVUs (Z = - 2.818; P = .005). Conclusions MenoVWL is a comprehensive and validated scale with a known factor structure. It constitutes a health care and safety outcome self-perceived measure of value to the early detection of voice-related limitations to work in FPVUs during menopause.Publicación What Voice-Related Metrics Change With Menopause? A Systematic Review and Meta-Analysis Study(Elsevier, 2022-05) Ardura Martínez, Diego; Filipa M.B., LãVoice complaints associated with menopause have been reported by a substantial number of studies. However, to assess the clinical relevance of menopause to voice is still difficult as the extent to which menopausal symptoms are reflected on voice metrics remains unclear. A comprehensive review and meta-analysis were carried out to identify voice-related metrics that change with menopause and to quantify the magnitude of those changes. Academic Search Premier, Medline, SciELO, Scopus, PubMed, and Web of Science were searched without restriction of publication year until January 2020. Cross-sectional studies comparing voice-related metrics between pre- and post-menopausal women were included. Studies assessing effects of hormonal-replacement therapy were excluded. Datasets with more than one publication were also disregarded. Methodological quality of included studies was assessed applying the Newcastle-Ottawa Scale for cross-sectional studies. Given the heterogeneous nature of the primary studies, random-effects models were applied to pool the estimates. Eight articles were considered eligible for meta-analyses, assessing the effects of menopause on 6 voice metrics: mean fundamental frequency (fo), extracted from (1) speech and (2) from sustained vowel /a/; frequency perturbation measures (3) jitter, (4) shimmer and (5) noise-to-harmonics ratio; and (6) maximum phonation time. Both speech fundamental frequency and fo for sustained vowel /a/ were found to be 0.94 and 1.18 semitones lower in post- as compared to pre-menopausal women, respectively. Although significant, the magnitude of these decreases is below the just noticeable interval difference and well above the cutting point for distinguishing female from male voices. No significant differences were found for jitter, shimmer, noise-to-harmonics ratio, and maximum phonation time. The evaluation of acoustic metrics that reflect a single aspect of voice production at a time may conceal the effects of hormonal shifts during menopause. In addition, several variables interplay during voice production and acoustical measures may constitute weak predictors of vocal folds’ status, where changes associated to sex steroid hormones are most likely to occur.Publicación Development and Validation of the Singing Voice Function Self-Efficacy Scale (Singing-VoSES)(['SAGE', 'SEMPRE'], 2023-02-11) Filipa M.B., Lã; Barro Fiuza, Mauro; Ardura Martínez, Diego; Filipa M.B., LãThis investigation aimed at developing and validating a scale measuring perceived self-efficacy in singing with respect to voice function, the Singing Voice Function Self-Efficacy Scale (Singing-VoSES). Voice experts validated an 18-item scale, subsequently administered online, targeting specifically professional and semi-professional female singers. These inclusion criteria were met by a total of 439 participants. Results of both exploratory and confirmatory factorial analysis suggest that Singing-VoSES is a valid scale, with items grouped into three self-efficacy dimensions: Higher Range and Transitions, Middle Range and Lower Range. Middle Range and Lower Range dimensions were both significantly higher than Higher Range and Transitions. Singing high notes and notes within transitional vocal ranges require a refined neuromotor control of the voice, and thus may be particularly challenging. Comparisons between pre and postmenopausal singers were made, as menopause has been associated with changes in voice function. Significantly lower self-efficacies for Higher Range and Transitions and Middle Range were found in post as compared to premenopausal singers. This result, together with the possible lack of coping strategies, may contribute to negative impacts on singers’ performances and, ultimately, lead to premature retirement from public performances. Thus, monitoring self-efficacy with respect to voice function seems relevant, particularly when assisting singers experiencing menopause-related voice difficulties.