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Young construction workers are exposed to high levels of occupational safety risk while often occupying relatively vulnerable positions in work groups. Safety voice is an important participatory mechanism for early hazard identification and occupational injury prevention. However, existing studies have mainly examined the net effects of individual predictors, offering limited insight into how multiple job demands, job resources, and personal capabilities combine to enable or constrain safety voice. Drawing on the job demands-resources framework, this study adopted a configurational perspective to examine how different combinations of job insecurity, perceived voice cost, psychological safety, safety empowering supervision, job control, and political skill are associated with high and low safety voice among young construction workers. Survey data from 240 young construction workers in China were analyzed using fuzzy-set qualitative comparative analysis. The findings reveal multiple configurations leading to high safety voice, indicating that no single condition is sufficient on its own. Instead, safety voice emerges when motivational permission, behavioral discretion, supervisory support, and interpersonal capability are jointly present or compensate for selected demand-side constraints. The configurations associated with low safety voice are not simple opposites of those producing high safety voice, suggesting clear causal asymmetry. This study extends occupational safety and public health research by showing how safety voice among young construction workers depends on configurations of work-related demands, resources, and personal capabilities. The findings provide practical implications for injury prevention, participatory safety management, and workplace health promotion in high-risk construction settings.

Teaching requires prolonged and intense voice use, making teachers vulnerable to voice-related symptoms. Although international evidence is strong, limited data are available from Tamil Nadu on how demographic, occupational, and preventive factors influence these symptoms. To examine the relationship between voice-related symptoms and demographic, occupational, and preventive factors among school teachers in Tamil Nadu, India. A cross-sectional survey was conducted in government and private schools across Tamil Nadu between June 2023 and June 2024. Four hundred full-time teachers, including general educators, special educators, physical education instructors, and language/subject specialists, participated. A structured questionnaire collected information on demographic details, teaching profile, self-reported voice symptoms, and voice-care practices. Data were analyzed using descriptive statistics. Associations between variables were tested using Pearson's Chi-square test, with statistical significance set at P < 0.05. More than half of the participants (57.8%) reported vocal tiredness at the end of the teaching day. Voice changes during the academic year were reported by 42.9%, and 21.8% experienced a voice problem lasting longer than two weeks in the previous year. Preventive voice-care behaviors were reported by 53.5%, and 68.3% consumed water regularly while teaching. Vocal tiredness was significantly associated with age (&#x3c7;&#xb2;=8.92, P = 0.03), gender (&#x3c7;&#xb2;=6.72, P = 0.01), educator category (&#x3c7;&#xb2;=8.21, P=0.04), and class size (&#x3c7;&#xb2;=6.41, P = 0.04). Preventive practices differed significantly by school sector (&#x3c7;&#xb2;=6.50, P = 0.01). Voice-related symptoms are common among teachers in Tamil Nadu. Younger age, female gender, physical education teaching, and larger class sizes increase risk, highlighting the need for structured vocal health promotion in schools.

Introduction: Singing-voice therapy by Speech and Language Therapists (SLTs) is the main treatment for singing-voice disorders. Who are the SLTs who treat singing-voice disorders? Who are their patients? What clinical tools do they use? This study answers these three questions through a survey conducted in the French-speaking clinical community. Method: 112 French-speaking SLTs responded to an open-ended survey. Descriptive and inferential statistical analyses were carried out, together with a comparison with existing voice therapy taxonomies. Results: Most of the SLTs who work with singers are musicians. They have received cross-disciplinary training from health professionals, singing teachers and voice pedagogues, and teachers of mind-body techniques. Most of them use the term "dysodia" to refer to singing-voice disorders. Semi-occluded vocal tract exercises constitute their primary clinical tool. Indirect therapy is significantly less common than direct therapy. SLTs work significantly less on the musculoskeletal system than on the other systems (respiratory, auditory, somatosensory and vocal function). Their patients are mainly amateur singers of all styles. Conclusions: This study provides a first structured overview of singing-voice therapy practices among French-speaking SLTs. It highlights clinical practices and tools consistent with recommendations in the literature. It lays the groundwork for future research on these specific therapeutic practices, as well as for the development of clinical guidelines, strengthened interprofessional collaboration, and international standardisation. The issue of therapeutic dosage has yet to be addressed. The predominance of amateur singers among singer-patients confirms the need for prevention.

BanglaVoice is a curated sentence-level dataset for grammatical voice analysis in Bangla, comprising 4397 annotated sentences categorized as Active (1459), Passive (1531), and Middle (1407). Each instance consists of a structurally complete clause containing a single dominant finite verb, accompanied by its English translation and a categorical voice label. Sentences were selectively compiled from publicly accessible Bangla digital sources published between 2023 and 2025 and underwent systematic cleaning, de-duplication, orthographic normalization, and UTF-8 standardization. Voice annotations were assigned using linguistically defined criteria and validated through multi-annotator agreement with majority voting. The dataset exhibits balanced class distribution and natural language characteristics, including a Zipfian rank-frequency distribution (s &#x2248; 0.98-0.99; R&#xb2; &#x2248; 0.99) and substantial lexical diversity (3234 unique tokens). Baseline experiments using six supervised classifiers are also provided, with LinearSVC achieving 93.18% accuracy and 93.10% F1-score, establishing reproducible reference benchmarks for future Bangla grammatical voice classification research. BanglaVoice is released as an open-access resource to support morpho-syntactic research and voice-aware modelling in Bangla natural language processing.

The experience of hearing an 'anorexic voice' is common amongst those diagnosed with anorexia nervosa and can act as a barrier to recovery. The relationship with the anorexic voice can become coercive and hostile. Relating Therapy promotes assertive responding to the anorexic voice and was previously evaluated over 16 sessions. Consultation with people with lived experience suggested that Relating Therapy should be offered over an extended duration to facilitate the guided application of learning to eating behaviours. The primary aim of this study was to inform the design of a future trial by exploring the feasibility of evaluating an extended course of Relating Therapy over 24 sessions. A secondary aim focused on the preliminary exploration of signals of change. A mixed-methods feasibility study used a case series with repeated within-person measures to explore signals of change. Seven of nine participants completed a course of Relating Therapy. Feasibility outcomes were positively confirmed. Signals of change were evident in relation to a greater ability to engage with important and meaningful aspects of life, a re-defined relationship with the anorexic voice, and reduced distress around eating and body image. The study generated evidence of the feasibility of evaluating an extended version of Relating Therapy for those who are distressed by an anorexic voice. Qualitative and quantitative data were suggestive of positive changes for some participants. A larger trial is warranted to evaluate the efficacy of Relating Therapy for the anorexic voice.

This study evaluated and compared the performance of machine learning models across four acoustic feature sets designed to distinguish pathological voices from normal controls. Additionally, Explainable Artificial Intelligence techniques were applied to identify the specific acoustic parameters driving the models' predictions. A total of 1111 voice samples were analyzed. Four feature sets were constructed: sustained vowel, connected speech, concatenated sample, and the combined feature set. Support Vector Machine, Random Forest, and eXtreme Gradient Boosting classifiers were trained and evaluated using an independent test set. Model performance was assessed via accuracy and Area Under the ROC Curve, with SHapley Additive exPlanations utilized for post hoc feature interpretation. The combined feature set achieved the highest classification performance, with eXtreme Gradient Boosting yielding the best overall results (accuracy = 97.31%). Differences in feature sets exerted a greater impact on performance than the choice of classifier, highlighting the critical role of acoustic information acquired from multiple speech tasks. CSID, CPP_v, L/H ratio_v, L/H ratio_SD, and AVQI emerged as the most influential predictors. Notably, all misclassifications occurred only between perceptually normal (grade 0) and mildly dysphonic (grade 1) voices, whereas no misclassifications were observed in moderate (grade 2) or severe (grade 3) dysphonia. Integrating acoustic information from multiple speech tasks significantly improves the discrimination of pathological voices. The deployment of explainable machine learning identified a compact, clinically meaningful subset of acoustic predictors, strongly supporting its potential as an objective and transparent screening tool for voice disorders.

Patients undergoing total pharyngo-laryngectomy with anterolateral thigh (ALT) free-flap neopharyngeal reconstruction require prolonged voice rehabilitation, yet whether preoperative psychological characteristics predict postoperative voice and quality-of-life (QoL) outcomes in this surgical population has not been examined. We aimed to characterize changes in voice and QoL after this surgery and to explore associations between baseline psychological characteristics and depressive somatic symptoms and these postoperative outcomes. In this preliminary, single-center prospective study, 12 adult male patients undergoing primary or salvage total pharyngo-laryngectomy with simultaneous ALT free-flap neopharyngeal reconstruction were enrolled. Health-related QoL (EORTC QLQ-C30 and QLQ-H&N35), personality (Big Five Inventory, BFI), and depressive somatic symptoms (Depression and Somatic Symptoms Scale, DSSS) were assessed at baseline, 3 months, and 6 months postoperatively; the structured psychiatric interview (Mini International Neuropsychiatric Interview, MINI) was administered at baseline. Voice intelligibility (word correct rate), maximum phonation time, and speaking rate were assessed at baseline, 3 months, and 6 months postoperatively. Within-participant changes were analyzed with the Friedman test, and associations were examined using Spearman correlation. Cancer diagnoses included hypopharyngeal (n = 6) and laryngeal (n = 6) cancer; 10 of 12 participants underwent salvage surgery. EORTC QLQ-H&N35 speech problem scores decreased at 6 months (p = 0.036) and dry mouth scores at 3 months (p = 0.044) relative to baseline, while QLQ-C30 cognitive functioning decreased (p = 0.048) and sense problem scores increased (p = 0.011) over follow-up. Higher baseline neuroticism (r = -0.928, p = 0.008) and DSSS total scores (r = -0.928, p = 0.008) were negatively correlated with the 3-to-6-month change in word correct rate. Higher baseline DSSS was associated with poorer 6-month cognitive (r = -0.678, p = 0.031) and social functioning (r = -0.786, p = 0.007), and with higher pain scores (r = 0.663, p = 0.037). In this preliminary cohort, voice intelligibility and several QoL domains improved relative to baseline after pharyngo-laryngectomy with ALT free-flap neopharyngeal reconstruction, while patient-reported cognitive function and sense problems declined. Higher baseline neuroticism and depressive somatic symptoms were associated with smaller postoperative gains. Given the small sample size and the absence of a comparator group, these exploratory findings require confirmation in larger studies before preoperative psychological screening can be recommended for routine clinical use.

Parkinson's disease (PD) can affect voice and swallowing from early stages, with relevant functional consequences. However, evidence on the relationship between self-perceived difficulties in these domains and motor impairment remains scarce in Chile. To analyze the relationship between self-perceived voice difficulties, self-perceived swallowing difficulties, and motor impairment severity in individuals with PD. An observational, cross-sectional, correlational study was conducted with 29 individuals with idiopathic PD recruited through non-probabilistic convenience sampling in Temuco, Chile. The Voice Handicap Index (VHI-30), Eating Assessment Tool-10 (EAT-10), and Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) were administered. Descriptive analyses, Pearson correlations, and partial correlations controlling for age were performed. The EAT-10 showed a mean score of 6.62 (SD&#xa0;=&#xa0;7.54), and 34.5% of participants scored &#x2265; 7. The VHI-30 showed a mean score of 28.97 (SD&#xa0;=&#xa0;29.49), with higher scores in the physical and functional domains. Significant bivariate correlations were observed among VHI-30, EAT-10, and MDS-UPDRS-III. After controlling for age, only the association between VHI-30 and EAT-10 remained statistically significant. Greater self-perceived voice difficulties were associated with greater self-perceived swallowing difficulties, independently of age. Associations with motor impairment appeared to be influenced by age, highlighting the need to consider this variable when interpreting self-reported bulbar symptoms in PD.

Biological therapies targeting type 2 inflammation have become an important treatment option for chronic rhinosinusitis with nasal polyps (CRSwNP). While their effects on polyp size and symptom severity are well documented, their potential impact on voice quality remains unknown. This study aimed to evaluate the effect of anti-interleukin-5 therapy (mepolizumab) on objective acoustic voice parameters in patients with type 2 CRSwNP. Eighteen adult patients with type 2 CRSwNP who had previously undergone endoscopic sinus surgery and were scheduled to receive mepolizumab were included. A control group consisted of 18 patients not receiving biological therapy. Voice recordings were obtained 3 months after surgery (baseline) and 6 months after initiation of therapy. Sustained vowel /a/ phonations were analyzed using Praat software. Fundamental frequency (F0), jitter, shimmer, noise-to-harmonics ratio (NHR), and harmonics-to-noise ratio (HNR) were evaluated. Within- and between-group comparisons were performed using appropriate parametric and nonparametric tests, and effect sizes were calculated. No significant baseline differences were observed between groups in any acoustic parameters. After 6 months, the mepolizumab group demonstrated significant reductions in jitter, shimmer, and NHR, and a significant increase in HNR compared with&#xa0;the control group with large to very large effect sizes. The most pronounced improvement was observed in NHR. Significant time*group interactions were detected for jitter, shimmer, NHR, and HNR (P < 0.001), indicating treatment-specific effects. Although F0 values changed significantly over time in both groups, no significant interaction effect was observed. Mepolizumab has resulted in significant improvement in objective acoustic voice parameters in patients with type 2 chronic rhinosinusitis and nasal polyps. The greatest post-treatment change was observed in the NHR parameter.

Maternal voice exposure provides significant neurodevelopmental benefits for preterm infants, yet its integration into routine clinical care remains inconsistent. Understanding the "knowledge-to-action" gap is critical for establishing effective developmental care practices in the neonatal intensive care unit (NICU). To determine the knowledge levels of NICU nurses regarding maternal voice exposure, evaluate their clinical practices, and identify perceived systemic barriers to implementation. A descriptive, cross-sectional design was used. Data were collected from 166 NICU nurses across T&#xfc;rkiye using a structured knowledge questionnaire (content validity index = 0.99) and a clinical practice assessment tool. Statistical analyses included descriptive statistics and group comparisons (t-tests and analysis of variance). The mean knowledge score was high (82.70 &#xb1; 9.29). Despite this, 75.9% of nurses did not implement maternal voice exposure in their units. A significant majority (94.0%) reported a total absence of written protocols. Key barriers identified were lack of guidelines, time constraints, and equipment shortages. Knowledge scores positively correlated with age and professional experience (P < .05). Although NICU nurses possess high theoretical knowledge, a profound "knowledge-to-action" gap exists. The primary systemic barrier is the lack of standardized, evidence-based written protocols. Neonatal intensive care unit leadership should prioritize developing clinical guidelines and nursing education programs that address perceived barriers, such as infection control and equipment use, to transition theoretical knowledge into routine bedside practice.

Speech in autism spectrum disorder (ASD) carries distinctive acoustic signatures that can offer valuable insight into the nature of autistic communication and its identification. Among these, vowel production remains insufficiently understood, despite its central role in speech intelligibility. This study investigates whether ASD is associated with systematic differences in vowel production. Eighteen Cypriot Greek adults with ASD and 18 peers with neurotypical development (ND), comparable in age, gender, education, nonverbal IQ, and verbal fluency, completed a controlled reading task. Participants produced disyllabic pseudowords embedding the five Greek vowels across four stress-syllable contexts. Acoustic analyses measured vowel-space organization, static spectral properties (F0, F1, F2, F3), dynamic trajectories (&#x394;F0, &#x394;F1, &#x394;F2, &#x394;F3), duration, and voice-quality indices (jitter, shimmer, harmonic-to-noise ratio [HNR], intensity). Bayesian models were used to evaluate group and vowel-specific differences. The results revealed a larger vowel-space area and greater vowel-space dispersion in the ASD group relative to the ND group, indicating a more expanded and dispersed acoustic vowel system. Group differences in individual acoustic measures were mostly selective rather than global: the clearest effects emerged in vowel-specific patterns of pitch, formants, and some dynamic formant measures. By contrast, duration, jitter, shimmer, and intensity did not show robust vowel-specific group differences. Among voice-quality measures, HNR showed the most consistent group difference across individual vowels, with ASD speakers showing higher HNR across all vowels. These findings challenge the notion of a single, uniform autistic voice, instead demonstrating that autism-related speech differences are multidimensional, vowel-specific, and language-sensitive. They therefore underscore the critical importance of segment-focused, cross-linguistically grounded approaches for advancing theory, assessment, and future speech-based identification in autism research.

Depression is common among adolescents and young people living with HIV (AYPLHIV) in sub-Saharan Africa, and is associated with poor antiretroviral therapy adherence, reduced retention in care and poorer health outcomes. In Uganda, routine depression screening using brief tools, such as the Patient Health Questionnaire-2, is recommended, but inconsistently implemented due to overburdened healthcare workers and limited mental health workforce capacity. Scalable approaches to improve early identification of depression among AYPLHIV are needed to bridge this implementation gap. We describe a protocol for a formative mixed-methods study designed to generate the contextual, user-level and health-system evidence needed to inform the design, feasibility and acceptability of an interactive voice response (IVR)-based depression-screening intervention for AYPLHIV in Uganda. We will conduct a convergent parallel mixed-methods study at Makerere University Walter Reed Program (MUWRP) HIV clinics in Central Uganda. The quantitative arm will survey 133 AYPLHIV aged 18-24 years on mobile phone access, digital habits and IVR preferences; the qualitative arm will run focus group discussions with healthcare workers to probe barriers to depression screening, whether the system can absorb the extra cases screening would find and how IVR could fit existing HIV care. The two strands will be triangulated to guide IVR design and implementation. The study will generate context-specific evidence on user-level access and preferences, health-system readiness, and referral pathway capacity to support a future IVR-based depression-screening intervention for AYPLHIV. These findings inform tailoring of a youth-centered IVR intervention aligned with national HIV and mental health guidelines.

Public payers in the US cover more than half of individuals who receive treatment for opioid use disorder (OUD). Despite this, patient-reported measures that reflect treatment engagement and quality of life are largely missing from OUD quality improvement initiatives. This commentary describes the survey protocol for Project ELVIS (ELevating patient VoIceS to Improve OUD Treatment Quality), 1 of 3 projects of the Medicaid Outcomes Distributed Research Network's initiative Examining Quality Improvement in Medicaid Programs. Project ELVIS collects patient experiences with OUD treatment and tests the relationship between patient-reported and claims-based measures of treatment quality. As this commentary describes, Project ELVIS is innovative in its approach to grounding measure development in sustained, iterative engagement with individuals with lived experience and Medicaid policymakers and in employing a policy-driven regional survey sampling approach that prioritizes Medicaid decision-making relevance. Our project is also innovative in its planned linkages of self-reported patient experiences and outcomes with quality measures based on administrative data, positioning patient experience to explain-not just quantify-treatment quality in Medicaid programs. The goals of this project are to inform mechanisms underlying providers' high (and low) performance on claims-based measures, offering insight into why patients initiate, remain engaged in, or discontinue medication for OUD. In doing so, this work endeavors to support the development of patient-centered, process-based quality measures that complement existing and emerging utilization-based metrics.

Researchers are exploring how branding theory can magnify the voice of registered nurses (RNs). An online survey was distributed to RNs in two Canadian regions to explore beliefs about a nursing brand. Five themes emerged regarding the current brand: confusion, working conditions, personal feelings, nursing stereotypes and caring. Four themes emerged outlining a future brand: leadership, nursing knowledge, caring and contributions to healthcare. Nurses are confused about the brand and conflate it with working conditions, stereotypes and personal grievances. The majority want the brand of nursing to reflect leadership, knowledge, caring attributes and contributions to healthcare.

Healthcare unionization is growing amid consolidation, burnout, and policy gridlock. Emerging evidence suggests unions improve healthcare delivery by enhancing worker conditions, staffing, and safety, which in turn support patient and public health outcomes. As physician organizing expands, unions play a vital role in advancing workplace standards, amplifying collective voice, and promoting a more equitable healthcare system.

VISH-DARIJA-TTS v1.0 is a publicly available synthetic multimodal dataset for vishing research in the Moroccan dialect (Darija), a low-resource Arabic variety where publicly documented labelled voice-fraud resources remain highly limited. The dataset was generated through a controlled pipeline comprising scenario authoring, dual-script transcription in Latin-script and Arabic-script Darija, text-to-speech synthesis with Google GenAI Gemini 3.1 Flash TTS, audio normalization, metadata enrichment, deterministic noise augmentation, and release-level validation. It contains 3400 balanced multi-turn scenarios - 1700 normal and 1700 scam/vishing dialogues - with 17,351 dialogue turns. The audio layer includes 3400 clean normalized mono WAV files at 24 kHz and PCM 16-bit, together with 10,200 noisy variants generated at signal-to-noise ratios of 20 dB, 10 dB, and 5 dB, for a total of 13,600 audio files representing approximately 22.61 h of clean audio and approximately 90.45 h when noisy variants are included. The repository includes clean and sanitized text layers, scenario-level and turn-level metadata, heuristic social-engineering labels, emotion and attack taxonomies, audio manifests, train/validation/test splits, SHA-256 checksums, documentation files, and reproducibility scripts. A public text layer replaces sensitive spans with structured placeholders to prevent redistribution of operational social-engineering templates. The dataset contains no real phone calls, real victims, or human-recorded speech. It can be reused for text-based, audio-based, and multimodal vishing detection research, Moroccan Darija speech processing, and controlled noise-robustness benchmarking.