Outcomes Intermediate Audio

[Roxanna Bornemann]

Healthcare delivery research at NCI is conceptualized as the study of cancercare, factors influencing care, and outcomes of care. Cancer care refers tomedical services offered across the cancer continuum, such as screeningindividuals not known to have cancer; treating cancer patients; following cancersurvivors for recurrence; and providing psychosocial support at the end of lifefor patients and their caregivers.

Understanding the many factors that influence care, and how they act andinteract, is an essential component of health care delivery research supportedby NCI. The knowledge generated from this research can be used to design andtest interventions that will promote patient-centered, evidence-based care.

Ultimately, the outcome of most interest in health care delivery research isreducing the burden of cancer on individuals and society. Outcomes of interestfor individuals and families include improved long-term health and survival, anddiminished psychosocial distress. Society benefits from reduced mortality andmorbidity in the population. Adverse economic impacts of cancer affect bothindividual financial well-being and societal resources. Because it can bechallenging to study these long-term outcomes, health care delivery researchoften uses intermediate outcomes such as receipt of certain therapies or qualityof life.

Health care delivery researchers are a diverse group. They may have amedical background, such a physicians and nurses; be trained in clinicalpsychology or social work; or come from formal research training programs inhealth services, public health, or social science. Substantial proportions ofresearchers in this field have both clinical and research training, or spanmultiple scientific fields. While many hold positions focused on research,others have positions with a stronger focus on education or health careadministration. Health care delivery research usually requires teams of peoplewith complimentary training, experience, and responsibilities.

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Voice modification work involves challenges for both the client and the clinician, especially clinicians newer to the field. Having a structured treatment protocol provides the clinician with the road map to walk the voice journey with the client and support them through the stages of treatment. Most learning processes are made up of a beginning, intermediate and more advanced stage. Voice therapy is no different. The intermediate and later stages of treatment are crucial for generalisation and particularly crucial for clients seeking a female perceived voice. The latter outcome is not always possible for every client who seeks it; however, it is possible for a large majority who undergo the stages of treatment with a suitably trained/skilled clinician. The initial voice changes that occur in the first stage, approximately between sessions one to four can make a significant impact in achieving a gender-neutral voice which can be sustained, particularly for clients who feel socially comfortable. We know however, that a large proportion of clients experience generalised anxiety and/or social anxiety which may or may not be related to gender identity to varying degrees. Nevertheless, any anxiety impacts voice and confidence in the early stages at least and supporting clients through this stage is an important part of the process, often helping clients to build enough awareness to progress to stage 2. Gender neutral to feminine voice typically occurs in the intermediate stage of therapy and this intermediate stage is more often when voice confidence tends to increase. This stage and the more advanced therapy that occurs in the later stage of treatment are discussed in the hierarchy of treatment presentation in the Level 2 - Advancing Clinical Skills course, followed by video presentations of therapy with clients.

It was fortunate that in my fourteen years at the Charing Cross London GIC, I had free reign to develop a treatment programme that aligned as closely as possible with client goals. This was an important aspect of developing and consolidating my method and being able to pass on knowledge and skills to other clinicians. Then, as now, the majority of trans clients were seeking a feminine voice. It was/is clear that sustained gender-neutral type voice outcome was usually achievable in up to 6 sessions. However, for a feminine voice to be successfully generalised, a therapy course of up to 12 sessions is required much more often than not. Some clients also particularly benefit from additional group sessions.

Treatment interventions comprising of 4-6 sessions is a standard appropriate length of treatment for a variety of voice conditions from muscle tension dysphonia to vocal cord palsy. A similar amount of sessions is typically adequate for voice masculinisation work. However, the generalisation challenge for trans females, is greater, not least because oestrogen hormone treatment has no effect on their voices. Ideally, generalisation requires sustained therapeutic support - the common suggestion that covering principles of voice modification over a few sessions and leaving clients to generalise these once discharged tends to limit client outcomes. Again, public services may be restricted in what can be offered and some clients may achieve their goals in less sessions. However, recognition of this potential limitation and discussion of other possible options for clients seeking more voice development ultimately provides more support for clients.

This Digital Filmmaking: Intermediate Production Design certificate helps prepare students with the intermediate skills needed for entry-level careers in the film, TV, and commercial video industries.

To print or save an overview of this program's information, including the program description, learning outcomes, requirements, suggested course sequencing (if applicable), and advising and graduation information, scroll to the bottom of the left-hand navigation menu and select "Print Options." This will give you the options to either "Send Page to Printer" or "Download PDF of This Page." The "Download PDF of This Page" option prepares a much more concise presentation of all program information. The PDF is also printable and may be preferable due to its brevity.

The following institutional requirements apply to all CMU or CMU Tech Technical Certificates. Specific programs may have different requirements that must be met in addition to institutional requirements.

This course extends on the skillset developed in Intermediate Persian A, itself a foundation on Introductory Persian A and B. It involves a more detailed presentation of functions of the language, oral and aural practice, and reading of texts and the writing of compositions that incorporate features of the language already presented through some important cultural issues. On completion of this subject students will have acquired upper-intermediate proficiency in Persian conversational forms, a versatile proficiency in understanding written structures and an ability to formulate such structures, an understanding of some of the commonly used grammatical structures of Persian and the ability to apply them in speech and writing, the ability to interpret messages of an average complexity occurring in audio-visual media and in individual and group spoken forms, and familiarity with some of the dominant cultural ideas and forms of Persian culture and history.

Exeter Innovation is a partner for transformative innovation. We harness the world leading research and education of the University of Exeter to create real and lasting impact, by working with organisations of all types and sizes on their innovation journey.

Activities between the University of British Columbia and Exeter include a joint research symposium focused on Community, Culture, Creativity, and Wellbeing held at Exeter in May 2018 and a faculty-led, co-funded initiatives in Sport, Exercise and Health Sciences, Climate Change and Digital Humanities.

University of South Florida and Exeter have entered into a 5 year student exchange between the two Universities. They launched the University of Exeter / University of South Florida Research Catalyst Fund to provide grants to support joint research initiatives between the two institutions.

The University of Exeter and Tsinghua University have launched a jointly-awarded PhD degree programme in climate and environmental sciences which supports six students to be co-supervised between Tsinghua's Department of Earth System Science and Colleges at Exeter that conduct research on earth systems and environmental sciences. Read more.

A partnership between Exeter and HKUST will enable students embarking on Engineering or Computer Science undergraduate degrees at HKUST to finish their degree at Exeter, before spending a fifth year at Exeter's Law School, completing either an LLM (Master of Laws) or a Juris Doctor (JD). Read more.

NTU and Exeter are working in partnership to deliver six split-site Biomedical PhD studentships. If successful, you will benefit from expert supervision from researchers in both institutions and have the opportunity to research and live in two great locations, for up to eighteen months in each.

To celebrate, and further extend, the strong relationship of staff within the University of Exeter and the University of Geneva, the two universities have launched a new seed fund to support developing research links.

The University of Exeter and The University of Queensland have partnered to establish the QUEX Institute, a new multi-million pound partnership designed to bolster their joint global research impact. Read more.

You are required to be able to converse and write in English at or above upper-intermediate (B2) level before starting the Fast Track programme. This module focuses on helping you develop the essential academic English skills to successfully complete assignments, both on this programme and subsequent university courses. These skills include self-directed learning and research skills along with academic writing, presentation, and seminar skills, following academic conventions and avoiding academic misconduct issues, such as plagiarism. Themes covered in this module will be linked to the CGI module topics so you will be able to focus on honing your academic English skills. The module is non-condonable and compulsory.

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