Effects of Cued and Uncued Swallowing in Patients With Dementia

2021 ◽  
pp. 1-10
Author(s):  
Rebekah Guastella ◽  
Stefania Oppedisano ◽  
Luis F. Riquelme ◽  
Ashwini M. Namasivayam-MacDonald
Keyword(s):  
Motor Control ◽  
Repeated Measures ◽  
Response Duration ◽  
Limited Data ◽  
Chi Square ◽  
Phase Duration ◽  
Transition Duration ◽  
Stage Transition Duration ◽  
Stage Transition ◽  
Impaired Cognition

Purpose: Parameters such as bolus location at swallow onset (BLSO), stage transition duration (STD), pharyngeal transition duration (PTD), pharyngeal response duration (PRD), and pharyngeal phase duration (PPD) often vary between cued and uncued swallowing conditions. Research has demonstrated that cued swallows may offer functional benefits that mitigate pathophysiological processes. However, there are limited data assessing differences between cued and uncued swallows in disordered populations, such as dementia. The purpose of this study was to evaluate if cued swallowing alters swallowing biomechanics in patients living with dementia. Method: Through a retrospective analysis of videofluoroscopic swallow studies (VFSS), 105 swallows from 26 participants living with dementia ( M age = 81 years; 14 women) were analyzed in duplicate by blinded raters using the Analysis of Swallowing Physiology, Events, Kinematics, and Timing method. Only VFSS with at least one cued and one uncued swallow were included in the analysis. Chi-square tests were used to explore differences in BLSO. Repeated-measures analyses of variance (ANOVAs) were used to explore differences in STD, PTD, PRD, and PPD. Results: Results revealed no significant differences in BLSO between cued and uncued swallows for patients living with dementia ( p = .934). Repeated-measures ANOVAs revealed no significant differences between the two types of swallows for STD ( p = .995), PTD ( p = .864), PRD ( p = .807), or PPD ( p = .660). Conclusions: This study suggests that there may be limited benefit to providing cued swallows to individuals living with dementia. Further research should investigate if this is due to impaired cognition and/or changes in motor control to volitionally complete the cued swallow.

scholarly journals Stage Transition Duration in Patients Poststroke

Dysphagia ◽  
2007 ◽  
Vol 22 (4) ◽  
pp. 299-305 ◽  
Author(s):  
Youngsun Kim ◽  
Gary H. McCullough
Keyword(s):  
Transition Duration ◽  
Stage Transition Duration ◽  
Stage Transition

scholarly journals Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS)

2021 ◽  
Vol 18 (2) ◽  
pp. 439
Author(s):  
Lidia Borghi ◽  
Elaine C. Meyer ◽  
Elena Vegni ◽  
Roberta Oteri ◽  
Paolo Almagioni ◽  
...  
Keyword(s):  
Communication Skills ◽  
Repeated Measures ◽  
Behavioral Changes ◽  
Chi Square ◽  
Future Directions ◽  
Public And Private ◽  
Learner Centered ◽  
Difficult Conversations ◽  
Booster Sessions ◽  
Before And After

To describe the experience of the Italian Program to Enhance Relations and Communication Skills (PERCS-Italy) for difficult healthcare conversations. PERCS-Italy has been offered in two different hospitals in Milan since 2008. Each workshop lasts 5 h, enrolls 10–15 interdisciplinary participants, and is organized around simulations and debriefing of two difficult conversations. Before and after the workshops, participants rate their preparation, communication, relational skills, confidence, and anxiety on 5-point Likert scales. Usefulness, quality, and recommendation of the program are also assessed. Descriptive statistics, t-tests, repeated-measures ANOVA, and Chi-square were performed. A total of 72 workshops have been offered, involving 830 interdisciplinary participants. Participants reported improvements in all the dimensions (p < 0.001) without differences across the two hospitals. Nurses and other professionals reported a greater improvement in preparation, communication skills, and confidence, compared to physicians and psychosocial professionals. Usefulness, quality, and recommendation of PERCS programs were highly rated, without differences by discipline. PERCS-Italy proved to be adaptable to different hospital settings, public and private. After the workshops, clinicians reported improvements in self-reported competencies when facing difficult conversations. PERCS-Italy’s sustainability is based on the flexible format combined with a solid learner-centered approach. Future directions include implementation of booster sessions to maintain learning and the assessment of behavioral changes.

Effects of Proximal Priority and Distal Priority Robotic Priming Techniques With Impairment-Oriented Training of Upper Limb Functions in Patients With Chronic Stroke: Study Protocol For A Single-Blind, Randomized Controlled Trial

2021 ◽  
Author(s):  
Yi-chen Lee ◽  
Yi-chun Li ◽  
KEH-CHUNG LIN ◽  
Chia-ling Chen ◽  
Yi-hsuan Wu ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Body Part ◽  
Chronic Stroke ◽  
Comparative Efficacy ◽  
Chi Square ◽  
Robotic Therapy ◽  
Single Blind

Abstract BackgroundThe sequence of establishing proximal stability or function before facilitation of the distal body part has long been recognized in stroke rehabilitation practice but lacks scientific evidence. This study plans to examine the effects of proximal priority robotic priming and impairment-oriented training (PRI) and distal priority robotic priming and impairment-oriented training (DRI). MethodsThis single-blind, randomized, comparative efficacy study will involve 40 participants with chronic stroke. Participants will be randomized into PRI or DRI groups and receive 18 intervention sessions (90 min/d, 3 d/wk for 6 weeks). The Fugl-Meyer Assessment Upper Extremity subscale, Medical Research Council Scale, Revised Nottingham Sensory Assessment, and Wolf Motor Function Test will be administered at baseline, after treatment, and at the 3-month follow-up. Two-way repeated-measures analysis of variance and the chi-square automatic interaction detector method will be used to examine the comparative efficacy and predictors of outcome, respectively, after PRI and DRI. DiscussionThrough manipulating the sequence of applying wrist and forearm robots in therapy, this study will attempt to examine empirically the priming effect of proximal or distal priority robotic therapy in upper extremity impairment-oriented training for people with stroke. The findings will provide directions for further studies and empirical implications for clinical practice in upper extremity rehabilitation after stroke.Trial RegistrationThis trial was registered on June 23, 2020, at www.clinicaltrials.gov (NCT04446273).

Comparing the Effect of Hand and Foot Reflexology Massages on the Severity of Nausea, Vomiting and Ileus in patients after Abdominal Surgery

2021 ◽  
Vol 15 (6) ◽  
pp. 1589-1593
Author(s):  
Elham Shahraki Moghadam ◽  
Zahrasadat Manzari ◽  
Hossein Rashki Ghalenow ◽  
Hajar Noori Sanchooli
Keyword(s):  
Abdominal Surgery ◽  
Repeated Measures ◽  
Abdominal Distension ◽  
Repeated Measure ◽  
Chi Square ◽  
Exact Test ◽  
Positive Effects ◽  
Significant Difference ◽  
The Mean ◽  
Hands And Feet

Background: Common clinical problems after surgery include nausea, vomiting and ileus that many patients complain of after their surgery. These complications can delay the patient's discharge from hospital. Nowadays, to reduce drug side effects, the use of complementary medicine, including reflexology, has received a great deal of attention. Aim: To compare the effect of hand and foot reflexology massages on the severity of nausea, vomiting and ileus in patients after abdominal surgery. Methods: This is a clinical trial study that was conducted between 2013 and 2015 in the emergency surgical departments of Imam Reza (AS) and Ghaem (AS) hospitals in Mashhad. The samples of this study included 90 women with cholecystitis and appendicitis who met the inclusion criteria. In this study, patients were randomly divided into 3 groups of hand reflexology massage, foot reflexology massage and control. To check the digestive status, gastrointestinal sounds were checked every hour using a clinical stethoscope. Also, information on gas and feces elimination was collected and recorded every hour. The intervention was performed 1 and 12 hours after the surgery. In both groups of hands and foot reflexology massages, after general massage of the hands and feet, the areas related to the abdominal distension and removal of the ileus were pressed. It should be noted that, the duration of massage for each person was 10 minutes (20 minutes in total). Data were analyzed by SPSS software version 16 using Chi-square, Fisher’s exact test, two-way ANOVA, Kruskal-Wallis test and repeated measures ANOVA. Results: There was no statistically significant difference in the mean score of severity of nausea before the intervention between the three groups (p = 0.90), but after the intervention a significant difference was observed in the mean score of severity of nausea between the three groups (p=0.002). Also, the result of ANOVA test with repeated measure showed a statistically significant difference in the mean score of nausea by group and stage (p<0.001). There was also no statistically significant difference in the frequency of vomiting severity between the three groups after the intervention. However, at 4 and 24 hours after the intervention, a statistically significant difference was observed between the three groups in that regard. Conclusion: The results showed that both types of hand and foot reflexology massage has positive effects on nausea and return of gastrointestinal movements, so nurses can use reflexology as a non-pharmacological and complementary method to reduce the severity of nausea and return gastrointestinal movements in postoperative patients. Since the reflexology had little or no effect on the severity of vomiting and the acceleration of gastrointestinal movements in patients, further studies in this area are recommended. Keywords: Reflexology, Pain, Nausea and vomiting, Ileus, Surgery

A Combination of Constraint-Induced Therapy and Motor Control Retraining in the Treatment of Focal Hand Dystonia in Musicians: A Long-term Follow-up Study

2013 ◽  
Vol 28 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Patrice Berque ◽  
Heather Gray ◽  
Angus McFadyen
Keyword(s):  
Motor Control ◽  
Repeated Measures ◽  
Motor Disorder ◽  
Long Term Effects ◽  
Focal Hand Dystonia ◽  
Repeated Measures Design ◽  
Abnormal Movements ◽  
Hand Dystonia

Focal hand dystonia (FHD) in musicians is a painless, task-specific motor disorder characterized by involuntary loss of control of individual finger movements. The aim of this study was to investigate the long-term effects of a combined behavioral therapy intervention aimed at normalizing finger movement patterns. METHODS: Eight musicians with FHD had taken part in the 1-year study involving intensive constraint-induced therapy and motor control retraining at slow speed as the interventions. Four of these subjects volunteered to take part in this 4-year follow-up. A quasi-experimental, repeated measures design was used, with 9 testing sessions over 4 years. Video recordings of the subjects playing two pieces were used for data analysis. The Frequency of Abnormal Movements scale (FAM) was the main outcome measure. It was hypothesized that there would be significant differences in FAM scores achieved over the 4-year period. RESULTS: The results from the ANOVA revealed a significant decrease, by approximately 80%, in the number of abnormal movements for both pieces over the 4-year period (F=7.85, df=8, p<0.001). Tukey’s post-hoc test revealed that significant improvements occurred after 6 months of therapy (p-values between p<0.001 and p=0.044). Although the results were not significant between month 12 and follow-up at year 4, the trend revealed that the progress achieved during the first year of intensive retraining was maintained at year 4. CONCLUSIONS: A 1-year period of intensive task-specific retraining may be a successful strategy with long-term, lasting effects for the treatment of musician’s FHD. Results suggest that retraining strategies may need to be carried out for at least 6 months before statistically significant changes are noted.

Effect of communication skills based group counseling on mothers’ sex dialogue with their adolescent daughters

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Tayebe Ziaei ◽  
Maryam Ghanbari Gorji ◽  
Naser Behnampour ◽  
Masumeh Rezaei Aval
Keyword(s):  
Communication Skills ◽  
Group Counseling ◽  
Repeated Measures ◽  
Intervention Group ◽  
Health Centers ◽  
Chi Square ◽  
Significant Difference ◽  
Mother And Daughter ◽  
Post Hoc ◽  
And Control

AbstractBackgroundSex dialogue is one of the most critical and challenging topics between mothers and adolescents. The knowledge and skills of mothers in sex dialogue with their daughters are essential. The purpose of this study is to determine the effect of group counseling based on communication skills on mothers through their sex dialogue with their daughters.MethodsA randomized controlled field trial was conducted on 168 couples of mothers and their daughters selected by the stratified matching method and randomly divided into two control and intervention groups. The mothers in the intervention group participated in a communication-based consultation in groups consisting of 6–12 people for 6–7 weekly sessions, each one lasting 60 min. The data collection tool was a Persian-translated questionnaire by Jaccard for sex dialogue between mother and daughter. The data were analyzed using Chi-square (χ2), ANOVA with repeated measures and modified post hoc Bonferroni tests.ResultsThere was a significant difference in the mean score of mother-daughter sex dialogue 1 week after intervention between the intervention (34.48 ± 8.74) and control (40.44 ± 9.49) groups (p = 0.001) and 1 month after the intervention between the intervention (30.41 ± 10.07) and control (42.47 ± 9.62) groups (p < 0.001).ConclusionThrough applying communication skills, an increase in mother-daughter sex dialogue frequency was observed after group counseling. Therefore, it is suggested to promote mother-daughter communication skills by accessing the mothers via schools, health centers and with the aid of midwifery counselors, midwives and other trained caretakers.

23 THE EFFECT OF WITHDRAWAL TIMING OF CONTROLLED INTERNAL DRUG RELEASE (CIDR) ON EWE REPRODUCTIVE PERFORMANCE

2017 ◽  
Vol 29 (1) ◽  
pp. 119 ◽  
Author(s):  
A. Swelum ◽  
A. Moumen ◽  
A. Alowaimer
Keyword(s):  
Drug Release ◽  
Pregnancy Rate ◽  
Repeated Measures ◽  
Detection Rate ◽  
Serum Concentrations ◽  
Chi Square ◽  
Withdrawal Time ◽  
Repeated Measures Analysis ◽  
Significant Difference ◽  
Equine Chorionic Gonadotropin

This study was carried out using 80 multiparous Awassi ewes during breeding season to compare the effects of controlled internal drug release (CIDR) withdrawal time on ewe fertility. Ewes were equally and randomly allotted into 4 groups (n = 20/group). Ewes had a CIDR inserted for 3, 6, 9, or 12 days with intramuscular administration of 300 IU of equine chorionic gonadotropin (eCG) at withdrawal time. Oestrus was detected using vasectomized ram starting 12 h after CIDR withdrawal and repeated every 12 h up to 84 h. Blood samples were collected from all groups at the time of CIDR withdrawal for measuring of oestradiol (E2) and progesterone (P4) serum concentrations using commercial ELISA kits and micro-titrimetric plates. Timed insemination was performed 48 h post CIDR withdrawal in all groups. Pregnancy was diagnosed by ultrasonography at day 23 post-insemination and confirmed at day 35. Comparisons among groups were evaluated using Chi Square (χ2) test in all measured parameters except hormones levels, which analysed by repeated-measures analysis of variance (ANOVA), using SAS (SAS Institute Inc., Cary, NC, USA). A difference was considered significant at P < 0.05 level. The results revealed that the retention, vaginal discharge and drawstring breakage rates after CIDR removal were insignificantly differed between all groups. On the other hand, pregnancy rate was significantly (P ≤ 0.05) higher in 9-d and 6-d groups (68.4 and 60%, respectively) than the 3-d group. While, no significant difference was detected between 12d group and other groups. The heat detection rate was significantly (P ≤ 0.05) higher in 12d group (100%) than 6-d and 3-d groups (80 and 45%, respectively). While, no significant difference was detected between 12-d and 9-d groups in heat detection rate. P4 was significantly higher in the 12-d group (13.4 ± 3.06 ng mL−1) than other groups. While E2 was significantly lower in the 12-d group (1.6 ± 0.06 pg mL−1) than other groups. These results indicated that withdrawal of CIDR devices after 9 days are efficient in synchronizing oestrus in ewes and provided higher pregnancy rate.

scholarly journals Cervical Cancer Screening with Pap Smear in Rural Population in Health Camp

2020 ◽  
Vol 22 (1-2) ◽  
pp. 62-66
Author(s):  
Astha Shrestha ◽  
S KC
Keyword(s):  
Repeated Measures ◽  
Blood Donors ◽  
Pap Smear ◽  
Blood Donation ◽  
Negative Impact ◽  
Muscle Tension ◽  
Plain Water ◽  
Hemodynamic Responses ◽  
Chi Square ◽  
Oral Rehydration

Adverse effects (AE) like vasovagal reactions (presyncope and syncope) have negative impact on old as well as new blood donors. Various methods have been suggested to prevent or attenuate AE in blood donors. This study assessed the effectiveness of prehydration with different fluids or applied muscle tension (AMT) during blood donation in preventing or attenuating AE. Consenting and eligible voluntary blood donors (n=448) were randomly allocated to Control (n=115), prehydration with 500 mL plain water (PW, n=97), prehydration with oral rehydration solution (ORS, n=71), prehydration with 400 mL fruit juice (FJ, n=74), or leg muscle tensing during blood removal (AMT, n=91) groups. Donors’ hemodynamic responses to blood donation were assessed by comparing blood pressures (systolic–SBP and diastolic–DBP) and heart rate (HR) recorded before blood removal to values midway during, and at 0 min, 5 min, 10 min and 15 min after blood removal. Presyncope and syncope were defined by BP and HR changes. Subjective AE were also recorded. Overall, 35 donors (7.8%) suffered AE with highest rates in PW (13.4%) and ORS (11.3%) groups and lowest in Control (3.5%) although group differences were not significant (p>0.05, Chi square). Blood removal was associated with significant falls in SBP and DBP (mean falls by 6.63 and 3.35 mmHg, respectively; p<0.001) but an insignificant rise in HR (mean increase by 0.67 bpm, p>0.05). Hemodynamic responses showed significant differences between groups (p<0.001, repeated measures ANOVA). Therefore, role of the interventions in relation to AE in blood donors could not be established.

scholarly journals A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery

2017 ◽  
Vol 06 (03) ◽  
pp. 170-175
Author(s):  
Ajay Hrishi ◽  
Karen Lionel ◽  
Prakash Nair
Keyword(s):  
Repeated Measures ◽  
Surgical Excision ◽  
Analysis Data ◽  
Nasal Passage ◽  
P Value ◽  
Continuous Variables ◽  
Chi Square ◽  
Analgesic Requirement ◽  
Hemodynamic Profile ◽  
Surgical Field

Introduction Transnasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative nasal passage preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for nasal preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value < 0.05 was considered as statistically significant and < 0.01 as highly significant. SPSS 17.0 was used for analysis. Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion Intranasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.

Nitrate Supplementation’s Improvement of 10-km Time-Trial Performance in Trained Cyclists

2012 ◽  
Vol 22 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Naomi M. Cermak ◽  
Martin J. Gibala ◽  
Luc J.C. van Loon
Keyword(s):  
Repeated Measures ◽  
Time Trial ◽  
Submaximal Exercise ◽  
Beetroot Juice ◽  
Limited Data ◽  
Double Blind ◽  
Time Trial Performance ◽  
Ergogenic Effects ◽  
Nitrate Supplementation ◽  
Trial Performance

Six days of dietary nitrate supplementation in the form of beetroot juice (~0.5 L/d) has been reported to reduce pulmonary oxygen uptake (VO2) during submaximal exercise and increase tolerance of high-intensity work rates, suggesting that nitrate can be a potent ergogenic aid. Limited data are available regarding the effect of nitrate ingestion on athletic performance, and no study has investigated the potential ergogenic effects of a small-volume, concentrated dose of beetroot juice. The authors tested the hypothesis that 6 d of nitrate ingestion would improve time-trial performance in trained cyclists. Using a double-blind, repeated-measures crossover design, 12 male cyclists (31 ± 3 yr, VO2peak = 58 ± 2 ml · kg−1 · min−1, maximal power [Wmax] = 342 ± 10 W) ingested 140 ml/d of concentrated beetroot (~8 mmol/d nitrate) juice (BEET) or a placebo (nitrate-depleted beetroot juice; PLAC) for 6 d, separated by a 14-d washout. After supplementation on Day 6, subjects performed 60 min of submaximal cycling (2 × 30 min at 45% and 65% Wmax, respectively), followed by a 10-km time trial. Time-trial performance (953 ± 18 vs. 965 ± 18 s, p < .005) and power output (294 ± 12 vs. 288 ± 12 W, p < .05) improved after BEET compared with PLAC supplementation. Submaximal VO2 was lower after BEET (45% Wmax = 1.92 ± 0.06 vs. 2.02 ± 0.09 L/min, 65% Wmax 2.94 ± 0.12 vs. 3.11 ± 0.12 L/min) than with PLAC (main effect, p < .05). Wholebody fuel selection and plasma lactate, glucose, and insulin concentrations did not differ between treatments. Six days of nitrate supplementation reduced VO2 during submaximal exercise and improved time-trial performance in trained cyclists.

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