Velopharyngeal dysfunction

2021 ◽  
pp. 777-786
Author(s):  
David C.G. Sainsbury ◽  
Caroline C. Williams ◽  
Felicity V. Mehendale
Keyword(s):  
Management Strategies ◽  
Speech Sound ◽  
Well Being ◽  
Surgical Interventions ◽  
Speech Evaluation ◽  
Oral Speech ◽  
Neuromotor Function ◽  
Velopharyngeal Function ◽  
Speech Learning ◽  
Nasal Regurgitation

This chapter explores velopharyngeal dysfunction (VPD), its impact, aetiology, assessment, and management. VPD may cause hypernasal, weak, and unintelligible speech, facial grimacing, nasal turbulence and nasal regurgitation, middle ear problems, and sinusitis. Such manifestations may be distressing for the patient, be associated with poor academic outcomes, be negatively perceived by others, lead to bullying and withdrawal, and result in relationship and employment difficulties. Like the effect of a visible difference on psychosocial confidence and self-esteem, the manifestations of VPD on emotional well-being and social interaction do not necessarily correlate with the amount of speech, language, or communication dysfunction. Normal anatomy, neuromotor function, and speech learning are prerequisites for effective velopharyngeal function. A problem with any of these components may result in a velopharyngeal mechanism that fails to efficiently and fully close throughout oral speech sound formation leading to VPD and an ensuing speech disorder. Perceptual speech evaluation is used to diagnose VPD. Lateral videofluoroscopy and nasoendoscopy are commonly deployed to assess velopharyngeal function and determine management strategies. Surgical interventions include pharyngoplasty, pharyngeal flaps, and velopharyngeal augmentation. Non-surgical interventions include speech prostheses and nasal obturators for speech improvement.

scholarly journals The Potential Role of Bacteriophages in the Treatment of Recalcitrant Chronic Rhinosinusitis

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 675
Author(s):  
Saartje Uyttebroek ◽  
Jolien Onsea ◽  
Willem-Jan Metsemakers ◽  
Lieven Dupont ◽  
David Devolder ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Biofilm Formation ◽  
Potential Role ◽  
Phage Therapy ◽  
Well Being ◽  
Treatment Alternative ◽  
Surgical Interventions ◽  
Social And Emotional ◽  
Promising Treatment

Chronic rhinosinusitis is a common condition affecting 5–12% of the general population worldwide. In a limited number of cases, the disease is recalcitrant to medical and surgical interventions, causing a major impact on physical, social and emotional well-being and increasing pressure on healthcare systems. Biofilm formation and dysbiosis caused by Staphylococcus aureus and Pseudomonas aeruginosa play a role in the pathogenesis of recalcitrant chronic rhinosinusitis. In these cases, a promising treatment alternative is the application of bacteriophages, which are viruses that infect and lyse bacteria. In this review, we appraise the evidence for the use of bacteriophages in the treatment of recalcitrant chronic rhinosinusitis. Additionally, (dis)advantages of bacteriophages and considerations for implementation of phage therapy in otorhinolaryngology practice will be discussed.

scholarly journals How to Intervene in the Health Management of the Oncological Patient and of Their Caregiver? A Narrative Review in the Psycho-Oncology Field

2021 ◽  
Vol 11 (7) ◽  
pp. 99
Author(s):  
Gian Piero Turchi ◽  
Marta Silvia Dalla Riva ◽  
Luisa Orrù ◽  
Eleonora Pinto
Keyword(s):  
Quality Of Life ◽  
Health Management ◽  
Psychological Treatment ◽  
Management Strategies ◽  
Well Being ◽  
Narrative Review ◽  
Treatment Modalities ◽  
Oncological Patient ◽  
Post Surgery

Starting from statistical data derived from the oncological field, some articles have highlighted the importance of communication in the patient–caregiver dyad and have considered the various roles involved in a cancer diagnosis situation. Thus, the question of how to intervene in terms of “quality of life” from the time of diagnosis to the recovery or death of a cancer patient, beyond the sanitary and physical dimensions, has become relevant. Therefore, the present narrative review aims to offer an overview of the state of the art in terms of the psychological treatment modalities of cancer patients, from the diagnosis to the post-surgery period. A total of 67 articles were collected and analyzed, in relation to (1) psychological constructs employed in the oncological field, (2) intervention models and (3) quality of life and well-being measurement and evaluation tools. We described these articles, differentiating between those focusing on the role of (1) the patient, (2) the caregiver, (3) the patient–caregiver dyad and (4) healthcare professional roles. The oncological diagnosis and its repercussions in the lives of the patient and caregiver were explored and critical aspects that emerged from the literature were highlighted. In conclusion, the analysis allowed some considerations about the need to define research protocols and useful management strategies for increasing the overall health of patients with cancer diagnoses and the people who surround them.

Three Years Later: Report on the State of Well-Being of Patients with Chronic Tinnitus Who Underwent Modified Tinnitus Retraining Therapy

2014 ◽  
Vol 20 (1) ◽  
pp. 26-38 ◽  
Author(s):  
Claudia Seydel ◽  
Heidemarie Haupt ◽  
Agnieszka J. Szczepek ◽  
Anne Hartmann ◽  
Matthias Rose ◽  
...  
Keyword(s):  
Management Strategies ◽  
Well Being ◽  
The State ◽  
Chronic Tinnitus ◽  
Tinnitus Retraining Therapy ◽  
Psychometric Instruments ◽  
Important Health ◽  
Retraining Therapy ◽  
Treatment Onset ◽  
A Minor

Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT. i 2014 S. Karger AG, Basel

scholarly journals Examining the spatial relationship between environmental health factors and house prices

2018 ◽  
Vol 11 (3) ◽  
pp. 353-398 ◽  
Author(s):  
Michael J. McCord ◽  
Sean MacIntyre ◽  
Paul Bidanset ◽  
Daniel Lo ◽  
Peadar Davis
Keyword(s):  
Air Quality ◽  
Environmental Quality ◽  
House Prices ◽  
Management Strategies ◽  
Noise Pollution ◽  
Well Being ◽  
Spatial Modelling ◽  
Content Type ◽  
The Impact ◽  
Health And Well Being

Purpose Air quality, noise and proximity to urban infrastructure can arguably have an important impact on the quality of life. Environmental quality (the price of good health) has become a central tenet for consumer choice in urban locales when deciding on a residential neighbourhood. Unlike the market for most tangible goods, the market for environmental quality does not yield an observable per unit price effect. As no explicit price exists for a unit of environmental quality, this paper aims to use the housing market to derive its implicit price and test whether these constituent elements of health and well-being are indeed capitalised into property prices and thus implicitly priced in the market place. Design/methodology/approach A considerable number of studies have used hedonic pricing models by incorporating spatial effects to assess the impact of air quality, noise and proximity to noise pollutants on property market pricing. This study presents a spatial analysis of air quality and noise pollution and their association with house prices, using 2,501 sale transactions for the period 2013. To assess the impact of the pollutants, three different spatial modelling approaches are used, namely, ordinary least squares using spatial dummies, a geographically weighted regression (GWR) and a spatial lag model (SLM). Findings The findings suggest that air quality pollutants have an adverse impact on house prices, which fluctuate across the urban area. The analysis suggests that the noise level does matter, although this varies significantly over the urban setting and varies by source. Originality/value Air quality and environmental noise pollution are important concerns for health and well-being. Noise impact seems to depend not only on the noise intensity to which dwellings are exposed but also on the nature of the noise source. This may suggest the presence of other externalities that arouse social aversion. This research presents an original study utilising advanced spatial modelling approaches. The research has value in further understanding the market impact of environmental factors and in providing findings to support local air zone management strategies, noise abatement and management strategies and is of value to the wider urban planning and public health disciplines.

scholarly journals Evaluación del discurso narrativo en pacientes con daño cerebral leve

2012 ◽  
Vol 4 (3) ◽  
pp. 61
Author(s):  
Ana María Cachón
Keyword(s):  
Clinical Practice ◽  
Brain Injury ◽  
Single Case ◽  
Speech Analysis ◽  
Recovery Stage ◽  
Language Therapist ◽  
Speech Evaluation ◽  
Mild Brain Injury ◽  
Oral Speech ◽  
The Subject

In clinical practice there are few test that language therapist can use for the oral speech evaluation. The battery that has been frecuently used for the aphasia assessment, doesn´t usually give us this type of data, and when it happens, it is just a global description of the language of the subject, which doesn't make possible a detailed pursuit of the evolution. The relevance of linguistic production´s assessment becomes more evident in the study of patients with mild injury as well as when patient is in an advanced recovery stage. An assessment without a speech analysis uses to overestimate the subject's capacities and usually ends in an incomplete and inadequate intervention. The aim of the present work was to review different studies that include the narrative speech as part of the assessment, and to explore, with the study of a single case, some applications in this kind of studies for language evaluation in mild brain injury patients.

scholarly journals Integrating local social-ecological knowledge to prioritise invasive species management

2018 ◽  
Author(s):  
Hernán Cáceres-Escobar ◽  
Katrina J Davis ◽  
Scott C Atkinson ◽  
Hugh P Possingham ◽  
Salit Kark
Keyword(s):  
Invasive Species ◽  
Local Knowledge ◽  
Management Strategies ◽  
Well Being ◽  
Local Economy ◽  
Ecological Knowledge ◽  
Invasive Species Management ◽  
Management Scenarios ◽  
Red Foxes ◽  
Species Management

There is a lot of uncertainty about how we pick the best invasive species management strategies to improve the environment, local economy, and human well-being, as invasive species management involves complex and multidimensional challenges. Invasive species management on inhabited islands is especially challenging, often due to perceived socio-political risks and unexpected technical difficulties. Failing to incorporate local knowledge and local perspectives in the early stages of planning can compromise the ability of decision-makers to achieve long-lasting conservation outcomes. Hence, including local knowledge and accounting for subjective stakeholder perceptions is essential for invasive species management, yet this often remains unaddressed. To address this gap, we present an application of invasive species management based on structured decision-making, and the resource allocation tool INFFER, on Minjerribah-North Stradbroke Island (Australia). We assessed the cost-effectiveness of six management scenarios, co-developed with local land managers and community groups, aimed at preserving the environmental and cultural significance of the island by eradicating European red foxes and feral cats. We further conducted a survey eliciting local stakeholders’ perspectives regarding the significance of the Island, their perception of the benefits of the proposed management scenarios, funding requirements, technical feasibility of implementation, and socio-political risk. We found that the best decisions when the budget is low are less cost-effective than when the budget is high. The best strategy focusses on control of European red fox on Minjerribah. However, our results also highlight the need for more research on feral cat management. This work demonstrates how to use a structured decision support tool, like INFFER, to assess contesting management strategies, this is particularly important when stakeholders’ perceptions regarding management outcomes are heterogeneous and uncertain.

scholarly journals Myeloproliferative Disease in Pregnancy and Other Management Issues

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 246-252 ◽  
Author(s):  
Tiziano Barbui ◽  
Guido Finazzi
Keyword(s):  
Common Sense ◽  
Management Strategies ◽  
Current Treatment ◽  
Bleeding Complications ◽  
Optimal Management ◽  
Myeloproliferative Disease ◽  
Surgical Interventions ◽  
Practical Recommendations ◽  
In Pregnancy ◽  
Management Issues

Abstract The goal of this review is to assess the current treatment and outcomes of special clinical situations in patients with myeloproliferative disease (MPD) such as pregnancy, major thrombotic and bleeding complications and surgical interventions. However, only a limited literature to support optimal management strategies is available. Many of the proposed strategies are the results of common sense or derive from the extrapolation of data from other studies not specifically designed to solve these problems. Therefore, practical recommendations to guide clinical decisions in these settings still remain largely empirical.

Tempering Hard Times: Integrating Well-Being Metrics Into Utility Analysis

2014 ◽  
Vol 7 (4) ◽  
pp. 554-568
Author(s):  
Aharon Tziner ◽  
Erich C. Fein ◽  
Assa Birati
Keyword(s):  
Management Strategies ◽  
Intervention Strategy ◽  
Well Being ◽  
Utility Analysis ◽  
Psychological Well Being ◽  
Quantitative Models ◽  
Hard Times ◽  
Value Estimation ◽  
Financial Gains

AbstractThis article highlights the virtue of integrating well-being metrics (e.g., psychological well-being, perceived meaning) into aspects of utility analysis for the purpose of enhancing human resource management strategies and worker performance. We present the reader with a review of conceptual and practical developments in this field and examples of utility analysis calculations, while we advocate for the necessity of including well-being metrics in utility analysis for the 21st century. The basic thrust of this effort is to encourage the greater employment by managers of quantitative models that allow decision makers to generate all the factors needed to estimate long-term financial gains and/or losses before any intervention strategy is implemented in the workplace. As indicated, the use of quantitative models to estimate the net financial gains of using particular intervention strategies, accompanied with the value estimation of certain types of employee states (e.g., psychological well-being) and worker behaviors (e.g., employee turnover), can ultimately save companies from making gross tactical errors and, more positively, can assist management in promoting the organization's long-term economic goals in conjunction with the enhanced well-being of employees.

“I’m Just Forgetting and I Don’t Know Why”: Exploring How People Living With HIV-Associated Neurocognitive Disorder View, Manage, and Obtain Support for Their Cognitive Difficulties

2018 ◽  
Vol 28 (6) ◽  
pp. 859-872 ◽  
Author(s):  
Alexander R. Terpstra ◽  
Catherine Worthington ◽  
Francisco Ibáñez-Carrasco ◽  
Kelly K. O’Brien ◽  
Aiko Yamamoto ◽  
...  
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Professionals ◽  
Management Strategies ◽  
Well Being ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cognitive Difficulties ◽  
Hiv Associated Neurocognitive Disorder ◽  
Living With Hiv

HIV-associated neurocognitive disorder (HAND) is common, but the lived experience of HAND is not well-understood. In this descriptive qualitative study, we explored how adults with HAND view, manage, and obtain support for cognitive difficulties. We interviewed 25 participants (20% female; median age = 51 years) who were diagnosed with HAND using neuropsychological assessment and a clinical interview. Semistructured interviews, co-developed with community members living with HIV, focused on how cognitive difficulties manifested and progressed, impacted well-being, and were discussed with others. We analyzed interview transcripts using a team-based, thematic approach. Participants described concentration, memory, and multitasking difficulties that fluctuated over time, as well as potential risk factors, management strategies, and psychosocial consequences. They reported they seldom discussed cognitive impairment with health care professionals, and that receiving a HAND diagnosis was validating, informative, yet somewhat disconcerting. Conversations between health care professionals and people living with HIV about HAND may provide opportunities for education, assessment, and support.

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