INNV-35. A MULTI-DISCIPLINARY REVIEW OF NEWLY DIAGNOSED HIGH GRADE GLIOMA REFERRALS TO THERAPIES, AND IMPLEMENTATION OF A SCREENING TOOL TO IMPROVE ACCESS TO THERAPIES AT THE ROYAL MARSDEN HOSPITAL (RMH)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi113-vi113
Author(s):  
Joanne Jethwa ◽  
Charmaine Jagger ◽  
Leanne Williams ◽  
Lizzy Jenkins ◽  
Kate Ashforth
Keyword(s):  
Screening Tool ◽  
Unmet Need ◽  
Clinical Excellence ◽  
High Grade Glioma ◽  
Outpatient Rehabilitation ◽  
Language Therapy ◽  
Oncological Treatment ◽  
Patient Tolerance ◽  
Royal Marsden Hospital ◽  
Therapy Intervention

Abstract Brain tumours make up 3% of all cancers. The disease and treatment have significant impact on function and quality of life (QoL). Early outpatient rehabilitation can improve function. National Institute of Clinical Excellence recommends patients have access to rehabilitation across the pathway, but unmet need is prevalent in this population. We recognised late referrals in our Trust and poor patient awareness of Therapies, resulting in reduced access to rehabilitation. METHOD: A retrospective notes review of new neuro-oncology patients (n=56) referred to RMH from July - December 2018 was undertaken to identify therapy needs and timeliness of referrals. A therapy screening tool was devised and piloted from July – December 2019. Additionally, an MDT questionnaire was circulated to gain feedback regarding this service. RESULTS: Retrospective review revealed that of those patients with identified therapy needs, 16% of physiotherapy (PT), 10% of Occupational Therapy (OT) and 9% of Speech and Language Therapy (SLT) were referred late. Additionally, referrals were not received for 40% of patients with OT needs, 32% for PT and 30% for SLT. Following implementation of the screening tool, referrals occurred earlier in the pathway, and rates increased by 60% in SLT, 59% in PT, and 25% in OT. An MDT questionnaire revealed 100% consensus that screening was beneficial to patients and the MDT with improved access to therapies. CONCLUSION: Brain tumour patients require prompt therapy intervention to improve and maintain function and QoL. We identified high levels of unmet need which was eliminated by a screening tool and subsequently increased referral rates. Patients and the MDT had improved awareness of the role of Therapies, as well as earlier access. The neuro-oncology MDT benefitted from the effects of therapy intervention improving patient tolerance to oncological treatment. Therapists were able to identify and manage impairments earlier, improving QoL.

scholarly journals Effect of speech therapy intervention program for non-fluent aphasic patients after stroke

CoDAS ◽  
2020 ◽  
Vol 32 (6) ◽  
Author(s):  
Amália Maria Nucci Freire ◽  
Rubens José Gagliardi ◽  
Michele Devido dos Santos
Keyword(s):  
Verbal Fluency ◽  
Intervention Program ◽  
Speech Therapy ◽  
Control Group ◽  
P Value ◽  
Language Therapy ◽  
Verbal Fluency Task ◽  
Therapy Program ◽  
Therapy Intervention ◽  
Fluency Task

ABSTRACT Purpose: the objective of this paper is to verify the effect of speech therapy intervention program in patients with non-fluent aphasia due to stroke in language tasks related to verbal fluency in semantic and phonological categories. Methods: Patients with aphasia due to stroke were selected to take part in this study. Two groups were formed: diagnosed patients with Broca/transcortical motor aphasia (GA), and a control group (healthy individuals). GA took a fluency verbal task (FAS, other complementary categories: phonological /p/ /l/ and semantic: “fruits” and “names”). These patients were all engaged in a language intervention program developed by the authors of this study. GA received speech therapy sessions (ten sessions lasting for an hour once a week), following a specific language program. After the sessions, the patients were re-evaluated. Results: GA had statistical significant improvement in the verbal fluency task after the speech therapy program (p-value < 0,001). Conclusion: The speech language therapy program we proposed was efficient enough to show improvement in the results for GA in the verbal fluency task.

scholarly journals A Novel Diagnostic Test to Screen SARS-CoV-2 Variants Containing E484K and N501Y Mutations

2021 ◽  
Author(s):  
Yanan Zhao ◽  
Annie Lee ◽  
Kaelea Composto ◽  
Marcus H. Cunningham ◽  
Jose R. Mediavilla ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Screening Tool ◽  
Unmet Need ◽  
Nasopharyngeal Swab ◽  
Slow Speed ◽  
Epidemiological Monitoring ◽  
Fast Spreading ◽  
Viral Sequencing ◽  
Simultaneous Identification ◽  
Efficient Screening

ABSTRACTSpike protein mutations E484K and N501Y carried by SARS-CoV-2 variants have been associated with concerning changes of the virus, including resistance to neutralizing antibodies and increased transmissibility. While the concerning variants are fast spreading in various geographical areas, identification and monitoring of these variants is lagging far behind, due in large part to the slow speed and insufficient capacity of viral sequencing. In response to the unmet need for a fast and efficient screening tool, we developed a single-tube duplex molecular assay for rapid and simultaneous identification of E484K and N501Y mutations from nasopharyngeal swab (NS) samples within 2.5 h from sample preparation to report. Using this tool, we screened a total of 435 clinical NS samples collected from COVID patients at 8 hospitals within the Hackensack Meridian Health network in New Jersey. While B.1.351 and P.1 variants were absent from the current study, our data revealed a dramatic increase in the frequency of E484K over time, underscoring the need for continuous epidemiological monitoring.

scholarly journals 218 Swallowing/Communication Screening in Older Adults Attending the Emergency Department and Association with Clinical Frailty Scale Scores

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Orla Boyle ◽  
Louise Kelly ◽  
Maeve Ryan ◽  
Deirdre Brady ◽  
Ruth Wade ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older Patients ◽  
Screening Tool ◽  
Future Research ◽  
Language Therapy ◽  
Clinical Frailty Scale ◽  
Acute Setting ◽  
Communication Difficulties ◽  
Scale Scores ◽  
High Level

Abstract Background Dysphagia, frailty and negative patient outcomes are interlinked1. Changes in communication may result from the ageing process, chronic conditions, and/or neurologic conditions presenting in later years2. However, unlike other cohorts, including stroke, frail older patients are not routinely screened for swallowing/communication difficulties in acute settings. We investigated the proportion of Speech and Language Therapy (SLT) referrals generated for older patients attending our Emergency Department (ED) following use of a swallowing/communication screening tool and their association with Clinical Frailty Scale (CFS) scores. Methods A retrospective analysis of data collected over a four week period was completed. Older patients presenting to ED were screened by the interdisciplinary gerontological ED team using a screening tool, including a locally developed swallow/communication screen. Statistical analyses were performed using STATA Version 12. Results Of 176 patients screened (mean age 81.8 years, SD 5.9 years), median CFS score was 5 (IQR 3-6). Thirty-seven percent (66/176) of patients were referred for SLT assessment following initial screen. SLT referrals were more commonly required in patients with a CFS score of ≥4 (46.2% vs. 19.3%, P=0.001) and likelihood of requiring SLT referral increased with greater CFS score (P<0.0001). Conclusion Results suggest that screening for swallowing and communication difficulties in older patients yields a high level of SLT referrals, with a higher frequency of SLT referrals observed with increasing frailty scores. Further research is required to determine the optimum swallowing/communication screening tool in the acute setting. Future research will focus on evaluating outcomes of SLT assessments completed and determining the prevalence of swallowing and/or communication difficulties in this cohort.

scholarly journals Diagnostic accuracy of the iCare rebound tonometer compared to the Perkins applanation tonometer in assessing intraocular pressure in rural patients

Diagnosis ◽  
2015 ◽  
Vol 2 (4) ◽  
pp. 227-234 ◽  
Author(s):  
Yifan Li ◽  
Christopher R. Carpenter ◽  
Kathryn Nicholson ◽  
William Ken Milne
Keyword(s):  
Intraocular Pressure ◽  
Rural Communities ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Screening Tool ◽  
Unmet Need ◽  
Negative Likelihood Ratio ◽  
Rebound Tonometer ◽  
Applanation Tonometer ◽  
Icare Rebound Tonometer

AbstractVision health is recognized as a critical unmet need in North America. The ocular morbidity associated with glaucoma results from increased intraocular pressure (IOP) and early detection is crucial for the management of glaucoma. Our objective was to find a diagnostically accurate screening tool for intraocular hypertension that can be used in rural communities. We sought to validate the diagnostic accuracy of the iCare rebound tonometer against the gold standard Perkins applanation tonometer (PAT) in measuring IOP.Patients from two rural communities in Ontario, Canada visiting their optometrists for routine appointments had their IOP measured by a non-contact tonometer (NCT), an iCare rebound tonometer, and a Perkins applanation tonometer (PAT). Values of sensitivity, specificity, and likelihood ratios for a positive and negative result were calculated for the iCare and the NCT.Complete data was collected from 209 patients. Overall, the iCare tonometer had high levels of validity, as compared to the gold standard PAT. The iCare tonometer displayed excellent sensitivity of 98.3% (90–99%, 95% CI) and excellent negative likelihood ratio of 0.024 (0.0088–0.066, 95% CI) which is useful for ruling out intraocular hypertension.The iCare tonometer is a reasonably valid tool for detecting elevated IOP. Its ease of use, simplicity, and accessibility makes it a good screening tool to improve eye health in rural areas.

Efficacy of a physiotherapy, speech and language therapy intervention (PSALTI) for patients with refractory chronic cough: a multi-centred RCT

Physiotherapy ◽  
2015 ◽  
Vol 101 ◽  
pp. e206-e207 ◽  
Author(s):  
S.A.F. Chamberlain ◽  
S.S. Birring ◽  
L. Clarke ◽  
A. Douiri ◽  
A. Pandyan ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Speech And Language ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Therapy Intervention

scholarly journals Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial

Thorax ◽  
2016 ◽  
Vol 72 (2) ◽  
pp. 129-136 ◽  
Author(s):  
Sarah A F Chamberlain Mitchell ◽  
Rachel Garrod ◽  
Lynne Clark ◽  
Abdel Douiri ◽  
Sean M Parker ◽  
...  
Keyword(s):  
Chronic Cough ◽  
Randomised Control Trial ◽  
Speech And Language ◽  
Language Therapy ◽  
Speech And Language Therapy ◽  
Therapy Intervention
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