Auditory-vocal integration impairment: New challenges and opportunities for voice assessment and therapy

This reflection paper addresses the importance of the interaction between voice perception and voice production, emphasizing the processes of auditory-vocal integration that are not yet widely reported in the context of voice clinicians. Given the above, this article seeks to 1) highlight the important link between voice production and voice perception and 2) consider whether this relationship might be exploited clinically for diagnostic purposes and therapeutic benefit. Existing theories on speech production and its interaction with auditory perception provide context for discussing why the evaluation of auditory-vocal processes could help identify associated origins of dysphonia and inform the clinician around appropriate management strategies. Incorporating auditory-vocal integration assessment through sensorimotor adaptation paradigm testing could prove to be an important addition to voice assessment protocols at the clinical level. Further, if future studies can specify the means to manipulate and enhance a person’s auditory-vocal integration, the efficiency of voice therapy could be increased, leading to improved quality of life for people with voice disorders.

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Early diagnosis of COPD: myth or a true perspective

European Respiratory Review ◽

10.1183/16000617.0131-2020 ◽

2020 ◽

Vol 29 (158) ◽

pp. 200131

Author(s):

Maria Eugenia Laucho-Contreras ◽

Mark Cohen-Todd

Keyword(s):

Early Detection ◽

Structural Changes ◽

Critical Role ◽

Management Strategies ◽

Future Studies ◽

Clinical Burden ◽

History Of ◽

Diagnostic Approaches ◽

Definition Of

The early stages of COPD have recently become a hot topic as many new risk factors have been proposed, but substantial knowledge gaps remain in explaining the natural history of the disease. If we are to modify the outcomes of COPD, early detection needs to play a critical role. However, we need to sort out the barriers to early detection and have a better understanding of the definition of COPD and its diagnosis and therapeutic strategies to identify and treat patients with COPD before structural changes progress. In this review, we aim to clarify the differences between early COPD, mild COPD and early detection of COPD, with an emphasis on the clinical burden and how different outcomes (quality of life, exacerbation, cost and mortality) are modified depending on which definition is used. We will summarise the evidence for the new multidimensional diagnostic approaches to detecting early pathophysiologic changes that potentially allow for future studies on COPD management strategies to halt or prevent disease development.

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Scialorrea e tappi di muco: consigli pratici di gestione nei pazienti eleggibili alle cure palliative pediatriche

QUADERNI ACP ◽

10.53141/qacp.2021.76-79 ◽

2021 ◽

Vol 28 (2) ◽

pp. 76-79

Author(s):

Irene Avagnina ◽

Chiara Paolin ◽

Micaela Santini ◽

Franca Benini

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Health Professionals ◽

Management Strategies ◽

Family Members ◽

Pediatric Palliative Care ◽

Oncological Disease ◽

Clinical Level ◽

High Care

Pediatric palliative care is a multidisciplinary area of pediatrics that aims to ensure a quality of life for children suffering from incurable diseases with high care complexity and also respond to their needs and those of their families. At the clinical level, there are many disturbing symptoms with a wide impact on the quality of life, which must be managed and treated. In particular some of them represent a major challenge for caregivers and health professionals looking after children eligible for PPC. This work aims to present, with a practical and immediately useful cut for the pediatrician, the management strategies of frequent symptoms, starting with drooling and mucus plugs; the latter are very frequent in children with non-oncological disease, followed by PPC. If not treated, they limit the child’s quality of life and have a significant impact on the concerns and management of family members / caregivers.

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An Overview of Facilities Providing Clinical Services for Persons Who Stutter in Kuwait

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig4.79 ◽

2016 ◽

Vol 1 (4) ◽

pp. 79-95

Author(s):

Latifa Alsalmi ◽

Robert Mayo

Keyword(s):

Special Education ◽

Department Heads ◽

Clinical Services ◽

Medical Settings ◽

Non Profit ◽

Future Studies ◽

Language Services ◽

Medical Centers ◽

Clinical Directors

Presently, no clear picture is available about the facilities providing clinical services for persons who stutter (PWS) in Kuwait. This information is crucial for any awareness program to be established in the future. The purpose of this study was to identify clinical facilities and speech-language personnel that provide services for PWS in Kuwait. Participants consisted of 21 clinical directors of governmental medical centers, non-profit clinics, and private clinics as well as department heads of governmental school clinics where speech-language services were provided. Participants were interviewed regarding the availability of speech-language services within their centers and whether or not PWS receive services. The results revealed that four out of five governmental medical centers with a total of 32 speech-language pathologists (SLPs) provided services for PWS. Additionally, 12 schools of special education were found to have 62 SLPs on their staff providing fluency services for students. Finally, two stand-alone private clinics and one non-profit clinic provided services for PWS. Results indicated an overall shortage of SLPs in the country, especially in medical settings. This study sets the foundation for a series of future studies investigating the type and quality of stuttering services provided by the identified facilities in Kuwait.

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Current Status and Potential of RNA Interference for the Management of Tomato Spotted Wilt Virus and Thrips Vectors

Pathogens ◽

10.3390/pathogens10030320 ◽

2021 ◽

Vol 10 (3) ◽

pp. 320

Author(s):

Alexander Nilon ◽

Karl Robinson ◽

Hanu R. Pappu ◽

Neena Mitter

Keyword(s):

Rna Interference ◽

Tomato Spotted Wilt Virus ◽

Cultural Practices ◽

Management Strategies ◽

Current Status ◽

Horticultural Crops ◽

Yield And Quality ◽

Tomato Spotted Wilt ◽

Wilt Virus

Tomato spotted wilt virus (TSWV) is the type member of the genus Orthotospovirus in the family Tospoviridae and order Bunyavirales. TSWV, transmitted by several species of thrips, causes significant disease losses to agronomic and horticultural crops worldwide, impacting both the yield and quality of the produce. Management strategies include growing virus-resistant cultivars, cultural practices, and managing thrips vectors through pesticide application. However, numerous studies have reported that TSWV isolates can overcome host-plant resistance, while thrips are developing resistance to pesticides that were once effective. RNA interference (RNAi) offers a means of host defence by using double-stranded (ds) RNA to initiate gene silencing against invading viruses. However, adoption of this approach requires production and use of transgenic plants and thus limits the practical application of RNAi against TSWV and other viruses. To fully utilize the potential of RNAi for virus management at the field level, new and novel approaches are needed. In this review, we summarize RNAi and highlight the potential of topical or exogenous application of RNAi triggers for managing TSWV and thrips vectors.

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Processes, Challenges and Optimisation of Rum Production from Molasses—A Contemporary Review

Fermentation ◽

10.3390/fermentation7010021 ◽

2021 ◽

Vol 7 (1) ◽

pp. 21

Author(s):

Tinashe Mangwanda ◽

Joel B. Johnson ◽

Janice S. Mani ◽

Steve Jackson ◽

Shaneel Chandra ◽

...

Keyword(s):

Management Practices ◽

Scientific Literature ◽

Asia Pacific ◽

Yeast Strains ◽

Challenges And Opportunities ◽

The Caribbean ◽

The Impact ◽

Production Industry ◽

Stringent Quality

The rum industry is currently worth USD 16 billion, with production concentrated in tropical countries of the Caribbean and Asia-Pacific regions. The primary feedstock for rum production is sugar cane molasses, a by-product of sugar refineries. The main variables known to affect rum quality include the composition of the molasses, the length of fermentation, and the type of barrels and length of time used for aging the rum. The goal of this review is to provide an overview of the impact of these variables on rum quality, and to highlight current challenges and opportunities in the production of rum from molasses. In order to achieve this, we review the relevant contemporary scientific literature on these topics. The major contemporary challenges in the rum production industry include minimising the effects of variability in feedstock quality, ensuring the fermentation process runs to completion, preventing microbial contamination, and the selection and maintenance of yeast strains providing optimum ethanol production. Stringent quality management practices are required to ensure consistency in the quality and organoleptic properties of the rum from batch to batch. Further research is required to fully understand the influences of many of these variables on the final quality of the rum produced.

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Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance

Multiple Sclerosis Journal ◽

10.1177/1352458521999970 ◽

2021 ◽

pp. 135245852199997

Author(s):

Kathleen M Zackowski ◽

Jennifer Freeman ◽

Giampaolo Brichetto ◽

Diego Centonze ◽

Ulrik Dalgas ◽

...

Keyword(s):

Symptom Management ◽

Psychosocial Support ◽

Management Strategies ◽

Research Priorities ◽

Significant Progress ◽

Call To Action ◽

Rehabilitation Research ◽

Relapsing Remitting ◽

Upper Extremity Impairment

Background: People with multiple sclerosis (MS) experience myriad symptoms that negatively affect their quality of life. Despite significant progress in rehabilitation strategies for people living with relapsing-remitting MS (RRMS), the development of similar strategies for people with progressive MS has received little attention. Objective: To highlight key symptoms of importance to people with progressive MS and stimulate the design and implementation of high-quality studies focused on symptom management and rehabilitation. Methods: A group of international research experts, representatives from industry, and people affected by progressive MS was convened by the International Progressive MS Alliance to devise research priorities for addressing symptoms in progressive MS. Results: Based on information from the MS community, we outline a rationale for highlighting four symptoms of particular interest: fatigue, mobility and upper extremity impairment, pain, and cognitive impairment. Factors such as depression, resilience, comorbidities, and psychosocial support are described, as they affect treatment efficacy. Conclusions: This coordinated call to action—to the research community to prioritize investigation of effective symptom management strategies, and to funders to support them—is an important step in addressing gaps in rehabilitation research for people affected by progressive MS.

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Preserving the Activities of Daily Living Independence in Late Life

Innovation in Aging ◽

10.1093/geroni/igaa057.735 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 228-228

Author(s):

Pao-feng Tsai ◽

Thomas Jakobs ◽

Reid Landes

Keyword(s):

Training Program ◽

Daily Living ◽

Cost Effective ◽

Computer Application ◽

Maximum Effect ◽

Activity Of Daily Living ◽

Nursing Assistant ◽

Future Studies ◽

Certified Nursing Assistant

Abstract Levels of Assistance (LoA) is an effective caregiving intervention for maintaining activity of daily living (ADL) independence. It is a structured, almost prescriptive, approach to encourage completing ADLs as independently as an elder’s capabilities permit. With appropriate prompts and assistance during dressing, elders can overcome disability, express retained competencies, and experience success. Simultaneously, caregivers learn to view their functions as maintaining the quality of life of able elders, and they receive reinforcement from elders who are more confident and happier. This study is a continuation of a previous project that created and tested a computer application training program for LoA in nursing homes. We refined the app to include grooming LoA and tested on 10 certified nursing assistant (CNA)/resident dyads at a local nursing home. The pilot results showed, although we did not see consistent improvement in CNA’s dressing LoA, we achieved 10% to 30% improvement in grooming LoA. This indicates that the dressing assistance training is able to transfer to grooming LoA. With only an average of one-hour app training, this improvement is cost effective as compared to training provided by care professionals. Future studies should consider incorporating a culture change strategy to improve CNAs’ intention for assisting elders. In addition, the training program should be offered in the initial hire to achieve maximum effect.

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

Behavioral Sciences ◽

10.3390/bs11070099 ◽

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.

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Patient-Reported Outcome Measures for Post-mastectomy Breast Reconstruction: A Systematic Review of Development and Measurement Properties

Annals of Surgical Oncology ◽

10.1245/s10434-020-08736-8 ◽

2020 ◽

Vol 28 (1) ◽

pp. 386-404 ◽

Cited By ~ 1

Author(s):

C. F. Davies ◽

R. Macefield ◽

K. Avery ◽

J. M. Blazeby ◽

S. Potter

Keyword(s):

Systematic Review ◽

Breast Reconstruction ◽

Content Validity ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Measurement Properties ◽

Future Studies ◽

Patient Reported ◽

Eortc Qlq

Abstract Background Breast reconstruction (BR) is performed to improve outcomes for patients undergoing mastectomy. A recently developed core outcome set for BR includes six patient-reported outcomes that should be measured and reported in all future studies. It is vital that any instrument used to measure these outcomes as part of a core measurement set be robustly developed and validated so data are reliable and accurate. The aim of this systematic review is to evaluate the development and measurement properties of existing BR patient-reported outcome measures (PROMs) to inform instrument selection for future studies. Methods A PRISMA-compliant systematic review of development and validation studies of BR PROMs was conducted to assess their measurement properties. PROMs with adequate content validity were assessed using three steps: (1) the methodological quality of each identified study was assessed using the COSMIN Risk of Bias checklist; (2) criteria were applied for assessing good measurement properties; and (3) evidence was summarized and the quality of evidence assessed using a modified GRADE approach. Results Fourteen articles reported the development and measurement properties of six PROMs. Of these, only three (BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23) were considered to have adequate content validity and proceeded to full evaluation. This showed that all three PROMs had been robustly developed and validated and demonstrated adequate quality. Conclusions BREAST-Q, BRECON-31, and EORTC QLQ-BRECON-23 have been well-developed and demonstrate adequate measurement properties. Work with key stakeholders is now needed to generate consensus regarding which PROM should be recommended for inclusion in a core measurement set.

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Anxiety in autistic individuals who speak few or no words: A qualitative study of parental experience and anxiety management

Autism ◽

10.1177/1362361320962366 ◽

2020 ◽

pp. 136236132096236

Author(s):

Joanne Tarver ◽

Effie Pearson ◽

Georgina Edwards ◽

Aryana Shirazi ◽

Liana Potter ◽

...

Keyword(s):

Quality Of Life ◽

Intellectual Disability ◽

Language Use ◽

Management Strategies ◽

Assessment Tools ◽

Evidence Based ◽

Structured Interviews ◽

Verbal Language ◽

Parental Recognition

Anxiety is a common co-occurring condition in autism and impacts quality of life of autistic individuals and their families; autistic individuals who speak few or no words represent an under-researched group. This qualitative study aimed to understand more about parental recognition and management of anxiety in autistic individuals who speak few or no words. Semi-structured interviews were conducted with parents/carers of 17 autistic individuals (mage = 14.29) recruited from an existing participant database and social media adverts. Using thematic analysis, 15 themes were placed under three a-priori grand themes: parental recognition of anxiety; parental management of anxiety; and anxiety impact on the autistic individual and their family. Due to reduced verbal language use and overlap with other behaviours, parents described difficulties recognising anxiety in their child. However, they also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. The findings of this study can help to inform the development of targeted intervention and assessment measures for anxiety in autistic individuals who speak few or no words. Lay abstract Anxiety is a common condition in autistic individuals, including those who also have an intellectual disability. Despite this, autistic individuals who have severe to profound intellectual disability, or use few or no words, are often excluded from autism research. There are also very few assessment tools and interventions with known effectiveness for autistic individuals with intellectual disability. In this study, we aimed to learn more about parent/carers experiences of recognising and managing anxiety in autistic individuals who use few or no words. We conducted semi-structured interviews with parents and carers to address three research questions: (1) what techniques and management strategies do parents describe for anxiety-related behaviour in their child; (2) how do communication difficulties impact parental understanding and management of anxiety provoking situations and behaviours; (3) what is the impact of anxiety-related behaviours on the quality of life of autistic individuals and their families? During the interviews, parents described difficulties recognising anxiety in their child, mostly due to reduced verbal language use and anxiety behaviours overlapping with other behaviours (e.g. autism characteristics). However, parents also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. We will use the findings of this study to inform future research to develop assessment tools and interventions for anxiety in autistic individuals who use few or no words.

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