ORCID Profile
0000-0001-8413-533X
Current Organisations
Memorial Sloan Kettering Cancer Center
,
University of Adelaide
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Elsevier BV
Date: 05-2007
DOI: 10.1016/J.JVOICE.2005.09.007
Abstract: The Voice Handicap Index is a tool for measuring the psychosocial consequences of voice disorders and consists of three dimensions. Previous psychometric evaluation of the VHI focused on the classic evaluation of reliability and validity, which is s le dependent. The authors used Rasch analysis to re-examine the dimensionality of the VHI and to produce item and scale statistics that are less s le dependent. In addition, they provide estimates of VHI item and person severities that are reported on the same logit unit scale, allowing a more straightforward interpretation of a VHI test score. Dysphonic patients (N = 530), who were referred for phoniatric examination, filled out the VHI. Rasch analysis revealed two truly uni-dimensional constructs: the 20-item psychosocial scale and the 9-item physical-functional scale. Logit item severity measures ranged from -2.1 to +2.7. Person severity scores ranged from -4.4 to + 4.4 logits. The internal consistency of the reduced scales was similar to that of the original total VHI (0.95 and 0.84). The VHI consisted of two uni-dimensional constructs. Raw test scores can be transformed into logit unit severity measures, making the VHI more suitable for evaluating the effectiveness of voice-related therapy.
Publisher: Elsevier BV
Date: 11-2018
Publisher: Consortium of Multiple Sclerosis Centers
Date: 03-2021
DOI: 10.7224/1537-2073.2020-096
Abstract: Activity Available Online: To access the article, post-test, and evaluation online, go to scare. Target Audience: The target audience for this activity is physicians, physician assistants, nursing professionals, speech pathologists, and other health care providers involved in the management of patients with multiple sclerosis (MS). Learning Objectives: 1) Identify several variables that may place a person with MS at risk of language symptoms. 2) Describe the role of frontline health care providers in management of language and communication symptoms in patients with MS. Accreditation Statement: In support of improving patient care, this activity has been planned and implemented by the Consortium of Multiple Sclerosis Centers (CMSC) and Delaware Media Group. The CMSC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Physician Credit: The CMSC designates this journal-based activity for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurse Credit: The CMSC designates this enduring material for 0.75 contact hour (none in the area of pharmacology). Disclosures: Francois Bethoux, MD, Editor in Chief of the International Journal of MS Care (IJMSC), has served as Physician Planner for this activity. He has disclosed relationships with Springer Publishing (royalty), Qr8 (receipt of intellectual property rights atent holder), Biogen (receipt of intellectual property rights atent holder, speakers’ bureau), GW Biosciences (consulting fee), MedRhythms (consulting fee, contracted research), Genentech (consulting fee), Helius Medical Technologies (consulting fee), Osmotica (consulting fee), and Adamas Pharmaceuticals (contracted research). Laurie Scudder, DNP, NP, has served as Reviewer for this activity. She has disclosed no relevant financial relationships. Sarah El-Wahsh, BAppSc (Sp Path) (Hons 1), has disclosed no relevant financial relationships. Rob Heard, PhD, has disclosed no relevant financial relationships. Hans Bogaardt, PhD, has disclosed no relevant financial relationships. Fiona Kumfor, PhD, has disclosed no relevant financial relationships. Kirrie J. Ballard, PhD, has disclosed founding a start-up unrelated to the topic of this article to date, the start-up designs apps for delivering speech therapy to children with developmental speech disorders. The peer reviewers for IJMSC have disclosed no relevant financial relationships. The staff at IJMSC, CMSC, and Delaware Media Group who are in a position to influence content have disclosed no relevant financial relationships. Note: Financial relationships may have changed in the interval between listing these disclosures and publication of the article. Method of Participation: Release Date: April 1, 2021 Valid for Credit Through: April 1, 2022 In order to receive CME/CNE credit, participants must: 1) Review the continuing education information, including learning objectives and author disclosures.2) Study the educational content.3) Complete the post-test and evaluation, which are available at scare. Statements of Credit are awarded upon successful completion of the evaluation and the post-test with a passing score of & %. The post-test may be retaken if necessary. There is no fee to participate in this activity. Disclosure of Unlabeled Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the FDA. The CMSC and Delaware Media Group do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the CMSC or Delaware Media Group. Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any medications, diagnostic procedures, or treatments discussed in this publication should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.
Publisher: American Speech Language Hearing Association
Date: 12-11-2020
DOI: 10.1044/2020_AJSLP-20-00163
Abstract: Speech-language pathologists are playing a crucial role in the assessment and management of patients infected with severe acute respiratory syndrome coronavirus 2. Our goal was to synthesize peer-reviewed literature and association guidelines from around the world regarding dysphagia assessment and management for this specific population. A review of publications available in the PubMed database and official guidelines of international groups was performed on May 23, 2020. The information was synthesized and categorized into three content areas for swallowing: clinical evaluation, instrumental assessment, and rehabilitation. Five publications were identified in the PubMed database. Following title, abstract, and full-text review, only three publications met inclusion criteria: two reviews and one narrative report. Additionally, 19 international guidelines were reviewed. To assess swallowing, a modified clinical evaluation was recommended and only following a risk assessment. Instrumental assessments were often considered aerosol generating, especially transnasal procedures such as endoscopy and manometry. For this reason, many associations recommended that these examinations be performed only when essential and with appropriate personal protective equipment. Guidelines recommended that intervention should focus on compensatory strategies, including bolus modification, maneuvers ostural changes, and therapeutic exercises that can be conducted with physical distancing. Respiratory training devices were not recommended during rehabilitation. International associations have provided extensive guidance regarding the level of risk related to the management of dysphagia in this population. To date, there are no scientific papers offering disease and/or recovery profiling for patients with dysphagia and coronavirus disease 2019. As a result, research in this area is urgently needed.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/6086894
Abstract: Introduction . Patients with head and neck cancer suffer from various impairments due to the primary illness, as well as secondary consequences of the oncological treatment. This systematic review describes the effects of radiotherapy and/or chemotherapy on the functions of the upper aerodigestive tract in patients with head and neck cancer. Methods . A systematic literature search was performed by two independent reviewers using the electronic databases PubMed and Embase. All dates up to May 2016 were included. Results . Of the 947 abstracts, sixty articles met the inclusion criteria and described one or more aspects of the sequelae of radiotherapy and/or chemotherapy. Forty studies described swallowing-related problems, 24 described voice-related problems, seven described trismus, and 25 studies described general quality of life. Only 14 articles reported that speech pathologists conducted the interventions, of which only six articles described in detail what the interventions involved. Conclusion . In general, voice quality improved following intervention, whereas quality of life, dysphagia, and oral intake deteriorated during and after treatment. However, as a consequence of the ersity in treatment protocols and patient characteristics, the conclusions of most studies cannot be easily generalised. Further research on the effects of oncological interventions on the upper aerodigestive tract is needed.
Publisher: Springer Science and Business Media LLC
Date: 23-12-2014
DOI: 10.1007/S00455-014-9590-1
Abstract: Swallowing problems are reported to be a common finding in patients who receive palliative care. In existing literature, the incidence of swallowing problems is mostly described in small numbers of patients at the start of the palliative phase. As we hypothesized that the incidence of dysphagia might increase as the palliative phase progresses, this study describes the incidence of swallowing problems and related problems in 164 unsedated patients at the end of the palliative phase, defined by the last 72 h before their death. To determine the incidence of swallowing problems and related problems, questionnaires were completed bereaved by relatives and nursing staff. Our data shows that in the palliative phase the incidence of swallowing problems can be as high as 79 %. A significant correlation was found between swallowing problems and reduced psycho-social quality of life as assessed by nursing staff (ρ = -.284). Overall the nursing staff rated the incidence and severity of swallowing problems (and related problems like frequent coughing, loss of appetite, and problems with oral secretions) lower than the relatives. This study suggests that incidence of swallowing problems at the end of the palliative phase is high and that these difficulties may not only result in discomfort for patients, but also can raise concern for caregivers. More information and education on management of swallowing problems in palliative settings might be needed for both relatives and nursing staff. However, the data also suggest that any intervention should be proportional to the level of distress caused by the intervention.
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.ANL.2007.08.003
Abstract: Voice rehabilitation after total laryngectomy is challenging. In order to investigate and understand the function of the neoglottis sophisticated measurements need to be made. During voice production, aerodynamic energy is transformed into sound energy. In non-laryngectomized patients, the voice production efficiency is called the vocal efficiency. Vocal efficiency is an indication of how efficient the transformation of energy takes place. Vocal efficiency is calculated by iding the output sound power by the aerodynamic power. In a group of eight laryngectomees with tracheoesophageal voice, we measured aerodynamic and acoustic quantities and calculated vocal efficiency. We used a computer setup with airflow transducers, pressure transducers, mikrotip transducers and sound intensity measurement to allow calculation of the needed parameters. The tables show the results of the power used and produced in various phonatory tasks. Relatively high levels of aerodynamic power are interpreted as increased effort to speak. The aerodynamic power is an indication of the effort needed for voice generation. The efficiency of TE-voice production is lower compared to laryngeal voice production but does show an increase when sound intensity increases, a known phenomenon in healthy laryngeal voice production.
Publisher: Informa UK Limited
Date: 28-03-2018
DOI: 10.1080/17549507.2018.1448895
Abstract: With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context. Relevant legal and ethical considerations in palliative and end-of-life care are described. SLPs have a role in palliative dysphagia management, however, this can involve unique legal and ethical challenges. The legal position on provision and cessation of nutrition and hydration differs between Australian States and Territories. Decisions by the courts have established a body of relevant case law. This article introduces SLPs to some of the important considerations for legal and ethical palliative care, but is not intended to be directive. SLPs are encouraged to explore their local options for ethical and medico-legal guidance. It is hoped that increasing SLPs awareness of many of the concepts discussed in this article enhances the provision of high-quality patient-centred care.
Publisher: Bohn Stafleu van Loghum
Date: 1999
Publisher: SAGE Publications
Date: 04-2009
DOI: 10.1177/000348940911800401
Abstract: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. Twenty-five patients (average age, 53.1 years SD, 9.8 years) with multiple sclerosis and swallowing problems were treated for 3 weeks with 2 sessions per week of neuromuscular electrostimulation. The average time since the onset of multiple sclerosis was 16.5 years (SD, 10.2 years). Seventeen patients were examined with transnasal flexible endoscopy 1 week before treatment and 1 week after treatment. After treatment, a significant decrease in pooling of saliva in the pyriform sinuses was seen in 6 patients (p = 0.03), and significantly less aspiration during swallowing of thin liquids (p 0.01) was seen in 9 patients. Overall, the 25 patients reported that their swallowing had improved (p 0.01), and in 20% of the patients, it had become less strenuous. No adverse effects of the treatment were reported. Our study showed that the treatment of swallowing problems with neuromuscular electrostimulation in patients with multiple sclerosis in this s le was successful in the reduction of pooling of saliva and in the reduction of aspiration.
Publisher: Informa UK Limited
Date: 21-09-2022
Publisher: Informa UK Limited
Date: 29-01-2019
Publisher: Springer International Publishing
Date: 2020
Publisher: Springer Science and Business Media LLC
Date: 17-11-2017
DOI: 10.1007/S00455-017-9864-5
Abstract: The 10-item Dysphagia in Multiple Sclerosis (DYMUS) questionnaire is a self-administered tool used to identify swallowing problems in adults with MS. The questionnaire was not validated against other existing questionnaires to assess its convergent validity. Moreover, its test-retest reliability was not measured previously. Therefore, the purpose of this study was to assess the factor analysis, internal consistency and test-retest reliability of the DYMUS, as well as its convergent validity against an established and validated questionnaire, the EAT-10. English-speaking adults with MS in New South Wales, Australia who were seen for routine medical check-ups were invited to complete two questionnaires across two phases. One hundred participants completed phase 1, while 55 completed phase 2. Statistical analyses were performed to investigate the psychometric properties of the DYMUS questionnaire. Internal consistency (Cronbach's Alpha) reduced the DYMUS questionnaire from ten to five items. The shortened version of the DYMUS showed high internal consistency (alpha = 0.904). It also showed satisfactory reproducibility, and adequate correlation with the 10-item Eating Assessment Tool (EAT-10). Evaluation of the DYMUS resulted in a shortened version of the questionnaire with five questions related to dysphagia. This shortened version is considered an easy and useful tool in identifying patients with MS-related dysphagia.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Springer Science and Business Media LLC
Date: 13-11-2011
Publisher: Informa UK Limited
Date: 22-10-2019
Publisher: Springer Science and Business Media LLC
Date: 29-01-2011
Publisher: Springer Science and Business Media LLC
Date: 03-08-2019
Publisher: Wiley
Date: 24-01-2019
DOI: 10.1002/HED.25631
Abstract: Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta-analysis demonstrates the effect that radiation has on swallowing. Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta-analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies. The majority of the papers found a correlation between radiation dose to the swallowing structures and dysphagia, however a meta-analysis found the studies carried a significant degree of heterogeneity. The appraisal demonstrates the need for large-scale studies using a randomized design and instrumental dysphagia assessments. Radiation dose to dysphagia and aspiration structures is correlated with incidence of dysphagia and aspiration. The variables in this population contribute to the heterogeneity within and cross studies and future studies should consider controlling for this.
Publisher: Informa UK Limited
Date: 07-09-2022
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.MSARD.2019.101896
Abstract: Language impairment has only recently begun to be considered a clinical manifestation of MS. A decline in language abilities can lead to restricted participation in everyday activities that require communication, including vocational, social, and educational contexts. The objectives of this study were to identify the prevalence and nature of self-reported language impairment in MS using a validated MS-specific patient-reported outcome measure and to determine the association with health-related quality of life (HRQoL) and demographic and clinical variables. In this cross-sectional study, 160 persons with MS completed the language items of the Speech pathology-specific questionnaire for persons with MS (SMS) to assess language and the 12-Item Short Form Survey (SF-12) to assess HRQoL. Participants were recruited internationally through professional MS bodies and support groups and completed all questionnaires online. 75% of persons with MS in this s le self-reported a language impairment. Of the total s le, 65.7% reported difficulty with word retrieval, 53.8% reported difficulty with expressive language, 49.4% reported difficulty with confrontational naming, and 40.6% reported difficulty with receptive language in spoken discourse. Statistical analyses revealed that age, sex, educational status, country of residence, disease duration, age at time of diagnosis, MS subtype, and medication management, were not associated with the prevalence of self-reported language impairment. Participants with self-reported language impairment had lower HRQoL than those without language impairment, scoring lower on both the SF-12 mental and physical component summary scores, with medium to large effect sizes (Cohen's d = 0.66 - 0.83). Participants with self-reported language impairment had higher rates of unemployment than those without language impairment (χ Language can be compromised in persons with MS regardless of clinical and demographic characteristics and is associated with lower HRQoL. These findings indicate that frontline healthcare providers need to be aware of potential language impairment in MS and should make timely referrals to speech pathologists for further evaluation and support. Further research is needed to investigate the underlying neural mechanisms of language impairment in MS. In future, this will help guide the design of evidence-based intervention for these symptoms.
Publisher: Informa UK Limited
Date: 28-04-2020
Publisher: Wiley
Date: 15-02-2016
DOI: 10.1111/COA.12578
Abstract: The short-term and long-term beneficial effects of HME use by laryngectomees are well described in literature. In this study, we document how laryngectomised patients, who previously did not use an HME, get accustomed to the use of HME and attachments. Thirty patients, who were at least 3 months post-laryngectomy and previously did not use an HME, were followed for 12 weeks and were asked to complete questionnaires about their experiences with the HME and attachments. Results show that when patients start using an HME, they report some difficulties with breathing resistance during the first 2 weeks of use. However, after 6 weeks, they have become accustomed to the breathing resistance and after 12 weeks over 96% reports that breathing was equal or less strenuous compared with breathing though an open stoma. Only a small proportion of patients experienced problems with increased coughing when starting HME use. This study provides insight in the way laryngectomised patients are experiencing the use of HMEs in the first weeks. These outcomes can contribute to a better knowledge of HME use by healthcare providers and help them to manage patient expectations and improving support to patients in achieving compliant HME use.
Publisher: Springer Science and Business Media LLC
Date: 2021
Publisher: SAGE Publications
Date: 26-03-2015
Abstract: Both the immediate beneficial physiological changes in a laboratory setting and the long-term clinical outcomes of heat and moisture exchanger (HME) use are well described. So far, there has not been any research published that provides detailed insight in the pattern of changes in both respiratory function and patients’ experiences with HMEs in the first weeks of use. A multicenter time-series study design with a 2-week double baseline period. All patients used the XtraHME for 12 weeks afterward. Data were collected 2 weeks, 6 weeks, and 12 weeks after the start of HME use. Data of 30 patients were analyzed. Pulmonary symptoms decreased significantly during the 12 weeks of HME use. After 2 weeks, a significant decrease in daily coughs and daily forced expectorations was seen. The general quality of life showed a significant increase throughout the study. More general physical complaints also significantly decreased with HME use. Patient satisfaction with the HME was high. This study shows that there is a significant influence of the XtraHME on pulmonary status that can already be observed after 2 weeks of using the XtraHME and continues to improve further after 6 weeks of XtraHME use.
Publisher: Springer Science and Business Media LLC
Date: 21-02-2007
Publisher: SAGE Publications
Date: 06-2013
DOI: 10.1177/000348941312200602
Abstract: After laryngectomy, pulmonary protection is mostly acquired by means of a heat and moisture exchanger (HME) that is placed on an airtight seal around the stoma. The effects of HMEs on the tracheal climate have been well described, and the filtration effect of an HME with an electrostatic filter has been described in vitro. The effects of HME use in patients have been documented in several trials in different countries. The follow-up time of the patients in these trials, however, is limited. Less is known about long-term use of HMEs, and studies describing long-term compliance with HME use are scarce. This study investigated the long-term use of HMEs in laryngectomees. Questionnaires were sent to 195 laryngectomees, and 75 questionnaires were returned. More than 85% of the respondents used an HME, of whom 77% were compliant users (ie, use for more than 20 hours per day). The incidence of pulmonary illnesses (either before or after surgery) was about 25%. More than 90% of the respondents were heavy smokers before laryngectomy. One third of the respondents are regularly exposed to dusty environments. Compliant HME users tend to make less use of external humidifiers and vaporizers, and have better pulmonary status and lower health-care costs. Regarding quality of life, patients who use a FreeHands device tended to have more frequent social contacts (r = 0.251 p = 0.030). The prevalence of depression is high, pointing to an urgent need to recognize and treat psychiatric problems such as depression and suicidal ideation in this patient group. These findings have implications for any postlaryngectomy research that uses pulmonary parameters.
Publisher: S. Karger AG
Date: 2009
DOI: 10.1159/000227997
Abstract: i Objective: /i To evaluate the efficacy of the use of surface electromyographic feedback in the treatment of stroke patients with chronic dysphagia. i Patients and Methods: /i Data of 11 consecutive patients with chronic dysphagia after stroke were analyzed. Our patients were treated for dysphagia with surface electromyography as biofeedback as adjunct to normal exercises. All patients suffered from dysphagia after stroke. The average time after onset was 31.1 months. All patients had been previously treated by speech therapists without success. Functional swallowing was estimated using the Functional Oral Intake Scale (FOIS). At the start of the treatment 8 patients were tube dependent (FOIS ≤4). Three patients were on an oral diet, but with restrictions (FOIS ≥5). i Results: /i The patients were treated on average seven 7 times. The time between the first and last treatment session was on average 76.1 days (SD ± 44.0 range = 29–168). Before treatment the average FOIS was 2.6 (SD ±2.3) and after treatment 5.6 (SD ±1.6). The median scores improved from 1 to 6, showing a significant and clinically relevant improvement (z = –2.820: p 0.01) in swallowing function. In 6 of initially 8 patients with percutaneous enteral gastrostomy tubes, the feeding tube could be removed after treatment. i Conclusion: /i Our data suggest that the use of surface electromyography as biofeedback in the treatment of chronic dysphagia after stroke could be an effective adjunct to standard therapy for swallowing disorders in 11 patients.
Publisher: Springer Science and Business Media LLC
Date: 27-11-2020
DOI: 10.1007/S00455-020-10219-7
Abstract: This letter is a response to the Letter to the Editor by Ghaemi et al. (2020), in which we discuss the comments made by Ghaemi et al. and conclude that, despite a minor error in wording, our systematic review provided an accurate reflection of the literature at that point in time.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2016
DOI: 10.1007/S00455-016-9738-2
Abstract: Dysphagia or swallowing difficulties have been reported to be a concern in adults with multiple sclerosis (MS). This problem can result in several complications including aspiration pneumonia, reduced quality of life and an increase in mortality rate. No previous systematic reviews on treatment effects for dysphagia in MS have been published. The main objective of this study is to summarise and qualitatively analyse published studies on treatment effects for dysphagia in MS. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied to conduct a systematic search of seven databases, using relevant key words, and subsequent analysis of the identified studies. The studies were required to meet all three inclusion criteria of including a statement on intention to treat, or measure the effects of treatment for dysphagia in adults with MS and data on treatment outcomes for at least one adult diagnosed with MS. Retained studies were evaluated by two independent reviewers using a critical appraisal tool. This study has not been registered. A total of 563 studies were identified from the database searches. After screening and assessment of full articles for eligibility, five studies were included in the review. Three examined electrical stimulation and two examined the use of botulinum toxin. One study testing electrical stimulation was a randomised controlled trial, two were well-designed case series and two were case series lacking experimental control. All studies reported some positive effects on dysphagia however, treatments that involved the use of electrical stimulation showed larger effect sizes. There is a paucity of evidence to guide treatment of dysphagia in MS, with only electrical stimulation and botulinum toxin treatment represented in the literature search conducted here. While both treatments show initial promise for reducing the swallowing impairment, they require further research using well-controlled experimental designs to determine their clinical applicability and long-term treatment effects for dysphagia across different types and severity of MS.
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.JVOICE.2008.10.004
Abstract: The objective of the study was to determine maximum phonation time reliability as a function of the number of trials, days, and raters in dysphonic and control subjects. Two groups of adult subjects participated in this reliability study: a group of outpatients with functional or organic dysphonia versus a group of healthy control subjects matched by age and gender. Over a period of maximally 6 weeks, three video recordings were made of five subjects' maximum phonation time trials. A panel of five experts were responsible for all measurements, including a repeated measurement of the subjects' first recordings. Patients showed significantly shorter maximum phonation times compared with healthy controls (on average, 6.6 seconds shorter). The averaged interclass correlation coefficient (ICC) over all raters per trial for the first day was 0.998. The averaged reliability coefficient per rater and per trial for repeated measurements of the first day's data was 0.997, indicating high intrarater reliability. The mean reliability coefficient per day for one trial was 0.939. When using five trials, the reliability increased to 0.987. The reliability over five trials for a single day was 0.836 for 2 days, 0.911 and for 3 days, 0.935. To conclude, the maximum phonation time has proven to be a highly reliable measure in voice assessment. A single rater is sufficient to provide highly reliable measurements.
Publisher: Wiley
Date: 16-09-2020
DOI: 10.1002/HED.26458
Publisher: Medical Journals Sweden AB
Date: 2018
Abstract: To describe telehealth interventions delivered by allied health professionals and nurses in rural and remote areas, and to compare the effects of telehealth interventions with standard face-to-face interventions. CINAHL, Embase, PsycINFO and PubMed databases were searched. The content of relevant journals and published articles were also searched. Studies examining the effectiveness of allied health and nursing telehealth interventions for rural and remote populations were included in descriptive analyses. Studies comparing telehealth intervention with standard face-to-face interventions grouped by type of intervention approach were used to examine between-groups effect sizes. Methodological quality of studies was rated using the QualSyst critical appraisal tool and the National Health and Medical Research Council (NHMRC) Evidence Hierarchy levels. After quality ratings, 43 studies were included. A majority of studies had strong methodological quality. The disciplines of psychology and nursing were represented most frequently, as were studies using a cognitive intervention approach. Meta-analysis results slightly favoured telehealth interventions compared with face-to-face interventions, but did not show significant differences. Interventions using a combined physical and cognitive approach appeared to be more effective. Telehealth services may be as effective as face-to-face interventions, which is encouraging given the potential benefits of telehealth in rural and remote areas with regards to healthcare access and time and cost savings.
Publisher: Informa UK Limited
Date: 26-07-2016
Publisher: Wiley
Date: 30-07-2019
Abstract: Oropharyngeal dysphagia and laryngeal dysfunction are two lesser known complications after lung and heart transplantation. The presence of these features places this immunocompromised population at high risk of pulmonary complications and subsequent medical deterioration. Early identification of swallowing and voice dysfunction would be beneficial to optimize management. To examine the association between patient risk factors and postoperative outcomes with referral to speech pathology (SP) following signs of swallowing and voice dysfunction. A retrospective review was conducted on demographic data, patient risk factors and postoperative course in 284 patients following lung and/or heart transplantation between 2010 and 2013. Variables were analysed for any association between pre- and postoperative factors and SP referral. A total of 24% were referred to SP with a mean age of 47 years. Binary logistic regression identified a statistically significant association between the number of intubations (odds ratio (OR) = 2.066, p = 0.028), intubation duration (OR = 1.004, p < 0.01), length of stay in the intensive care unit (ICU) (OR = 1.068, p < 0.01), and number of ICU admissions (OR = 1.384, p = 0.046) and SP referral. Intubation time and the total days in ICU were greater for patients referred to SP. Mortality also increased for these variables and for the numbers of reintubations and readmissions. Analysis of pre-operative risk factors revealed cerebrovascular disease to be a significant predictor of SP referral (OR = 6.747, p = 0.032). This study demonstrates significant clinical indicators for referral to SP for the management of oropharyngeal dysphagia and laryngeal dysfunction in patients after lung or heart transplantation. Further studies are needed to investigate the most efficacious intervention approaches to manage swallowing and voice dysfunction in these patients.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2008
DOI: 10.1007/S00455-008-9174-Z
Abstract: The aim of this work was to translate the 44-item SWAL-QoL into Dutch (SWAL-QoL-NL) and compare the validity of this questionnaire against Euroqol in a Dutch population with dysphagia. SWAL-QoL was translated according to international guidelines. SWAL-QoL-NL and Euroqol were completed by 152 patients in seven diagnosis groups. Internal consistency and correlations were calculated. Scores for nine subscales (General burden, Food selection, Eating duration, Fear of eating, Sleep, Fatigue, Mental health, Social functioning and a symptom score) ranged between 0.80 and 0.92 (Cronbach's alpha). Two subscales (Eating desire and Communication scored 0.67 and 0.60, respectively, and were removed from the questionnaire. The 14-item battery on clinical symptoms showed an internal consistency of 0.80, allowing the use of a sum score on group level in clinical research. Correlation of SWAL-QoL-NL subscales with the Euroqol was negligible to low (Pearson's correlations range = 0.09-0.36). The 39-item SWAL-QoL-NL proved to be a reliable tool to examine the impact of dysphagia on quality of life in a Dutch population. Internal consistency allows the use of nine subscales of SWAL-QoL-NL for comparisons on a group level (0.80 < alpha < 0.92) only. Also a Symptom score can be derived from the raw data.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.MSARD.2018.08.003
Abstract: Multiple Sclerosis (MS) refers to a chronic inflammation of the central nervous system including the brain and spinal cord. Dysphagia is one of the symptoms that represent challenges in clinical practice for the management of MS patients. Dysphagia can result in serious complications leading to morbidity and death in late stages of MS. However, little attention is given to dysphagia, its symptoms and how it affects the quality of life of adults with MS. The purpose of this study is to identify the frequency of dysphagia in adults with MS and determine the main symptoms suggestive of dysphagia and its impact on the patients' quality of life. In total, 103 adults with MS agreed to participate in the study. Data were collected at the Multiple Sclerosis outpatient Clinic of a major metropolitan Australian hospital using patient reported questionnaires. 38% of adults with MS reported having swallowing problems that resulted in various physical and social consequences including but not limited to coughing, throat clearing, choking on food and liquid, reduced eating desire, increased eating duration and mealtime anxiety. Adults with MS-related dysphagia had reduced scores across all domains of swallowing-related quality of life. These findings support referral to speech-language pathologists for management of dysphagia from the early stages of the disease. Further work is required to determine whether early intervention for dysphagia can sustain or improve swallowing function as well as swallowing-related quality of life domains further into the disease course.
Publisher: Informa UK Limited
Date: 18-02-2018
DOI: 10.1080/09638288.2018.1430174
Abstract: The aims of this study were to determine the self-efficacy of speech pathology students in conducting evidence-based practice before and after a comprehensive evidence-based practice course, and the impact of timing of the course (Semester 1/2). Students attended a 13-week course in their final year of study. The evidence-based practice confidence scale (EPIC) was used to measure the students' self-efficacy pre- and post-training. Ninety-two percent of students enrolled over six semesters participated. Students began the evidence-based practice course with high confidence in asking patients their preferences but low confidence in interpreting and analysing statistics. A significant improvement in confidence in all evidence-based practice areas was found, with greatest improvement occurring in the critical appraisal of research. Overall, the teaching had greatest effect on a group of skills for finding valid EBP information. There were significant differences between semester one and two students in only 18% of responses. Semester two students were more confident in half of these responses. An evidence-based practice course made a significant difference to student self-efficacy across all aspects, with few differences related to timing of the course. Implications are discussed. Implications for Rehabilitation Health professionals must be confident implementing evidence-based practice throughout the course of their careers, as best practice changes over time. A capstone unit of study/course for undergraduate speech pathology students significantly improved their self-efficacy in implementing evidence-based practice. This has positive implications for evidence-based practice across a wide range of clinical settings including rehabilitation and disability as the graduate entry level students enter the workforce. For on-going success, graduate entry level students must continue to implement evidence-based practice as clinicians if they are to maintain their confidence and further develop their skill set.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2022
DOI: 10.1038/S41598-022-05687-W
Abstract: As a global health emergency, the rapid spread of the novel coronavirus disease (COVID-19) led to the implementation of widespread restrictions (e.g., quarantine, physical/social distancing measures). However, while these restrictions reduce the viral spread of COVID-19, they may exacerbate behavioural and cognitive symptoms in dementia patients and increase pressure on caregiving. Here, we aimed to assess the impact of COVID-19 and related restrictions on both carers and people living with dementia across the world. We conducted an international survey (Australia, Germany, Spain, and the Netherlands) to assess the impact of COVID-19 on carers and people living with dementia. People with dementia experienced worsened neuropsychiatric symptoms since the outbreak of COVID-19, most commonly, depression, apathy, delusions, anxiety, irritability, and agitation. Regression analyses revealed that limited understanding of the COVID-19 situation and not living with the carer was associated with worsened neuropsychiatric symptoms. Carers also reported a decline in their own mental health, increased stress and reduced social networks as a result of COVID-19 and related restrictions. Regression analyses revealed uncertainty about the future and loneliness were associated with worsened carer mental health. Findings from this study will inform strategies for the development of support services and compassionate protocols that meet the evolving needs of those living with dementia and their carers.
Publisher: Wiley
Date: 09-03-2021
DOI: 10.1002/HED.26675
Abstract: Heterogeneity within studies examining transoral robotic surgery (TORS) for oropharyngeal cancer (OPC) has made it challenging to make clear conclusions on functional outcomes. Infrequent use of instrumental swallow examinations compounds uncertainty surrounding the proposed functional advantage to TORS. A prospective cohort of 49 patients underwent speech and swallowing assessment 12 months following treatment for OPC. Patients were assessed using fibreoptic endoscopic evaluation of swallowing (FEES), clinician‐ and patient‐reported outcomes. Participants were matched according to tumor site, T category, and age. Speech and swallowing outcomes were compared for those receiving TORS versus chemoradiation. When adjuvant radiotherapy to the primary site could be avoided, TORS demonstrated an advantage for feeding tube duration, secretion severity, penetration/aspiration, M. D. Anderson Dysphagia Inventory (MDADI), and airway protection. This explorative study suggests that a treatment philosophy of selecting patients for TORS where adjuvant therapy can be omitted or confined to the neck warrants further evaluation.
Publisher: Elsevier BV
Date: 05-2023
Location: United States of America
No related grants have been discovered for Hans Bogaardt.