Search

The aim of this study was to assess the effect of cognitive behavioural therapy intervention on sleep and health improvement in patients with cardiometabolic syndrome and sleep problems. This study also aimed to assess the effect of different study designs to explain the overall intervention effect through subgroup analysis. Relevant randomized controlled trial studies were searched through six online databases. The PEDro scale was used to assess the quality of the included studies. The random effects model was used to assess the mean difference, effect size, and standard deviation of the outcome variables. The heterogeneity of the included studies was assessed using I2 and Q tests. Publication bias was assessed by the Egger test. Cognitive behavioural therapy intervention provided a significant effect in improving the Pittsburgh Sleep Quality Index, Insomnia Severity Index, total sleep time, sleep efficiency, depression, fatigue, and HbA1c. The effect of cognitive behavioural therapy is more significant when relaxation training and education components are included. Cognitive behavioural therapy is suitable for the treatment of sleep problems in patients with cardiometabolic syndrome. Cognitive behavioural therapy is also effective on depression and fatigue but has a limited effect on blood pressure and biomedical indicators related to cardiometabolic syndrome. [ABSTRACT FROM AUTHOR]

Problem: Traditionally, journal editors expect individuals to complete peer reviews of submitted manuscripts on their own. Recently, a number of editors of health sciences journals have begun to support, and even espouse, the practice of group peer review (GPR). With GPR, multiple individuals work together to complete the review with permission from the journal editor. Motivated by the idea that GPR could provide a meaningful service learning experience for participants in an interprofessional educational scholarship course, we conducted three such reviews and subsequently reflected on our experience and the lessons we learned. We frame our reflections using guiding principles from the domains of peer review, professional development, and educational scholarship. Intervention: The course director arranged for manuscripts to review with the editors of three health sciences journals. Each GPR occurred during a separate weekly session of the course. Each GPR was completed using a similar set of steps, which included (a) gaining familiarity with review criteria, (b) reading aloud and discussing the manuscript's abstract as a class, (c) reading and critiquing assigned sections as individuals and then small groups, (d) building consensus and sharing notes, (e) having the course director synthesize notes into a single review for submission to the journal. Context: The course on educational scholarship involved 15 faculty representing faculty from the University of Utah's School of Medicine, College of Nursing, College of Pharmacy, College of Health, and School of Dentistry. The course director led three GPR sessions mid-way through the yearlong course. Impact: Participants' reflections indicate that GPR (a) conformed to principles of effective peer review; (b) resulted in a meaningful service learning experience within a formal professional development program, deepening understanding of core concepts of educational scholarship; and (c) represented an authentic example of engaging in educational scholarship (i.e., designing and evaluating an intervention while drawing upon and contributing to a body of shared understanding within a community of practice). Lessons Learned: Our principles-based approach to completing GPR within a professional development course on educational scholarship can serve as a model for others to follow. A rigorous, meaningful group review can occur in 1 hour using a combination of group and individual activities focused on matching review criteria to the submitted manuscript. As a result, we continue to include GPR in future offerings of this interprofessional course on educational scholarship, and we continue to study ways to optimize its value as a service learning experience. [ABSTRACT FROM AUTHOR]

Purpose: This pilot study aimed to evaluate the effects of an intensive hybrid service delivery model (i.e., combining face-to-face individual, computer and group therapy) on communication and well-being for people with aphasia (PWA) in the hospital setting. Materials and methods: The study explored two different intensities of the hybrid model, 4 h/week (Hybrid-4) and 8 h/week (Hybrid-8) both for 8 weeks. Participants ranging from 1 month to 5 years post-onset were allocated using matched-pair randomisation to receive either Hybrid-4 (n = 5) or Hybrid-8 (n = 4) and assessed using a comprehensive language battery by a blinded assessor, as well as selected activity, participation and well-being measures before, immediately after and 4-week post-treatment. Results: All participants in Hybrid-4 and three out of four participants in Hybrid-8 demonstrated clinically significant improvement to measures of language impairment immediately post-treatment, with the majority also demonstrating maintenance effects 4-week post-treatment. Clinically significant improvements to activity, participation and well-being measures were also observed across participants in both groups. Conclusions: Findings support the potential benefit of employing an intensive hybrid service model and suggest that both 4 and 8 h per week of impairment-based treatment for 8 weeks may result in improvements in communication and well-being for some PWA across different stages of recovery. Implications for rehabilitation: The present findings help bridge the gap between what evidence suggests is effective intensity of rehabilitation for aphasia and what can be practically delivered in real-world hospital settings. Findings support the potential clinical value of employing a hybrid service model (using computer, group and individual therapy) to deliver intensive rehabilitation to people with aphasia in the hospital setting, and suggest that clinically significant improvements to communication and well-being can result when the model is delivered at either 4 or 8 h per week. The current study highlights that people with aphasia in the early stages of aphasia recovery can potentially benefit from intensive impairment-based hybrid models of intervention. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify factors that influence the decision to supervise a Level II occupational therapy fieldwork student. A survey was sent to occupational therapists identified from licensure boards and alumni rosters, including those who have and have not supervised students (n = 548). The results identified both positive and negative influences along with predictive factors of supervising a student. While positive factors included continuing education units, education on fieldwork expectations, their own fieldwork experiences, shared supervision, and access to educational resources, negative influences consisted of: job responsibilities, caseload, productivity standards, working part-time, and fear of failing a student. The discussion focuses on how to address the needs of the clinician and facilitate fieldwork placement. [ABSTRACT FROM AUTHOR]

Background: Semantic priming in individuals with anomic aphasia has never been the primary focus of an investigation. To date, one study investigated the effects of semantic priming in individuals with fluent aphasia (including anomic aphasia), revealing an inconsistency in semantic priming in the anomic group. Parallels from Broca’s aphasia and Wernicke’s aphasia literature may be drawn. However, due to the heterogeneity of anomic aphasia, a focused investigation was necessary. Aims: Semantic priming effects were investigated using a cross-modal pairwise paradigm. It was hypothesised that participants with anomic aphasia would demonstrate priming patterns at a stimulus onset asynchrony (SOA) of 500 ms with slower overall reaction times (RTs) than the control participants. It was further hypothesised that the participants with anomic aphasia might show less inhibition effects than the control participants. Methods & Procedures: Participants with anomic aphasia (n = 11) and healthy control participants (n = 16) completed a lexical decision task where prime–target pairs were present in equal proportions (related, unrelated, and nonwords). A neutral prime condition was also incorporated. Using a cross-modal pairwise paradigm, participants heard a spoken word 500 ms later, a written word appeared on screen (for 4000 ms). Participants were required to make a decision as to whether the written word was real, and RTs were recorded. Outcomes & Results: Linear mixed model analysis was undertaken and revealed no significant two-way interaction effect, indicating both groups showed priming patterns. A main effect of group was evident, showing faster RTs by the control participant group, confirming our hypothesis that people with anomic aphasia primed at an SOA of 500 ms in a similar manner to the control participants, with slower RTs. Conclusions: Semantic priming effects were present in anomic aphasia at relatively short SOAs and may be contributed to by automatic processes. Several parameters are proposed that should be adopted for further investigation into semantic priming in anomic aphasia including electrophysiological measures and manipulation of SOAs and relatedness proportions (RPs) to more precisely measure the effects of controlled versus automatic processes. Such investigation has the potential to inform new assessment and management techniques. [ABSTRACT FROM AUTHOR]

Focuses on the book 'Foundations of Stuttering,' by Marcel Wingate on the study of stuttering. Nature of stuttering; Problems in the field of stuttering research; Classification of disruptions to fluency.

This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing. A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication. 21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; n = 321). Treatment approaches included singing therapy (n = 10), loudness therapy (n = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) (n = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches. There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment. Group therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease. Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures. Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD. PROSPERO registration number: CRD42015029374. [ABSTRACT FROM AUTHOR]

Background: Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees. Aims: This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills. We hypothesised that knowledge of swallow anatomy and physiology, visual perceptual skills, self‐efficacy and interest, and prior clinical exposure would all influence VFSS novice analysts' skill development. Methods & Procedures: Participants were undergraduate speech pathology students recruited from an Australian university, who had completed the required theoretical units in dysphagia. Data assessing the factors of interest were collected—the participants identified anatomical structures on a still radiographic image, completed a physiology questionnaire, completed subsections of the Developmental Test of Visual Processing—Adults, self‐reported the number of dysphagia cases they managed on placement, and self‐rated their confidence and interest. Data for 64 participants relating to the factors of interest were compared with their ability to accurately identify swallowing impairments following 15 h of VFSS analytical training, using correlation and regression analysis. Outcomes & Results: Success in VFSS analytical training was best predicted by clinical exposure to dysphagia cases and the ability to identify anatomical landmarks on still radiographic images. Conclusions & Implications: Novice analysts vary in the acquisition of beginner‐level VFSS analytical skill. Our findings suggest that speech pathologists who are new to VFSS may benefit from clinical exposure to dysphagia cases, sound foundational knowledge of anatomy relevant to swallowing and the ability to see the anatomical landmarks on still radiographic images. Further research is required to equip VFSS trainers and trainees for training, to understand differences between learners during skill development. WHAT THIS PAPER ADDS: What is already known on the subject: The existing literature suggests that no vice Video fluoroscopic Swallowing Study (VFSS) analysts training may be influenced by their personal characteristics and experience. What this study adds: This study found that student clinicians, clinical exposure to dysphagia cases and their ability to identify anatomical landmarks relevant to swallowing on still radiographic images prior to training best predicted their ability to identify swallowing impairments after training. What are the clinical implications of this work?: Given the expense of training health professionals, further research is required into the factors that successfully prepare clinicians for VFSS training, including clinical exposure, foundational knowledge of anatomy relevant to swallowing and the ability to identify the anatomical landmarks on still radiographic images. [ABSTRACT FROM AUTHOR]

Judgments of sentence well-formedness have played an important role in research into the nature of the agrammatic comprehension deficit in Broca's aphasia. This article presents a study, which aims to extend the scope of the offline well-formedness judgment (WFJ) paradigm, by investigating systematic interactions between grammatical classes of sentences and types of syntactic and semantic anomaly. The results suggest that Broca's aphasic performance during well-formedness judgment tasks is markedly influenced by both sentence-type and error-type. The poor ability to detect inflectional errors support previous findings from the WFJ literature that Broca's aphasic speakers have a reduction in sensitivity to error-types involved in syntactic parsing operations.

Using principles of community-based participatory research we developed a new theory-based measure of health-related quality of life (HRQOL) for individuals with intellectual disability (ID). We recruited adults with ID (n = 129) to take part in interviews and review successive versions of HRQOL items. Critical input about content and understandability shaped the items, as did input from four focus groups of parents/caregivers (n = 16) and representative stakeholders from community-based agencies (n = 7). The resulting HRQOL measure, called the HRQOL-IDD, contains 42 items. The response format depicts a gradient of fluid-filled cups ("none" to "full") to represent frequency of experience of each item on a 5-point scale. [ABSTRACT FROM AUTHOR]

Digital Interprofessional Learning Client Documentation (D-IPL Client Docs) is an initiative designed to develop student interprofessional communication skills through electronic record writing and a virtual simulation (VS) or live virtual simulation (LVS) case conference. The aims of the study were to (a) identify whether D-IPL Client Docs supports student learning in the affective domain and (b) compare the learning outcomes for students participating in the VS versus the LVS case conference. Data were drawn from 83 Bachelor of Social Work students who had participated with other health professional students in the D-IPL Client Docs activities. The reflective journals submitted by this cohort of social work students were analyzed qualitatively and quantitatively using the Griffith University Affective Learning Scale. Qualitative analyses revealed that the activities enabled students in both groups to learn about themselves, their roles, and the roles of others, and the benefits of interprofessional collaboration in optimizing client outcomes. Quantitatively, the VS mode appeared to be more effective in supporting students to develop higher order affective learning; however, the effect size was small. Future studies should involve a larger sample size and include students from various professions to ascertain the transferability of findings. [ABSTRACT FROM AUTHOR]

Background: Simulation‐based learning provides students with a safe learning environment, guaranteed exposure to specific clinical scenarios and patients, time for reflection and repetition of tasks, and an opportunity to receive feedback from multiple sources. Research including studies specific to allied health training programmes have demonstrated that simulation‐based learning also helps increase learners' confidence and reduces anxiety related to clinical environments, activities and skills. Such evidence, together with increasing challenges in provision of workplace clinical education, has supported an expansion of integrating simulation‐based learning into university curricula. Aims: To provide detailed information about the processes and considerations involved in the development of a simulation‐based learning programme for speech–language pathology. Methods & Procedures: Through reflection on the development process of a 5‐day simulation‐based learning programme, and in light of existing research in simulation, this paper outlines the important steps and considerations required for the development of a simulation‐based learning programme to support student competency development in adult speech pathology range of practice areas. Main Contribution: A proposed framework for the development of future simulation‐based learning programmes in speech–language pathology. Conclusions & Implications: The framework can be applied to simulation‐based learning for university programmes and/or workplace training in speech–language pathology and across several other health disciplines. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine presence of clinical complications related to dysphagia and to explore their operational outcomes. Background Dysphagia is a common complication of stroke. The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding. Dysphagia-related complications have been shown to have a significant impact on morbidity and mortality, length of stay and cost of admission. Design Retrospective cohort study. Methods A total of 110 patients presenting with an ischaemic stroke were chart-audited. Results Aspiration pneumonia poststroke was found to be significantly associated with increased overall length of stay, poorer functional outcomes poststroke as well as being associated with a high risk of mortality. The presence of a nasogastric tube was also associated with reduced functional outcomes poststroke and increased risk of death. Conclusion High prevalence and cost of complications associated with stroke highlight the complexity of providing nursing and allied health care to this patient population. This provides a snapshot of dysphagia-related complications experienced by stroke patients. Relevance to clinical practice This paper highlights that poststroke complications can significantly impact on patient outcomes and operational factors such as cost of admission; therefore, poststroke care requires a multidisciplinary approach to management. Furthermore, preventing and managing complications poststroke is a key element of nursing care and has the potential to significantly reduce incidence of mortality, length of stay and cost of hospital admission. [ABSTRACT FROM AUTHOR]

Background:While evidence suggests that intensive aphasia therapy is associated with positive patient outcomes, speech language pathologists continue to report delivering therapy at low intensity schedules. Investigation of the barriers and enablers of delivering intensive therapy in hospital settings is needed to help address this evidence–practice gap. Aims:To explore clinicians’ perceptions of delivering high intensity aphasia treatment through three different service models and their recommendations for future directions in implementing high intensity aphasia clinics in a public health setting. Methods & Procedures:A sequential mixed methods design was employed. Thirteen speech language pathologists who provided intensive aphasia therapy to 31 patients across three facilities as part of a larger study consented to participate. Participants contributed to a log of barriers and facilitators while delivering treatment and completed a questionnaire in the last week of treatment. Findings were used to inform the question guide for a focus group interview conducted with nine of the clinicians post-treatment. Outcomes & Results:Most clinicians found the increased intensity of treatment more difficult to deliver than standard treatment, and reported barriers included patient fatigue, patient personal factors, locating resources, scheduling and coordination issues, and clinician workload and potential burn-out. Emotional challenges were less expected and were potentially intensified by the frequency of contact with patients. Despite this, clinicians remained dedicated, and were motivated by patient progress, peer support and the opportunity to prove the worth of speech language pathology. They were positive about the perceived benefits of patient confidence, clinician development, teamwork, and the relationships that formed between patients, carers and clinicians. Conclusions:Clinicians agreed that delivering the treatment brought great rewards and benefits, but also challenges. Communicating the benefits and finding ways to address the barriers identified by the participants of this study may be instrumental in assisting future implementation of high intensity models of aphasia treatment in existing services. [ABSTRACT FROM PUBLISHER]

Purpose: This article describes the effects of a new intensive dysarthria treatment program (Be Clear) on speech intelligibility in adults with dysarthria secondary to stroke and traumatic brain injury. Method: A small group–repeated measures research design was used to examine the effects of treatment on the speech of 8 participants with nonprogressive dysarthria. Treatment consisted of a 1-hr prepractice session followed by 1-hr therapy sessions, 4 times per week, for 4 weeks (16 sessions). Paired-comparison ratings of speech intelligibility served as the primary outcome measure for the study. Perceptual data, quality of life, and communication partner opinion were obtained at 3 time intervals: (a) prior to treatment, (b) immediately posttreatment, and (c) 1–3 months posttreatment. Results: Following treatment, group data demonstrated substantial improvements in speech intelligibility as perceived by naive listeners on a paired-comparison rating task. Word intelligibility was clinically significantly improved posttreatment and sentence intelligibility demonstrated statistically significant improvement. Communication partner ratings of speech intelligibility and overall communicative function were statistically significantly improved posttreatment. Conclusions: The results of this study suggest that this new intensive treatment may have potential as an effective intervention for nonprogressive dysarthria. However, controlled studies are required to establish treatment efficacy. [ABSTRACT FROM AUTHOR]

This study evaluated the feasibility and outcomes of a telerehabilitation adaptation of the Be Clear speech treatment program for adults with non-progressive dysarthria to determine clinical delivery viability and future research directions. Treatment effects on speech clarity, intelligibility, communication effectiveness, and participation, as well as psychosocial outcomes in 15 participants with non-progressive dysarthria, were explored. Intervention involved daily 1-h online sessions (4 days per week for 4 weeks, totalling 16 sessions) and daily home practice. Outcome measures were obtained at baseline (PRE), post-treatment (POST), and 12 weeks following treatment (FUP). Feasibility measures targeting participant satisfaction, treatment adherence and fidelity, and technical viability were also employed. The programme was feasible concerning technical viability and implementation, treatment adherence and fidelity. High levels of participant satisfaction were reported. Increases in overall ratings of communication participation and effectiveness were identified at POST and FUP. Reductions in speech rate were identified at FUP. Improvements in aspects of lingual and laryngeal function were also noted after treatment. Over time, improvements relating to the negative impact of dysarthria were identified. Naïve listeners perceived negligible changes in speech clarity following treatment. Online delivery of the Be Clear speech treatment program was feasible, and some positive speech benefits were observed. Due to the small sample size included in this research, statistically significant findings related to speech outcomes must be interpreted with caution. An adequately powered randomised controlled trial of Be Clear online is warranted to evaluate treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: Intensive comprehensive aphasia programs (ICAPs) are gaining popularity in the international aphasia rehabilitation community. ICAPs comprise at least three hours of treatment per day over at least two weeks, have definable start and end dates for one cohort and use a variety of formats including individual treatment, group therapy, education and technology to improve language and communication. While intensive treatment approaches have demonstrated equivocal results on impairment-based measures, positive changes on activity/participation measures provide support for ICAPs in rehabilitation of chronic aphasia. Aphasia Language Impairment and Functional Therapy (LIFT) is a research-based ICAP developed for the purpose of evaluating treatment outcomes across the International Classification of Functioning, Disability and Health (ICF) domains. Aims: The aim of this study was to estimate the magnitude of treatment effects yielded by Aphasia Aphasia LIFT in the domains of language impairment, functional communication and communication-related quality of life (QOL). Methods & Procedures: Eleven individuals with chronic post-stroke aphasia (mean = 26.9 months) completed Aphasia LIFT. The programme comprised individual impairment-based and functional treatment, group therapy, and computer-based treatment for 40 hours over two weeks (n= 4, LIFT 1) or 100 hours over four weeks (n= 7, LIFT 2). Assessments of confrontation naming, discourse production, functional communication and communication-related quality of life were completed at pre-treatment, immediately post-treatment and six to eight weeks following treatment termination. Outcomes & Results: Group-level analyses revealed acquisition and maintenance of treatment effects, as evidenced by significant improvement on at least one outcome measure at follow-up in all domains. The most consistent pattern of improvement at an individual level was observed on measures of functional communication and communication-related QOL. Conclusions: Aphasia LIFT yielded positive outcomes across ICF domains, and in many cases the treatment effect was enduring. These results demonstrate that Aphasia LIFT was successful in meeting the overarching goal of ICAPs, to maximise communication and enhance life participation in individuals with aphasia. Further research into ICAPs is warranted. [ABSTRACT FROM AUTHOR]

The article offers information on DrugSpeak workshop, a learning module that was created aimed at increasing the drug pronunciation proficiency of pharmacy students. Topics covered include the problem that was addressed by the learning tool, the design of the learning module or program, and the lessons that were learned from designing and implementing the program as well as the extent to which it has achieved its goal based on feedback from participants.