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Introduction Arsenic (As) in well water is a well-documented public health issue around the world, including in Northern New England states. Of particular note is that bladder cancer mortality rates [...], BACKGROUND: Exposure to arsenic (As) in well water is a well-documented public health issue for Maine and New Hampshire, as well as for other states in the United States and abroad. Arsenic contamination of well water in these locations is primarily attributed to metasedimentary bedrock that leaches As into groundwater. However, As can also enter groundwater reserves from soils contaminated by the historical use of arsenical pesticides. Approximately half of the households in Maine and New Hampshire rely on private wells, many of which have elevated As. Arsenic exposure has been associated with an increased risk of cancer, cardiovascular disease, reduced infection resistance, and lower intelligence quotient in children. Despite these known health impacts, well water testing and treatment are not universal. OBJECTIVES: We have approached the problem of low well water testing rates in Maine and New Hampshire communities by developing the All About Arsenic (AAA) project, which engages secondary school teachers and students as citizen scientists in collecting well water samples for analysis of As and other toxic metals and supports their outreach efforts to their communities. METHODS: We assessed this project's public health impact by analyzing student data relative to existing well water quality datasets in both states. In addition, we surveyed private well owners who contributed well water samples to the project to determine the actions taken to mitigate As in well water. RESULTS: Students collected 3,070 drinking water samples for metals testing, and 752 exceeded New Hampshire's As standard of 5ppb. The AAA data has more than doubled the amount of information available to public health agencies about well water quality in multiple municipalities across both states. Students also collected information about well types and treatment systems. Their data reveal that some homeowners did not know what type of wells they had or whether they had filtration systems. Those with filtration systems were often unaware of the type of system, what the system was filtering for, or whether the system was designed to remove As. Through interviews with pilot survey participants, we learned that some had begun mitigating their exposure to As and other toxic metals in response to test results from the AAA project. DISCUSSION: A school-based approach to collecting and analyzing private well water samples can successfully reach communities with low testing rates for toxic elements, such as As and other metals. Importantly, information generated through the program can impact household decisionmaking, and students can influence local and state policymaking by sharing information in their communities. https://doi.org/10.1289/EHP13421

Secondary schools in Maine and New Hampshire have been involved in a citizen science program called "All About Arsenic" aimed at addressing arsenic contamination of well water, one of the most pressing public health issues in both states. Nearly half of the population of Maine and New Hampshire derive their drinking water from private wells which often have arsenic levels above the EPA limit of 10 ppb. Arsenic exposure can cause cancer, adverse cardiovascular effects, and other health problems. Addressing this issue in schools provides context and motivation for students to engage in scientific inquiry and acquire data literacy skills. This project involves students collecting well water samples for arsenic analysis, entering their data into an online citizen science data portal, Anecdata, and using Tuva online software tools to visualize and interpret their data. Students present their data at public meetings to inform community members of their findings with the goal of moving "data to action". The COVID-19 pandemic presented multiple challenges for teachers engaging their students in this citizen science project. We adapted our program and implemented a series of interventions aimed at supporting teachers in their continued efforts to engage their students the "All About Arsenic" project.

Background: The need for effective compensatory strategies in neurogenic dysphagia management has led to the exploration of sensory enhancement strategies (SES), such as carbonated liquids. Despite some positive findings, evidence related to the efficacy of carbonation as an SES is limited. Aims: To determine if carbonated thin liquids reduced dysphagia symptoms and to explore clinical factors associated with response to carbonation. Methods & Procedures: Participants (n = 29) with neurogenic dysphagia demonstrating deep penetration or aspiration on thin liquids during videofluoroscopic swallow studies (VFSS) completed a set protocol: discrete sips of non-carbonated thin fluids (DS-NC) followed by discrete sips of carbonated thin fluids (DS-C) and then consecutive sips of carbonated fluids (CS-C). The impact of carbonation was identified through changes to swallow physiology (videofluoroscopy dysphagia scale--VDS) and depth of airway compromise (penetration-aspiration scale--PAS). Demographic variables including genetic taste type, cranial nerve function and key results from the VDS were examined for association with carbonation response using both individual parameter analysis and exploratory cluster analysis. Outcomes & Results: Significant (p < 0.05) improvements in PAS scores were noted in DS-C and CS-C conditions compared with DS-NC. Total VDS score was also significantly (p < 0.05) reduced (i.e., improved function) in the DS-NC condition. Individual variability in response to carbonation was noted and no clear clinical factors associated with carbonation response in the current set of parameters were identified. Conclusion & Implications: Findings support that carbonated thin fluids sometimes result in neurogenic dysphagia symptom reduction. However, identifying the clinical characteristics of patients who may benefit from trials of carbonation needs further investigation.

Introduction: Irritable Bowel Syndrome (IBS) is a highly prevalent functional gastrointestinal disease that is commonly associated with psychological comorbidities and maladaptive thought patterns. Previous studies report psychological therapies such as cognitive behavioral therapy (CBT) and gutdirected therapy (GDP) improve IBS symptom management and quality of life. This review seeks to understand the effectiveness of various psychotherapies across delivery methods for patients with irritable bowel syndrome. Methods: A scoping literature review of PubMed articles highlighting psychological and stress reduction treatments for IBS was conducted. 120 studies were included in the title and abstract screening. 32 studies were selected for full text review. Primary and secondary research studies that investigated the benefit of psychological therapies focusing on stress reduction and cognitive therapies for patients with gastrointestinal condition's symptom relief met inclusion criteria for the review. 12 studies were selected for inclusion. Results: All 12 reviewed studies reported statistically significant improvements in IBS symptoms with psychological therapies. 8 studies also addressed quality of life and reported statistically significant improvement in intervention groups. 3 studies demonstrated persistent improvement after 12 months. 2 studies compared different types of psychotherapies and reported improvements compared to control groups but no significant differences between psychotherapies. 6 studies that compared face to face therapy with minimal contact or telephone therapy showed no difference in clinical outcomes. Discussion: Psychological therapies demonstrate reported statistically significant improvements in IBS symptoms and patient quality of life with no reported statistically significant difference across forms of healthcare delivery. Most improvements reportedly persist long-term. Further research with a broader demographic base is needed to assess the economic costs of psychological therapies and their implications for underserved communities. [ABSTRACT FROM AUTHOR]

The present study examined the effects of neurosurgical management of Parkinson's disease (PD), including the procedures of pallidotomy, thalamotomy, and deep-brain stimulation (DBS) on perceptual speech characteristics, speech intelligibility, and oromotor function in a group of 22 participants with PD. The surgical participant group was compared with a group of 25 non-neurologically impaired individuals matched for age and sex. In addition, the study investigated 16 participants with PD who did not undergo neurosurgical management to control for disease progression. Results revealed that neurosurgical intervention did not significantly change the surgical participants' perceptual speech dimensions or oromotor function despite significant postoperative improvements in ratings of general motor function and disease severity. Reasons why neurosurgical intervention resulted in dissimilar outcomes with respect to participants' perceptual speech dimensions and general motor function are proposed.KEY WORDS: Parkinson's disease, dysarthria, neurosurgery

The objective of this study was to evaluate the effects of posteroventral pallidotomy on perceptual and physiological measures of articulatory function and speech intelligibility in Parkinson disease (PD). The study [...]

Background. Nonspeech investigations of tongue function in persons with Parkinson's disease (PD) have generally reported impaired tongue strength, endurance, and fine force control. However, these investigations did not specifically evaluate the relative contribution of age effects to the deficits in tongue function observed. Furthermore, the relationship between these nonspeech measures of tongue function and the speech disorder present in PD remains equivocal. Therefore, the current study investigated the strength, rate of repetitive movement, fine force control, and endurance of the tongue in three groups of participants. Methods. Participants in the study included 14 older adults with PD and imprecise consonant articulation, 11 neurologically healthy older adults, and 15 neurologically healthy young adults. All participants were assessed using a comprehensive nonspeech assessment battery of tongue function. Results. The results of the investigation revealed similar levels of tongue strength, rate of repetitive movement, and endurance between the persons with PD and the older control participants. Significant age effects were noted, with both groups demonstrating significantly reduced functioning on those measures when compared to young control participants. However, the three participant groups had similar levels of fine force control. No relationship was found between the nonspeech measures of tongue function employed and the severity of consonant imprecision. Conclusion. The nonspeech measures used failed to provide useful diagnostic information regarding the physiologic basis of perceived articulatory dysfunction in the persons with PD who were examined.

To examine the inter-rater reliability, intra-rater reliability, internal consistency and practice effects associated with a new test, the Brisbane Evidence-Based Language Test. Reliability estimates were obtained in a repeated-measures design through analysis of clinician video ratings of stroke participants completing the Brisbane Evidence-Based Language Test. Inter-rater reliability was determined by comparing 15 independent clinicians' scores of 15 randomly selected videos. Intra-rater reliability was determined by comparing two clinicians' scores of 35 videos when re-scored after a two-week interval. Intraclass correlation coefficient (ICC) analysis demonstrated almost perfect inter-rater reliability (0.995; 95% confidence interval: 0.990–0.998), intra-rater reliability (0.994; 95% confidence interval: 0.989–0.997) and internal consistency (Cronbach's α = 0.940 (95% confidence interval: 0.920–1.0)). Almost perfect correlations (0.998; 95% confidence interval: 0.995–0.999) between face-to-face and video ratings were obtained. The Brisbane Evidence-Based Language Test demonstrates almost perfect inter-rater reliability, intra-rater reliability and internal consistency. High correlation coefficients and narrow confidence intervals demonstrated minimal practice effects with scoring or influence of years of clinical experience on test scores. Almost perfect correlations between face-to-face and video scoring methods indicate these reliability estimates have direct application to everyday practice. The test is available from brisbanetest.org. The Brisbane Evidence-Based Language Test is a new measure for the assessment of acquired language disorders. The Brisbane Evidence-Based Language Test demonstrated almost perfect inter-rater reliability, intra-rater reliability and internal consistency. High reliability estimates and narrow confidence intervals indicated that test ratings vary minimally when administered by clinicians of different experience levels, or different levels of familiarity with the new measure. The test is a reliable measure of language performance for use in clinical practice and research. [ABSTRACT FROM AUTHOR]

Purpose: Sensory enhancement techniques, like other compensatory strategies, aim to reduce dysphagia symptoms. The use of carbonated liquids has been proposed as a possible sensory technique, however to date, there is limited information of its efficacy or guidance for clinical implementation. A narrative synthesis was completed to determine the quality and strength of the evidence base for use of carbonation as a compensatory strategy in dysphagia rehabilitation. Methods: From 101 articles initially identified, 14 articles met the study criteria. Eleven papers described the effects of carbonation on swallowing in healthy participants whereas three described the impact of carbonation in dysphagic populations. A narrative synthesis of papers was undertaken given the diversity of identified studies. Results: Synthesis of findings was challenging given the exploratory phase of most research activity with diverse populations described and extensive differences in research methodologies. There is currently weak, but potentially positive evidence to support using carbonation as a compensatory technique in dysphagia rehabilitation. Conclusion: Despite future potential, existing evidence fails to provide clear direction for the clinical implementation of carbonation. Validation of carbonation use with the dysphagic population requires further research with consistent, controlled methodologies, and larger cohorts of participants to inform potential for dysphagia rehabilitation. [ABSTRACT FROM AUTHOR]

Background. Nonspeech investigations of tongue function in persons with Parkinson's disease (PD) have generally reported impaired tongue strength, endurance, and fine force control. However, these investigations did not specifically evaluate the relative contribution of age effects to the deficits in tongue function observed. Furthermore, the relationship between these nonspeech measures of tongue function and the speech disorder present in PD remains equivocal. Therefore, the current study investigated the strength, rate of repetitive movement, fine force control, and endurance of the tongue in three groups of participants. Methods. Participants in the study included 14 older adults with PD and imprecise consonant articulation, 11 neurologically healthy older adults, and 15 neurologically healthy young adults. All participants were assessed using a comprehensive nonspeech assessment battery of tongue function. Results. The results of the investigation revealed similar levels of tongue strength, rate of repetitive movement, and endurance between the persons with PD and the older control participants. Significant age effects were noted, with both groups demonstrating significantly reduced functioning on those measures when compared to young control participants. However, the three participant groups had similar levels of fine force control. No relationship was found between the nonspeech measures of tongue function employed and the severity of consonant imprecision. Conclusion. The nonspeech measures used failed to provide useful diagnostic information regarding the physiologic basis of perceived articulatory dysfunction in the persons with PD who were examined. [ABSTRACT FROM AUTHOR]