Mobile applications to detect hearing impairment: opportunities and challenges.
Swanepoel W1, De Sousa KC1, Smits C2, Moore DR3.
Author information
1
Department of Speech-Language Pathology and Audiology, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
2
Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
3
Communication Sciences Research Center, Cincinnati Children's Hospital, Ohio, United States of America.
PMID: 31656337 PMCID: PMC6796675 DOI: 10.2471/BLT.18.227728
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Select item 31656334
2.
Bull World Health Organ. 2019 Oct 1;97(10):691-698. doi: 10.2471/BLT.18.224659. Epub 2019 Aug 20.
Training for hearing care providers.
Bhutta MF1, Bu X2, de Muñoz PC3, Garg S4, Kong K5.
Author information
1
Department of Ear, Nose and Throat, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, England.
2
Jiangsu Ear and Hearing Centre, Jiangsu Province Hospital, Nanjing, China.
3
Centro de Audición CEDAF, Guatemala City, Guatemala.
4
Department of Community Medicine, Maulana Azad Medical College, New Delhi, India.
5
School of Medicine and Public Health, University of Newcastle, Callaghan, Australia.
Abstract
The lack of an appropriately trained global hearing-care workforce is recognized as a barrier to developing and implementing services to treat ear and hearing disorders. In this article we examine some of the published literature on the current global workforce for ear and hearing care. We outline the status of both the primary-care workforce, including community health workers, and specialist services, including audiologists, ear, nose and throat specialists, speech and language therapists, and teachers of the deaf. We discuss models of training health workers in ear and hearing care, including the role of task-sharing and the challenges of training in low and middle-income countries. We structure the article by the components of ear and hearing care that may be delivered in isolation or in integrated models of care: primary care assessment and intervention; screening; hearing tests; hearing rehabilitation; middle-ear surgery; deaf services; and cochlear implant programmes. We highlight important knowledge gaps and areas for future research and reporting.

(c) 2019 The authors; licensee World Health Organization.

PMID: 31656334 PMCID: PMC6796672 DOI: 10.2471/BLT.18.224659
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Select item 31656333
3.
Bull World Health Organ. 2019 Oct 1;97(10):681-690. doi: 10.2471/BLT.18.227371. Epub 2019 Aug 20.
Hearing care across the life course provided in the community.
Suen JJ1, Bhatnagar K2, Emmett SD3, Marrone N4, Kleindienst Robler S5, Swanepoel W6, Wong A4, Nieman CL7.
Author information
1
Johns Hopkins University School of Nursing, Baltimore, United States of America (USA).
2
Social Business Innovation, Medtronic Labs, New Delhi, India.
3
Department of Head & Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, USA.
4
Department of Speech, Language and Hearing Sciences, University of Arizona, Tucson, USA.
5
Norton Sound Health Corporation, Nome, USA.
6
Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
7
Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, 2024 E Monument Street, Suite 2-700, Baltimore, Maryland, 21205, USA.
Abstract
Untreated hearing loss is recognized as a growing global health priority because of its prevalence and harmful effects on health and well-being. Until recently, little progress had been made in expanding hearing care beyond traditional clinic-based models to incorporate public health approaches that increase accessibility to and affordability of hearing care. As demonstrated in numerous countries and for many health conditions, sharing health-care tasks with community health workers (CHWs) offers advantages as a complementary approach to expand health-service delivery and improve public health. This paper explores the possibilities of task shifting to provide hearing care across the life course by reviewing several ongoing projects in a variety of settings - Bangladesh, India, South Africa and the United States of America. The selected programmes train CHWs to provide a range of hearing-care services, from childhood hearing screening to management of age-related hearing loss. We discuss lessons learnt from these examples to inform best practices for task shifting within community-delivered hearing care. Preliminary evidence supports the feasibility, acceptability and effectiveness of hearing care delivered by CHWs in these varied settings. To make further progress, community-delivered hearing care must build on established models of CHWs and ensure adequate training and supervision, delineation of the scope of practice, supportive local and national legislation, incorporation of appropriate technology and analysis of programme costs and cost-effectiveness. In view of the growing evidence, community-delivered hearing care may now be a way forward to improve hearing health equity.

(c) 2019 The authors; licensee World Health Organization.

PMID: 31656333 PMCID: PMC6796676 DOI: 10.2471/BLT.18.227371
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Select item 31656332
4.
Bull World Health Organ. 2019 Oct 1;97(10):672-680. doi: 10.2471/BLT.18.227876. Epub 2019 Jun 19.
Hearing and vision screening for preschool children using mobile technology, South Africa.
Eksteen S1, Launer S2, Kuper H3, Eikelboom RH4, Bastawrous A3, Swanepoel W1.
Author information
1
Department of Speech-Language Pathology and Audiology, University of Pretoria, c/o Lynnwood and University Roads, Hatfield, Pretoria 0002, South Africa.
2
Sonova AG, Science and Technology, Stäfa, Switzerland.
3
International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, England.
4
Ear Science Institute Australia, Subiaco, Australia.
Abstract
OBJECTIVE:
To implement and evaluate a community-based hearing and vision screening programme for preschool children in the Western Cape, South Africa, supported by mobile health technology (mHealth) and delivered by community health workers (CHWs).

METHODS:
We trained four CHWs to provide dual sensory screening in preschool centres of Khayelitsha and Mitchells Plain during September 2017-December 2018. CHWs screened children aged 4-7 years using mHealth software applications on smartphones. We used logistic regression analysis to evaluate the association between screening results and age, sex and test duration, and, for hearing, excessive background noise levels.

RESULTS:
CHWs screened 94.4% (8023/10 362) of eligible children at 271 centres at a cost of 5.63 United States dollars per child. The number of children who failed an initial hearing and visual test was 435 (5.4%) and 170 (2.1%), respectively. Hearing test failure was associated with longer test times (odds ratio, OR: 1.022; 95% confidence interval, CI: 1.021-1.024) and excessive background noise levels at 1 kilohertz (kHz) (e.g. OR for left ear: 1.688; 95% CI: 1.198-2.377). Visual screening failure was associated with longer test duration (OR: 1.003; 95% CI: 1.002-1.005) and younger age (OR: 0.629; 95% CI: 0.520-0.761). Of the total screened, 111 (1.4%) children were diagnosed with a hearing and/or visual impairment.

CONCLUSION:
mHealth-supported CHW-delivered hearing and vision screening in preschool centres provided a low-cost, acceptable and accessible service, contributing to lower referral numbers to resource-constrained public health institutions.

(c) 2019 The authors; licensee World Health Organization.

PMID: 31656332 PMCID: PMC6796667 DOI: 10.2471/BLT.18.227876
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Select item 31656331
5.
Bull World Health Organ. 2019 Oct 1;97(10):663-671. doi: 10.2471/BLT.18.220939. Epub 2019 Sep 3.
Pilot implementation of newborn hearing screening programme at four hospitals in southern Thailand.
Pitathawatchai P1, Khaimook W1, Kirtsreesakul V1.
Author information
1
Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich road, Hat Yai, Chang Wat Songkhla, 90110, Thailand.
Abstract
OBJECTIVE:
To determine the effectiveness and benefit of a universal newborn hearing screening programme at four different hospitals in southern Thailand, between January and July 2017.

METHODS:
One screener per hospital recorded demographic data of all newborns and their exposure to risk of hearing loss, and evaluated their hearing by transient otoacoustic emission technology. Those who demonstrated bilateral moderate to profound hearing loss at both a first and second screening were referred for diagnostic assessment. Those with confirmed hearing loss received treatment and regular follow-up appointments, and their speech development was assessed at 1 year of age. We determined effectiveness by comparing our achieved coverage and proportion of follow-up and referrals with benchmarks set by the American Academy of Pediatrics (≥ 95%, ≥ 95% and ≤ 4%, respectively), and determined benefit by calculating the composite language scores of hearing-impaired infants who received early intervention.

FINDINGS:
We screened 6140 eligible newborns, and achieved a screening coverage of 95.4% (5859/6140), lost 25.7% (63/245) and 22.0% (9/41) to follow-up at the second screening and diagnostic assessment stages, respectively, and obtained an overall proportion of referrals of 0.7% (41/6140). Twelve infants were confirmed as having hearing loss and received early intervention; nine (75%) demonstrated normal speech development by their first birthday. Our universal hearing screening yielded a prevalence of sensorineural hearing loss of less than 0.1% (3/6140).

CONCLUSION:
Although ineffective by American Academy of Pediatrics standards, we demonstrated the benefit of early intervention in infants diagnosed with hearing loss.

(c) 2019 The authors; licensee World Health Organization.

PMID: 31656331 PMCID: PMC6796664 DOI: 10.2471/BLT.18.220939
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Select item 31655145
6.
J Commun Disord. 2019 Oct 12;83:105947. doi: 10.1016/j.jcomdis.2019.105947. [Epub ahead of print]
Proceduralization and grammatical development: Comments on "Speech-language development as proceduralization and skill learning" ().
Rispoli M1, Hadley P2.
Author information
1
Speech and Hearing Science, University of Illinois, United States. Electronic address: mrispoli@illinois.edu.
2
Speech and Hearing Science, University of Illinois, United States.
PMID: 31655145 DOI: 10.1016/j.jcomdis.2019.105947
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Select item 31653411
7.
J Commun Disord. 2019 Oct 17:105948. doi: 10.1016/j.jcomdis.2019.105948. [Epub ahead of print]
A neural perspective on implicit learning: A reply to Kamhi (2019).
Plante E1.
Author information
1
Department of Speech, Language, & Hearing Sciences, The University of Arizona, PO Box 210071, Tucson, AZ, 85721-0071, United States. Electronic address: eplante@email.arizona.edu.
PMID: 31653411 DOI: 10.1016/j.jcomdis.2019.105948
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Select item 31652619
8.
Int J Environ Res Public Health. 2019 Oct 22;16(20). pii: E4051. doi: 10.3390/ijerph16204051.
Relationship between Physical Activity Level and Depression of Elderly People Living Alone.
Byeon H1.
Author information
1
Department of Speech Language Pathology, School of Public Health, Honam University, 417, Eodeung-daero, Gwangsan-gu, Gwangju 62399, Korea. bhwpuma@naver.com.
Abstract
BACKGROUND AND OBJECTIVES:
Only a few studies analyzed the physical activity level of elderly people living alone in local communities and evaluated the relationship between it and mental health. The purpose of this study was to investigate the relationship between regular physical activity and depression in the elderly living alone and to provide basic data for the prevention of depression in the elderly.

MATERIALS AND METHODS:
We analyzed 256 elderly people living alone aged 65 years or older who completed the 2014 Korea National Health and Nutrition Examination Survey. Depression was defined as a score of 10 or higher using Patient Health Questionnaire-9 (PHQ-9). This study investigated walking per week, days of muscular strength exercise performance in the past 1 week, days of flexibility exercise in the past 1 week, mean hours in a sitting position per day, the numbers of days and hours conducting a high intensity physical activity in the past 1 week, and numbers of days and hours conducting a medium intensity physical activity in the past 1 week to define physical activity. Our study presented prevalence odds ratios (pOR) and 95% confidence interval (CI) by using complex sample logistic regression analysis in order to identify the relationship between physical activity and depression.

RESULTS:
The results of complex sample logistic regression analysis showed that flexibility exercise was significantly related to depression (p < 0.05). On the other hand, the mean hours in a sitting position per day, aerobic physical activity, walking, and muscular strength exercise were not significantly related to geriatric depression.

CONCLUSIONS:
The results of our study implied that persistent flexibility exercise might be more effective to maintain a healthy mental status than muscular strength exercise. A longitudinal study is required to prove the causal relationship between physical activity and depression in the old age.

KEYWORDS:
Patient Health Questionnaire-9; complex sample logistic regression; depression; elderly people living alone; flexibility exercise; muscular strength exercise; physical activity

PMID: 31652619 DOI: 10.3390/ijerph16204051
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Conflict of interest statement
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Select item 31652522
9.
Brain Sci. 2019 Oct 22;9(10). pii: E286. doi: 10.3390/brainsci9100286.
Is It Speech or Song? Effect of Melody Priming on Pitch Perception of Modified Mandarin Speech.
Tsai CG1,2, Li CW3.
Author information
1
Graduate Institute of Musicology, National Taiwan University, Taipei 106, Taiwan. tsaichengia@ntu.edu.tw.
2
Neurobiology and Cognitive Science Center, National Taiwan University, Taipei 106, Taiwan. tsaichengia@ntu.edu.tw.
3
Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan. 799032@w.tmu.edu.tw.
Abstract
Tonal languages make use of pitch variation for distinguishing lexical semantics, and their melodic richness seems comparable to that of music. The present study investigated a novel priming effect of melody on the pitch processing of Mandarin speech. When a spoken Mandarin utterance is preceded by a musical melody, which mimics the melody of the utterance, the listener is likely to perceive this utterance as song. We used functional magnetic resonance imaging to examine the neural substrates of this speech-to-song transformation. Pitch contours of spoken utterances were modified so that these utterances can be perceived as either speech or song. When modified speech (target) was preceded by a musical melody (prime) that mimics the speech melody, a task of judging the melodic similarity between the target and prime was associated with increased activity in the inferior frontal gyrus (IFG) and superior/middle temporal gyrus (STG/MTG) during target perception. We suggest that the pars triangularis of the right IFG may allocate attentional resources to the multi-modal processing of speech melody, and the STG/MTG may integrate the phonological and musical (melodic) information of this stimulus. These results are discussed in relation to subvocal rehearsal, a speech-to-song illusion, and song perception.

KEYWORDS:
inferior frontal gyrus; melody perception; priming effect; tonal language

PMID: 31652522 DOI: 10.3390/brainsci9100286
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Select item 31652412
10.
Am J Speech Lang Pathol. 2019 Oct 24:1-30. doi: 10.1044/2019_AJSLP-CAC48-18-0234. [Epub ahead of print]
A Systematically Conducted Scoping Review of the Evidence and Fidelity of Treatments for Verb Deficits in Aphasia: Verb-in-Isolation Treatments.
Hickin J1, Cruice M1, Dipper L1.
Author information
1
Division of Language and Communication Science, City, University of London, United Kingdom.
Abstract
Purpose Aphasia research demonstrates increasing interest in the treatment of verb retrieval deficits. This systematically conducted scoping review reports on the level and fidelity of the current evidence for verb treatments; on its effectiveness regarding the production of trained and untrained verbs, functional communication, sentences, and discourse; and on the potential active ingredients. Recommendations to guide clinical decision making and future research are made. Method The computerized database search included studies from January 1980 to September 2018. The level of evidence of each study was documented, as was fidelity in terms of treatment delivery, enactment, and receipt. Studies were also categorized according to the treatment methods used. Results Thirty-seven studies were accepted into the review, and all but 1 constituted a low level of evidence. Thirty-three studies (89%) described treatment in sufficient detail to allow replication, dosage was poorly reported, and the fidelity of treatment was rarely assessed. The most commonly reported treatment techniques were phonological and semantic cueing in 25 (67.5%) and 20 (54%) studies, respectively. Retrieval of trained verbs improved for 80% of participants, and improvements generalized to untrained verbs for 15% of participants. There was not sufficient detail to evaluate the impact of treatment on sentence production, functional communication, and discourse. Conclusions The evidence for verb treatments is predominantly of a low level. There are encouraging findings in terms of treatments being replicable; however, this is tempered by poor monitoring of treatment fidelity. The quality of verb treatment research would be improved by researchers reaching consensus regarding outcome measures (including generalization to, e.g., sentences and discourse) by manualizing treatment to facilitate implementation and exploring the opinions of participants. Finally, while treatment is largely effective in improving production of trained verbs, lack of generalization to untrained items leads to the recommendation that personally relevant verbs are prioritized.

PMID: 31652412 DOI: 10.1044/2019_AJSLP-CAC48-18-0234
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Select item 31652408
11.
J Speech Lang Hear Res. 2019 Oct 25:1-35. doi: 10.1044/2019_JSLHR-H-18-0137. [Epub ahead of print]
Effectiveness of Rehabilitation Approaches Proposed to Children With Severe-to-Profound Prelinguistic Deafness on the Development of Auditory, Speech, and Language Skills: A Systematic Review.
Demers D1,2, Bergeron F1,2.
Author information
1
Rehabilitation Department, Faculty of Medicine, Université Laval, Québec, Canada.
2
Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada.
Abstract
Purpose The purpose of this systematic review is to identify and evaluate the available scientific evidence on the effectiveness of rehabilitation approaches proposed to children with severe-to-profound prelinguistic deafness on the hearing, speech, and language skills development. Method Databases (PubMed, CINHAL, PsycInfo, Cochrane, ERIC, and EMBASE) were searched with relevant key words (children, deafness, rehabilitation approach, auditory, speech, and language). Studies published between 2000 and 2017 were included. The methodological quality of the studies was evaluated with the Quality Assessment Tool for Quantitative Studies, and the level of evidence was evaluated with the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Every step of the selection and analysis was made by 2 independent judges. Results Of 1,739 articles listed in different databases, 38 met the inclusion criteria and were selected for analysis. The majority of included articles present a relatively low level of evidence. Rehabilitation approaches that do not include signs appear more frequently associated with a better auditory, speech, and language development, except for receptive language, than approaches that included any form of signs. Conclusion More robust studies are needed to decide on the approach to prioritize with severe-to-profound deaf children.

PMID: 31652408 DOI: 10.1044/2019_JSLHR-H-18-0137
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Select item 31652405
12.
J Speech Lang Hear Res. 2019 Oct 25:1-14. doi: 10.1044/2019_JSLHR-L-18-0341. [Epub ahead of print]
Bilingualism and Attention in Typically Developing Children and Children With Developmental Language Disorder.
Park J1, Miller CA2, Sanjeevan T3, van Hell JG4, Weiss DJ4, Mainela-Arnold E1,5.
Author information
1
Department of Speech-Language Pathology, University of Toronto, Ontario, Canada.
2
Department of Communication Sciences and Disorders, Pennsylvania State University, University Park.
3
Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
4
Department of Psychology, Pennsylvania State University, University Park.
5
Department of Psychology and Speech-Language Pathology, University of Turku, Finland.
Abstract
Purpose The aim of the current study was to investigate whether dual language experience modulates the efficiency of the 3 attentional networks (alerting, orienting, and executive control) in typically developing (TD) children and in children with developmental language disorder (DLD). Method We examined the attentional networks in monolingual and bilingual school-aged children (ages 8-12 years) with and without DLD. TD children (35 monolinguals, 23 bilinguals) and children with DLD (17 monolinguals, 9 bilinguals) completed the Attention Network Test (Fan et al., 2002; Fan, McCandliss, Fossella, Flombaum, & Posner, 2005). Results Children with DLD exhibited poorer executive control than TD children, but executive control was not modified by bilingual experience. The bilingual group with DLD and both TD groups exhibited an orienting effect, but the monolingual group with DLD did not. No group differences were found for alerting. Conclusions Children with DLD have weak executive control skills. These skills are minimally influenced by dual language experience, at least in this age range. A potential bilingual advantage in orienting may be present in the DLD group.

PMID: 31652405 DOI: 10.1044/2019_JSLHR-L-18-0341
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Select item 31651424
13.
Curr Opin Otolaryngol Head Neck Surg. 2019 Oct 23. doi: 10.1097/MOO.0000000000000582. [Epub ahead of print]
An update on treatment of voice-gender incongruence by otolaryngologists and speech-language pathologists.
Pasternak K1, Francis DO2.
Author information
1
UW Health Voice & Swallow Clinics, University Hospital.
2
Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, School of Medicine, Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Abstract
PURPOSE OF REVIEW:
The current review provides an update of literature published in the past 2 years related to treatment of voice-gender incongruence in the gender expansive population, commonly referred to as transgender voice modification.

RECENT FINDINGS:
Four main themes have emerged in research during the review period. These include comparison of surgical and behavioral techniques for raising pitch, with consistent findings of a greater increase in fundamental frequency (F0) following endoscopic glottoplasty compared with cricothyroid approximation. Voice therapy similarly can increase pitch (F0), often to degrees commensurate with surgical approaches. A second theme identifies the perceptual correlates of gender in voice and communication, highlighting recent findings that perception of gender relates primarily to nonpitch-related features of voice. A third theme is the importance of considering patient-reported outcomes in treatment and research. Finally, several recent studies challenge the assumption that transmasculine individuals taking HRT are satisfied with their voice and communication.

SUMMARY:
Speech-language pathologists and otolaryngologists should work collaboratively to treat voice-gender incongruence. Together, we should consider treatment evidence, individual patient goals, and validated patient-reported outcome measures when recommending treatment and evaluating outcomes. Understanding the nuance of how each individual defines benefit is critical to clinicians whose aim is to personalize and optimize treatment of voice-gender incongruence. This is particularly important as management broadens to include individuals across the gender spectrum.

PMID: 31651424 DOI: 10.1097/MOO.0000000000000582
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Select item 31650559
14.
Muscle Nerve. 2019 Oct 25. doi: 10.1002/mus.26750. [Epub ahead of print]
Neurodevelopmental, Behavioral, and Emotional Symptoms in Becker Muscular Dystrophy.
Lambert JT1, Darmahkasih AJ2, Horn PS3, Rybalsky I1, Shellenbarger KC4, Tian C3, Wong BL4.
Author information
1
Neurology Division, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.
2
Pediatric Residency Program, University of California-Irvine/Children's Hospital of Orange County, Orange, CA, United States of America.
3
Division of Neurology, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States of America.
4
Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
Abstract
INTRODUCTION:
Becker muscular dystrophy (BMD) results in decreased dystrophin with implications for mental health.

METHODS:
This is a retrospective case series of neurodevelopmental, behavioral, and emotional symptoms and respective pharmacotherapies of 70 BMD patients.

RESULTS:
Fifty-four patients (77.1%) exhibited at least one symptom, and 19 patients (27.1%) exhibited four or more. The most prevalent symptoms were specific learning disabilities or special education needs (31.4%), inattention/hyperactivity (35.7%), language/speech delays (35.7%), and emotional or behavioral dysregulation (38.6%). Fisher's exact tests indicated that anxiety was more prevalent with mutations upstream of exon 30 (p = 0.049), but the prevalence of other symptoms did not differ with respect to mutation sites. Similarly, the number of symptoms individual BMD subjects exhibited did not differ with respect to mutation sites. Seventeen (24.3%) patients required pharmacotherapy to manage symptoms.

DISCUSSION:
Neurodevelopmental, behavioral, and emotional symptoms are prevalent in patients with BMD regardless of dystrophin gene mutation site. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS:
Becker muscular dystrophy; Behavioral; Cognitive Impairment; Dystrophin; Emotional; Fluoxetine; Genetics; Learning Disabilities; Neurodevelopmental; Pharmacotherapy

PMID: 31650559 DOI: 10.1002/mus.26750
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Select item 31650547
15.
Muscle Nerve. 2019 Oct 25. doi: 10.1002/mus.26749. [Epub ahead of print]
Loss of Appetite in ALS is Associated with Weight Loss and Decreased Calorie Consumption Independent of Dysphagia.
Mezoian T1, Belt E1, Garry J2, Hubbard J2, Breen CT1, Miller L1, Levine-Weinberg M1, Nalipinski P3, Sullivan S3, Chan J4, Wills AM1,5.
Author information
1
Neurology Clinical Research Institute and Department of NeurologyMassachusetts General Hospital.
2
Clinical Research Center, Massachusetts General Hospital, member of the Harvard Catalyst, The Harvard Clinical and Translational Science Center, Boston, MA.
3
Department of Speech, Language, Swallowing and Reading Disabilities, Massachusetts General Hospital, Boston, MA.
4
Biostatistics Center, Massachusetts General Hospital, Boston, MA.
5
Harvard Medical School, Boston, MA.
Abstract
INTRODUCTION:
Loss of appetite has been reported to affect up to half of people with ALS and to be associated with weight loss. We wished to test whether loss of appetite correlates with reduced dietary intake independent of dysphagia.

METHODS:
Appetite was measured repeatedly using the Council on Nutrition Appetite Questionnaire (CNAQ) in participants in the Electronic health Application To Measure Outcomes REmotely study. Dietary intake and weight were compared to appetite, ALS Functional Rating Scale-Revised (ALSFRS-R) total and bulbar scores (dysphagia).

RESULTS:
The average baseline CNAQ score was 30.4 (n=61, SD=3.9) with 18.0% scoring <28 points (severe loss of appetite). Lower CNAQ scores correlated with greater weight loss since diagnosis (Pearson correlation coefficient, r= -0.34, p=0.009) and lower baseline energy intake (p= 0.007), independent of dysphagia.

DISCUSSION:
Our results support an association between loss of appetite and decreased calorie intake and weight in ALS which is independent of dysphagia. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS:
ALS; Appetite; Nutrition; Weight loss

PMID: 31650547 DOI: 10.1002/mus.26749
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Select item 31650190
16.
Pediatr Radiol. 2019 Oct 18. doi: 10.1007/s00247-019-04527-w. [Epub ahead of print]
Capturing infant swallow impairment on videofluoroscopy: timing matters.
McGrattan KE1,2, McGhee HC3,4, McKelvey KL3,4, Clemmens CS5, Hill EG6, DeToma A6, Hill JG7, Simmons CE7, Martin-Harris B3,5,8.
Author information
1
Department of Speech-Language and Hearing Sciences, University of Minnesota, 164 Pillsbury Drive SE, Minneapolis, MN, 55455, USA. kmcgratt@umn.edu.
2
Department of Otolaryngology, Boston Children's Hospital, Boston, MA, USA. kmcgratt@umn.edu.
3
Evelyn Trammell Institute for Voice and Swallowing, Medical University of South Carolina, Charleston, SC, USA.
4
Department of Speech Language Pathology, Medical University of South Carolina, Charleston, SC, USA.
5
Department of Otolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
6
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
7
Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
8
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.
Abstract
BACKGROUND:
Infant videofluoroscopic swallow studies (VFSSs) require clinicians to make determinations about swallowing deficits based on a limited number of fluoroscopically observed swallows. Although airway protection is known to decline throughout a bottle-feed, the paucity of data regarding the timing of this degradation has limited the development of procedural protocols that maximize diagnostic validity.

OBJECTIVE:
We tested the stability of key components of swallow physiology and airway protection at four standardized timepoints throughout the VFSS.

MATERIALS AND METHODS:
Thirty bottle-fed infants with clinical signs of swallow dysfunction underwent VFSS. Fluoroscopy was turned on to allow visualization of five swallows at 0:00, 0:30, 1:30 and 2:30 (minutes:seconds [min:s]). We evaluated swallows for components of swallow physiology (oral bolus hold, initiation of pharyngeal swallow, timing of swallow initiation) and airway protection (penetration, aspiration). We used model-based linear contrasts to test differences in the percentage of swallows with low function component attributes.

RESULTS:
All components of swallow physiology exhibited a change throughout the VFSS (P≤0.0005). Changes were characterized by an increase in the number of sucks per swallow (P<0.0001), percentage of swallows with incomplete bolus hold (P=0.0005), delayed initiation of pharyngeal swallow (P<0.0001), delayed timing of swallow initiation (P=0.0004) and bolus airway entry (P<0.0001). These findings demonstrate that infants with dysphagia exhibit a change in swallow physiology throughout the videofluoroscopic swallow exam.

CONCLUSION:
Fluoroscopic visualization that is confined to the initial swallows of the bottle feed limit the exam's diagnostic validity. Developing evidence-based procedural guidelines for infant VFSS execution is crucial for maximizing the exam's diagnostic and treatment yield.

KEYWORDS:
Dysphagia; Infants; Standardization; Swallowing; Videofluoroscopic swallow studies

PMID: 31650190 DOI: 10.1007/s00247-019-04527-w
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Select item 31649766
17.
Int Arch Otorhinolaryngol. 2019 Oct;23(4):e445-e450. doi: 10.1055/s-0039-1693140. Epub 2019 Oct 22.
Singing Style, Vocal Habits, and General Health of Professional Singers.
Santos SS1, Montagner T1, Bastilha GR1, Frigo LF2, Cielo CA1.
Author information
1
Departamen of Phonoaudiology, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
2
Departament of Physiotherapy, Universidade Franciscana, Santa Maria, RS, Brazil.
Abstract
Introduction  For the singer, the voice is a medium used to express feelings that capture the listener. Every singing style has specific demands, and a vocal alteration may prevent the singer from meeting them. Objective  To compare the singing style, the vocal habits, and the general health data of professional singers. Methods  Cross-sectional, quantitative and retrospective study of a survey database. Data on the singing style, the vocal habits, and the health conditions and history of 57 professional singers, 31 female singers and 26 male singers, aged from 19 to 57 years old (average of 32 years old), from a mid-sized town were analyzed Results  There was a prevalence of female (54 ± 2%) popular singers (91 ± 2%), in the adult age (51 ± 2%), nonsmokers (89 ± 2%), nonusers of alcohol (77 ± 2%), with respiratory problems (53 ± 2%), mainly rhinitis (23 ± 2%), and without other health problems. There was a significant use of alcohol in males ( p  = 0.010); among the alcohol users, there was a significant presence of respiratory problems ( p  = 0.046), of pharyngitis/tonsillitis ( p  = 0.003), and of gastroesophageal reflux (GER) ( p  = 0.043); there was a significant presence of GER in subjects reporting endocrine problems ( p  = 0.023), of gastritis ( p  = 0.023), and of pharyngitis/tonsillitis ( p  = 0.030). Conclusion  There was a predominance of adult professional popular female singers, with complaints of respiratory issues (with a higher prevalence of rhinitis), without other general health issues, of nonsmokers, and of nonusers of alcohol.

KEYWORDS:
language and hearing science; singing style; singing voice; speech; voice

PMID: 31649766 PMCID: PMC6805201 DOI: 10.1055/s-0039-1693140
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18.
Int Arch Otorhinolaryngol. 2019 Oct;23(4):e380-e383. doi: 10.1055/s-0039-1677754. Epub 2019 May 28.
Test-Retest Reliability of the Speech, Spatial and Qualities of Hearing Scale (SSQ) in Brazilian Portuguese.
Aguiar RGR1, Almeida K1, Miranda-Gonsalez EC1.
Author information
1
Faculty of Medical Sciences, School of Speech-Language Pathology and Audiology, Santa Casa de São Paulo, São Paulo, SP, Brasil.
Abstract
Introduction  The Speech, Spatial and Qualities of Hearing Scale (SSQ) is a questionnaire designed to assess the auditory experience and quantify hearing disabilities in realistic communication situations, with particular attention to binaural hearing. Objective  To determine the test-retest reliability of the SSQ in Brazilian Portuguese. Method  A total of 35 individuals with mean age of 61 years and mean education of 7 years were interviewed. The mean auditory threshold was 44.29 dBNA in the best ear and 58.04 dBNA in the worst ear. The SSQ in Portuguese was applied at two time points, test and retest. An interval of 7 to 20 days between interviews was established. The level of significance adopted was 0.05, or 5%. Results  The analysis revealed a high Cronbach α coefficient for the three domains and for the general component of the scale, demonstrating good internal consistency between the items. In addition, a significant strong correlation was detected between test and retest of the SSQ on the analysis by domain and for the general component of the scale. A significant moderate-to-strong correlation between test and retest by question was found, except for question 2 of Part I. Conclusion  The test-retest reliability indicators showed good stability of the Portuguese version of the SSQ, indicating that the scale is suitable for use in the hearing-impaired population in Brazil.

KEYWORDS:
hearing; reproducibility of results; surveys and questionnaires

PMID: 31649755 PMCID: PMC6805206 DOI: 10.1055/s-0039-1677754
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Select item 31649585
19.
Front Psychol. 2019 Oct 9;10:2235. doi: 10.3389/fpsyg.2019.02235. eCollection 2019.
Altered Functional Connectivity and Brain Network Property in Pregnant Women With Cleft Fetuses.
Li Z1,2, Li C1,2, Liang Y3, Wang K3, Zhang W4, Chen R4, Wu Q5, Zhang X1,2.
Author information
1
School of Biomedical Engineering, Capital Medical University, Beijing, China.
2
Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China.
3
Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
4
Department of Oral and Maxillofacial Plastic and Trauma Surgery, Center of Cleft Lip and Palate Treatment, Beijing Stomatological Hospital, Beijing, China.
5
Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Abstract
Non-syndromic clefts of the lip and/or palate (NSCLP) is the most common congenital anomaly in the craniofacial region. NSCLP is a highly gene-associated malformation. We speculate that pregnant women with NSCLP fetuses (pregnancies with NSCLP) may have specific brain changes during pregnancy. To explore characteristic brain function changes of pregnancies with NSCLP, we analyzed resting-state fMRI (rs-fMRI) data of 42 pregnant women (21 pregnancies with NSCLP and 21 pregnancies with normal fetuses) to compare intergroup differences of (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), regional homogeneity (Reho), functional connectivity (FC) and network topological properties. Compared with the control group, increased ALFF in the left hippocampus, the right fusiform and the left anterior cingulate (ACG), increased Reho in left middle occipital gyrus (MOG) and right medial frontal gyrus (MFG) were found for pregnancies with NSCLP. Meanwhile, FC between the left supramarginal gyrus (SMG) and bilateral olfactory cortex (OLF), FC between left precentral gyrus (PreCG) and right MFG, FC between right inferior frontal gyrus (IFG) and left inferior temporal gyrus (ITG) were enhanced in pregnancies with NSCLP. Besides, FC between left PreCG and left amygdala, bilateral para-hippocampal gyrus, FC between left amygdala and left MFG, right IFG were decreased. Graph theory-based analysis explored increased degree centrality (DC), betweenness centrality (BC) and nodal efficiency (Ne) in the left ITG and left SMG for pregnancies with NSCLP. Pregnancies with NSCLP has widespread decreased FC within neural networks of speech and language, which indicated that they were more likely to be associated with defects in speech and language skills. At the same time, increased topological indices showed that speech and language related regions played dominant role in their brain networks. These findings may provide clues for early detection of NSCLP fetuses.

Copyright © 2019 Li, Li, Liang, Wang, Zhang, Chen, Wu and Zhang.

KEYWORDS:
brain network; functional connectivity (FC); non-syndromic cleft lip and/or palate (NSCLP); pregnant women; resting state functional magnetic resonance (rs-fMRI)

PMID: 31649585 PMCID: PMC6795235 DOI: 10.3389/fpsyg.2019.02235
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Select item 31649519
20.
Front Hum Neurosci. 2019 Oct 9;13:356. doi: 10.3389/fnhum.2019.00356. eCollection 2019.
Sympathetic Nervous System Activity in Preschoolers Who Stutter.
Walsh B1, Smith A2, Christ SL3, Weber C2.
Author information
1
Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States.
2
Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN, United States.
3
Human Development and Family Studies, Purdue University, West Lafayette, IN, United States.
Abstract
BACKGROUND:
In our Dynamic Pathways, account, we hypothesized that childhood stuttering reflects an impairment in speech sensorimotor control that is conditioned by cognitive, linguistic, and emotional factors. The purpose of this study was to investigate potential differences in levels of sympathetic arousal during performance of speech and non-speech tasks between children who do and do not stutter.

METHODS:
Seventy-two preschool-aged children participated in the study, 47 children who stutter (CWS; 38 boys) and 25 children who do not stutter (CWNS; 18 boys). We recorded skin conductance and blood pulse volume (BPV) signals, indices of sympathetic arousal, during higher/lower load speech tasks (structured sentence production and picture description) and non-speech tasks (jaw wagging and forceful blowing). We included a measure that reflects children's attitudes about their communication skills and a parent-report assessment of temperament.

RESULTS:
We found no significant differences between preschool CWS and CWNS in phasic skin conductance response amplitude or frequency, BPV, and pulse rate for any of the experimental tasks. However, compared to CWNS, CWS had, on average, significantly higher skin conductance levels (SCL), indexing slowly changing tonic sympathetic activity, across both speech and non-speech experimental conditions. We found distinctive task-related profiles of sympathetic arousal in both groups of preschool children. Most children produced the highest levels of sympathetic arousal in the physically demanding blowing task rather than in speech, as seen in previous studies of adults. We did not find differences in temperament between the two groups of preschool children nor a relationship among behavioral indices of temperament and communication attitude and physiological measures of sympathetic arousal.

CONCLUSION:
We did not find that atypically high, speech-related sympathetic arousal is a significant factor in early childhood stuttering. Rather, CWS had higher, on average, task-related tonic SCLs across speech and non-speech tasks. A relationship among behavioral measures of temperament and physiological measures of sympathetic arousal was not confirmed. Key questions for future experiments are how the typical coupling of sympathetic and speech sensorimotor systems develops over childhood and adolescence and whether task related developmental profiles follow a different course in children who continue to stutter.

Copyright © 2019 Walsh, Smith, Christ and Weber.

KEYWORDS:
autonomic nervous system; blood pulse volume; children; electrodermal activity; pulse rate; speech; stuttering; sympathetic arousal

PMID: 31649519 PMCID: PMC6795148 DOI: 10.3389/fnhum.2019.00356