scholarly journals A Cognitive-Perceptual Approach to Conceptualizing Speech Intelligibility Deficits and Remediation Practice in Hypokinetic Dysarthria

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Kaitlin L. Lansford ◽  
Julie M. Liss ◽  
John N. Caviness ◽  
Rene L. Utianski
Keyword(s):  
Speech Intelligibility ◽  
Behavioral Treatment ◽  
Evidence Base ◽  
Speaking Rate ◽  
Medical Practitioners ◽  
Medical Interventions ◽  
Perceptual Skills ◽  
Hypokinetic Dysarthria ◽  
Speech Language Pathologist

Hypokinetic dysarthria is a common manifestation of Parkinson's disease, which negatively influences quality of life. Behavioral techniques that aim to improve speech intelligibility constitute the bulk of intervention strategies for this population, as the dysarthria does not often respond vigorously to medical interventions. Although several case and group studies generally support the efficacy of behavioral treatment, much work remains to establish a rigorous evidence base. This absence of definitive research leaves both the speech-language pathologist and referring physician with the task of determining the feasibility and nature of therapy for intelligibility remediation in PD. The purpose of this paper is to introduce a novel framework for medical practitioners in which to conceptualize and justify potential targets for speech remediation. The most commonly targeted deficits (e.g., speaking rate and vocal loudness) can be supported by this approach, as well as underutilized and novel treatment targets that aim at the listener's perceptual skills.

scholarly journals Effects of Finding the Speech-Language Pathologist Likeable on Postlaryngectomy Speech Intelligibility Outcomes

2021 ◽  
pp. 1-9
Author(s):  
Marlies Feiner ◽  
Judith Keszte ◽  
Alexandra Meyer ◽  
Stefan T. Kulnik ◽  
Martin Maasz ◽  
...  
Keyword(s):  
Interpersonal Relationships ◽  
Therapeutic Relationship ◽  
Speech Intelligibility ◽  
Voice Rehabilitation ◽  
Future Studies ◽  
Hierarchical Logistic Regression ◽  
Speech Language Pathologist ◽  
Intelligibility Test ◽  
Study Participants

Introduction: Speech-language pathologists (SLPs) work with patients after total laryngectomy (TL) to regain verbal communication. The influence of the quality of the therapeutic relationship on the success of TL voice rehabilitation in terms of speech intelligibility is not known. Finding each other likeable is an important factor in establishing and maintaining interpersonal relationships in everyday life. The fit of therapist and client is relevant to the therapeutic relationship. The purpose of this study therefore was to assess the association between the degree of SLPs’ likeability ratings and postlaryngectomy speech intelligibility. Methods: In a multicentre prospective cohort study, participants rated their SLPs’ likeability after finishing TL rehabilitation. Speech intelligibility was measured objectively with the Post-Laryngectomy Telephone Intelligibility Test and subjectively with the Questionnaire for Adjustment after Laryngectomy. The association of SLPs’ likeability with speech intelligibility was analysed using hierarchical logistic regression, expressed with odds ratios (OR) with corresponding 95% confidence intervals (CI). Results: Altogether 124 patients from 13 institutions participated. The degree of finding the SLP likeable was not significantly associated with objective speech intelligibility (OR 1.30; 95% CI 0.78–2.18; p = 0.32) or subjective speech intelligibility (OR 1.01; 95% CI 0.60–1.72; p = 0.96) after controlling for age, sex and education factors. Discussion/Conclusion: In this patient cohort, there was no evidence for an association between ratings of SLPs’ likeability and speech intelligibility outcomes after rehabilitation. Future studies could consider the use of alternative instruments for measuring likeability.

Practice Guidelines: How Good are Medicine's New Recipes?

1995 ◽  
Vol 23 (1) ◽  
pp. 47-48 ◽  
Author(s):  
Alexander Morgan Capron
Keyword(s):  
Health Care ◽  
Nonprofit Organizations ◽  
Medical Knowledge ◽  
Medical Specialty ◽  
Therapeutic Interventions ◽  
Medical Interventions ◽  
Practice Parameters ◽  
Wide Range ◽  
Standard Of Practice

Over the last decade, standards for when and how to undertake a wide range of medical interventions have poured forth from medical specialty groups, commercial and nonprofit organizations, and state and federal panels. Known by a variety of names—from practice parameters to clinical guidelines—and intended for a range of purposes—from diminishing the incidence of maloccurences in hospitals to cutting the costs of health care—these guidelines share one important feature: the intention of decreasing the range of variation in medical practice. Such standardization immediately appeals to anyone interested in improving the quality of health care and, in particular, reducing inappropriate medical interventions, in light of the difficulties for a conscientious physician today in adhering to the best standard of practice when faced with ever increasing medical knowledge and the growing number and complexity of diagnostic, preventive, and therapeutic interventions.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

Therapeutic Affordances of Social Media and Associated Quality of Life Outcomes in Young Adults

2021 ◽  
pp. 089443932110329
Author(s):  
Paul Dodemaide ◽  
Mark Merolli ◽  
Nicole Hill ◽  
Lynette Joubert
Keyword(s):  
Quality Of Life ◽  
Social Media ◽  
Young Adults ◽  
Well Being ◽  
Evidence Base ◽  
Social And Emotional ◽  
Perceived Quality Of Life ◽  
Use Of Social Media ◽  
The Relationship

There is a growing body of literature exploring the general population’s use of social media for assistance in dealing with stigmatized health issues. This study presents novel research examining the relationship between social media use and young adults. It utilizes a therapeutic affordance (TA) framework. Quantitative results from this study are complemented by qualitative data. The relationships between distinct social media and their TA (a–b) are presented to highlight their potential to impact positively on social and emotional well-being outcomes. Evidence includes broad support for “connection,” “narration,” and “collaboration” TAs in this context and the relationship between the use of distinct social media and perceived quality of life (QOL) outcomes (a–c). TA provides an appropriate and valuable theoretical framework which is useful for the development of an evidence-base from the analysis of young adult’s social media usage. An analysis of the association between social media and their QOL outcomes is presented according to the TA relationship pathway (a–c–b). The adoption of a TA framework enables a nuanced analysis of significant associations between specific social media, TA, and improved QOL outcomes. This study demonstrates the significant association between social media and perceived QOL outcomes in young adults.

scholarly journals Evaluation of Internship Assessment in Medical Colleges of Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 14-17
Author(s):  
Farhana Noman ◽  
AKM Asaduzzaman ◽  
Humayun Kabir Talukder ◽  
ASM Shamsul Arefin ◽  
Shamima Rahman
Keyword(s):  
Feedback System ◽  
Descriptive Study ◽  
Current Status ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
Assessment Feedback ◽  
Assessment Techniques ◽  
Major Discipline ◽  
Medical Colleges

This study aimed to evaluate the current status of the internship assessment in medical colleges of Bangladesh. Internship acts as the pathway from being a medical student to becoming a registered doctor. Hence, a rigorous and robust internship leads to producing better doctor and in turn better healthcare. Thus, proper assessment is necessary to ensure the quality of the future medical practitioners. Unfortunately, no study has been done in Bangladesh related to this context. A cross-sectional descriptive study with pre-tested self-administered questionnaires covering study place and population and factors relevant to intern assessment (assessment after each major discipline completion, assessment techniques, and feedback) was performed. The study was carried out in 8 medical colleges (4 public and 4 non-government; 4 inside Dhaka and 4 outside). 300 completed questionnaires (250 interns, 50 supervisors) were analyzed. All the collected data were analyzed and presented with SPSS v 19.0 software. Results revealed that there was no assessment present after completion of major placement rotation (about 54% interns and 24% teachers). Furthermore, only logbook was signed as the prevailing assessment technique (more than 66% interns and 72% doctors). Moreover, assessment feedback system was not fully functional (48.7% respondent views). Hence, the overall scenario is shabby and poses questions on our future doctors' skill set.Bangladesh Journal of Medical Education Vol.8(1) 2017: 14-17

scholarly journals Non-attendance rates among patients attending different grades of psychiatrist and a clinical psychologist within a community mental health clinic

2004 ◽  
Vol 28 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Ronan McIvor ◽  
Emma Ek ◽  
Jerome Carson
Keyword(s):  
Health Clinic ◽  
Clinical Psychologist ◽  
Junior Doctors ◽  
Attendance Rates ◽  
Administration System ◽  
Medical Interventions ◽  
Community Mental Health Clinic ◽  
Linear Contrast ◽  
Patient Administration System

Aims and MethodTo examine non-attendance rates in patients seen by psychiatrists of different grades and a consultant clinical psychologist. Rates were obtained from the patient administration system over a 21-month period.ResultsA planned linear contrast showed that the clinical psychologist's patients had the lowest rate of non-attendance (7.8%), followed in turn by those of consultant psychiatrists (18.6%), specialist registrars (34%) and senior house officers (37.5%).Clinical ImplicationsFactors such as continuity of care, perceived clinical competence and the provision of non-medical interventions might have an impact on attendance rates. These results indicate the difficulty in reconciling the training needs of junior doctors with the provision of continuity and quality of care for patients. Reminder systems for people seeing training doctors might be an effective way of reducing non-attendance rates.

The quality of research exploring in-session measures of CBT competence: a systematic review

2021 ◽  
pp. 1-17
Author(s):  
Kathryn Rayson ◽  
Louise Waddington ◽  
Dougal Julian Hare
Keyword(s):  
English Language ◽  
Research Training ◽  
Evidence Base ◽  
Small Sample ◽  
Measurement Properties ◽  
Future Research ◽  
Sample Sizes ◽  
Fidelity Assessment ◽  
Quality Of Research

Abstract Background: Cognitive behavioural therapy (CBT) is in high demand due to its strong evidence base and cost effectiveness. To ensure CBT is delivered as intended in research, training and practice, fidelity assessment is needed. Fidelity is commonly measured by assessors rating treatment sessions, using CBT competence scales (CCSs). Aims: The current review assessed the quality of the literature examining the measurement properties of CCSs and makes recommendations for future research, training and practice. Method: Medline, PsychINFO, Scopus and Web of Science databases were systematically searched to identify relevant peer-reviewed, English language studies from 1980 onwards. Relevant studies were those that were primarily examining the measurement properties of CCSs used to assess adult 1:1 CBT treatment sessions. The quality of studies was assessed using a novel tool created for this study, following which a narrative synthesis is presented. Results: Ten studies met inclusion criteria, most of which were assessed as being ‘fair’ methodological quality, primarily due to small sample sizes. Construct validity and responsiveness definitions were applied inconsistently in the studies, leading to confusion over what was being measured. Conclusions: Although CCSs are widely used, we need to pay careful attention to the quality of research exploring their measurement properties. Consistent definitions of measurement properties, consensus about adequate sample sizes and improved reporting of individual properties are required to ensure the quality of future research.

Interventions Aimed at Reducing Use of Low-Value Health Services: A Systematic Review

2016 ◽  
Vol 74 (5) ◽  
pp. 507-550 ◽  
Author(s):  
Carrie H. Colla ◽  
Alexander J. Mainor ◽  
Courtney Hargreaves ◽  
Thomas Sequist ◽  
Nancy Morden
Keyword(s):  
Performance Feedback ◽  
Risk Sharing ◽  
Pay For Performance ◽  
Clinical Decision ◽  
Evidence Base ◽  
Provider Education ◽  
Rigorous Evaluation ◽  
And Performance ◽  
Multicomponent Interventions

The effectiveness of different types of interventions to reduce low-value care has been insufficiently summarized to allow for translation to practice. This article systematically reviews the literature on the effectiveness of interventions to reduce low-value care and the quality of those studies. We found that multicomponent interventions addressing both patient and clinician roles in overuse have the greatest potential to reduce low-value care. Clinical decision support and performance feedback are promising strategies with a solid evidence base, and provider education yields changes by itself and when paired with other strategies. Further research is needed on the effectiveness of pay-for-performance, insurer restrictions, and risk-sharing contracts to reduce use of low-value care. While the literature reveals important evidence on strategies used to reduce low-value care, meaningful gaps persist. More experimentation, paired with rigorous evaluation and publication, is needed.

Speech Intelligibility Parameters for Evaluating the Perception of Background Noise in Open-Plan Office Users: A Case Study

2021 ◽  
Author(s):  
María Serrano Ruiz
Keyword(s):  
Background Noise ◽  
Speech Intelligibility ◽  
Acoustic Analysis ◽  
Physical Factors ◽  
Space Design ◽  
Transmission Index ◽  
Open Plan ◽  
Design Characteristics

This document presents a case study of acoustic analysis in an open-plan office. Since Mexico does not have a standard for evaluating acoustic conditions in offices, it is relevant to compare different acoustic evaluation methods used for open-plan offices. According to several studies, one of the main acoustic characteristics for open-plan office spaces is speech intelligibility. Therefore, the purpose of this document is to compare psychoacoustic parameters to evaluate speech intelligibility in open-plan offices. We analyzed physical factors as reverberation and speech clarity in different office points, as well as semantic factors based on subjective methods with standardized values of the quality of speech intelligibility. The study was carried out under real open-plan office conditions in a library in a university in northern Mexico. The study factors of interest were type of sound, sound source, and location of the listener, with Reverberation Time (RT), Speech Transmission Index (STI) and Loss of consonant articulation (%ALCons) as the measures of impact on intelligibility. This case study provides additional evidence of the relationship between intelligibility and the position of sound sources; also, it was noted that location of listeners influenced analyzed intelligibility parameters. On the other hand, this case study offers information concerning to use psychoacoustic parameters for subjective classification of quality of the speech intelligibility to evaluate how is background noise perceived in open-plan office users. However, it is noteworthy that this study represents a single office with its own interior and space design characteristics.

The Keloid Intervention Benefit Inventory 21: A New Assessment Tool for the Quality of Life of Patients with Auricular Keloids

2021 ◽  
Author(s):  
Daniel Häussler ◽  
Stefanie Hüttemann ◽  
Christel Weiß ◽  
Nicole Karoline Rotter ◽  
Haneen Sadick
Keyword(s):  
Quality Of Life ◽  
Internal Consistency ◽  
Social Impact ◽  
Assessment Tool ◽  
Clinical Symptoms ◽  
Physical Symptoms ◽  
Medical Intervention ◽  
Medical Interventions ◽  
Before And After

Abstract Purpose The assessment of the quality of life (QoL) of patients with chronic diseases before and after medical interventions has gained increasing importance in recent decades. Particularly for patients with visible keloid scars in the head and neck region, standardized measurement tools are either absent or have been shown to be insufficient. The aim of the present study was to create a new standardized questionnaire that is specific to auricular keloid patients and reflects their clinical symptoms and QoL. Methods The Keloid Intervention Benefit Inventory 21 (KIBI-21) questionnaire was developed in two stages. First, a group of experts identified a pool of 26 questions and modified and supplemented the items through a comparison with existing QoL assessments so that they related to keloid-specific clinical symptoms and the QoL of patients with auricular keloids before and after a medical intervention. This questionnaire was distributed to 27 outpatients who had undergone medical interventions for visible auricular keloids. Second, a sequential statistical analysis was conducted. This included a single-item assessment and reduction, analysis for internal consistency, construct validity, and divergence validity as well as a factor analysis. The analyses were performed for the entire questionnaire and for the items in the subcategories General Health, Physical Symptoms, Self-Esteem, and Social Impact. Results The final version of this newly validated and standardized KIBI questionnaire consisted of 21 items, of which each item was assigned to only one subscale. The questionnaire showed a Cronbach's α of 0.84 with a good internal consistency. In the item correlation validity, strong associations were found in all subscales, except for the Social Impact Subscale. Conclusion The keloid-specific QoL questionnaire KIBI-21 proved to be a reliable and reproducible instrument to assess the QoL and clinical symptoms in patients suffering from auricular keloids before and after a medical treatment.

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