WorldWideScience

Sample records for swallow electronic resource

  1. Epidermal electronics for electromyography: An application to swallowing therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Jeong, Jae-Woong; Li, Xinda; Scott, Dylan K; Jang, Kyung-In; Chung, Hyun-Joong; Rogers, John A; Rieger, Jana

    2016-08-01

    Head and neck cancer treatment alters the anatomy and physiology of patients. Resulting swallowing difficulties can lead to serious health concerns. Surface electromyography (sEMG) is used as an adjuvant to swallowing therapy exercises. sEMG signal collected from the area under the chin provides visual biofeedback from muscle contractions and is used to help patients perform exercises correctly. However, conventional sEMG adhesive pads are relatively thick and difficult to effectively adhere to a patient's altered chin anatomy, potentially leading to poor signal acquisition in this population. Here, the emerging technology of epidermal electronics is introduced, where ultra-thin geometry allows for close contouring of the chin. The two objectives of this study were to (1) assess the potential of epidermal electronics technology for use with swallowing therapy and (2) assess the significance of the reference electrode placement. This study showed comparative signals between the new epidermal sEMG patch and the conventional adhesive patches used by clinicians. Furthermore, an integrated reference yielded optimal signal for clinical use; this configuration was more robust to head movements than when an external reference was used. Improvements for future iterations of epidermal sEMG patches specific to day-to-day clinical use are suggested. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  2. Soft Electronics Enabled Ergonomic Human-Computer Interaction for Swallowing Training

    Science.gov (United States)

    Lee, Yongkuk; Nicholls, Benjamin; Sup Lee, Dong; Chen, Yanfei; Chun, Youngjae; Siang Ang, Chee; Yeo, Woon-Hong

    2017-04-01

    We introduce a skin-friendly electronic system that enables human-computer interaction (HCI) for swallowing training in dysphagia rehabilitation. For an ergonomic HCI, we utilize a soft, highly compliant (“skin-like”) electrode, which addresses critical issues of an existing rigid and planar electrode combined with a problematic conductive electrolyte and adhesive pad. The skin-like electrode offers a highly conformal, user-comfortable interaction with the skin for long-term wearable, high-fidelity recording of swallowing electromyograms on the chin. Mechanics modeling and experimental quantification captures the ultra-elastic mechanical characteristics of an open mesh microstructured sensor, conjugated with an elastomeric membrane. Systematic in vivo studies investigate the functionality of the soft electronics for HCI-enabled swallowing training, which includes the application of a biofeedback system to detect swallowing behavior. The collection of results demonstrates clinical feasibility of the ergonomic electronics in HCI-driven rehabilitation for patients with swallowing disorders.

  3. ELECTRONIC HUMAN RESOURCE MANAGEMENT

    OpenAIRE

    Dr. M. Panneerselvam

    2017-01-01

    Electronic Human Resource Management is an essence the revolution of human resource functions to management and employees. These functions are typically used via intranet and web technology. This helps the organization to improve their standards where they can able to review and forward. All those documents can be viewed within a fraction of second with help of client and server links. The phenomenon of E- HRM deserves closer and more fundamental roots to HR activity. The E-HRM develops and b...

  4. Educating for Electronic Resources

    Science.gov (United States)

    Grogg, Jill E.

    2008-01-01

    While mission statements for various libraries and information centers necessarily vary, all librarians face "two very pressing charges: make voluminous numbers of electronic resources as visible as possible in a landscape of multiple access points and simultaneously manage all the technology, tasks, and data necessary to facilitate such…

  5. Electronic Resource Management Systems

    Directory of Open Access Journals (Sweden)

    Mark Ellingsen

    2004-10-01

    Full Text Available Computer applications which deal with electronic resource management (ERM are quite a recent development. They have grown out of the need to manage the burgeoning number of electronic resources particularly electronic journals. Typically, in the early years of e-journal acquisition, library staff provided an easy means of accessing these journals by providing an alphabetical list on a web page. Some went as far as categorising the e-journals by subject and then grouping the journals either on a single web page or by using multiple pages. It didn't take long before it was recognised that it would be more efficient to dynamically generate the pages from a database rather than to continually edit the pages manually. Of course, once the descriptive metadata for an electronic journal was held within a database the next logical step was to provide administrative forms whereby that metadata could be manipulated. This in turn led to demands for incorporating more information and more functionality into the developing application.

  6. Dynamic evaluation of swallowing disorders with electron-beam tomography; Funktionelle Schluckaktuntersuchungen mit der Elektronenstrahlcomputertomographie

    Energy Technology Data Exchange (ETDEWEB)

    Raith, J. [Universitaetsklinik fuer Radiologie, Graz (Austria); Lindbichler, F. [Universitaetsklinik fuer Radiologie, Graz (Austria); Kern, R. [Universitaetsklinik fuer Radiologie, Graz (Austria); Groell, R. [Universitaetsklinik fuer Radiologie, Graz (Austria); Rienmueller, R. [Universitaetsklinik fuer Radiologie, Graz (Austria)

    1996-03-01

    Three cases preselected by videofluorography were studied to evaluate whether electron beam tomography (EBT) permits more detailed dynamic imaging of swallowing disorders focusing on the mesonasopharyngeal segment, the hypopharynx and the upper esophageal sphincter (UES). Immediately after videofluorographic examination of the oropharyngeal deglutition, EBT is performed. The patient is in a supine position and while the patient swallows a 20 ml bolus of water or diluted iodine containing contrast agent, a sequence of 20 images per level is scanned. The levels, which are determined by using the scout view, are oriented parallel to the hard palate either at the level of the hard palate to image the mesonasopharyngel segment or just above the hyoid bone to focus on the hypopharynx or at the location of the USE. The scan technique is a single-slice cinemode with a slice thickness of 3 mm (exposure time 100 ms, interscan delay 16 ms, 130 kV, 620 mA). The following structural interactions that we have so far been unable to image can be clearly demonstrated with EBT: During normal swallowing, the mesonasopharyngeal segment is completely and symmetrically closed by the soft palate and Passavant`s cushion; lateral hypopharyngeal pouches can be located more precisely; and disorders of the UES can be differentiated into functional or morphologically caused disorders (e.g., goiter or cervical osteophytes). Videofluorography and cinematography are still the gold standard in functional evaluation of swallowing disorders. However, EBT permits dynamic imaging of pharyngeal deglutition in a preselected transverse plane and can give useful additional information concerning functional anatomical changes in the pharynx during swallowing. Further clinical evaluation is needed. (orig.) [Deutsch] Videofluorographie und Kinematographie gelten derzeit als Goldstandard fuer die Abklaerung von Schluckstoerungen. Methodisch bedingt ist jedoch keine ueberlagerungsfreie Darstellung der

  7. Electronic Resource Management and Design

    Science.gov (United States)

    Abrams, Kimberly R.

    2015-01-01

    We have now reached a tipping point at which electronic resources comprise more than half of academic library budgets. Because of the increasing work associated with the ever-increasing number of e-resources, there is a trend to distribute work throughout the library even in the presence of an electronic resources department. In 2013, the author…

  8. Resource optimized TTSH-URA for multimedia stream authentication in swallowable-capsule-based wireless body sensor networks.

    Science.gov (United States)

    Wang, Wei; Wang, Chunqiu; Zhao, Min

    2014-03-01

    To ease the burdens on the hospitalization capacity, an emerging swallowable-capsule technology has evolved to serve as a remote gastrointestinal (GI) disease examination technique with the aid of the wireless body sensor network (WBSN). Secure multimedia transmission in such a swallowable-capsule-based WBSN faces critical challenges including energy efficiency and content quality guarantee. In this paper, we propose a joint resource allocation and stream authentication scheme to maintain the best possible video quality while ensuring security and energy efficiency in GI-WBSNs. The contribution of this research is twofold. First, we establish a unique signature-hash (S-H) diversity approach in the authentication domain to optimize video authentication robustness and the authentication bit rate overhead over a wireless channel. Based on the full exploration of S-H authentication diversity, we propose a new two-tier signature-hash (TTSH) stream authentication scheme to improve the video quality by reducing authentication dependence overhead while protecting its integrity. Second, we propose to combine this authentication scheme with a unique S-H oriented unequal resource allocation (URA) scheme to improve the energy-distortion-authentication performance of wireless video delivery in GI-WBSN. Our analysis and simulation results demonstrate that the proposed TTSH with URA scheme achieves considerable gain in both authenticated video quality and energy efficiency.

  9. Managing electronic resources a LITA guide

    CERN Document Server

    Weir, Ryan O

    2012-01-01

    Informative, useful, current, Managing Electronic Resources: A LITA Guide shows how to successfully manage time, resources, and relationships with vendors and staff to ensure personal, professional, and institutional success.

  10. Swallowing Trouble

    Science.gov (United States)

    ... it is important to seek treatment to avoid malnutrition and dehydration. How are swallowing disorders treated? Many ... causing discomfort. Other causes may include: hypertension; diabetes; thyroid disease; stroke; progressive neurologic disorder; the presence of ...

  11. Swallowing difficulty

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007543.htm Swallowing difficulty To use the sharing features on this page, ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map ...

  12. Electronic Resources Management Project Presentation 2012

    KAUST Repository

    Ramli, Rindra M.

    2012-11-05

    This presentation describes the electronic resources management project undertaken by the KAUST library. The objectives of this project is to migrate information from MS Sharepoint to Millennium ERM module. One of the advantages of this migration is to consolidate all electronic resources into a single and centralized location. This would allow for better information sharing among library staff.

  13. Implementing CORAL: An Electronic Resource Management System

    Science.gov (United States)

    Whitfield, Sharon

    2011-01-01

    A 2010 electronic resource management survey conducted by Maria Collins of North Carolina State University and Jill E. Grogg of University of Alabama Libraries found that the top six electronic resources management priorities included workflow management, communications management, license management, statistics management, administrative…

  14. Bank Swallow - Monitoring [ds6

    Data.gov (United States)

    California Department of Resources — The data set represents the annual count of bank swallow burrows at nesting colonies located along the Sacramento River. The data set contains two databases which...

  15. PRINCIPLES OF CONTENT FORMATION EDUCATIONAL ELECTRONIC RESOURCE

    Directory of Open Access Journals (Sweden)

    О Ю Заславская

    2017-12-01

    Full Text Available The article considers modern possibilities of information and communication technologies for the design of electronic educational resources. The conceptual basis of the open educational multimedia system is based on the modular architecture of the electronic educational resource. The content of the electronic training module can be implemented in several versions of the modules: obtaining information, practical exercises, control. The regularities in the teaching process in modern pedagogical theory are considered: general and specific, and the principles for the formation of the content of instruction at different levels are defined, based on the formulated regularities. On the basis of the analysis, the principles of the formation of the electronic educational resource are determined, taking into account the general and didactic patterns of teaching.As principles of the formation of educational material for obtaining information for the electronic educational resource, the article considers: the principle of methodological orientation, the principle of general scientific orientation, the principle of systemic nature, the principle of fundamentalization, the principle of accounting intersubject communications, the principle of minimization. The principles of the formation of the electronic training module of practical studies in the article include: the principle of systematic and dose based consistency, the principle of rational use of study time, the principle of accessibility. The principles of the formation of the module for monitoring the electronic educational resource can be: the principle of the operationalization of goals, the principle of unified identification diagnosis.

  16. Electronic Resources Management System: Recommendation Report 2017

    KAUST Repository

    Ramli, Rindra M.

    2017-05-01

    This recommendation report provides an overview of the selection process for the new Electronic Resources Management System. The library has decided to move away from Innovative Interfaces Millennium ERM module. The library reviewed 3 system as potential replacements namely: Proquest 360 Resource Manager, Ex Libris Alma and Open Source CORAL ERMS. After comparing and trialling the systems, it was decided to go for Proquest 360 Resource Manager.

  17. CHALLENGES OF ELECTRONIC INFORMATION RESOURCES IN ...

    African Journals Online (AJOL)

    This paper discusses the role of policy for proper and efficient library services in the electronic era. It points out some of the possible dangers of embarking in electronic resources without a proper focus at hand. Thus, it calls for today's librarians and policy makers to brainstorm and come up with working policies suitable to ...

  18. Library training to promote electronic resource usage

    DEFF Research Database (Denmark)

    Frandsen, Tove Faber; Tibyampansha, Dativa; Ibrahim, Glory

    2017-01-01

    Purpose: Increasing the usage of electronic resources is an issue of concern for many libraries all over the world. Several studies stress the importance of information literacy and instruction in order to increase the usage. Design/methodology/approach: The present article presents the results...... of implementing training programmes to encourage the use of the e-library. Findings: Training sessions increase the usage of library e-resources significantly; however, the effect seems to be short-lived and training sessions alone may not increase the overall long-term usage. Originality/value: The present paper...... presents a study of training sessions as means to increase awareness and usage of library e-resources. Implications for the planning of training are discussed....

  19. Library Training to Promote Electronic Resource Usage

    DEFF Research Database (Denmark)

    Frandsen, Tove Faber; Tibyampansha, Dativa; Ibrahim, Glory

    2017-01-01

    Purpose: Increasing the usage of electronic resources is an issue of concern for many libraries all over the world. Several studies stress the importance of information literacy and instruction in order to increase the usage. Design/methodology/approach: The present article presents the results...... of implementing training programmes to encourage the use of the e-library. Findings: Training sessions increase the usage of library e-resources significantly; however, the effect seems to be short-lived and training sessions alone may not increase the overall long-term usage. Originality/value: The present paper...... presents a study of training sessions as means to increase awareness and usage of library e-resources. Implications for the planning of training are discussed....

  20. Electronic resource management systems a workflow approach

    CERN Document Server

    Anderson, Elsa K

    2014-01-01

    To get to the bottom of a successful approach to Electronic Resource Management (ERM), Anderson interviewed staff at 11 institutions about their ERM implementations. Among her conclusions, presented in this issue of Library Technology Reports, is that grasping the intricacies of your workflow-analyzing each step to reveal the gaps and problems-at the beginning is crucial to selecting and implementing an ERM. Whether the system will be used to fill a gap, aggregate critical data, or replace a tedious manual process, the best solution for your library depends on factors such as your current soft

  1. Speech and Swallowing

    Science.gov (United States)

    ... You are here Home › Speech and Swallowing Problems Speech and Swallowing Problems People with Parkinson’s may notice ... How do I know if I have a speech or voice problem? My voice makes it difficult ...

  2. 2015 Utilization of Electronic Information Resources in Ramat

    African Journals Online (AJOL)

    Utilization of Electronic Information Resources in Ramat Library, University of Maiduguri, Nigeria. 195 ... Information Impact Vol. 6 (2) 2015. Introduction. The concept of "e-resources" which stands for electronic resources has become a global phenomenon which emerged as a ... Science, Delta State University Abaraka,.

  3. Use of Electronic Resources in a Private University in Nigeria ...

    African Journals Online (AJOL)

    The study examined awareness and constraints in the use of electronic resources by lecturers and students of Ajayi Crowther University, Oyo, Nigeria. It aimed at justifying the resources expended in the provision of electronic resources in terms of awareness, patronage and factors that may be affecting awareness and use ...

  4. Electronic Resource Management System. Vernetzung von Lizenzinformationen

    Directory of Open Access Journals (Sweden)

    Michaela Selbach

    2014-12-01

    Full Text Available In den letzten zehn Jahren spielen elektronische Ressourcen im Bereich der Erwerbung eine zunehmend wichtige Rolle: Eindeutig lässt sich hier ein Wandel in den Bibliotheken (fort vom reinen Printbestand zu immer größeren E-Only-Beständen feststellen. Die stetig wachsende Menge an E-Ressourcen und deren Heterogenität stellt Bibliotheken vor die Herausforderung, die E-Ressourcen effizient zu verwalten. Nicht nur Bibliotheken, sondern auch verhandlungsführende Institutionen von Konsortial- und Allianzlizenzen benötigen ein geeignetes Instrument zur Verwaltung von Lizenzinformationen, welches den komplexen Anforderungen moderner E-Ressourcen gerecht wird. Die Deutsche Forschungsgemeinschaft (DFG unterstützt ein Projekt des Hochschulbibliothekszentrums des Landes Nordrhein-Westfalen (hbz, der Universitätsbibliothek Freiburg, der Verbundzentrale des Gemeinsamen Bibliotheksverbundes (GBV und der Universitätsbibliothek Frankfurt, in dem ein bundesweit verfügbares Electronic Ressource Managementsystem (ERMS aufgebaut werden soll. Ein solches ERMS soll auf Basis einer zentralen Knowledge Base eine einheitliche Nutzung von Daten zur Lizenzverwaltung elektronischer Ressourcen auf lokaler, regionaler und nationaler Ebene ermöglichen. Statistische Auswertungen, Rechteverwaltung für alle angeschlossenen Bibliotheken, kooperative Datenpflege sowie ein über standardisierte Schnittstellen geführter Datenaustausch stehen bei der Erarbeitung der Anforderungen ebenso im Fokus wie die Entwicklung eines Daten- und Funktionsmodells. In the last few years the importance of electronic resources in library acquisitions has increased significantly. There has been a shift from mere print holdings to both e- and print combinations and even e-only subscriptions. This shift poses a double challenge for libraries: On the one hand they have to provide their e-resource collections to library users in an appealing way, on the other hand they have to manage these

  5. Electronic human resource management: Enhancing or entrancing?

    Directory of Open Access Journals (Sweden)

    Paul Poisat

    2017-01-01

    Full Text Available Orientation: This article provides an investigation into the current level of development of the body of knowledge related to electronic human resource management (e-HRM by means of a qualitative content analysis. Several aspects of e-HRM, namely definitions of e-HRM, the theoretical perspectives around e-HRM, the role of e-HRM, the various types of e-HRM and the requirements for successful e-HRM, are examined.Research purpose: The purpose of the article was to determine the status of e-HRM and examine the studies that report on the link between e-HRM and organisational productivity.Motivation for the study: e-HRM has the capacity to improve organisational efficiency and leverage the role of human resources (HR as a strategic business partner.Main findings: The notion that the implementation of e-HRM will lead to improved organisational productivity is commonly assumed; however, empirical evidence in this regard was found to be limited.Practical/managerial implications: From the results of this investigation it is evident that more research is required to gain a greater understanding of the influence of e-HRM on organisational productivity, as well as to develop measures for assessing this influence.Contribution: This article proposes additional areas to research and measure when investigating the effectiveness of e-HRM. It provides a different lens from which to view e-HRM assessment whilst keeping it within recognised HR measurement parameters (the HR value chain. In addition, it not only provides areas for measuring e-HRM’s influence but also provides important clues as to how the measurements may be approached. 

  6. Utilization of electronic information resources by academic staff at ...

    African Journals Online (AJOL)

    The study investigated the utilization of Electronic Information resources by the academic staff of Makerere University in Uganda. It examined the academic staff awareness of the resources available, the types of resources provided by the Makerere University Library, the factors affecting resource utilization. The study was ...

  7. Electronic Resource Management: Functional Integration in Technical Services

    OpenAIRE

    Stachokas, George

    2014-01-01

    Declining usage of print materials along with increasing usage of electronic resources makes it necessary for libraries to reallocate personnel from print management to electronic resources management. Electronic resources management should be the primary focus of technical services units in the early twenty-first century. Print should no longer be treated as the default format, and the work of library staff must be reorganized and reintegrated with librarians and other professionals to refle...

  8. Swallowed toothbrush: Case series

    Directory of Open Access Journals (Sweden)

    S Kiran

    2016-01-01

    Full Text Available Toothbrush swallowing is rare, and most cases are seen in young women with anorexia nervosa or bulimia or associated with mental retardation or schizophrenia. Prompt removal is recommended because no cases of spontaneous passage have been reported. There is no previously reported case series on swallowed toothbrush in mentally normal young men. Here, we report three cases of swallowed toothbrush found in the esophagus and stomach on endoscopy. In our case series, successful removal of the toothbrush was done without endotracheal intubation or over tube, without any complications. To our knowledge, this is the first documented case series of swallowed toothbrush managed successfully endoscopically.

  9. impact of the use of electronic resources on research output

    African Journals Online (AJOL)

    manda

    Abstract. This paper examines the impact of the use of electronic information resources on research output in the universities in Tanzania. Research for this paper was conducted in five public universities in Tanzania with varied levels of access to electronic information resources. The selection of the sample universities was ...

  10. Page 170 Use of Electronic Resources by Undergraduates in Two ...

    African Journals Online (AJOL)

    The evolution of information technology in the twentieth century has influenced students' use of information resources. Today, many students access information electronically via the Internet using desktop, laptop, palmtop and mobile phones. Electronic resources supply all the information that a library provides through ...

  11. The impact of electronic information resource use on research output

    African Journals Online (AJOL)

    This paper examines the impact of the use of electronic information resources on research output in the universities in Tanzania. Research for this paper was conducted in five public universities in Tanzania with varied levels of access to electronic information resources. The selection of the sample universities was ...

  12. Use of electronic resources by undergraduates in two selected ...

    African Journals Online (AJOL)

    The purpose of this study is to know the extent of use of electronic resources and identify the type of electronic resources used by undergraduates in universities in Nigeria. Questionnaire was used for data collection. The study population includes all undergraduate students in the faculty of engineering in Niger Delta ...

  13. The Role of the Acquisitions Librarian in Electronic Resources Management

    Science.gov (United States)

    Pomerantz, Sarah B.

    2010-01-01

    With the ongoing shift to electronic formats for library resources, acquisitions librarians, like the rest of the profession, must adapt to the rapidly changing landscape of electronic resources by keeping up with trends and mastering new skills related to digital publishing, technology, and licensing. The author sought to know what roles…

  14. Use of electronic information resources in goverment libraries

    Directory of Open Access Journals (Sweden)

    Simona Omahen

    2003-01-01

    Full Text Available The article presents the use of electronic information resources in government libraries in Slovenia. It starts with the definition of government libraries and electronic publications. On a selected sample of government libraries, the state of the usage of electronic information resources in government libraries was studied. On the basis of interviews, carried out in five government libraries, it was established that government libraries mostly do not focus on, or even think about, the use of electronic information resources. What they have and use seems self-evident to them.

  15. Movements of temporomandibular condyles during swallowing.

    Science.gov (United States)

    Čimić, Samir; Šimunković, Sonja Kraljević; Gospić, Renata Kevilj; Badel, Tomislav; Dulčić, Nikša; Ćatić, Amir

    2015-03-01

    There have been studies that investigated mandibular movements and positioning during swallowing, but the results were inconsistent, and still the exact position of the condyles during swallowing is unknown. The purpose of this investigation was to study the kinematics of the mandible and the condyles, and to determine the actual movement paths and position of mandible and condyles during the process of swallowing. The study was performed on a sample of 44 dental students. Measurements were done with an electronic axiograph. After non-occlusing attachment was fixed in the mouth, every subject swallowed for five times from the rest position. The final swallowing position of the left and the right condyles was measured in the sagittal plane. The final swallowing position of the sagittal incisal point was measured in sagittal, frontal and horizontal plane, and data was statistically analyzed. The condyles showed average movement toward posterior (left 0.17 mm, SD 0.28, right 0.16 mm, SD 0.25) and superior (left 0.14 mm, SD 0.20, right 0.14 mm, SD 0.23). Anterior and/or inferior position had 20% of participants. The average sagittal incisal point movement during swallowing was toward anterior (0.30 mm, SD 0.53) and superior (0.81 mm, SD 0.84). The mean mandibular lateral movement was 0.1 mm (SD 0.1). The results of the study suggest that retrusion during swallowing is not the rule, although on average there is a slight tendency of condylar movement toward posterior. Swallowing can be used as auxiliary method for determining vertical dimension of occlusion.

  16. Electronic information resources for food toxicology.

    Science.gov (United States)

    Winter, Carl K

    2002-04-25

    This manuscript provides a brief overview of many useful Internet resources concerning food toxicology. Specific topic areas include pesticide residues, food additives, natural toxins, environmental contaminants, and food allergies; numerous links and evaluative information are provided within each topic area. Several helpful Internet resources have been identified and include government, industry, academic, and consumer sites.

  17. Electronic resources preferred by pediatric hospitalists for clinical care.

    Science.gov (United States)

    Beck, Jimmy B; Tieder, Joel S

    2015-10-01

    There is little research on pediatric hospitalists' use of evidence-based resources. The aim of this study was to determine the electronic resources that pediatric hospitalists prefer. Using a web-based survey, the authors determined hospitalists' preferred electronic resources, as well as their attitudes toward lifelong learning, practice, and experience characteristics. One hundred sixteen hospitalists completed the survey. The most preferred resource for general information, patient handouts, and treatment was UpToDate. Online search engines were ranked second for general information and patient handouts. Pediatric hospitalists tend to utilize less rigorous electronic resources such as UpToDate and Google. These results can set a platform for discussing the quality of resources that pediatric hospitalists use.

  18. Improving Electronic Resources through Holistic Budgeting

    Science.gov (United States)

    Kusik, James P.; Vargas, Mark A.

    2009-01-01

    To establish a more direct link between its collections and the educational goals of Saint Xavier University, the Byrne Memorial Library has adopted a "holistic" approach to collection development. This article examines how traditional budget practices influenced the library's selection of resources and describes how holistic collection…

  19. Electronic learning and open educational resources in the health ...

    African Journals Online (AJOL)

    Electronic learning and open educational resources in the health sciences in Ghana. ... Methods: Two e-learning materials were developed, one on the polymerase ... 95% (18) at UG report having access to a computer for learning purposes.

  20. Integrating Electronic Resources into the Library Catalog: A Collaborative Approach.

    Science.gov (United States)

    Herrera, Gail; Aldana, Lynda

    2001-01-01

    Describes a project at the University of Mississippi Libraries to catalog purchased electronic resources so that access to these resources is available only via the Web-based library catalog. Discusses collaboration between cataloging and systems personnel; and describes the MARC catalog record field that contains the information needed to locate…

  1. Utilisation of Electronic Information Resources By Lecturers in ...

    African Journals Online (AJOL)

    This study assesses the use of information resources, specifically, electronic databases by lecturers/teachers in Universities and Colleges of Education in South Western Nigeria. Information resources are central to teachers' education. It provides lecturers/teachers access to information that enhances research and ...

  2. Euler European Libraries and Electronic Resources in Mathematical Sciences

    CERN Document Server

    The Euler Project. Karlsruhe

    The European Libraries and Electronic Resources (EULER) Project in Mathematical Sciences provides the EulerService site for searching out "mathematical resources such as books, pre-prints, web-pages, abstracts, proceedings, serials, technical reports preprints) and NetLab (for Internet resources), this outstanding engine is capable of simple, full, and refined searches. It also offers a browse option, which responds to entries in the author, keyword, and title fields. Further information about the Project is provided at the EULER homepage.

  3. Building an electronic resource collection a practical guide

    CERN Document Server

    Lee, Stuart D

    2004-01-01

    This practical book guides information professionals step-by-step through building and managing an electronic resource collection. It outlines the range of electronic products currently available in abstracting and indexing, bibliographic, and other services and then describes how to effectively select, evaluate and purchase them.

  4. CDC and ATSDR electronic information resources for health officers.

    Science.gov (United States)

    Friede, A; O'Carroll, P W

    1996-12-01

    This article catalogs some of the Centers for Disease Control and Prevention's (CDC) more important information resource offerings, which make public health information accessible via computer and automated telephone systems and on electronic media (diskette and CD-ROM). We review mechanisms for (1) finding and retrieving CDC reports, (2) querying CDC's numeric data files, (3) transmitting surveillance and other data files to CDC, (4) exchanging electronic mail with CDC staff, and (5) disseminating state and local public health information and data by using CDC tools. Each resource is followed with a section on how to obtain access to these resources.

  5. Speech and Swallowing

    Science.gov (United States)

    ... of Smell Cognitive Changes Depression Fatigue Constipation & Nausea Hallucinations/Delusions Pain Skeletal & Bone Health Skin Changes Sleep Disorders Speech & Swallowing Problems Urinary Incontinence Vision Changes Weight Management Help Us Make a Difference ...

  6. Organizational matters of competition in electronic educational resources

    Directory of Open Access Journals (Sweden)

    Ирина Карловна Войтович

    2015-12-01

    Full Text Available The article examines the experience of the Udmurt State University in conducting competitions of educational publications and electronic resources. The purpose of such competitions is to provide methodological support to educational process. The main focus is on competition of electronic educational resources. The technology of such contests is discussed through detailed analysis of the main stages of the contest. It is noted that the main task of the preparatory stage of the competition is related to the development of regulations on competition and the definition of criteria for selection of the submitted works. The paper also proposes a system of evaluation criteria of electronic educational resources developed by members of the contest organizing committee and jury members. The article emphasizes the importance of not only the preparatory stages of the competition, but also measures for its completion, aimed at training teachers create quality e-learning resources.

  7. USE OF VIDEO IN MULTIMEDIA ELECTRONIC EDUCATIONAL RESOURCES

    Directory of Open Access Journals (Sweden)

    Svitlana Denisenko

    2015-10-01

    Full Text Available The widespread introduction of electronic educational resources in the educational process requires the development of a scientific basis for all aspects related to their creation and use. These modern means are designed not just to convey to learners the required course material, but also to create conditions for its most effective study. This is possible in conditions of reasonable approach to the presentation of educational material on the screen. The article is devoted to consideration of the problem of presenting educational material in electronic educational resources. Visuals are powerful didactic tool that enhances the perception and understanding of educational information. Particular attention is paid to the use of such a powerful medium like video. Investigated the role and importance of video in the learning process, their educational opportunities and benefits. Shows types of video and their use in electronic educational resources. Grounded requirements for training videos. The recommendations are given on the use of video in combination with other media in electronic educational resources. Adduced the example a real electronic multimedia educational resource and shows the possibility of using video.

  8. Access to electronic resources by visually impaired people

    Directory of Open Access Journals (Sweden)

    Jenny Craven

    2003-01-01

    Full Text Available Research into access to electronic resources by visually impaired people undertaken by the Centre for Research in Library and Information Management has not only explored the accessibility of websites and levels of awareness in providing websites that adhere to design for all principles, but has sought to enhance understanding of information seeking behaviour of blind and visually impaired people when using digital resources.

  9. Practical guide to electronic resources in the humanities

    CERN Document Server

    Dubnjakovic, Ana

    2010-01-01

    From full-text article databases to digitized collections of primary source materials, newly emerging electronic resources have radically impacted how research in the humanities is conducted and discovered. This book, covering high-quality, up-to-date electronic resources for the humanities, is an easy-to-use annotated guide for the librarian, student, and scholar alike. It covers online databases, indexes, archives, and many other critical tools in key humanities disciplines including philosophy, religion, languages and literature, and performing and visual arts. Succinct overviews of key eme

  10. Difficulty Swallowing After Stroke (Dysphagia)

    Science.gov (United States)

    ... Stroke Heroes Among Us Difficulty Swallowing After Stroke (Dysphagia) Updated:Nov 15,2016 Excerpted and adapted from "Swallowing Disorders After a Stroke," Stroke Connection Magazine July/August ...

  11. Atypical swallowing: a review.

    Science.gov (United States)

    Maspero, C; Prevedello, C; Giannini, L; Galbiati, G; Farronato, G

    2014-06-01

    Atypical swallowing is a myofunctional problem consisting of an altered tongue position during the act of swallowing. High incidence in population, multifactorial etiology and the recurring connection with the presence of malocclusions made it a topic of strong interest and discussion in science. The purpose of this review is to illustrate the current orientation on the topic of atypical swallowing, trying in particular to answer two questions: 1) what kind of connection is there between atypical swallowing and malocclusion; 2) what kind of therapy should be used to solve it. This review was conducted on the Medline database [www.ncbi.nim.nih.gov/pubmed] searching for the keywords "atypical swallowing" and "tongue thrust". We examined all the documents from the year 1990 onwards, excluding the ones about syndromic cases of the central motor system. The causal relation between the two problems seems to be biunique: some authors affirm that this oral habit starts as a compensation mechanism for a preexisting malocclusion (especially in case of open-bite); other texts show that it has a tendency to exacerbate cases of malocclusion; it is also proven that a non-physiological tongue thrust can negatively influence the progress of an ongoing orthodontic therapy. Thereby, the best therapeutic approach seems to be a multidisciplinary one: beside orthodontics, which is necessary to correct the malocclusion, it is essential to set up a myofunctional rehabilitation procedure to correct the oral habit, therefore granting long time permanent results. There is also proof of a substantial difference between the results obtained from early (deciduous or primary mixed dentition) or later treatments. The biunique causal relation between atypical swallowing and malocclusion suggests a multidisciplinary therapeutic approach, orthodontic and myofunctional, to temporarily solve both problems. An early diagnosis and a prompt intervention have a significantly positive influence on the

  12. Electronic Commerce Resource Centers. An Industry--University Partnership.

    Science.gov (United States)

    Gulledge, Thomas R.; Sommer, Rainer; Tarimcilar, M. Murat

    1999-01-01

    Electronic Commerce Resource Centers focus on transferring emerging technologies to small businesses through university/industry partnerships. Successful implementation hinges on a strategic operating plan, creation of measurable value for customers, investment in customer-targeted training, and measurement of performance outputs. (SK)

  13. Providing Access to Electronic Information Resources in Further Education

    Science.gov (United States)

    Banwell, Linda; Ray, Kathryn; Coulson, Graham; Urquhart, Christine; Lonsdale, Ray; Armstrong, Chris; Thomas, Rhian; Spink, Sin; Yeoman, Alison; Fenton, Roger; Rowley, Jennifer

    2004-01-01

    This article aims to provide a baseline for future studies on the provision and support for the use of digital or electronic information services (EIS) in further education. The analysis presented is based on a multi-level model of access, which encompasses access to and availability of information and communication technology (ICT) resources,…

  14. use of electronic resources by graduate students of the department ...

    African Journals Online (AJOL)

    the media (internet, cyber café, Phone and University cafe). 2. There is no significant difference in the level of use of electronic resources between male and female postgraduate students of the department of educational technology and library science in the University of Uyo. 3. There is no significant difference in the of.

  15. Printed And Electronic Resources Utilization By Agricultural Science ...

    African Journals Online (AJOL)

    This paper examines the use of printed and electronic resources by agricultural science students in three Nigerian universities. A two-part questionnaire was designed to elicit necessary information from the respondents selected for the study. One thousand three hundred (1300) respondents from faculties of Agriculture in ...

  16. Adoption and use of electronic information resources by medical ...

    African Journals Online (AJOL)

    This study investigated the adoption and use of electronic information resources by medical science students of the University of Benin. The descriptive survey research design was adopted for the study and 390 students provided the data. Data collected were analysed with descriptive Statistics(Simple percentage and ...

  17. Electronic resources access and usage among the postgraduates of ...

    African Journals Online (AJOL)

    This study investigated electronic resources access and usage among the postgraduates of a Nigerian University of Technology. The Taro Yamane's sample size formula was used to determine sample size of 276 respondents from the total population of the study and systematic random sampling was used to select the ...

  18. Electronic information resource sharing among university libraries in ...

    African Journals Online (AJOL)

    The study explored the state of electronic information resource sharing among university libraries in Southern part of Nigeria, highlighting the prospects and the challenges. The study was an empirical research which adopted the descriptive survey as the design. The questionnaire was used to collect data from the ...

  19. Access to electronic information resources by students of federal ...

    African Journals Online (AJOL)

    The paper discusses access to electronic information resources by students of Federal Colleges of Education in Eha-Amufu and Umunze. Descriptive survey design was used to investigate sample of 526 students. Sampling technique used was a Multi sampling technique. Data for the study were generated using ...

  20. ANALYTICAL REVIEW OF ELECTRONIC RESOURCES FOR THE STUDY OF LATIN

    Directory of Open Access Journals (Sweden)

    Olena Yu. Balalaieva

    2014-04-01

    Full Text Available The article investigates the current state of development of e-learning content in the Latin language. It is noted that the introduction of ICT in the educational space has expanded the possibility of studying Latin, opened access to digital libraries resources, made it possible to use scientific and educational potential and teaching Latin best practices of world's leading universities. A review of foreign and Ukrainian information resources and electronic editions for the study of Latin is given. Much attention was paid to the didactic potential of local and online multimedia courses of Latin, electronic textbooks, workbooks of interactive tests and exercises, various dictionaries and software translators, databases and digital libraries. Based on analysis of the world market of educational services and products the main trends in the development of information resources and electronic books are examined. It was found that multimedia courses with interactive exercises or workbooks with interactive tests, online dictionaries and translators are the most widely represented and demanded. The noticeable lagging of Ukrainian education and computer linguistics in quantitative and qualitative measures in this industry is established. The obvious drawback of existing Ukrainian resources and electronic editions for the study of Latin is their noninteractive nature. The prospects of e-learning content in Latin in Ukraine are outlined.

  1. Use of Internet and Electronic Resources amongst Postgraduate ...

    African Journals Online (AJOL)

    A Nigerian private university is newly venturing into p ostgraduate study programs and has an enrolled postgraduate student population of about a hundred. This study evaluates the postgraduate students' use of library; their information format preference, internet access and electronic resources used in their various ...

  2. The impact of electronic information resource use on research output

    African Journals Online (AJOL)

    The selection of the sample universities was purposive. ... This was demonstrated in the increased number of proposals prepared, submitted and funded, research reports submitted, journal articles published and chapters in books and books published with increased access to and use of electronic information resources.

  3. Technical Communicator: A New Model for the Electronic Resources Librarian?

    Science.gov (United States)

    Hulseberg, Anna

    2016-01-01

    This article explores whether technical communicator is a useful model for electronic resources (ER) librarians. The fields of ER librarianship and technical communication (TC) originated and continue to develop in relation to evolving technologies. A review of the literature reveals four common themes for ER librarianship and TC. While the…

  4. Gender Analysis Of Electronic Information Resource Use: The Case ...

    African Journals Online (AJOL)

    This article is based on an empirical study that examined the association between gender and the use of electronic information resources among postgraduate students at the University of Dar es salaam, Tanzania. The study was conducted in December 2005 and integrated both qualitative and quantitative research ...

  5. Users satisfaction with electronic information resources and services ...

    African Journals Online (AJOL)

    Users satisfaction with electronic information resources and services in A.B.U & UNIBEN MTN Net Libraries. ... Lastly, management of the MTN Net Libraries should conduct user studies annually in order to have feedback from users on how well the library is meeting their information needs. The results of the survey should ...

  6. Skills and training needs for use of electronic information resources ...

    African Journals Online (AJOL)

    The article reports on the findings regarding students' knowledge, skill and training needs in using Electronic Information Resources (EIRs). Data was collected using a questionnaire-based survey administered to 1123 undergraduate students. Probability sampling was used to sample students across the four universities, ...

  7. Think Locally: A Prudent Approach to Electronic Resource Management Systems

    Science.gov (United States)

    Gustafson-Sundell, Nat

    2011-01-01

    A few articles have drawn some amount of attention specifically to the local causes of the success or failure of electronic resource management system (ERMS) implementations. In fact, it seems clear that local conditions will largely determine whether any given ERMS implementation will succeed or fail. This statement might seem obvious, but the…

  8. Evaluating the appropriateness of electronic information resources for learning.

    Science.gov (United States)

    Saparova, Dinara; Nolan, Nathanial S

    2016-01-01

    Current US medical students have begun to rely on electronic information repositories-such as UpToDate, AccessMedicine, and Wikipedia-for their pre-clerkship medical education. However, it is unclear whether these resources are appropriate for this level of learning due to factors involving information quality, level of evidence, and the requisite knowledgebase. This study evaluated appropriateness of electronic information resources from a novel perspective: amount of mental effort learners invest in interactions with these resources and effects of the experienced mental effort on learning. Eighteen first-year medical students read about three unstudied diseases in the above-mentioned resources (a total of fifty-four observations). Their eye movement characteristics (i.e., fixation duration, fixation count, visit duration, and task-evoked pupillary response) were recorded and used as psychophysiological indicators of the experienced mental effort. Post reading, students' learning was assessed with multiple-choice tests. Eye metrics and test results constituted quantitative data analyzed according to the repeated Latin square design. Students' perceptions of interacting with the information resources were also collected. Participants' feedback during semi-structured interviews constituted qualitative data and was reviewed, transcribed, and open coded for emergent themes. Compared to AccessMedicine and Wikipedia, UpToDate was associated with significantly higher values of eye metrics, suggesting learners experienced higher mental effort. No statistically significant difference between the amount of mental effort and learning outcomes was found. More so, descriptive statistical analysis of the knowledge test scores suggested similar levels of learning regardless of the information resource used. Judging by the learning outcomes, all three information resources were found appropriate for learning. UpToDate, however, when used alone, may be less appropriate for first

  9. E-Resources Management: How We Positioned Our Organization to Implement an Electronic Resources Management System

    Science.gov (United States)

    White, Marilyn; Sanders, Susan

    2009-01-01

    The Information Services Division (ISD) of the National Institute of Standards and Technology (NIST) positioned itself to successfully implement an electronic resources management system. This article highlights the ISD's unique ability to "team" across the organization to realize a common goal, develop leadership qualities in support of…

  10. MODEL OF AN ELECTRONIC EDUCATIONAL RESOURCE OF NEW GENERATION

    Directory of Open Access Journals (Sweden)

    Anatoliy V. Loban

    2016-01-01

    Full Text Available The mathematical structure of the modular architecture of an electronic educational resource (EER of new generation, which allows to decompose the process of studying the subjects of the course at a hierarchically ordered set of data (knowledge and procedures for manipulating them, to determine the roles of participants of process of training of and technology the development and use of EOR in the study procrate.

  11. Journals, Data and Abstracts Make an Integrated Electronic Resource

    Science.gov (United States)

    Boyce, P.

    1996-12-01

    Astronomy now has an integrated, Web-based information resource for research papers, data and bibliographic information. The major scholarly research journals, a comprehensive abstract service and the astronomical data centers are now linked together to provide an information resource which is not available to most other scientific disciplines. As of January, 1997, the Astrophysical Journal joins the ApJ Letters on the Web. Astronomy and Astrophysics Supplements now has a page image version. Elsevier's electronic journal New Astronomy has recently made its appearance. Over forty percent of the new peer-reviewed, astronomical literature is now available electronically. The main Astronomy and Astrophysics journal, the Astronomical Journal and others will be available by 1998, at which point ninety percent of the literature will be available electronically, a figure not approached by any other scientific discipline. With so many different sources, one of the challenges has been to integrate the on-line, peer-reviewed literature into a resource which serves the astronomical community in a unified and coherent manner. Following the lead of the AAS, the major publishers have chosen to rely upon the NASA-supported Astrophysics Data System (ADS) and the astronomical data centers to provide the means by which the various separate journals can interoperate. The data centers and the ADS have developed unique identification codes for journal articles. By adopting the existing standard "bibcodes" and integrating them into their WWW links, each of the major astronomical journals are able to link to the abstracts of most of the referenced articles. Since the ADS also serves as an on-line repository for page images of the past twenty years of the major astronomical journals, the full text of many of the referenced articles are available, too. The articles in the ADS have recently been linked through their references, both forward and backward in time. With the "bibcode" providing

  12. Evaluating increased resource use in fibromyalgia using electronic health records.

    Science.gov (United States)

    Margolis, Jay M; Masters, Elizabeth T; Cappelleri, Joseph C; Smith, David M; Faulkner, Steven

    2016-01-01

    The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR) database to explore data from patients diagnosed with FM. This was a retrospective analysis of de-identified EHR data from the Humedica database. Adults (≥18 years) with FM were identified based on ≥2 International Classification of Diseases, Ninth Revision codes for FM (729.1) ≥30 days apart between January 1, 2008 and December 31, 2012 and were required to have evidence of ≥12 months continuous care pre- and post-index; first FM diagnosis was the index event; 12-month pre- and post-index reporting periods. Multivariable analysis evaluated relationships between variables and resource utilization. Patients were predominantly female (81.4%), Caucasian (87.7%), with a mean (standard deviation) age of 54.4 (14.8) years. The highest health care resource utilization was observed for the categories of "medication orders" and "physician office visits," with 12-month post-index means of 21.2 (21.5) drug orders/patient and 15.1 (18.1) office visits/patient; the latter accounted for 73.3% of all health care visits. Opioids were the most common prescription medication, 44.3% of all patients. The chance of high resource use was significantly increased ( P FM patients.

  13. Analysis of Human Resources Management Strategy in China Electronic Commerce Enterprises

    Science.gov (United States)

    Shao, Fang

    The paper discussed electronic-commerce's influence on enterprise human resources management, proposed and proved the human resources management strategy which electronic commerce enterprise should adopt from recruitment strategy to training strategy, keeping talent strategy and other ways.

  14. COLLECTIONS OF ELECTRONIC INFORMATION RESOURCES AND THEIR METADESCRIPTIONS AS COMPONENTS OF SCIENTIFIC ELECTRONIC LIBRARY

    Directory of Open Access Journals (Sweden)

    Zoya V. Savchenko

    2011-02-01

    Full Text Available The article presents the results of scientific research components of digital libraries, the main ones being the collection of electronic scientific information resources. An important specific characteristics of collections of scientific information resources, resources of their formation, structure collections, methods of their organization, technology creation, support and use of scientific collections, the role and function of metadata in collections and metadata management technology are represented. On the stage of planning and introduction of scientific e-libraries there can be used results of researches presented in the article, namely: chart of forming of collections of scientific informative resources; stages of planning and development of metadescriptions, and similarly the use of standard the Dublin kernel, creation of metadescriptions.

  15. Electronic Resources and Mission Creep: Reorganizing the Library for the Twenty-First Century

    Science.gov (United States)

    Stachokas, George

    2009-01-01

    The position of electronic resources librarian was created to serve as a specialist in the negotiation of license agreements for electronic resources, but mission creep has added more functions to the routine work of electronic resources such as cataloging, gathering information for collection development, and technical support. As electronic…

  16. Electronic Document Management: A Human Resource Management Case Study

    Directory of Open Access Journals (Sweden)

    Thomas Groenewald

    2004-11-01

    Full Text Available This case study serve as exemplar regarding what can go wrong with the implementation of an electronic document management system. Knowledge agility and knowledge as capital, is outlined against the backdrop of the information society and knowledge economy. The importance of electronic document management and control is sketched thereafter. The literature review is concluded with the impact of human resource management on knowledge agility, which includes references to the learning organisation and complexity theory. The intervention methodology, comprising three phases, follows next. The results of the three phases are presented thereafter. Partial success has been achieved with improving the human efficacy of electronic document management, however the client opted to discontinue the system in use. Opsomming Die gevalle studie dien as voorbeeld van wat kan verkeerd loop met die implementering van ’n elektroniese dokumentbestuur sisteem. Teen die agtergrond van die inligtingsgemeenskap en kennishuishouding word kennissoepelheid en kennis as kapitaal bespreek. Die literatuurstudie word afgesluit met die inpak van menslikehulpbronbestuur op kennissoepelheid, wat ook die verwysings na die leerorganisasie en kompleksietydsteorie insluit. Die metodologie van die intervensie, wat uit drie fases bestaan, volg daarna. Die resultate van die drie fases word vervolgens aangebied. Slegs gedeelte welslae is behaal met die verbetering van die menslike doeltreffendheid ten opsigte van elektroniese dokumentbestuur. Die klient besluit egter om nie voort te gaan om die huidige sisteem te gebruik nie.

  17. "Will a Black Hole Eventually Swallow the Earth?" Fifth Graders' Interest in Questions from a Textbook, an Open Educational Resource, and Other Students' Questions

    Science.gov (United States)

    Swirski, Hani; Baram-Tsabari, Ayelet

    2015-01-01

    Can questions sent to Open-Educational-Resource (OER) websites such as Ask-An-Expert serve as indicators for students' interest in science? This issue was examined using an online questionnaire which included an equal number of questions about the topics "space" and "nutrition" randomly selected from three different sources: a…

  18. Will a Black Hole Eventually Swallow Earth?” Fifth Graders' Interest in Questions from a Textbook, an Open Educational Resource and Other Students' Questions

    Directory of Open Access Journals (Sweden)

    Hani Swirski

    2015-12-01

    Full Text Available Can questions sent to Open-Educational-Resource (OER websites such as Ask-An-Expert serve as indicators for students’ interest in science? This issue was examined using an online questionnaire which included an equal number of questions about the topics “space” and “nutrition” randomly selected from three different sources: a 5th-grade science textbook, the “Ask-An-Expert” website, and questions collected from other students in the same age group. A sample of 113 5th-graders from two elementary schools were asked to rate their interest level in finding out the answer to these questions without knowledge of their source. Significant differences in students’ interest level were found between questions: textbook questions were ranked lowest for both subjects, and questions from the open-resource were ranked high. This finding suggests that questions sent to an open-resource could be used as an indicator of students’ interest in science. In addition, the high correlation of interests expressed by students from the two schools may point to a potential generalization of the findings. This study contributes by highlighting OER as a new and promising indicator of student interest, which may help bring “student voices” into mainstream science teaching to increase student interest in science.

  19. Utility of a Clinical Swallowing Exam for Understanding Swallowing Physiology.

    Science.gov (United States)

    Rangarathnam, Balaji; McCullough, Gary H

    2016-08-01

    A clinical swallowing examination (CSE) is generally believed to be inadequate for making judgments regarding swallowing physiology compared to objective assessments. A large volume of studies has heavily focused on identifying aspiration using a CSE and research addressing physiologic information gathered from a CSE is sparse. The purpose of this study was to examine the utility of the CSE for assessing physiology compared to videofluoroscopic swallowing studies (VFSS). Data were derived from a prior investigation of sixty adult patients post-stroke tested with CSE and VFSS. The CSE included an examination of historical measures, oral motor/speech/voice, and trial swallows. The VFSS consisted of swallows of controlled portions of thin, thick, puree, and solid boluses. Previous results from these patients demonstrated significant accuracy in making binary estimates of aspiration and the presence of dysphagia. This analysis of data focused on physiologic measures, as well as overall dysphagia severity and diet recommendations. Significant associations between CSE and VFSS ratings were observed for hyolaryngeal elevation, overall swallowing severity, and diet recommendations. These findings were specific for certain bolus consistencies. These data suggest that the CSE may not provide significant physiological information other than hyolaryngeal excursion. This does not preclude the fact that the CSE is important in providing substantial information about overall dysphagia severity. It appears that the CSE is more powerful than simply a "screening" tool. More prospective research designs are warranted to substantiate the strengths of the CSE.

  20. Effect of posture on swallowing.

    African Journals Online (AJOL)

    neck flexed, head/neck extend- ed and lying supine. There are individual differences in swallowing and dys- phagia limit depending on individual condition, prefer- ences and habits. However, different head and neck posi- tions can facilitate ...

  1. Electronic Safety Resource Tools -- Supporting Hydrogen and Fuel Cell Commercialization

    Energy Technology Data Exchange (ETDEWEB)

    Barilo, Nick F.

    2014-09-29

    The Pacific Northwest National Laboratory (PNNL) Hydrogen Safety Program conducted a planning session in Los Angeles, CA on April 1, 2014 to consider what electronic safety tools would benefit the next phase of hydrogen and fuel cell commercialization. A diverse, 20-person team led by an experienced facilitator considered the question as it applied to the eight most relevant user groups. The results and subsequent evaluation activities revealed several possible resource tools that could greatly benefit users. The tool identified as having the greatest potential for impact is a hydrogen safety portal, which can be the central location for integrating and disseminating safety information (including most of the tools identified in this report). Such a tool can provide credible and reliable information from a trustworthy source. Other impactful tools identified include a codes and standards wizard to guide users through a series of questions relating to application and specific features of the requirements; a scenario-based virtual reality training for first responders; peer networking tools to bring users from focused groups together to discuss and collaborate on hydrogen safety issues; and a focused tool for training inspectors. Table ES.1 provides results of the planning session, including proposed new tools and changes to existing tools.

  2. Sword swallowing and its side effects.

    Science.gov (United States)

    Witcombe, Brian; Meyer, Dan

    2006-12-23

    To evaluate information on the practice and associated ill effects of sword swallowing. Letters sent to sword swallowers requesting information on technique and complications. Membership lists of the Sword Swallowers' Association International. 110 sword swallowers from 16 countries. We had information from 46 sword swallowers. Major complications are more likely when the swallower is distracted or swallows multiple or unusual swords or when previous injury is present. Perforations mainly involve the oesophagus and usually have a good prognosis. Sore throats are common, particularly while the skill is being learnt or when performances are too frequent. Major gastrointestinal bleeding sometimes occurs, and occasional chest pains tend to be treated without medical advice. Sword swallowers without healthcare coverage expose themselves to financial as well as physical risk. Sword swallowers run a higher risk of injury when they are distracted or adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation.

  3. Resources

    Science.gov (United States)

    ... disease - resources Hemophilia - resources Herpes - resources Incest - resources Incontinence - resources Infertility - resources Interstitial cystitis - resources Kidney disease - resources Leukemia - resources Liver disease - resources Loss ...

  4. Controlling user access to electronic resources without password

    Science.gov (United States)

    Smith, Fred Hewitt

    2015-06-16

    Described herein are devices and techniques for remotely controlling user access to a restricted computer resource. The process includes pre-determining an association of the restricted computer resource and computer-resource-proximal environmental information. Indicia of user-proximal environmental information are received from a user requesting access to the restricted computer resource. Received indicia of user-proximal environmental information are compared to associated computer-resource-proximal environmental information. User access to the restricted computer resource is selectively granted responsive to a favorable comparison in which the user-proximal environmental information is sufficiently similar to the computer-resource proximal environmental information. In at least some embodiments, the process further includes comparing user-supplied biometric measure and comparing it with a predetermined association of at least one biometric measure of an authorized user. Access to the restricted computer resource is granted in response to a favorable comparison.

  5. Utilization of electronic information resources in Ramat Library ...

    African Journals Online (AJOL)

    Data was analysed using descriptive statistics of percentage and frequency counts. ... available in the Ramat Library for the purpose of enhancing learning outcome. Keywords: e-Resources, information resources, utilization, Ramat library ...

  6. Swallowing disorders after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Gabriela Camargo Remesso

    2011-10-01

    Full Text Available OBJECTIVE: To investigate occurrences of swallowing disorders after ischemic stroke. METHOD: This was a retrospective study on 596 medical files. The inclusion criterion was that the patients needed to have been hospitalized with a diagnosis of ischemic stroke; the exclusion criteria were the presence of associated cardiac problems and hospital stay already more than 14 days. RESULTS: 50.5% were men and 49.5% women; mean age 65.3 years (SD=±11.7 (p<0.001. Among the risk factors, 79.4% had hypertension, 36.7% had diabetes (p<0.001 and 42.7% were smokers. 13.3% of the patients died. Swallowing disorders occurred in 19.6%, among whom 91.5% had mild difficulty and 8.5% had severe difficulty. 87.1% had spontaneous recovery after a mean of 2.4 months. A lesion in the brainstem region occurred in 6.8% (p<0.001. CONCLUSION: Swallowing disorders occurred in almost 20% of the population and most of the difficulty in swallowing found was mild. The predictors for swallowing disorders were older age, diabetes mellitus and lesions in the brainstem region.

  7. The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

    Science.gov (United States)

    Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

    2015-01-01

    Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half

  8. Bridging the Two Cultures: A Collaborative Approach to Managing Electronic Resources.

    Science.gov (United States)

    Dupuis, John; Ryan, Patti

    2002-01-01

    Highlights an example of cross-discipline collaboration in an academic library and describes a collaborative approach to managing electronic resources that is used at York University (Canada). Explains a model in which a science librarian and a humanities/social science librarian work together to manage electronic resources. (Author/LRW)

  9. Checklist Manifesto for Electronic Resources: Getting Ready for the Fiscal Year and Beyond

    Science.gov (United States)

    England, Lenore; Fu, Li; Miller, Stephen

    2011-01-01

    Organization of electronic resources workflow is critical in the increasingly complicated and complex world of library management. A simple organizational tool that can be readily applied to electronic resources management (ERM) is the use of checklists. Based on the principles discussed in The Checklist Manifesto: How to Get Things Right, the…

  10. Developing Humanities Collections in the Digital Age: Exploring Humanities Faculty Engagement with Electronic and Print Resources

    Science.gov (United States)

    Kachaluba, Sarah Buck; Brady, Jessica Evans; Critten, Jessica

    2014-01-01

    This article is based on quantitative and qualitative research examining humanities scholars' understandings of the advantages and disadvantages of print versus electronic information resources. It explores how humanities' faculty members at Florida State University (FSU) use print and electronic resources, as well as how they perceive these…

  11. Application of the electronic educational resources in the higher educational institution

    Directory of Open Access Journals (Sweden)

    Александр Петрович Колошеин

    2014-12-01

    Full Text Available In article approaches to effective application of electronic educational resources are described. The analysis of methods and forms of education in higher education institution is carried out, the principles of application of the electronic educational resources, adequate to used methods and forms of education are established.

  12. Application of the electronic educational resources in the higher educational institution

    OpenAIRE

    Александр Петрович Колошеин

    2014-01-01

    In article approaches to effective application of electronic educational resources are described. The analysis of methods and forms of education in higher education institution is carried out, the principles of application of the electronic educational resources, adequate to used methods and forms of education are established.

  13. Influence of attention and bolus volume on brain organization during swallowing.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-10-20

    It has been shown that swallowing involves certain attentional and cognitive resources which, when disrupted can influence swallowing function with in dysphagic patient. However, there are still open questions regarding the influence of attention and cognitive demands on brain activity during swallowing. In order to understand how brain regions responsible for attention influence brain activity during swallowing, we compared brain organization during no-distraction swallowing and swallowing with distraction. Fifteen healthy male adults participated in the data collection process. Participants performed ten 1 ml, ten 5 ml, and ten 10 ml water swallows under both no-distraction conditions and during distraction while EEG signals were recorded. After standard pre-processing of the EEG signals, brain networks were formed using the time-frequency based synchrony measure. The brain networks formed were then compared between the two sets of conditions. Results showed that there are differences in the Delta, Theta, Alpha, Beta, and Gamma frequency bands between no-distraction swallowing and swallowing with distraction. Differences in the Delta and Theta frequency bands can be attributed to changes in subliminal processes, while changes in the Alpha and Beta frequency bands are directly associated with the various levels of attention and cognitive demands during swallowing process, and changes in the Gamma frequency band are due to changes in motor activity. Furthermore, we showed that variations in bolus volume influenced the swallowing brain networks in the Delta, Theta, Alpha, Beta, and Gamma frequency bands. Changes in the Delta, Theta, and Alpha frequency bands are due to sensory perturbations evoked by the various bolus volumes. Changes in the Beta frequency band are due to reallocation of cognitive demands, while changes in the Gamma frequency band are due to changes in motor activity produced by variations in bolus volume. These findings could potentially lead to

  14. A contrasting study: cliff and bank swallows

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the project was to contrast as population of Cliff Swallows and a population of Bank Swallows. Both populations had nests located in a gravel pit near...

  15. Electronic resource management practical perspectives in a new technical services model

    CERN Document Server

    Elguindi, Anne

    2012-01-01

    A significant shift is taking place in libraries, with the purchase of e-resources accounting for the bulk of materials spending. Electronic Resource Management makes the case that technical services workflows need to make a corresponding shift toward e-centric models and highlights the increasing variety of e-formats that are forcing new developments in the field.Six chapters cover key topics, including: technical services models, both past and emerging; staffing and workflow in electronic resource management; implementation and transformation of electronic resource management systems; the ro

  16. Swallowing disorders in Parkinson's disease.

    Science.gov (United States)

    Mamolar Andrés, Sandra; Santamarina Rabanal, María Liliana; Granda Membiela, Carla María; Fernández Gutiérrez, María José; Sirgo Rodríguez, Paloma; Álvarez Marcos, César

    Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias. The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease. The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fiberoptic endoscopic evaluation of swallowing. Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO 2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year. The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  17. Use of Internet and Electronic Resources amongst Postgraduate ...

    African Journals Online (AJOL)

    Findings indicate that the study group has regular access to the internet , and preferred using free online resources from Google and Wikipedia to institutionally subscribed academic online resources in databases such as HINARI, EBSCO Host, Questia , JSTOR and High Beam.This shows that technology alone cannot help ...

  18. Strategic Planning for Electronic Resources Management: A Case Study at Gustavus Adolphus College

    Science.gov (United States)

    Hulseberg, Anna; Monson, Sarah

    2009-01-01

    Electronic resources, the tools we use to manage them, and the needs and expectations of our users are constantly evolving; at the same time, the roles, responsibilities, and workflow of the library staff who manage e-resources are also in flux. Recognizing a need to be more intentional and proactive about how we manage e-resources, the…

  19. Does Barium Influence Tongue Behaviors during Swallowing?

    Science.gov (United States)

    Steele, Catriona M.; van Lieshout, Pascal H. H. M.

    2005-01-01

    The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8…

  20. Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke.

    Science.gov (United States)

    May, Nelson H; Pisegna, Jessica M; Marchina, Sarah; Langmore, Susan E; Kumar, Sandeep; Pearson, William G

    2017-05-01

    Computational analysis of swallowing mechanics (CASM) is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke-related dysphagia, (2) decipher the impact of left and right hemispheric strokes on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age- and gender-matched controls were selected from well-controlled data sets. Patient data including laterality and penetration-aspiration status were collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke versus controls (D = 2.19, P mechanics associated with each comparison were visualized using eigenvectors. Whereas current literature focuses on timing changes in stroke-related dysphagia, these data suggest that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by the affected hemisphere and the penetration-aspiration status. CASM can be used to identify patient-specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. EWWW!: Electronic Resources in the Twenty-First Century

    OpenAIRE

    Ogier, Andrea; Brown, Ladd; Bailey, Annette; Stovall, Connie

    2013-01-01

    Initiating necessary change in a modern library environment is quite a difficult task when faced with constantly-evolving technology, limited resources, and low budgets. This paper discusses Virginia Tech’s approach to successful e-resource management when faced with a multitude of challenges. The long-term goal is the development of a proactive information delivery eco-system that will allow staff to anticipate the information and data needs of a single user or user population based on previ...

  2. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, J.E.; Brennan, M.T.; Verdonck- de Leeuw, I.M.; Gibson, R.J.; Eilers, J.G.; Waltimo, T.; Bots, C.P.; Michelet, M.; Sollecito, T.P.; Rouleau, T.S.; Sewnaik, A.; Bensadoun, R.J.; Fliedner, M.C.; Silverman, S.; Spijkervet, F.K.L.

    2012-01-01

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  3. Swallowing dysfunction in cancer patients

    NARCIS (Netherlands)

    Raber-Durlacher, Judith E.; Brennan, Mike T.; Leeuw, Irma M. Verdonck-de; Gibson, Rachel J.; Eilers, June G.; Waltimo, Tuomas; Bots, Casper P.; Michelet, Marisol; Sollecito, Thomas P.; Rouleau, Tanya S.; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C.; Silverman, Sol; Spijkervet, Fred K. L.

    Purpose Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools,

  4. Effect of posture on swallowing.

    African Journals Online (AJOL)

    lowing stroke, motor neuron disease, Parkinson's disease, cerebral palsy, etc.3,4 It can further lead to aspiration pneu- ... umes of water, healthy adults didn't experience piecemeal deglutition or aspiration; however while ... help in treatment of dysphagia by affecting bolus flow to improve speed and safety of swallowing by ...

  5. Coordination of Mastication, Swallowing and Breathing

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2009-01-01

    Summary The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing. PMID:20161022

  6. Controlling user access to electronic resources without password

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Fred Hewitt

    2017-08-22

    Described herein are devices and techniques for remotely controlling user access to a restricted computer resource. The process includes obtaining an image from a communication device of a user. An individual and a landmark are identified within the image. Determinations are made that the individual is the user and that the landmark is a predetermined landmark. Access to a restricted computing resource is granted based on the determining that the individual is the user and that the landmark is the predetermined landmark. Other embodiments are disclosed.

  7. Challenges associated with cataloguing of electronic resources in ...

    African Journals Online (AJOL)

    The aim of the paper is to identify challenges associated with the cataloguing of e resources in some selected university libraries in south –south Nigeria. The descriptive survey design involving the use of questionnaire as the research instrument was adopted. The population comprised of cataloguers in five selected ...

  8. impact of the use of electronic resources on research output

    African Journals Online (AJOL)

    manda

    document delivery since 2000. License to access these resources has been country-wide for most databases. PERI project also includes a training component on ... Sciences (MUHAS). The final sample comprised 222 members of teaching and research staff, selected using purposive and convenience techniques. Findings ...

  9. Neonatal swallowing assessment using fiberoptic endoscopic evaluation of swallowing (FEES).

    Science.gov (United States)

    Vetter-Laracy, Susanne; Osona, Borja; Roca, Antonia; Peña-Zarza, Jose A; Gil, Jose A; Figuerola, Joan

    2018-01-22

    Swallowing disorders which lead to aspiration are common in premature infants with a postmenstrual age (PMA) of >36 weeks. Aspiration is often silent and the unique symptom is desaturation during feeding. The aim of this study was 1) to determine the number of prematures with desaturations during feeding due to aspiration, using Fiberoptic Endoscopic Evaluation of Swallowing (FEES); 2) to relate clinical factors and FEES findings to aspiration; and 3) to describe type and efficacy of suggested treatments. A retrospective review of 62 ex-premature babies with a median PMA of 40 weeks which underwent FEES due to persistent feeding desaturations. Aspiration was related to other FEES findings and to clinical and demographic data. The efficacy of the treatment was evaluated during the FEES and by comparing recorded desaturations during feeding 7 days before and after FEES. A total of 44 (71%) infants were diagnosed with aspiration and/or penetration. No relation was found to demographic or clinical data. The accumulation of saliva and residues post-swallowing were related to aspiration (P thickener seemed to reduce aspiration during FEES and was suggested as a treatment. 13.6% of infants received anti-reflux treatment after FEES and 9.1% required gastrostomy. Aspiration is very frequent in premature infants who present desaturations during feeding and FEES is a useful method for diagnosing and suggesting treatments. © 2018 Wiley Periodicals, Inc.

  10. MODELING OF QUALITY MANAGEMENT SYSTEM FOR ELECTRONIC LEARNING RESOURCES: THE INTEGRATED AND DIFFERENTIATED APPROACHES

    Directory of Open Access Journals (Sweden)

    H. M. Kravtsov

    2012-03-01

    Full Text Available Abstract. Results on modeling of quality management system of electronic information resources on the basis of the analysis of its elements functioning with use of the integrated and differentiated approaches are presented. Application of such model is illustrated on an example of calculation and optimization of parameters of a quality management system at the organization of the co-ordinated work of services of monitoring, an estimation of quality and support of electronic learning resources.

  11. Surface electromyography pattern of human swallowing

    Directory of Open Access Journals (Sweden)

    Spadaro Alessandro

    2008-03-01

    Full Text Available Abstract Background The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion. Despite the clinical importance given to spontaneous swallowing, few physiologic works have studied stomatognathic muscular activation and mandibular movement during spontaneous saliva swallowing. The aim of our study was to investigate the activity patterns of the mandibular elevator muscles (masseter and anterior temporalis muscles, the submental muscles, and the neck muscles (sternocleidomastoid muscles in healthy people during spontaneous swallowing of saliva and to relate the muscular activities to mandibular movement. Methods The spontaneous swallowing of saliva of 111 healthy individuals was analyzed using surface electromyography (SEMG and a computerized kinesiography of mandibular movement. Results Fifty-seven of 111 patients swallowed without occlusal contact (SNOC and 54 individuals had occlusal contact (SOC. The sternocleidomastoid muscles showed a slight, but constant activation during swallowing. The SEMG of the submental and sternocleidomastoid muscles showed no differences between the two groups. The SEMG of the anterior temporalis and masseter muscles showed significant differences (p Conclusion The data suggest that there is not a single "normal" or "typical" pattern for spontaneous saliva swallowing. The polygraph seemed a valuable, simple, non-invasive and reliable tool to study the physiology of swallowing.

  12. A Study on Developing Evaluation Criteria for Electronic Resources in Evaluation Indicators of Libraries

    Science.gov (United States)

    Noh, Younghee

    2010-01-01

    This study aimed to improve the current state of electronic resource evaluation in libraries. While the use of Web DB, e-book, e-journal, and other e-resources such as CD-ROM, DVD, and micro materials is increasing in libraries, their use is not comprehensively factored into the general evaluation of libraries and may diminish the reliability of…

  13. An Evaluation of Electronic Product Design Education Using Hypermedia-Resourced Learning Environments

    Science.gov (United States)

    Page, Tom; Thorsteinsson, Gisli

    2006-01-01

    The work outlined here provides a comprehensive report and formative observations of the development and implementation of hypermedia resources for learning and teaching used in conjunction with a managed learning environment (MLE). These resources are used to enhance teaching and learning of an electronics module in product design at final year…

  14. Video Killed the Radio Star: Language Students' Use of Electronic Resources-Reading or Viewing?

    Science.gov (United States)

    Kiliçkaya, Ferit

    2016-01-01

    The current study aimed to investigate language students' use of print and electronic resources for their research papers required in research techniques class, focusing on which reading strategies they used while reading these resources. The participants of the study were 90 sophomore students enrolled in the research techniques class offered at…

  15. Oral Health and Swallowing Problems

    OpenAIRE

    Furuta, Michiko; Yamashita, Yoshihisa

    2013-01-01

    Oral health impacts systemic health. Therefore, oral care is an important consideration in maintaining quality of life (QOL). Previously, maintenance and improvement of oral hygiene was considered essential for achieving oral health. In addition to oral hygiene, oral care in terms of oral function is now considered to maintain QOL. Ingestion of exogenous nutrients via the oral cavity is fundamental to the function of all higher animals, not only human beings. Chewing and swallowing processes ...

  16. Problems and future of electronic textbooks and electronic educational resources in technical college

    OpenAIRE

    Kulikov Dmitry

    2016-01-01

    This article describes the problems and prospects of introduction of electronic textbooks in the educational space of technical colleges. Practical recommendations for the maintenance, monitoring, organization and development of electronic textbooks projects.

  17. Electronic information resource use: implications for teaching and library staff

    Directory of Open Access Journals (Sweden)

    Roger Ottewill

    1997-12-01

    Full Text Available Within institutions of higher education, teaching staff and library-based information specialists have tended to occupy separate worlds. Although there has been some contact, in the main this has been partial and intermittent. For first-year students, one consequence of this state of affairs has been the absence of a systematic and co-ordinated strategy for enabling them to acquire, practise and develop information-gathering skills. Teaching staff have seen their role in this respect mainly in terms of issuing students with reading lists containing a mix of books and journal articles, and underlying this approach is the expectation that information specialists will be on hand to provide whatever additional help is needed to access these resources, for example through the provision of introductory talks and one-to-one support sessions. Relatively few teaching staff have incorporated library exercises into their teaching and assessment, or adopted a more creative approach to information gathering by students, such as helping them use bibliographic and other aids to prepare personalized reading lists. Consequently, when students have been required to do this at later stages of their studies, especially in the context of preparing a dissertation, they have not been adequately prepared, and often find it extremely difficult to access and evaluate information resources effectively.

  18. Electronic Information Resources in Undergraduate Education: An Exploratory Study of Opportunities for Student Learning and Independence.

    Science.gov (United States)

    McDowell, Liz

    2002-01-01

    This qualitative interview-based study examines lecturer perspectives on the roles of electronic information resources in undergraduate education. Highlights include electronic academic libraries; changes toward more constructivist approaches to learning; information quality on the Web; plagiarism; information use; information literacy; and…

  19. Where Do Electronic Books Fit in the College Research Arsenal of Resources?

    Science.gov (United States)

    Barbier, Patricia

    2007-01-01

    Student use of electronic books has become an accepted supplement to traditional resources. Student use and satisfaction was monitored through an online course discussion board. Increased use of electronic books indicate this service is an accepted supplement to the print book collection.

  20. End-of-life resource recovery from emerging electronic products

    DEFF Research Database (Denmark)

    Parajuly, Keshav; Habib, Komal; Cimpan, Ciprian

    2016-01-01

    -case scenario, only 47% of the total materials in RVCs are ultimately recycled. While this low material recovery is mainly due to the lower plastic recycling rate, other market realities and the complex material flows in the recycling chain also contribute to it. The study provides a robust methodological...... at a conventional ‘shred-and-separate’ type preprocessing plant in Denmark. A detailed material flow analysis was performed throughout the recycling chain. The results show a mismatch between product design and EoL processing, and the lack of practical implementation of ‘Design for EoL’ thinking. In the best...... approach for assessing the EoL performance based on the knowledge of a product and its complex recycling chain. The lessons learned can be used to support both the design and EoL processing of products with similar features, which carry a high potential for resource recovery, especially at the initial...

  1. Surface Electromyographic Assessment of Swallowing Function

    Directory of Open Access Journals (Sweden)

    Marziyeh Poorjavad

    2017-03-01

    Full Text Available The reliability of surface electromyographic (sEMG variables during swallowing determines the potential usefulness of these measures in swallowing assessment and treatment. This study aimed to establish the reliability of the sEMG measures of the swallowing function of muscles during different swallowing conditions in healthy young and old volunteers. Two groups of volunteers (24 older adults, 10 younger adults participated in this cross-sectional study during 2014. The activity of masseter, submental, and infrahyoid groups were measured using sEMG during three repetitions of different swallowing tasks. Both the relative and absolute reliability (characterized respectively by ICC, SEM%, and SRD% were calculated for the sEMG indices of muscle activity during swallowing events. Statistical analyses were performed by the SPSS 19.0 and Microsoft Excel 2007 software packages. Statistical significance was set at P≤0.05. The relative reliability calculations showed significant agreements between repetitions for the mean and peak amplitude and the average of median frequency (MDF of the studied muscles function during most swallowing types in both groups. However, the duration and particularly the time to peak of muscle activity showed significant agreements during fewer swallowing conditions. Excluding MDF, we found high SEM% and SRD% for the studied measures (particularly timing measures of muscles function during most swallowing types in both groups. The reliability of sEMG measures was influenced by the age and swallowing types. Our findings suggest that the MDF of muscle function during almost all studied swallowing types can be a reliable measure for the sEMG assessment of swallowing function in both younger and older adults.

  2. The Effects of Removable Denture on Swallowing

    OpenAIRE

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-01-01

    Objective To investigate the relationship between removable dentures and swallowing and describe risks. Methods Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Hea...

  3. Electronic textbooks as a professional resource after dental school.

    Science.gov (United States)

    Bates, Michael L; Strother, Elizabeth A; Brunet, Darlene P; Gallo, John R

    2012-05-01

    In two previous studies of dental students' attitudes about the VitalSource Bookshelf, a digital library of dental textbooks, students expressed negative opinions about owning and reading electronic textbooks. With the assumption that dentists would find the digital textbooks useful for patient care, the authors surveyed recent graduates to determine if their attitude toward the VitalSource Bookshelf had changed. A brief survey was sent to 119 alumni from the classes of 2009 and 2010 of one U.S. dental school. Forty-seven (39.5 percent) completed the questionnaire. Eighteen respondents (48.3 percent) reported using the e-textbooks often or sometimes. The twenty-nine dentists who said they have not used the collection since graduation reported preferring print books or other online sources or having technical problems when downloading the books to a new computer. Only five respondents selected the VitalSource Bookshelf as a preferred source of professional information. Most of the respondents reported preferring to consult colleagues (37.8 percent), the Internet (20 percent), or hardcopy books (17.8 percent) for information. When asked in an open-ended question to state their opinion of the Bookshelf, nineteen (42.2 percent) responded positively, but almost one-third of these only liked the search feature. Six respondents reported that they never use the program. Twenty-two said they have had technical problems with the Bookshelf, including fifteen who have not been able to install it on a new computer. Many of them said they have not followed up with either the dental school or VitalSource support services to overcome this problem. Our study suggests that dentists, similar to dental students, dislike reading electronic textbooks, even with the advantage of searching a topic across more than sixty dental titles.

  4. Lung Volume during Swallowing: Single Bolus Swallows in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen M. Wheeler; Huber, Jessica E.; Pitts, Teresa; Sapienza, Christine M.

    2009-01-01

    Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed. Method: Nine men and 11 women between the ages of 19 and 28 years…

  5. Swallowing dysfunction in cancer patients.

    Science.gov (United States)

    Raber-Durlacher, Judith E; Brennan, Mike T; Verdonck-de Leeuw, Irma M; Gibson, Rachel J; Eilers, June G; Waltimo, Tuomas; Bots, Casper P; Michelet, Marisol; Sollecito, Thomas P; Rouleau, Tanya S; Sewnaik, Aniel; Bensadoun, Rene-Jean; Fliedner, Monica C; Silverman, Sol; Spijkervet, Fred K L

    2012-03-01

    Dysphagia (swallowing dysfunction) is a debilitating, depressing, and potentially life-threatening complication in cancer patients that is likely underreported. The present paper is aimed to review relevant dysphagia literature between 1990 and 2010 with a focus on assessment tools, prevalence, complications, and impact on quality of life in patients with a variety of different cancers, particularly in those treated with curative chemoradiation for head and neck cancer. The literature search was limited to the English language and included both MEDLINE/PubMed and EMBASE. The search focused on papers reporting dysphagia as a side effect of cancer and cancer therapy. We identified relevant literature through the primary literature search and by articles identified in references. A wide range of assessment tools for dysphagia was identified. Dysphagia is related to a number of factors such as direct impact of the tumor, cancer resection, chemotherapy, and radiotherapy and to newer therapies such as epidermal growth factor receptor inhibitors. Concomitant oral complications such as xerostomia may exacerbate subjective dysphagia. Most literature focuses on head and neck cancer, but dysphagia is also common in other types of cancer. Swallowing impairment is a clinically relevant acute and long-term complication in patients with a wide variety of cancers. More prospective studies on the course of dysphagia and impact on quality of life from baseline to long-term follow-up after various treatment modalities, including targeted therapies, are needed.

  6. Analytical Study of Usage of Electronic Information Resources at Pharmacopoeial Libraries in India

    Directory of Open Access Journals (Sweden)

    Sunil Tyagi

    2014-02-01

    Full Text Available The objective of this study is to know the rate and purpose of the use of e-resource by the scientists at pharmacopoeial libraries in India. Among other things, this study examined the preferences of the scientists toward printed books and journals, electronic information resources, and pattern of using e-resources. Non-probability sampling specially accidental and purposive technique was applied in the collection of primary data through administration of user questionnaire. The sample respondents chosen for the study consists of principle scientific officer, senior scientific officer, scientific officer, and scientific assistant of different division of the laboratories, namely, research and development, pharmaceutical chemistry, pharmacovigilance, pharmacology, pharmacogonosy, and microbiology. The findings of the study reveal the personal experiences and perceptions they have had on practice and research activity using e-resource. The major findings indicate that of the total anticipated participants, 78% indicated that they perceived the ability to use computer for electronic information resources. The data analysis shows that all the scientists belonging to the pharmacopoeial libraries used electronic information resources to address issues relating to drug indexes and compendia, monographs, drugs obtained through online databases, e-journals, and the Internet sources—especially polices by regulatory agencies, contacts, drug promotional literature, and standards.

  7. Quantitative classification of pediatric swallowing through accelerometry

    Directory of Open Access Journals (Sweden)

    Celeste Merey

    2012-06-01

    Full Text Available Abstract Background Dysphagia or swallowing disorder negatively impacts a child’s health and development. The gold standard of dysphagia detection is videofluoroscopy which exposes the child to ionizing radiation, and requires specialized clinical expertise and expensive institutionally-based equipment, precluding day-to-day and repeated assessment of fluctuating swallowing function. Swallowing accelerometry is the non-invasive measurement of cervical vibrations during swallowing and may provide a portable and cost-effective bedside alternative. In particular, dual-axis swallowing accelerometry has demonstrated screening potential in older persons with neurogenic dysphagia, but the technique has not been evaluated in the pediatric population. Methods In this study, dual-axis accelerometric signals were collected simultaneous to videofluoroscopic records from 29 pediatric participants (age 6.8 ± 4.8 years; 20 males previously diagnosed with neurogenic dysphagia. Participants swallowed 3-5 sips of barium-coated boluses of different consistencies (normally, from thick puree to thin liquid by spoon or bottle. Videofluoroscopic records were reviewed retrospectively by a clinical expert to extract swallow timings and ratings. The dual-axis acceleration signals corresponding to each identified swallow were pre-processed, segmented and trimmed prior to feature extraction from time, frequency, time-frequency and information theoretic domains. Feature space dimensionality was reduced via principal components. Results Using 8-fold cross-validation, 16-17 dimensions and a support vector machine classifier with an RBF kernel, an adjusted accuracy of 89.6% ± 0.9 was achieved for the discrimination between swallows with and with out airway entry. Conclusions Our results suggest that dual-axis accelerometry has merit in the non-invasive detection of unsafe swallows in children and deserves further consideration as a pediatric medical device.

  8. Connecting knowledge resources to the veterinary electronic health record: opportunities for learning at point of care.

    Science.gov (United States)

    Alpi, Kristine M; Burnett, Heidi A; Bryant, Sheila J; Anderson, Katherine M

    2011-01-01

    Electronic health records (EHRs) provide clinical learning opportunities through quick and contextual linkage of patient signalment, symptom, and diagnosis data with knowledge resources covering tests, drugs, conditions, procedures, and client instructions. This paper introduces the EHR standards for linkage and the partners-practitioners, content publishers, and software developers-necessary to leverage this possibility in veterinary medicine. The efforts of the American Animal Hospital Association (AAHA) Electronic Health Records Task Force to partner with veterinary practice management systems to improve the use of controlled vocabulary is a first step in the development of standards for sharing knowledge at the point of care. The Veterinary Medical Libraries Section (VMLS) of the Medical Library Association's Task Force on Connecting the Veterinary Health Record to Information Resources compiled a list of resources of potential use at point of care. Resource details were drawn from product Web sites and organized by a metric used to evaluate medical point-of-care resources. Additional information was gathered from questions sent by e-mail and follow-up interviews with two practitioners, a hospital network, two software developers, and three publishers. Veterinarians with electronic records use a variety of information resources that are not linked to their software. Systems lack the infrastructure to use the Infobutton standard that has been gaining popularity in human EHRs. While some veterinary knowledge resources are digital, publisher sites and responses do not indicate a Web-based linkage of veterinary resources with EHRs. In order to facilitate lifelong learning and evidence-based practice, veterinarians and educators of future practitioners must demonstrate to veterinary practice software developers and publishers a clinically-based need to connect knowledge resources to veterinary EHRs.

  9. Elektronik Bilgi Kaynaklarının Seçimi / Selection of Electronic Information Resources

    Directory of Open Access Journals (Sweden)

    Pınar Al

    2003-04-01

    Full Text Available For many years, library users have used only from the printed media in order to get the information that they have needed. Today with the widespread use of the Web and the addition of electronic information resources to library collections, the use of information in the electronic environment as well as in printed media is started to be used. In time, such types of information resources as, electronic journals, electronic books, electronic encyclopedias, electronic dictionaries and electronic theses have been added to library collections. In this study, selection criteria that can be used for electronic information resources are discussed and suggestions are provided for libraries that try to select electronic information resources for their collections.

  10. Considering Point-of-Care Electronic Medical Resources in Lieu of Traditional Textbooks for Medical Education.

    Science.gov (United States)

    Hale, LaDonna S; Wallace, Michelle M; Adams, Courtney R; Kaufman, Michelle L; Snyder, Courtney L

    2015-09-01

    Selecting resources to support didactic courses is a critical decision, and the advantages and disadvantages must be carefully considered. During clinical rotations, students not only need to possess strong background knowledge but also are expected to be proficient with the same evidence-based POC resources used by clinicians. Students place high value on “real world” learning and therefore may place more value on POC resources that they know practicing clinicians use as compared with medical textbooks. The condensed nature of PA education requires students to develop background knowledge and information literacy skills over a short period. One way to build that knowledge and those skills simultaneously is to use POC resources in lieu of traditional medical textbooks during didactic training. Electronic POC resources offer several advantages over traditional textbooks and should be considered as viable options in PA education.

  11. Awareness and use of electronic resources at a university campus in ...

    African Journals Online (AJOL)

    This study looks into the use of electronic resources by the faculty members of College of Technology Education, Kumasi of the University of Education, Winneba, Ghana. Sixty-two copies of a questionnaire were sent to the entire faculty and 31 were returned which gave a response rate of 50%. The responses showed very ...

  12. Localising versus standardising electronic human resource management: complexities and tensions between HRM and IT departments

    NARCIS (Netherlands)

    Tate, Mary; Furtmueller-Ettinger, Elfriede; Wilderom, Celeste P.M.

    2013-01-01

    In this paper, we provide an analysis of the complexities involved during global e-HRM (Electronic Human Resource Management) implementation. We present findings from a case study on the challenge of global integration versus local responsiveness of e-HRM systems. We take a local site lens,

  13. Lung Volume Measured during Sequential Swallowing in Healthy Young Adults

    Science.gov (United States)

    Hegland, Karen Wheeler; Huber, Jessica E.; Pitts, Teresa; Davenport, Paul W.; Sapienza, Christine M.

    2011-01-01

    Purpose: Outcomes from studying the coordinative relationship between respiratory and swallow subsystems are inconsistent for sequential swallows, and the lung volume at the initiation of sequential swallowing remains undefined. The first goal of this study was to quantify the lung volume at initiation of sequential swallowing ingestion cycles and…

  14. Identification of Swallowing Tasks from a Modified Barium Swallow Study That Optimize the Detection of Physiological Impairment

    Science.gov (United States)

    Hazelwood, R. Jordan; Armeson, Kent E.; Hill, Elizabeth G.; Bonilha, Heather Shaw; Martin-Harris, Bonnie

    2017-01-01

    Purpose: The purpose of this study was to identify which swallowing task(s) yielded the worst performance during a standardized modified barium swallow study (MBSS) in order to optimize the detection of swallowing impairment. Method: This secondary data analysis of adult MBSSs estimated the probability of each swallowing task yielding the derived…

  15. Perceived Effect of Accessibility and Utilization of Electronic Resources on Productivity of Academic Staff in Selected Nigerian Universities

    Directory of Open Access Journals (Sweden)

    Okon E. Ani

    2015-10-01

    Full Text Available Access to information is vital for efficient research at universities. Electronic resources provide new platforms for information to aid in conducting research at universities. This study explores the perceived effect of accessibility and utilization of electronic resources on research productivity at Nigerian universities. A quantitative research approach was adopted for the study with a survey as research method. Data were collected for the study with a self-reporting questionnaire. Regression analysis in the study revealed that accessibility and use of electronic resources had a significant perceived positive effect on research productivity at the surveyed Nigerian universities. However, there was no significant perceived effect of accessibility and use of electronic resources by discipline on research productivity in the survey. In terms of gender, it was found that there was no significant perceived effect of accessibility and use of electronic resources by gender on research productivity among respondents at the surveyed Nigerian universities. Based on these findings, it is recommended that effective development of digital libraries in Nigerian universities would ameliorate the problems of accessibility and utilization of electronic resources by academic staff in research. Furthermore, the Nigerian university libraries should develop an electronic collection development policy to enhance equitable access and use of electronic resources at Nigerian universities. Policy for sustainable digitization of relevant library materials should be evolved to support digital libraries effectively for efficient accessibility and utilization of electronic resources.

  16. Management of sword-swallower injuries.

    Science.gov (United States)

    Moberly, A C; Fritsch, M H; Mosier, K M

    2011-02-01

    To report an unusual case of hypopharyngeal perforation in a sword-swallower, with emphasis on management options. Case report and review of the English language literature concerning sword-swallowing injuries to the hypopharynx and oesophagus. A 29-year-old male sword-swallower suffered hypopharyngeal perforation during a performance. The patient received conservative management, with intensive care unit admission, infectious disease consultation, intravenous antibiotics, discontinuation of oral intake and close observation. He progressed well, resumed oral intake on hospital day six, and was discharged home on hospital day eight. Sword-swallowing is an unusual vocation which may lead to potentially devastating injuries. This case report and review of the literature illustrates the management options for such hypopharyngeal and oesophageal injuries.

  17. [The physiologic and the pathologic swallowing process].

    Science.gov (United States)

    Cantemir, S; Laubert, A

    2017-03-01

    It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.

  18. The Andean Swallow (Orochelidon andecola) in Argentina

    OpenAIRE

    Mazar Barnett, Juan; Pugnali, Germán D.; Pearman Morrison, Mark; Bodrati, Alejandro; Moschione, Flavio; Clark, Ricardo; Roesler, Carlos Ignacio; Monteleone, Diego; Casañas, Hernán; Burgos Gallardo, Freddy; Segovia, José; Pagano, Luis; Povedano, Hernán; Areta, Juan Ignacio

    2016-01-01

    During ornithological studies in the provinces of Jujuy, Salta, and San Juan, we recorded the Andean Swallow Orochelidon andecola at 40 localities. These are the first records in Argentina, and also represent the southernmost for the species. Some of these localities are up to 1500 m lower than the previously known elevational limit (now 800 masl), and up to 1100 km southwards. This is a relatively poorly known swallow, and we present novel natural history data. We found evidence of breeding ...

  19. Library Electronic Resource Sharing Among Liberal Arts Colleges: ACS Palladian Alliance Project

    Directory of Open Access Journals (Sweden)

    Wenxian Zhang

    1997-03-01

    Full Text Available 無Effective electronic resource sharing is critical to library information services of the 1990s. Explosion of data and increased cost of information force libraries to work together, and technological advancements present the library service profession a platform for resource sharing. The Palladian Alliance Project of the Associated Colleges of the South is designed to provides ACS member institutions an effective means to enhance information access for their faculty and students, and achieve significant cost containment in the years to come.

  20. Instrumentation for bedside analysis of swallowing disorders.

    Science.gov (United States)

    Greco, Catiuscia S S; Nunes, Luiz G Q; Melo, Pedro L

    2010-01-01

    Disordered swallowing, or dysphagia, is a common problem seen in patients undergoing treatment for cancer, stroke and neurodegenerative illnesses. This disease is associated with aspiration-induced chest infections. The methods currently used for diagnosis, however, are qualitative or based on expensive equipment. Swallowing accelerometry is a promising low-cost, quantitative and noninvasive tool for the evaluation of swallowing. This work describes the design and application of a bedside instrument able to evaluate swallowing mechanisms and to identify patients at risk of aspiration. Three-axis swallowing accelerometry was used to measure the neck vibrations associated with deglutition, providing analog signals to a virtual instrument developed in LabVIEW environment. In vivo tests in normal subjects as well as tests with disphagic patients showed that the system was able to easily and non-invasively detect changes in the swallowing acceleration pattern associated with increasing values of water volume (p disphagia. We concluded that the developed system could be a useful tool for the objective bedside evaluation of patients at risk of aspiration.

  1. ELECTRONIC EDUCATIONAL RESOURCES FOR ONLINE SUPPORT OF MODERN CHEMISTRY CLASSES IN SPECIALIZED SCHOOL

    OpenAIRE

    Maria D. Tukalo

    2013-01-01

    This article contains material of some modern electronic educational resources that can be used via the Internet to support the modern chemistry classes in specialized school. It was drawn attention to the educational chemical experiments as means of knowledge; simulated key motivational characteristics to enhance students interest for learning subjects, their cognitive and practical activity in the formation of self-reliance and self-creative; commented forecasts for creating of conditions t...

  2. A systematic review of portable electronic technology for health education in resource-limited settings.

    Science.gov (United States)

    McHenry, Megan S; Fischer, Lydia J; Chun, Yeona; Vreeman, Rachel C

    2017-08-01

    The objective of this study is to conduct a systematic review of the literature of how portable electronic technologies with offline functionality are perceived and used to provide health education in resource-limited settings. Three reviewers evaluated articles and performed a bibliography search to identify studies describing health education delivered by portable electronic device with offline functionality in low- or middle-income countries. Data extracted included: study population; study design and type of analysis; type of technology used; method of use; setting of technology use; impact on caregivers, patients, or overall health outcomes; and reported limitations. Searches yielded 5514 unique titles. Out of 75 critically reviewed full-text articles, 10 met inclusion criteria. Study locations included Botswana, Peru, Kenya, Thailand, Nigeria, India, Ghana, and Tanzania. Topics addressed included: development of healthcare worker training modules, clinical decision support tools, patient education tools, perceptions and usability of portable electronic technology, and comparisons of technologies and/or mobile applications. Studies primarily looked at the assessment of developed educational modules on trainee health knowledge, perceptions and usability of technology, and comparisons of technologies. Overall, studies reported positive results for portable electronic device-based health education, frequently reporting increased provider/patient knowledge, improved patient outcomes in both quality of care and management, increased provider comfort level with technology, and an environment characterized by increased levels of technology-based, informal learning situations. Negative assessments included high investment costs, lack of technical support, and fear of device theft. While the research is limited, portable electronic educational resources present promising avenues to increase access to effective health education in resource-limited settings, contingent

  3. Potential resource and toxicity impacts from metals in waste electronic devices.

    Science.gov (United States)

    Woo, Seung H; Lee, Dae Sung; Lim, Seong-Rin

    2016-04-01

    As a result of the continuous release of new electronic devices, existing electronic devices are quickly made obsolete and rapidly become electronic waste (e-waste). Because e-waste contains a variety of metals, information about those metals with the potential for substantial environmental impact should be provided to manufacturers, recyclers, and disposers to proactively reduce this impact. This study assesses the resource and toxicity (i.e., cancer, noncancer, and ecotoxicity) potentials of various heavy metals commonly found in e-waste from laptop computers, liquid-crystal display (LCD) monitors, LCD TVs, plasma TVs, color cathode ray tube (CRT) TVs, and cell phones and then evaluates such potentials using life cycle impact-based methods. Resource potentials derive primarily from Cu, Sb, Ag, and Pb. Toxicity potentials derive primarily from Pb, Ni, and Hg for cancer toxicity; from Pb, Hg, Zn, and As for noncancer toxicity; and from Cu, Pb, Hg, and Zn for ecotoxicity. Therefore, managing these heavy metals should be a high priority in the design, recycling, and disposal stages of electronic devices. © 2015 SETAC.

  4. Opening a Can of wERMS: Texas A&M University's Experiences in Implementing Two Electronic Resource Management Systems

    Science.gov (United States)

    Hartnett, Eric; Price, Apryl; Smith, Jane; Barrett, Michael

    2010-01-01

    Over the past few years, Texas A&M University (TAMU) has searched for a way to administer its electronic subscriptions as well as the electronic subscriptions shared among the TAMU System. In this article, we address our attempts to implement an effective electronic resource management system (ERMS), both for subscriptions on the main campus…

  5. Model of e-learning with electronic educational resources of new generation

    Directory of Open Access Journals (Sweden)

    A. V. Loban

    2017-01-01

    Full Text Available Purpose of the article: improving of scientific and methodical base of the theory of the е-learning of variability. Methods used: conceptual and logical modeling of the е-learning of variability process with electronic educational resource of new generation and system analysis of the interconnection of the studied subject area, methods, didactics approaches and information and communication technologies means. Results: the formalization complex model of the е-learning of variability with electronic educational resource of new generation is developed, conditionally decomposed into three basic components: the formalization model of the course in the form of the thesaurusclassifier (“Author of e-resource”, the model of learning as management (“Coordination. Consultation. Control”, the learning model with the thesaurus-classifier (“Student”. Model “Author of e-resource” allows the student to achieve completeness, high degree of didactic elaboration and structuring of the studied material in triples of variants: modules of education information, practical task and control tasks; the result of the student’s (author’s of e-resource activity is the thesaurus-classifier. Model of learning as management is based on the principle of personal orientation of learning in computer environment and determines the logic of interaction between the lecturer and the student when determining the triple of variants individually for each student; organization of a dialogue between the lecturer and the student for consulting purposes; personal control of the student’s success (report generation and iterative search for the concept of the class assignment in the thesaurus-classifier before acquiring the required level of training. Model “Student” makes it possible to concretize the learning tasks in relation to the personality of the student and to the training level achieved; the assumption of the lecturer about the level of training of a

  6. Theoretical Aspects of the Use of Electronic Educational Resources in Professional Activity of Future Teachers of Technology

    Directory of Open Access Journals (Sweden)

    Iryna Smyrnova

    2017-06-01

    Full Text Available In this paper, we tried to determine the requirements for ESM, to study theoretical aspects of electronic educational resources in the professional activity of future teachers. The results created by the introduction of our course “Methodology development and use of electronic educational resources” for future teachers of technology ITOS in the process of professional specialty “Technology” in the educational process of higher educational institutions of Ukraine. The article states the rapid development of computer hardware and computer software, IT technologies have an opportunity to significantly develop the field of electronic educational resources. This is due to the emergence of global networks where information technologies have become the second paradigm, which is based on the current understanding of electronic educational resources. We determined that the dynamism inherent in information technology, enabling expectations of new approaches that will change the meaning of electronic educational resources.

  7. Postgraduate medical students' acceptance and understanding of scientific information databases and electronic resources.

    Science.gov (United States)

    Azami, Mohammad; Khajouei, Reza; Rakhshani, Safiyeh

    2016-03-01

    The significance and validity of web-based scientific databases are increasing dramatically in the scientific community. Moreover, a great number of students use these resources without having sufficient and accurate knowledge and understanding. In order for students to use these databases and electronic resources optimally, identifying the factors that affect the understanding and acceptance of these resources seems necessary. The aim of this study was to determine postgraduate medical students' acceptance and understanding of these resources. This cross-sectional study was conducted on 311 postgraduate medical students from Kerman University of Medical Science (KMU) in 2013. Data were collected using a researcher-made questionnaire, and the data were analyzed using SPSS. In order to design the model (i.e., the interaction between study variables and to determine the relationships between them in an integrated pattern), LISREL version 8.7 and a structural equation model were used. Descriptive statistics and t-tests also were used in data analysis. The results showed that the average components of the perception of usefulness, perception of ease of use, attitude towards use, decision to use, using to perform duties, and using to increase knowledge were 4.31, 4.14, 4.24, 16.27, 20.85, and 16.13 respectively. Accordingly, the average of all these indicators was significantly higher than the assumed amount (p < 0.01). Moreover, the results obtained from factor analysis and the structural equation model indicated that the model of the present study fit the data perfectly. Based on the findings of this study, the more these databases are considered useful and easy to use, the more they are used. Therefore, designers of databases and electronic resources can design systems that are both useful and easy to learn by considering the components of the research model.

  8. Chemical Sensing Regulates Mastication/Swallowing.

    Science.gov (United States)

    Yamamura, Kensuke; Kurose, Masayuki; Okamoto, Keiichiro

    2016-01-01

    Mastication and swallowing are the first stage of digestion involving several motor processes such as food intake, intra-oral food transport, bolus formation and chewing and swallowing reflex. These complicated motor functions are accomplished by the well-coordinated activities in the jaw, hyoid, tongue, facial and pharyngeal muscles. Although the basic activity patterns of these movements are controlled by the brainstem pattern generators, these movements generate various peripheral sensory inputs. Among the sensory inputs, it is well-known that somatic sensory inputs play important roles in reflexively modulating the movements so that the final motor outputs fit the environmental demand. However, little is known about the effects of chemical sensory inputs such as taste and olfaction originating from the ingested foods by these movements. A possible reason could be raised that cognition of the chemical sensory inputs at the higher brain also influences the movements, so it is difficult to discuss the neural mechanisms underlying the observed effect. In this review, we focus on the effects of chemical sensory inputs on the masticatory movements and initiation of swallowing. We first summarize chemical sensory inputs occurring during mastication and swallowing, and their receptive mechanisms. In addition, we will introduce the effect of application of monosodium L-glutamate (MSG) solution as an umami taste to the oropharynx on the swallow initiation which is involuntary controlled and the possible neural mechanisms underlying this effect is discussed.

  9. The interaction between breathing and swallowing in amyotrophic lateral sclerosis.

    Science.gov (United States)

    Erdem, Nazan Simsek; Karaali, Kamil; Ünal, Ali; Kızılay, Ferah; Öğüş, Candan; Uysal, Hilmi

    2016-12-01

    The aim of the study is to determine the association between respiratory swallow patterns in amyotrophic lateral sclerosis (ALS) patients. Furthermore, it aims to clarify the role of the dysphagia limit in defining the relationship between swallowing disorders and respiratory disorders. Functional rating scales were used to describe swallowing and respiratory function. Swallowing was observed using the dysphagia limit. Dysphagia limit is the volume at which a second or more swallows are required to swallow the whole bolus. Laryngeal and chest movement sensors, pulmonary function tests, submental, and diaphragm electromyography activity were used to evaluate the relationship between swallowing and respiratory phase. Of the 27 patients included in the study, 14 were dysphagic and 13 were non-dysphagic. Tests showed normal respiratory function in 11 of the non-dysphagic patients and 3 of the dysphagic patients. There was a high correlation between the dysphagia limit and Amyotrophic Lateral Sclerosis Functional Rating Scale swallowing parameters. Non-dysphagic patients were able to swallow during inspiration but only six patients in the dysphagic group were able to swallow during inspiration. The occurrence of dysphagia in ALS is related to piecemeal deglutition and respiration consistency during swallowing. Detecting the timing of disturbances in the relationship between swallowing and respiration may be a way of identifying dysphagia. Dysphagia limit may be a useful, complementary test for assessing swallowing disturbances in amyotrophic lateral sclerosis.

  10. Review of material recovery from used electric and electronic equipment-alternative options for resource conservation.

    Science.gov (United States)

    Friege, Henning

    2012-09-01

    For waste from electric and electronic equipment, the WEEE Directive stipulates the separate collection of electric and electronic waste. As to new electric and electronic devices, the Restriction of Hazardous Substances (RoHS) Directive bans the use of certain chemicals dangerous for man and environment. From the implementation of the WEEE directive, many unsolved problems have been documented: poor collection success, emission of dangerous substances during collection and recycling, irretrievable loss of valuable metals among others. As to RoHS, data from the literature show a satisfying success. The problems identified in the process can be reduced to some basic dilemmas at the borders between waste management, product policy and chemical safety. The objectives of the WEEE Directive and the specific targets for use and recycling of appliances are not consistent. There is no focus on scarce resources. Extended producer responsibility is not sufficient to guarantee sustainable waste management. Waste management reaches its limits due to problems of implementation but also due to physical laws. A holistic approach is necessary looking at all branch points and sinks in the stream of used products and waste from electric and electronic equipment. This may be done with respect to the general rules for sustainable management of material streams covering the three dimensions of sustainable policy. The relationships between the players in the field of electric and electronic devices have to be taken into account. Most of the problems identified in the implementation process will not be solved by the current amendment of the WEEE Directive.

  11. EFFECT OF GUM CHEWING ON AIR SWALLOWING, SALIVA SWALLOWING AND BELCHING

    Directory of Open Access Journals (Sweden)

    Ana Cristina Viana da SILVA

    2015-09-01

    Full Text Available BackgroundEructation is a physiologic event which allows gastric venting of swallowed air and most of the time is not perceived as a symptom. This is called gastric belching. Supragastric belching occurs when swallowed air does not reach the stomach and returns by mouth a short time after swallowing. This situation may cause discomfort, life limitations and problems in daily life.ObjectiveOur objective in this investigation was to evaluate if gum chewing increases the frequency of gastric and/or supragastric belches.MethodsEsophageal transit of liquid and gas was evaluated by impedance measurement in 16 patients with complaint of troublesome belching and in 15 controls. The Rome III criteria were used in the diagnosis of troublesome belching. The esophageal transit of liquid and gas was measured at 5 cm, 10 cm, 15 cm and 20 cm from the lower esophageal sphincter. The subjects were evaluated for 1 hour which was divided into three 20-minute periods: (1 while sitting for a 20-minute base period; (2 after the ingestion of yogurt (200 mL, 190 kcal, in which the subjects were evaluated while chewing or not chewing gum; (3 final 20-minute period in which the subjects then inverted the task of chewing or not chewing gum. In gastric belch, the air flowed from the stomach through the esophagus in oral direction and in supragastric belch the air entered the esophagus rapidly from proximal and was expulsed almost immediately in oral direction. Air swallows were characterized by an increase of at least 50% of basal impedance and saliva swallow by a decrease of at least 50% of basal impedance, that progress from proximal to distal esophagus.ResultsIn base period, air swallowing was more frequent in patients than in controls and saliva swallowing was more frequent in controls than in patients. There was no difference between the medians of controls and patients in the number of gastric belches and supragastric belches. In six patients, supragastric belches

  12. The effects of a xanthan gum-based thickener on the swallowing function of patients with dysphagia.

    Science.gov (United States)

    Rofes, L; Arreola, V; Mukherjee, R; Swanson, J; Clavé, P

    2014-05-01

    Increasing bolus viscosity of thin liquids is a basic therapeutic strategy to protect patients with oropharyngeal dysphagia (OD) from aspiration. However, conventional starch thickeners increase post-deglutitive residue. To assess the therapeutic effect of a new xanthan gum-based thickener, Resource ThickenUp Clear (Nestlé Health Science, Vevey, Switzerland) on patients with oropharyngeal dysphagia. We studied the effect of Resource ThickenUp Clear using a clinical method and videofluoroscopy on 120 patients with oropharyngeal dysphagia (66 with stroke, 41 older and 13 with neurodegenerative diseases) and 14 healthy volunteers while swallowing thin-liquid, nectar-like and spoon-thick boluses. We assessed the prevalence of signs of impaired safety and efficacy of swallow and the physiology of the swallow response. Increasing bolus viscosity with Resource ThickenUp Clear: (i) improved safety of swallow demonstrated by a reduction in the prevalence of cough and voice changes in the clinical study and penetrations and aspirations during video fluoroscopy. Prevalence of aspirations was 12.7% with thin liquid, 7.7% with nectar-like (P < 0.01) and 3.4% with spoon-thick (P < 0.01) viscosities. Penetration-Aspiration Scale was reduced from 3.24 ± 0.18 at thin liquid to 2.20 ± 0.18 at nectar-like (P < 0.001) and to 1.53 ± 0.13 at spoon-thick (P < 0.001) viscosities; (ii) did not enhance pharyngeal residue; (iii) nectar-like viscosity did not affect bolus velocity nor timing of swallow response and (iv) spoon-thick viscosity reduced bolus velocity. Resource ThickenUp Clear improves the safety of swallow without increasing residue providing a viscosity-dependent therapeutic effect for patients with oropharyngeal dysphagia. At nectar viscosity, the effect is due to intrinsic texture properties, spoon-thick viscosity adding changes in swallow physiology. NCT01158313. © 2014 John Wiley & Sons Ltd.

  13. Integrating electronic information resources for NHS Glasgow staff at the point of need: a model of interlibrary collaboration and resource sharing.

    Science.gov (United States)

    Davies, S; Wales, A

    2001-12-01

    The Glasgow NHS Libraries Consortium has harnessed the political imperative of collaboration and the capability of electronic information resources to address inequalities in access to the knowledge base across NHS Glasgow. They have negotiated consortium arrangements to an extensive range of electronic databases and journals which no single Glasgow NHS library could afford independently. A Project Officer was appointed to undertake the administration, technical work and promotion required to build a Web-based electronic library to deliver resources to all NHS Glasgow staff on an equitable basis. Close partnership with online content providers enabled the Project Officer to find solutions to problems caused by authentication systems and license restrictions. These efforts have culminated in the production of a fully integrated virtual library--the NHS Glasgow e-Library--delivering 11 major electronic databases, 440 full-text electronic journals, 48 electronic textbooks and over 5000 journal contents pages. The NHS Glasgow e-Library is without precedent within the NHS in terms of its wealth of resources, and it provides a model for Scotland-wide access to the knowledge base. The sustainability and transferability of the resource is dependent on a number of key areas-maintenance, user training, evaluation, IT infrastructure and ongoing collaboration and unification. Ongoing research will monitor how far the NHS Glasgow e-Library has strengthened the connection between research evidence and clinical practice.

  14. Comparing Electronic Human Resource Management Systems Efficiency In Production Organization amp Service Organizations

    Directory of Open Access Journals (Sweden)

    Ali Hadian

    2015-08-01

    Full Text Available Today the organizations used information technology in performing human resource department affairs and this is called as electronic human resource management EHRM. In fact as the competitive complexity increases the need for implementing EHRM in production and service businesses increases too. This paper is written in order to specify the importance of implementing EHRM in production and service organizations and also to evaluate efficiency rate and the importance degree in these two ones. In this paper first the topics literature and the most important aspects of implementing these systems will be reviewed and after categorizing these views the hierarchal model will be proposed by applying AHP method. The result of analyzing this model by EXPERT CHOICE software shows that implementing EHRM in both kinds of organizations has the same importance however there is a large difference between them in implementing aspects.

  15. The Synthesis of the Hierarchical Structure of Information Resources for Management of Electronic Commerce Entities

    Directory of Open Access Journals (Sweden)

    Krutova Anzhelika S.

    2017-06-01

    Full Text Available The aim of the article is to develop the theoretical bases for the classification and coding of economic information and the scientific justification of the content of information resources of an electronic commerce enterprise. The essence of information resources for management of electronic business entities is investigated. It is proved that the organization of accounting in e-commerce systems is advisable to be built on the basis of two circuits: accounting for financial flows and accounting associated with transformation of business factors in products and services as a result of production activities. There presented a sequence of accounting organization that allows to combine the both circuits in a single information system, which provides a possibility for the integrated replenishment and distributed simultaneous use of the e-commerce system by all groups of users. It is proved that the guarantee of efficient activity of the information management system of electronic commerce entities is a proper systematization of the aggregate of information resources on economic facts and operations of an enterprise in accordance with the management tasks by building the hierarchy of accounting nomenclatures. It is suggested to understand nomenclature as an objective, primary information aggregate concerning a certain fact of the economic activity of an enterprise, which is characterized by minimum requisites, is entered into the database of the information system and is to be reflected in the accounting system. It is proposed to build a database of e-commerce systems as a part of directories (constants, personnel, goods / products, suppliers, buyers and the hierarchy of accounting nomenclatures. The package of documents regulating the organization of accounting at an enterprise should include: the provision on the accounting services, the order on the accounting policy, the job descriptions, the schedules of information exchange, the report card and

  16. ELECTRONIC EDUCATIONAL RESOURCES FOR ONLINE SUPPORT OF MODERN CHEMISTRY CLASSES IN SPECIALIZED SCHOOL

    Directory of Open Access Journals (Sweden)

    Maria D. Tukalo

    2013-09-01

    Full Text Available This article contains material of some modern electronic educational resources that can be used via the Internet to support the modern chemistry classes in specialized school. It was drawn attention to the educational chemical experiments as means of knowledge; simulated key motivational characteristics to enhance students interest for learning subjects, their cognitive and practical activity in the formation of self-reliance and self-creative; commented forecasts for creating of conditions to enhance the creative potential of students in a modern learning environment.

  17. Remote management of voice and swallowing disorders.

    Science.gov (United States)

    Mashima, Pauline A; Brown, Janet E

    2011-12-01

    Telehealth or telepractice can alleviate shortages of speech-language pathologists, particularly in rural and underserved areas, where specialists in voice and swallowing disorders may not be available. In addition to improving access to services, telehealth offers the opportunity for patients to receive care in their natural environment, as in the case of home health care where treatment can include family members and caregivers. This article presents an overview of telehealth applications in the remote management of voice and swallowing disorders including historical background, current issues, and a brief review of clinical effectiveness studies. Published by Elsevier Inc.

  18. THE MODEL OF LINGUISTIC TEACHERS’ COMPETENCY DEVELOPMENT ON DESIGNING MULTIMEDIA ELECTRONIC EDUCATIONAL RESOURCES IN THE MOODLE SYSTEM

    Directory of Open Access Journals (Sweden)

    Anton M. Avramchuk

    2017-10-01

    Full Text Available The article is devoted to the problem of developing the competency of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system. The concept of "the competence of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system" is justified and defined. Identified and characterized the components by which the levels of the competency development of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system should be assessed. Developed a model for the development of the competency of teachers of language disciplines on designing multimedia electronic educational resources in the Moodle system, which is based on the main scientific approaches, used in adult education, and consists of five blocks: target, informative, technological, diagnostic and effective.

  19. Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review.

    Science.gov (United States)

    Syzdykova, Assel; Malta, André; Zolfo, Maria; Diro, Ermias; Oliveira, José Luis

    2017-11-13

    Despite the great impact of information and communication technologies on clinical practice and on the quality of health services, this trend has been almost exclusive to developed countries, whereas countries with poor resources suffer from many economic and social issues that have hindered the real benefits of electronic health (eHealth) tools. As a component of eHealth systems, electronic health records (EHRs) play a fundamental role in patient management and effective medical care services. Thus, the adoption of EHRs in regions with a lack of infrastructure, untrained staff, and ill-equipped health care providers is an important task. However, the main barrier to adopting EHR software in low- and middle-income countries is the cost of its purchase and maintenance, which highlights the open-source approach as a good solution for these underserved areas. The aim of this study was to conduct a systematic review of open-source EHR systems based on the requirements and limitations of low-resource settings. First, we reviewed existing literature on the comparison of available open-source solutions. In close collaboration with the University of Gondar Hospital, Ethiopia, we identified common limitations in poor resource environments and also the main requirements that EHRs should support. Then, we extensively evaluated the current open-source EHR solutions, discussing their strengths and weaknesses, and their appropriateness to fulfill a predefined set of features relevant for low-resource settings. The evaluation methodology allowed assessment of several key aspects of available solutions that are as follows: (1) integrated applications, (2) configurable reports, (3) custom reports, (4) custom forms, (5) interoperability, (6) coding systems, (7) authentication methods, (8) patient portal, (9) access control model, (10) cryptographic features, (11) flexible data model, (12) offline support, (13) native client, (14) Web client,(15) other clients, (16) code

  20. Success criteria for electronic medical record implementations in low-resource settings: a systematic review.

    Science.gov (United States)

    Fritz, Fleur; Tilahun, Binyam; Dugas, Martin

    2015-03-01

    Electronic medical record (EMR) systems have the potential of supporting clinical work by providing the right information at the right time to the right people and thus make efficient use of resources. This is especially important in low-resource settings where reliable data are also needed to support public health and local supporting organizations. In this systematic literature review, our objectives are to identify and collect literature about success criteria of EMR implementations in low-resource settings and to summarize them into recommendations. Our search strategy relied on PubMed queries and manual bibliography reviews. Studies were included if EMR implementations in low-resource settings were described. The extracted success criteria and measurements were summarized into 7 categories: ethical, financial, functionality, organizational, political, technical, and training. We collected 381 success criteria with 229 measurements from 47 articles out of 223 articles. Most papers were evaluations or lessons learned from African countries, published from 1999 to 2013. Almost half of the EMR systems served a specific disease area like human immunodeficiency virus (HIV). The majority of criteria that were reported dealt with the functionality, followed by organizational issues, and technical infrastructures. Sufficient training and skilled personnel were mentioned in roughly 10%. Political, ethical, and financial considerations did not play a predominant role. More evaluations based on reliable frameworks are needed. Highly reliable data handling methods, human resources and effective project management, as well as technical architecture and infrastructure are all key factors for successful EMR implementation. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Impact of Knowledge Resources Linked to an Electronic Health Record on Frequency of Unnecessary Tests and Treatments

    Science.gov (United States)

    Goodman, Kenneth; Grad, Roland; Pluye, Pierre; Nowacki, Amy; Hickner, John

    2012-01-01

    Introduction: Electronic knowledge resources have the potential to rapidly provide answers to clinicians' questions. We sought to determine clinicians' reasons for searching these resources, the rate of finding relevant information, and the perceived clinical impact of the information they retrieved. Methods: We asked general internists, family…

  2. Resource conservation approached with an appropriate collection and upgrade-remanufacturing for used electronic products.

    Science.gov (United States)

    Zlamparet, Gabriel I; Tan, Quanyin; Stevels, A B; Li, Jinhui

    2018-03-01

    This comparative research represents an example for a better conservation of resources by reducing the amount of waste (kg) and providing it more value under the umbrella of remanufacturing. The three discussed cases will expose three issues already addressed separately in the literature. The generation of waste electrical and electronic equipment (WEEE) interacts with the environmental depletion. In this article, we gave the examples of addressed issues under the concept of remanufacturing. Online collection opportunity eliminating classical collection, a business to business (B2B) implementation for remanufactured servers and medical devices. The material reuse (recycling), component sustainability, reuse (part harvesting), product reuse (after repair/remanufacturing) indicates the recovery potential using remanufacturing tool for a better conservation of resources adding more value to the products. Our findings can provide an overview of new system organization for the general collection, market potential and the technological advantages using remanufacturing instead of recycling of WEEE or used electrical and electronic equipment. Copyright © 2017. Published by Elsevier Ltd.

  3. Nonspecific effects of gap paradigm on swallowing.

    Science.gov (United States)

    Yoneda, Masaki; Saitoh, Kazuya

    2017-02-01

    Analogous to the gap paradigm in experiments for saccadic eye movements with very short reaction times, we hypothesized that the initiation of oropharyngeal swallowing movements guided by visual cues are encouraged under experimental conditions using a similar gap paradigm. A red visual cue indicating to hold a bolus in the mouth and a blue one indicating to swallow the bolus were sequentially provided on a computer display to 11 healthy participants. The gap period between these cues varied from 0 to 800ms. Swallowing kinetics and kinematics were recorded using surface electromyography and a laser displacement sensor, respectively. In comparison with the no-gap paradigm, the delay from the onset of muscle activities to initiation of movement significantly decreased with a 100- (pparadigm of 100-200ms. Wrist flexion was boosted in a similar manner. Thus, the gap effect may be a generalized warning effect. Our findings might provide insights into the contribution of the basal ganglia to volitional swallowing. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Reducing clinical trial monitoring resource allocation and costs through remote access to electronic medical records.

    Science.gov (United States)

    Uren, Shannon C; Kirkman, Mitchell B; Dalton, Brad S; Zalcberg, John R

    2013-01-01

    With electronic medical records (eMRs), the option now exists for clinical trial monitors to perform source data verification (SDV) remotely. We report on a feasibility study of remote access to eMRs for SDV and the potential advantages of such a process in terms of resource allocation and cost. The Clinical Trials Unit at the Peter MacCallum Cancer Centre, in collaboration with Novartis Pharmaceuticals Australia, conducted a 6-month feasibility study of remote SDV. A Novartis monitor was granted dedicated software and restricted remote access to the eMR portal of the cancer center, thereby providing an avenue through which perform SDV. Six monitoring visits were conducted during the study period, four of which were performed remotely. The ability to conduct two thirds of the monitoring visits remotely in this complex phase III study resulted in an overall cost saving to Novartis. Similarly, remote monitoring eased the strain on internal resources, particularly monitoring space and hospital computer terminal access, at the cancer center. Remote access to patient eMRs for SDV is feasible and is potentially an avenue through which resources can be more efficiently used. Although this feasibility study involved limited numbers, there is no limit to scaling these processes to any number of patients enrolled onto large clinical trials.

  5. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review.

    Science.gov (United States)

    Lam, Lisetta; Samman, Nabil

    2013-06-01

    This was a systematic review of the current research on speech and swallowing outcomes and the factors affecting these outcomes after primary resection of tongue cancer and free flap reconstruction. A structured search in various electronic databases and relevant journals was performed. Retrieved articles were critically appraised in three rounds according to the level of evidence, the methodological quality, and the specific domain of speech and swallowing. A total of 21 articles were in the final review and the findings were categorized according to the area of tongue resection. For patients with resection and free flap reconstruction limited to either the oral tongue or the base of tongue (BOT), significant decline in speech and swallowing function was evident in the early postoperative phase, but the majority recovered close to preoperative level after 1 year. Poorer speech and swallowing outcomes were found following resections involving both oral and base of tongue (OBOT) regardless of the type of free flap reconstruction. Results overall were influenced by multiple factors including tumor size, area of resection, method of reconstruction and the use of adjuvant therapy. The use of free flaps in the immediate reconstruction of the tongue after tumor resection should aim at the maintenance of the mobility of the residual tongue and restoration of tongue bulk in order to optimize the recovery of speech and swallowing function. Future research in this field should employ standardized and reliable evaluation of speech and swallowing outcomes using multiple modalities in well-designed cohort studies with longer follow-up. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Electronic theses and dissertations: a review of this valuable resource for nurse scholars worldwide.

    Science.gov (United States)

    Goodfellow, L M

    2009-06-01

    A worldwide repository of electronic theses and dissertations (ETDs) could provide worldwide access to the most up-to-date research generated by masters and doctoral students. Until that international repository is established, it is possible to access some of these valuable knowledge resources. ETDs provide a technologically advanced medium with endless multimedia capabilities that far exceed the print and bound copies of theses and dissertations housed traditionally in individual university libraries. CURRENT USE: A growing trend exists for universities worldwide to require graduate students to submit theses or dissertations as electronic documents. However, nurse scholars underutilize ETDs, as evidenced by perusing bibliographic citation lists in many of the research journals. ETDs can be searched for and retrieved through several digital resources such as the Networked Digital Library of Theses and Dissertations (http://www.ndltd.org), ProQuest Dissertations and Theses (http://www.umi.com), the Australasian Digital Theses Program (http://adt.caul.edu.au/) and through individual university web sites and online catalogues. An international repository of ETDs benefits the community of nurse scholars in many ways. The ability to access recent graduate students' research electronically from anywhere in the world is advantageous. For scholars residing in developing countries, access to these ETDs may prove to be even more valuable. In some cases, ETDs are not available for worldwide access and can only be accessed through the university library from which the student graduated. Public access to university library ETD collections is not always permitted. Nurse scholars from both developing and developed countries could benefit from ETDs.

  7. Intrarater and interrater reliability for measurements in videofluoroscopy of swallowing

    Energy Technology Data Exchange (ETDEWEB)

    Baijens, Laura, E-mail: laura.baijens@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands); Barikroo, Ali, E-mail: a.Barikroo@ufl.edu [Swallowing Research Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, FL (United States); Pilz, Walmari, E-mail: walmari.pilz@mumc.nl [Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht (Netherlands)

    2013-10-01

    Objective: Intrarater and interrater reliability is crucial to the quality of diagnostic and therapy-effect studies. This paper reports on a systematic review of studies on intrarater and interrater reliability for measurements in videofluoroscopy of swallowing. The aim of this review was to summarize and qualitatively analyze published studies on that topic. Materials and methods: Those published up to March 2013 were found through a comprehensive electronic database search using PubMed, Embase, and The Cochrane Library. Two reviewers independently assessed the studies using strict inclusion criteria. Results: Nineteen studies were included and then qualitatively analyzed. In several of these, methodological problems were found. Moreover, intrarater and interrater reliability varied with the measure applied. A meta-analysis was not carried out as studies were not of sufficient quality to warrant doing so. Conclusion: In order to achieve reliable measurements in videofluoroscopy of swallowing, it is recommended that raters use well-defined guidelines for the levels of ordinal visuoperceptual variables. Furthermore, in order to make the measurements reliable (intrarater and interrater) it is recommended that, following protocolled pre-experimental training, the raters should have maximum consensus about the definition of the measured variables.

  8. Senescent Swallowing: Impact, Strategies and Interventions

    Science.gov (United States)

    Ney, Denise; Weiss, Jennifer; Kind, Amy; Robbins, JoAnne

    2010-01-01

    The risk for disordered oropharyngeal swallowing (dysphagia) increases with age. Loss of swallowing function can have devastating health implications including dehydration, malnutrition, and pneumonia, as well as reduced quality of life. Age-related changes place older adults at risk for dysphagia for two major reasons: One is that natural, healthy aging takes its toll on head and neck anatomy and physiologic and neural mechanisms underpinning swallowing function. This progression of change contributes to alterations in the swallowing in healthy older adults and is termed presbyphagia, naturally diminishing functional reserve. Second, disease prevalence increases with age and dysphagia is a co-morbidity of many age-related diseases and/or their treatments. Sensory changes, medication, sarcopenia and age-related diseases are discussed herein. Relatively recent findings that health complications are associated with dysphagia are presented. Nutrient requirements, fluid intake and nutritional assessment for older adults are reviewed relative to their relations to dysphagia. Dysphagia screening and the pros and cons of tube feeding as a solution are discussed. Optimal intervention strategies for elders with dysphagia ranging from compensatory interventions to more rigorous exercise approaches are presented. Compelling evidence of improved functional swallowing and eating outcomes resulting from active rehabilitation focusing on increasing strength of head and neck musculature is provided. In summary, while oropharyngeal dysphagia may be life-threatening, so are some of the traditional alternatives, particularly for frail, elderly patients. While the state of the evidence calls for more research, this review indicates the behavioral, dietary and environmental modifications emerging in this past decade are compassionate, promising and in many cases preferred alternatives to the always present option of tube feeding. PMID:19483069

  9. The effects of removable denture on swallowing.

    Science.gov (United States)

    Son, Dae-Sik; Seong, Jin Wan; Kim, Younghoon; Chee, Youngjoon; Hwang, Chang Ho

    2013-04-01

    To investigate the relationship between removable dentures and swallowing and describe risks. Twenty-four patients with removable dentures who were referred for videofluoroscopic swallowing study (VFSS) were enrolled. We evaluated the change of swallowing function using VFSS before and after the removal of the removable denture. The masticatory performance by Kazunori's method, sensation of oral cavity by Christian's method, underlying disease, and National Institutes of Health Stroke Scale for level of consciousness were collected. Functional dysphagia scales, including the oral transit time (OTT), pharyngeal transit time (PTT), percentage of oral residue, percentage of pharyngeal residue, oropharyngeal swallow efficiency (OPSE), and presence of aspiration were measured. Four patients dropped out and 20 patients were analyzed (stroke, 13 patients; pneumonia, 3 patients; and others, 4 patients). The mean age was 73.3±11.4 years. There were significant differences before and after the removal of the denture for the OTT. OTT was significantly less after the removal of the denture (8.87 vs. 4.38 seconds, p=0.01). OPSE increased remarkably after the removal of the denture, but without significance (18.24%/sec vs. 25.26%/sec, p=0.05). The OTT and OPSE, while donning a removable denture, were correlated with the masticatory performance (OTT, p=0.04; OPSE, p=0.003) and sensation of oral cavity (OTT, p=0.006; OPSE, p=0.007). A removable denture may have negative effects on swallowing, especially OTT and OPSE. These affects may be caused by impaired sensation of the oral cavity or masticatory performance induced by the removable denture.

  10. Swallowing Disorders in Severe Brain Injury in the Arousal Phase.

    Science.gov (United States)

    Bremare, A; Rapin, A; Veber, B; Beuret-Blanquart, F; Verin, E

    2016-08-01

    The objective of this study was to determine the clinical characteristics of swallowing disorders in severe brain injury in the arousal phase after coma. Between December 1, 2013 and June 30, 2014, eleven patients with severe acquired brain injury who were admitted to rehabilitation center (Male 81.8 %; 40.7 ± 14.6 years) were included in the study. Evaluation of swallowing included a functional examination, clinical functional swallowing test, and naso-endoscopic swallowing test. All patients had swallowing disorders at admission. The first functional swallowing test showed oral (77.8 %) and pharyngeal (66.7 %) food bolus transport disorders; and alterations in airway protection mechanisms (80 %). Swallowing test under endoscopic control showed a disorder in swallowing coordination in 55.6 % of patients tested. Seven (63.6 %) patients resumed oral feeding within an average of 6 weeks after admission to rehabilitation center and 14 weeks after acquired brain injury. Six (85.7 %) of these seven patients continued to require modified solid and liquid textures. Swallowing disorders are a major concern in severe brain injury in the arousal phase. Early bedside assessment of swallowing is essential for detection of swallowing disorders to propose appropriate medical rehabilitation care to these patients in a state of altered consciousness.

  11. From Millennium ERM to Proquest 360 Resource Manager: Implementing a new Electronic Resources Management System ERMS in an International Graduate Research University in Saudi Arabia

    KAUST Repository

    Ramli, Rindra M.

    2017-05-17

    An overview of the Recommendation Study and the subsequent Implementation of a new Electronic Resources Management system ERMS in an international graduate research university in the Kingdom of Saudi Arabia. It covers the timeline, deliverables and challenges as well as lessons learnt by the Project Team.

  12. DEVELOPMENT AND USAGE OF THE ELECTRONIC VIDEO RESOURCES FOR EDUCATIONAL PURPOSES

    Directory of Open Access Journals (Sweden)

    Yaroslav M. Hlynsky

    2017-04-01

    Full Text Available This article discusses the theoretical foundation, the creation and implementation of the electronic educational video resources (EEVR in the example of the development and the usage of the collection of video tutorials in event-driven programming theme, which is studied in the framework of the subject "Informatics" by students of many specialties. It offers some development of the existing conceptual and categorical apparatus concerning EEVR development. It is alleged that the video tutorials allow you to automate the process of learning, redistribute instructional time for the benefit of students' independent work, to provide classroom release time for the teaching of the theoretical issues of the course that is aimed at improving the fundamental nature of training. Practical recommendations for the development of the effective EEVR, which may be useful for the authors of e-learning courses for students of different forms of training are proposed.

  13. [HYGIENIC REGULATION OF THE USE OF ELECTRONIC EDUCATIONAL RESOURCES IN THE MODERN SCHOOL].

    Science.gov (United States)

    Stepanova, M I; Aleksandrova, I E; Sazanyuk, Z I; Voronova, B Z; Lashneva, L P; Shumkova, T V; Berezina, N O

    2015-01-01

    We studied the effect of academic studies with the use a notebook computer and interactive whiteboard on the functional state of an organism of schoolchildren. Using a complex of hygienic and physiological methods of the study we established that regulation of the computer activity of students must take into account not only duration but its intensity either. Design features of a notebook computer were shown both to impede keeping the optimal working posture in primary school children and increase the risk offormation of disorders of vision and musculoskeletal system. There were established the activating influence of the interactive whiteboard on performance activities and favorable dynamics of indices of the functional state of the organism of students under keeping optimal density of the academic study and the duration of its use. There are determined safety regulations of the work of schoolchildren with electronic resources in the educational process.

  14. Availability, Use and Constraints to Use of Electronic Information Resources by Postgraduates Students at the University of Ibadan

    Directory of Open Access Journals (Sweden)

    Dare Samuel Adeleke

    2017-12-01

    Full Text Available Availability, awareness and use of electronic resources provide access to authoritative, reliable, accurate and timely access to information. The use of electronic information resources (EIRs can enable innovation in teaching and increase timeliness in research of postgraduate students which will eventual result into encouragement of the expected research-led enquiry in this digital age. The study adopted a descriptive survey design. Samples of 300 of postgraduate students within seven out 13 Faculties were randomly selected. Data were collected using questionnaire designed to elicit response from respondents and data were analyzed using descriptive statistics methods percentages, mean, and standard deviation. Results indicated that internet was ranked most available and used in the university. Low level of usage of electronic resources, in particular, full texts data bases is linked to a number of constraints: Interrupted power supply was ranked highest among other factors as speed and capacity of computers, retrieval of records with high recall and low precision, retrieving records relevant to information need, lack of knowledge of search techniques to retrieve information effectively, non possession of requisite IT skills and problems accessing the internet. The study recommended that usage of electronic resources be made compulsory, intensifying awareness campaigns concerning the availability, training on use of electronic resources and the problem of power outage be addressed.

  15. Factors Influencing Students' Use of Electronic Resources and their Opinions About this Use: The Case of Students at An-Najah National University

    Directory of Open Access Journals (Sweden)

    Wajeeh M. Daher

    2010-12-01

    Full Text Available Electronic resources are becoming an integral part of the modern life and of the educational scene, especially the high education scene. In this research we wanted to verify what influences first degree university students' use of electronic resources and their opinions regarding this use. Collecting data from 202 students and analyzing it using SPSS, we found that more than one half of the participants had high level of electronic media use and more than one third had moderate level of electronic media use. These levels of use indicate the students' awareness of the role and benefits of electronic media use. Regarding the factors that influence the students' se of electronic resources we found that the student's use of electronic resources had significant strong positive relationships with the provision of electronic resources by the academic institution. It had significant moderate positive relationships with the resources characteristics and the course requirement, and had significant weak relationships with the instructor's support and the student's characteristics. We explained these relationships as resulting from the influence of the surrounding community. Regarding the students' opinions about the use of electronic resources, we found that the student's opinion of electronic resources has significant strong positive relationships with student's use of electronic resources, level of this use, the academic institution available facilities, student's characteristics and resources characteristics. It does not have significant relationships with the instructor's support or the course requirement. We explained these relationships depending on activity theory and its integration with ecological psychology.

  16. Aspirating and Nonaspirating Swallow Sounds in Children: A Pilot Study.

    Science.gov (United States)

    Frakking, Thuy; Chang, Anne; O'Grady, Kerry; David, Michael; Weir, Kelly

    2016-12-01

    Cervical auscultation (CA) may be used to complement feeding/swallowing evaluations when assessing for aspiration. There are no published pediatric studies that compare the properties of sounds between aspirating and nonaspirating swallows. To establish acoustic and perceptual profiles of aspirating and nonaspirating swallow sounds and determine if a difference exists between these 2 swallowing types. Aspiration sound clips were obtained from recordings using CA simultaneously undertaken with videofluoroscopic swallow study. Aspiration was determined using the Penetration-Aspiration Scale. The presence of perceptual swallow/breath parameters was rated by 2 speech pathologists who were blinded to the type of swallow. Acoustic data between groups were compared using Mann Whitney U-tests, while perceptual differences were determined by a test of 2 proportions. Combinations of perceptual parameters of 50 swallows (27 aspiration, 23 no aspiration) from 47 children (57% male) were statistically analyzed using area under a receiver operating characteristic (aROC), sensitivity, specificity, and positive and negative predictive values to determine predictors of aspirating swallows. The combination of post-swallow presence of wet breathing and wheeze and absence of GRS and normal breathing was the best predictor of aspiration (aROC = 0.82, 95% CI, 0.70-0.94). There were no significant differences between these 2 swallow types for peak frequency, duration, and peak amplitude. Our pilot study has shown that certain characteristics of swallow obtained using CA may be useful in the prediction of aspiration. However, further research comparing the acoustic swallowing sound profiles of normal children to children with dysphagia (who are aspirating) on a larger scale is required. © The Author(s) 2016.

  17. Speech, language and swallowing in Huntington’ Disease

    Directory of Open Access Journals (Sweden)

    Maryluz Camargo-Mendoza

    2017-04-01

    Full Text Available Huntington’s disease (HD has been described as a genetic condition caused by a mutation in the CAG (cytosine-adenine-guanine nucleotide sequence. Depending on the stage of the disease, people may have difficulties in speech, language and swallowing. The purpose of this paper is to describe these difficulties in detail, as well as to provide an account on speech and language therapy approach to this condition. Regarding speech, it is worth noticing that characteristics typical of hyperkinetic dysarthria can be found due to underlying choreic movements. The speech of people with HD tends to show shorter sentences, with much simpler syntactic structures, and difficulties in tasks that require complex cognitive processing. Moreover, swallowing may present dysphagia that progresses as the disease develops. A timely, comprehensive and effective speech-language intervention is essential to improve the quality of life of people and contribute to their communicative welfare.

  18. Assessing children's swallowing: Parent and professional perceptions

    OpenAIRE

    Cockerill, H.; Van Den Engel-Hoek, L.; Harding, C.

    2016-01-01

    Purpose-For infants and children who have difficulties with eating, drinking and swallowing (dysphagia), there are significant health risks that include aspiration (food and fluid entering the lungs) and poor growth. Videofluoroscopy is often the instrumental method of assessment used to exclude or confirm aspiration. The purpose of this paper is to investigate parental and referrer perceptions of the reasons for and the outcomes of videofluoroscopy. \\ud \\ud Design/methodology/approach-Data w...

  19. SAGES: a suite of freely-available software tools for electronic disease surveillance in resource-limited settings.

    Directory of Open Access Journals (Sweden)

    Sheri L Lewis

    Full Text Available Public health surveillance is undergoing a revolution driven by advances in the field of information technology. Many countries have experienced vast improvements in the collection, ingestion, analysis, visualization, and dissemination of public health data. Resource-limited countries have lagged behind due to challenges in information technology infrastructure, public health resources, and the costs of proprietary software. The Suite for Automated Global Electronic bioSurveillance (SAGES is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings. One or more SAGES tools may be used in concert with existing surveillance applications or the SAGES tools may be used en masse for an end-to-end biosurveillance capability. This flexibility allows for the development of an inexpensive, customized, and sustainable disease surveillance system. The ability to rapidly assess anomalous disease activity may lead to more efficient use of limited resources and better compliance with World Health Organization International Health Regulations.

  20. SAGES: A Suite of Freely-Available Software Tools for Electronic Disease Surveillance in Resource-Limited Settings

    Science.gov (United States)

    Lewis, Sheri L.; Feighner, Brian H.; Loschen, Wayne A.; Wojcik, Richard A.; Skora, Joseph F.; Coberly, Jacqueline S.; Blazes, David L.

    2011-01-01

    Public health surveillance is undergoing a revolution driven by advances in the field of information technology. Many countries have experienced vast improvements in the collection, ingestion, analysis, visualization, and dissemination of public health data. Resource-limited countries have lagged behind due to challenges in information technology infrastructure, public health resources, and the costs of proprietary software. The Suite for Automated Global Electronic bioSurveillance (SAGES) is a collection of modular, flexible, freely-available software tools for electronic disease surveillance in resource-limited settings. One or more SAGES tools may be used in concert with existing surveillance applications or the SAGES tools may be used en masse for an end-to-end biosurveillance capability. This flexibility allows for the development of an inexpensive, customized, and sustainable disease surveillance system. The ability to rapidly assess anomalous disease activity may lead to more efficient use of limited resources and better compliance with World Health Organization International Health Regulations. PMID:21572957

  1. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2016-12-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Functional connectivity patterns of normal human swallowing: difference among various viscosity swallows in normal and chin-tuck head positions

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Perera, Subashan

    2016-01-01

    Consuming thicker fluids and swallowing in the chin-tuck position has been shown to be advantageous for some patients with neurogenic dysphagia who aspirate due to various causes. The anatomical changes caused by these therapeutic techniques are well known, but it is unclear whether these changes alter the cerebral processing of swallow-related sensorimotor activity. We sought to investigate the effect of increased fluid viscosity and chin-down posture during swallowing on brain networks. 55 healthy adults performed water, nectar-thick, and honey thick liquid swallows in the neutral and chin-tuck positions while EEG signals were recorded. After pre-processing of the EEG timeseries, the time-frequency based synchrony measure was used for forming the brain networks to investigate whether there were differences among the brain networks between the swallowing of different fluid viscosities and swallowing in different head positions. We also investigated whether swallowing under various conditions exhibit small-world properties. Results showed that fluid viscosity affects the brain network in the Delta, Theta, Alpha, Beta, and Gamma frequency bands and that swallowing in the chin-tuck head position affects brain networks in the Alpha, Beta, and Gamma frequency bands. In addition, we showed that swallowing in all tested conditions exhibited small-world properties. Therefore, fluid viscosity and head positions should be considered in future swallowing EEG investigations. PMID:27693396

  3. Anatomical Directional Dissimilarities in Tri-axial Swallowing Accelerometry Signals.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdic, Ervin

    2017-05-01

    Swallowing accelerometry is a noninvasive approach currently under consideration as an instrumental screening test for swallowing difficulties, with most current studies focusing on the swallowing vibrations in the anterior-posterior (A-P) and superior-inferior (S-I) directions. However, the displacement of the hyolaryngeal structure during the act of swallowing in patients with dysphagia involves declination of the medial-lateral (M-L), which suggests that the swallowing vibrations in the M-L direction have the ability to reveal additional details about the swallowing function. With this motivation, we performed a broad comparison of the swallowing vibrations in all three anatomical directions. Tri-axial swallowing accelerometry signals were concurrently collected from 72 dysphagic patients undergoing videofluoroscopic evaluation of swallowing (mean age: 63.94 ± 12.58 years period). Participants swallowed one or more thickened liquids with different consistencies including thin-thick liquids, nectar-thick liquids, and pudding-thick liquids with either a comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5-ml spoon. Swallows were grouped based on the viscosity of swallows and the participant's stroke history. Then, a comprehensive set of features was extracted in multiple signal domains from 881 swallows. The results highlighted inter-axis dissimilarities among tri-axial swallowing vibrations including the extent of variability in the amplitude of signals, the degree of predictability of signals, and the extent of disordered behavior of signals in time-frequency domain. First, the upward movement of the hyolaryngeal structure, representing the S-I signals, were actually more variable in amplitude and showed less predictable behavior than the sideways and forward movements, representing the A-P and M-L signals, during swallowing. Second, the S-I signals, which represent the upward movement of the hyolaryngeal structure

  4. Theoretical Aspects of the Use of Electronic Educational Resources in Professional Activity of Future Teachers of Technology

    OpenAIRE

    Iryna Smyrnova

    2017-01-01

    In this paper, we tried to determine the requirements for ESM, to study theoretical aspects of electronic educational resources in the professional activity of future teachers. The results created by the introduction of our course “Methodology development and use of electronic educational resources” for future teachers of technology ITOS in the process of professional specialty “Technology” in the educational process of higher educational institutions of Ukraine. The article states the rapid ...

  5. Gas swallow during meals in patients with excessive belching.

    Science.gov (United States)

    Caballero, N; Serra, J

    2017-09-01

    Swallowed gas is an important source of abdominal gas, and aerophagia is often believed as a putative cause of gas-related abdominal symptoms. However, altered gas-swallow during meals has not been demonstrated. Our aim was to characterize the number of gas swallows during meals in patients complaining of excessive belching and gaseousness and a control group without abdominal symptoms during a 24-h period. A 24-h pH-impedance monitoring was performed in 10 patients with excessive belching, and 11 patients without digestive symptoms or reflux in the pH-impedance study. During the study, patients followed their daily routine and customary meals, without any specific limitation. In each patient the number and content of swallows and belches were analyzed. Total meal periods were similar in controls (75±26 min) and patients (79±21 min; P=.339), but the number of gaseous swallows was greater in patients (114±13 swallows) than controls (71±8 swallows; P=.007), due to a greater frequency of gaseous swallows during meals (15±2 swallows/10 min vs 10±1 swallows/10 min, respectively; P=.008). During the 24-h study period, 66±13 belches were recorded in patients, but only 13±3 belches in controls (PGas is frequently swallowed during meals. Patients complaining of excessive belching have a different swallow pattern during meals, with an increased ingestion of gas that correlates with increased gastric belching events. © 2017 John Wiley & Sons Ltd.

  6. Importance of the swallowing atypical in them malocclusions

    OpenAIRE

    Jiménez Jiménez, Jonatan; Universidad Nacional Mayor de San Marcos, Facultad de Odontología.

    2017-01-01

    This review aims to determine the atypical swallowing malocclusions. When there are inadequate move-ments of the tongue and / or other structures during oral and pharyngolaryngeal phase of swallowing, talking about atypical swallowing, as a non-physiological habit. Its objectives may be multiple, simul-taneously acting alone or cumulatively. The size of a large tongue has been found as an impediment to correct such alternations, though this is a cause of causing malocclusion. the importance o...

  7. Assessment of swallowing sounds by digital cervical auscultation in children.

    Science.gov (United States)

    Almeida, Sheila T; Ferlin, Elton L; Parente, Maria Alice M P; Goldani, Helena A S

    2008-04-01

    There is a lack of studies regarding swallowing sounds in children 3 to 11 years of age. This study aimed to assess swallowing sounds by digital cervical auscultation in children of this age group without symptoms of oropharyngeal dysphagia. Digital cervical auscultation was performed in 118 subjects by use of a piezoelectric microphone. The children swallowed 5 mL of liquid and yogurt. The components of perceptual acoustic analysis were discrete initial signal (DIS), main signal of swallowing sound (MS), discrete final signal (DFS), and expiratory return (ER). Duration in seconds was the objective parameter of the swallowing sound signal analyzed. Fifty-six boys and 62 girls were evaluated at a mean (+/- SD) age of 6.9 +/- 2.03 years. A complete DIS-MS-DFS-ER swallowing sequence was found in 60% of the children. There was no significant difference in swallowing sound duration between both food consistencies (p = .189) or between genders either for liquid (p = .327) or yogurt (p = .792). There was no correlation between age and duration of the swallowing sound for liquid or yogurt. We concluded that digital cervical auscultation was able to provide objective information about the swallowing process that could contribute to methodological standardization in children.

  8. A simple bedside test to assess the swallowing dysfunction in Parkinson′s disease

    Directory of Open Access Journals (Sweden)

    S Vinoth Kanna

    2014-01-01

    Full Text Available Background: Swallowing changes are common in Parkinson′s disease (PD. Early identification is essential to avoid complications of aspiration. Objectives: To evaluate the swallowing ability of the PD patients and to correlate it with the indicators of disease progression. Materials and Methods: A total of 100 PD patients (70 males and 30 females aged between 50 years and 70 years with varying stage, duration, and severity were enrolled in a cross-sectional study carried out between January and May 2012. A simple bedside water swallowing test was performed using standard 150 ml of water. Swallowing process was assessed under three categories-swallowing speeds (ml/s, swallowing volume (ml/swallow and swallowing duration (s/swallow. Equal number of age and sex matched controls were also evaluated. Results: All of them completed the task of swallowing. A mean swallowing speed (27.48 ml/s, swallowing volume (28.5 ml/s, and swallowing duration (1.05 s/swallow was established by the control group. The PD patients showed decreased swallowing speed (7.15 ml/s in males and 6.61 ml/s in females, decreased swallowing volume (14.59 ml/swallow and 14 ml/swallow in females, and increased swallowing duration (2.37 s/swallow and 2.42 s/swallow which are statistically significant. There was a significant positive correlation between the severity, duration, and staging of the disease with the swallowing performance and a poor correlation between the subjective reports of dysphagia and the objective performance on water swallow test. Conclusion: The water swallowing test is a simple bedside test to identify the swallowing changes early in PD. It is recommended to do the test in all PD Patients to detect dysphagia early and to intervene appropriately.

  9. Resources.

    Science.gov (United States)

    Stewart, John; MacDonald, Ian

    1980-01-01

    Presents a guide to resources on television drama available to teachers for classroom use in television curriculum. Lists American and British television drama videorecordings of both series and individual presentations and offers a bibliography of "one-off" single fiction plays produced for British television. (JMF)

  10. Impact of Electronic Resources and Usage in Academic Libraries in Ghana: Evidence from Koforidua Polytechnic & All Nations University College, Ghana

    Science.gov (United States)

    Akussah, Maxwell; Asante, Edward; Adu-Sarkodee, Rosemary

    2015-01-01

    The study investigates the relationship between impact of electronic resources and its usage in academic libraries in Ghana: evidence from Koforidua Polytechnic & All Nations University College, Ghana. The study was a quantitative approach using questionnaire to gather data and information. A valid response rate of 58.5% was assumed. SPSS…

  11. Utilization of Electronic Information Resources by Undergraduate Students of University of Ibadan: A Case Study of Social Sciences and Education

    Science.gov (United States)

    Owolabi, Sola; Idowu, Oluwafemi A.; Okocha, Foluke; Ogundare, Atinuke Omotayo

    2016-01-01

    The study evaluated utilization of electronic information resources by undergraduates in the Faculties of Education and the Social Sciences in University of Ibadan. The study adopted a descriptive survey design with a study population of 1872 undergraduates in the Faculties of Education and the Social Sciences in University of Ibadan, from which a…

  12. True Serials: A True Solution for Electronic Resource Management Needs in a Medium-Size Academic Library

    Science.gov (United States)

    Milczarski, Vivian; Garofalo, Denise A.

    2011-01-01

    A desire for more functionality seemed to clash with the fiscal reality of limited funds, but after investigating alternatives, Mount Saint Mary College was able to provide its faculty and students with a more useful and function-rich electronic resource management through a move to a hosted open source service. (Contains 8 figures.)

  13. Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD).

    Science.gov (United States)

    Newman, Roger; Vilardell, Natàlia; Clavé, Pere; Speyer, Renée

    2016-04-01

    Fluid thickening is a well-established management strategy for oropharyngeal dysphagia (OD). However, the effects of thickening agents on the physiology of impaired swallow responses are not fully understood, and there is no agreement on the degree of bolus thickening. To review the literature and to produce a white paper of the European Society for Swallowing Disorders (ESSD) describing the evidence in the literature on the effect that bolus modification has upon the physiology, efficacy and safety of swallowing in adults with OD. A systematic search was performed using the electronic Pubmed and Embase databases. Articles in English available up to July 2015 were considered. The inclusion criteria swallowing studies on adults over 18 years of age; healthy people or patients with oropharyngeal dysphagia; bolus modification; effects of bolus modification on swallow safety (penetration/aspiration) and efficacy; and/or physiology and original articles written in English. The exclusion criteria consisted of oesophageal dysphagia and conference abstracts or presentations. The quality of the selected papers and the level of research evidence were assessed by standard quality assessments. At the end of the selection process, 33 articles were considered. The quality of all included studies was assessed using systematic, reproducible, and quantitative tools (Kmet and NHMRC) concluding that all the selected articles reached a valid level of evidence. The literature search gathered data from various sources, ranging from double-blind randomised control trials to systematic reviews focused on changes occurring in swallowing physiology caused by thickened fluids. Main results suggest that increasing bolus viscosity (a) results in increased safety of swallowing, (b) also results in increased amounts of oral and/or pharyngeal residue which may result in post-swallow airway invasion, (c) impacts the physiology with increased lingual pressure patterns, no major changes in impaired

  14. Swallowing difficulties in Duchenne muscular dystrophy: indications for feeding assessment and outcome of videofluroscopic swallow studies

    DEFF Research Database (Denmark)

    Aloysius, A.; Born, P.; Kinali, M.

    2008-01-01

    Feeding difficulties are known to occur with advancing age in Duchenne muscular dystrophy (DMD). We evaluated the role of videofluoroscopy swallow study (VFSS) in a group of 30 DMD patients with feeding difficulties. Indications for feeding assessment were: respiratory infections potentially...

  15. The Use of Electronic Resources by Academic Staff at the University of Ilorin, Nigeria

    Science.gov (United States)

    Tella, Adeyinka; Orim, Faith; Ibrahim, Dauda Morenikeji; Memudu, Suleiman Ajala

    2018-01-01

    The use of e-resources is now commonplace among academics in tertiary educational institutions the world over. Many academics including those in the universities are exploring the opportunities of e-resources to facilitate teaching and research. As the use of e-resources is increasing particularly among academics at the University of Ilorin,…

  16. Novel open-source electronic medical records system for palliative care in low-resource settings.

    Science.gov (United States)

    Shah, Kamal G; Slough, Tara Lyn; Yeh, Ping Teresa; Gombwa, Suave; Kiromera, Athanase; Oden, Z Maria; Richards-Kortum, Rebecca R

    2013-08-14

    The need for palliative care in sub-Saharan Africa is staggering: this region shoulders over 67% of the global burden of HIV/AIDS and cancer. However, provisions for these essential services remain limited and poorly integrated with national health systems in most nations. Moreover, the evidence base for palliative care in the region remains scarce. This study chronicles the development and evaluation of DataPall, an open-source electronic medical records system that can be used to track patients, manage data, and generate reports for palliative care providers in these settings.DataPall was developed using design criteria encompassing both functional and technical objectives articulated by hospital leaders and palliative care staff at a leading palliative care center in Malawi. The database can be used with computers that run Windows XP SP 2 or newer, and does not require an internet connection for use. Subsequent to its development and implementation in two hospitals, DataPall was tested among both trained and untrained hospital staff populations on the basis of its usability with comparison to existing paper records systems as well as on the speed at which users could perform basic database functions. Additionally, all participants evaluated this program on a standard system usability scale. In a study of health professionals in a Malawian hospital, DataPall enabled palliative care providers to find patients' appointments, on average, in less than half the time required to locate the same record in current paper records. Moreover, participants generated customizable reports documenting patient records and comprehensive reports on providers' activities with little training necessary. Participants affirmed this ease of use on the system usability scale. DataPall is a simple, effective electronic medical records system that can assist in developing an evidence base of clinical data for palliative care in low resource settings. The system is available at no cost, is

  17. The surgical management and speech and swallowing rehabilitation ...

    African Journals Online (AJOL)

    Advanced tongue cancer may have a devastating effect on a person's ability to speak and to swallow. Very little is known about the surgical management and speech and swallowing rehabilitation of persons with advanced tongue cancer in South Africa. The aim of this study was to obtain information regarding clinical ...

  18. Breeding biology and taxonomy of the Red-breasted Swallow ...

    African Journals Online (AJOL)

    Nocturnal trapping and ringing of swallows around Harare, Zimbabwe, showed that at least five species have adapted their breeding behaviour to manmade road culverts, none more so than the Red-breasted Swallow, Hirundo semirufa, which may be found nesting in the smallest (46cm diameter) of pipe culverts.

  19. Vocalizations of the South African cliff swallow Hirundo spilodera

    African Journals Online (AJOL)

    the impression that all chicks had these facial markings but never actually stated the number that really had these markings. In the South African swallow less than 250/0 of all chicks examined had any white markings, probably too few for facial recognition of chicks to be universal in a South. African cliff swallow colony.

  20. Swallow Characteristics in Patients with Oculopharyngeal Muscular Dystrophy

    Science.gov (United States)

    Palmer, Phyllis M.; Neel, Amy T.; Sprouls, Gwyneth; Morrison, Leslie

    2010-01-01

    Purpose: This prospective investigation evaluates oral weakness and its impact on swallow function, weight, and quality of life in patients with oculopharyngeal muscular dystrophy (OPMD). Method: Intraoral pressure, swallow pressure, and endurance were measured using an Iowa Oral Performance Instrument in participants with OPMD and matched…

  1. Emetic stimulation inhibits the swallowing reflex in decerebrate rats.

    Science.gov (United States)

    Kurozumi, Chiharu; Yamagata, Ryuzo; Himi, Naoyuki; Koga, Tomoshige

    2008-06-01

    The effects of emetic stimulation on the swallowing reflex were investigated in decerebrated rats. Hypoxia, gastric distension and LiCl administration were used as emetic stimulations. The swallowing reflex was elicited by electrical stimulation of the superior laryngeal nerve (SLN, 20 Hz, 3-5 V, 0.3 ms duration) for 20 s. To examine the effect of hypoxia, nitrogen gas was inhaled under artificial ventilation. There were significantly fewer swallows during a decrease in PO(2) than under air ventilation (p<0.05). The number of swallows during 3-ml stomach distension was significantly lower than that before distension (p<0.05). Intravenous administration of LiCl (100 mg/kg) also significantly reduced the number of swallows (p<0.05). The combination of SLN stimulation and emetic stimuli occasionally produced burst activity of abdominal muscles, which might be associated with the gag reflex. Both the gag and swallowing reflexes are well known to be mediated by the nucleus of the solitary tract. The physiological roles of the gag reflex and the swallowing reflex are considered to be reciprocal. Taken together, these results suggest that emetic stimulation inhibits the swallowing pattern generator via the nucleus of the solitary tract, which in turn facilitates the gag reflex.

  2. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curativ...

  3. Swallow-wort (Vincetoxicum spp.) biological control update

    Science.gov (United States)

    Pale swallow-wort (Vincetoxicum rossicum = Cynanchum rossicum) and black swallow-wort (V. nigrum = C. louiseae) are herbaceous, perennial, viney milkweeds introduced from Europe (Apocynaceae-subfamily Asclepiadoideae). Both species are becoming increasingly invasive in a variety of natural and manag...

  4. Current distribution and population size of the Blue Swallow Hirundo ...

    African Journals Online (AJOL)

    Two surveys of Blue Swallows were conducted in the southern Tanzanian highland grasslands in order to determine the habitat preferences and estimate the size of this subpopulation. During the 2008/09 and 2012 surveys, a total distance of 3 635 km was travelled in search of Blue Swallows (at an altitude of above 1 400 ...

  5. Human resource requirements for quality-assured electronic data capture of the tuberculosis case register

    Directory of Open Access Journals (Sweden)

    Hoa Nguyen B

    2012-01-01

    Full Text Available Abstract Background The tuberculosis case register is the data source for the reports submitted by basic management units to the national tuberculosis program. Our objective was to measure the data entry time required to complete and double-enter one record, and to estimate the time for the correction of errors in the captured information from tuberculosis case registers in Cambodia and Viet Nam. This should assist in quantifying the additional requirements in human resources for national programs moving towards electronic recording and reporting. Methods Data from a representative sample of tuberculosis case registers from Cambodia and Viet Nam were double-entered and discordances resolved by rechecking the original case register. Computer-generated data entry time recorded the time elapsed between opening of a new record and saving it to disk. Results The dataset comprised 22,732 double-entered records of 11,366 patients (37.1% from Cambodia and 62.9% from Viet Nam. The mean data entry times per record were 97.5 (95% CI: 96.2-98.8 and 66.2 (95% CI: 59.5-73.0 seconds with medians of 90 and 31 s respectively in Cambodia and in Viet Nam. The percentage of records with an error was 6.0% and 39.0% respectively in Cambodia and Viet Nam. Data entry time was inversely associated with error frequency. We estimate that approximately 118-person-hours were required to produce 1,000 validated records. Conclusions This study quantifies differences between two countries for data entry time for the tuberculosis case register and frequencies of data entry errors and suggests that higher data entry speed is partially offset by requiring revisiting more records for corrections.

  6. Use and Cost of Electronic Resources in Central Library of Ferdowsi University Based on E-metrics

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Davarpanah

    2012-07-01

    Full Text Available The purpose of this study was to investigate the usage of electronic journals in Ferdowsi University, Iran based on e-metrics. The paper also aimed to emphasize the analysis of cost-benefit and the correlation between the journal impact factors and the usage data. In this study experiences of Ferdowsi University library on licensing and usage of electronic resources was evaluated by providing a cost-benefit analysis based on the cost and usage statistics of electronic resources. Vendor-provided data were also compared with local usage data. The usage data were collected by tracking web-based access locally, and by collecting vender-provided usage data. The data sources were one-year of vendor-supplied e-resource usage data such as Ebsco, Elsevier, Proquest, Emerald, Oxford and Springer and local usage data collected from the Ferdowsi university web server. The study found that actual usage values differ for vendor-provided data and local usage data. Elsevier has got the highest usage degree in searches, sessions and downloads. Statistics also showed that a small number of journals satisfy significant amount of use while the majority of journals were used less frequent and some were never used at all. The users preferred the PDF rather than HTML format. The data in subject profile suggested that the provided e-resources were best suited to certain subjects. There was no correlation between IF and electronic journal use. Monitoring the usage of e-resources gained increasing importance for acquisition policy and budget decisions. The article provided information about local metrics for the six surveyed vendors/publishers, e.g. usage trends, requests per package, cost per use as related to the scientific specialty of the university.

  7. Effective Knowledge Development in Secondary Schools Educational Level in Contemporary Information Age: Assessment of Availability of Electronic Information Resources in Nigerian School Libraries

    Science.gov (United States)

    Bello, Stephen Adeyemi; Ojo, Funmilayo Roseline; Ocheje, Charles Bala

    2015-01-01

    Relevant electronic information resources in contemporary information age are necessity to buttress teaching and learning for effective knowledge development in educational institutions. The purpose of the study is to know the state of availability of electronic information resources in government owned secondary school libraries in Ijumu Local…

  8. Challenges in the implementation of an electronic surveillance system in a resource-limited setting: Alerta, in Peru

    Directory of Open Access Journals (Sweden)

    Soto Giselle

    2008-11-01

    Full Text Available Abstract Background Infectious disease surveillance is a primary public health function in resource-limited settings. In 2003, an electronic disease surveillance system (Alerta was established in the Peruvian Navy with support from the U.S. Naval Medical Research Center Detachment (NMRCD. Many challenges arose during the implementation process, and a variety of solutions were applied. The purpose of this paper is to identify and discuss these issues. Methods This is a retrospective description of the Alerta implementation. After a thoughtful evaluation according to the Centers for Disease Control and Prevention (CDC guidelines, the main challenges to implementation were identified and solutions were devised in the context of a resource-limited setting, Peru. Results After four years of operation, we have identified a number of challenges in implementing and operating this electronic disease surveillance system. These can be divided into the following categories: (1 issues with personnel and stakeholders; (2 issues with resources in a developing setting; (3 issues with processes involved in the collection of data and operation of the system; and (4 issues with organization at the central hub. Some of the challenges are unique to resource-limited settings, but many are applicable for any surveillance system. For each of these challenges, we developed feasible solutions that are discussed. Conclusion There are many challenges to overcome when implementing an electronic disease surveillance system, not only related to technology issues. A comprehensive approach is required for success, including: technical support, personnel management, effective training, and cultural sensitivity in order to assure the effective deployment of an electronic disease surveillance system.

  9. RESEARCH OF INFLUENCE OF QUALITY OF ELECTRONIC EDUCATIONAL RESOURCES ON QUALITY OF TRAINING WITH USE OF DISTANCE TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    H. M. Kravtsov

    2013-03-01

    Full Text Available Communication improving of educational processes requires today new approaches to the management arrangements and forming of educational policy in the field of distance learning, which is based on the use of modern information and communication technologies. An important step in this process is the continuous monitoring of the development and implementation of information technology and, in particular, the distance learning systems in higher educational establishments. The main objective of the monitoring is the impact assessment on the development of distance learning following the state educational standards, curricula, methodical and technical equipment and other factors; factors revelation that influence the implementation and outcomes of distance learning; results comparison of educational institution functioning and distance education systems in order to determine the most efficient ways of its development. The paper presents the analysis results of the dependence of the quality of educational services on the electronic educational resources. Trends in educational services development was studied by comparing the quality influence of electronic educational resources on the quality of educational services of higher pedagogical educational institutions of Ukraine as of 2009-2010 and 2012-2013. Generally, the analysis of the survey results allows evaluating quality of the modern education services as satisfactory and it can be said that almost 70% of the success of their future development depends on the quality of the used electronic educational resources and distance learning systems in particular.

  10. Ginger Orally Disintegrating Tablets to Improve Swallowing in Older People.

    Science.gov (United States)

    Hirata, Ayumu; Funato, Hiroki; Nakai, Megumi; Iizuka, Michiro; Abe, Noriaki; Yagi, Yusuke; Shiraishi, Hisashi; Jobu, Kohei; Yokota, Junko; Hirose, Kahori; Hyodo, Masamitsu; Miyamura, Mitsuhiko

    2016-01-01

    We previously prepared and pharmaceutically evaluated ginger orally disintegrating (OD) tablets, optimized the base formulation, and carried out a clinical trial in healthy adults in their 20 s and 50s to measure their effect on salivary substance P (SP) level and improved swallowing function. In this study, we conducted clinical trials using the ginger OD tablets in older people to clinically evaluate the improvements in swallowing function resulting from the functional components of the tablet. The ginger OD tablets were prepared by mixing the excipients with the same amount of mannitol and sucrose to a concentration of 1% ginger. Eighteen healthy older adult volunteers aged 63 to 90 were included in the swallowing function test. Saliva was collected before and 15 min after administration of the placebo and ginger OD tablets. Swallowing endoscopy was performed by an otolaryngologist before administration and 15 min after administration of the ginger OD tablets. A scoring method was used to evaluate the endoscopic swallowing. Fifteen minutes after taking the ginger OD tablets, the salivary SP amount was significantly higher than prior to ingestion or after taking the placebo (pginger OD tablets. Our findings showed that the ginger OD tablets increased the salivary SP amount and improved swallowing function in older people with appreciably reduced swallowing function.

  11. Risk factors for swallowing dysfunction in stroke patients

    Directory of Open Access Journals (Sweden)

    Anna Flávia Ferraz Barros Baroni

    2012-06-01

    Full Text Available CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.

  12. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Directory of Open Access Journals (Sweden)

    Suntrup Sonja

    2009-06-01

    Full Text Available Abstract Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery.

  13. Tactile thermal oral stimulation increases the cortical representation of swallowing

    Science.gov (United States)

    Teismann, Inga K; Steinsträter, Olaf; Warnecke, Tobias; Suntrup, Sonja; Ringelstein, Erich B; Pantev, Christo; Dziewas, Rainer

    2009-01-01

    Background Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Little is known about the possible mechanisms by which this interventional therapy may work. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. Data were analyzed by means of synthetic aperture magnetometry (SAM) and the group analysis of individual SAM data was performed using a permutation test. Results Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. Conclusion In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. These findings facilitate our understanding of the role of cortical reorganization in dysphagia treatment and recovery. PMID:19566955

  14. Fabrication of Artificial Food Bolus for Evaluation of Swallowing.

    Directory of Open Access Journals (Sweden)

    Miyu Hosotsubo

    Full Text Available Simple and easy methods to evaluate swallowing are required because of the recently increased need of rehabilitation for dysphagia. "Artificial food bolus", but not "artificial food", would be a valuable tool for swallowing evaluation without considering the mastication effect which is altered according to the individual's oral condition. Thus, this study was carried out to fabricate artificial bolus resembling natural food bolus. The mechanical property and the volume change of food bolus in normal people were firstly investigated. Thirty healthy adults without dysphagia were selected and asked to chew four sample foods (rice cake, peanut, burdock, and gummy candy. The results indicated that Young's modulus of bolus before swallowing was below 150 kPa. The bolus volume before swallowing was below 400 mm3. In addition, the saliva component ratio of each bolus was approximately 30wt%, and the average saliva viscosity of research participants was approximately 10 mPa•s. Based on the obtained data, artificial food bolus was designed and fabricated by using alginate hydrogel as a visco-elastic material and gelatin solution as a viscotic material with a ratio of 7:3 based on weight. Consequently, the swallowing time of fabricated artificial food bolus was measured among the same participants. The results indicated the participants swallowed fabricated food bolus with similar manner reflecting their mechanical property and volume. Thus, this artificial food bolus would be a promising tool for evaluation of swallowing.

  15. Tracking the Flow of Resources in Electronic Waste - The Case of End-of-Life Computer Hard Disk Drives.

    Science.gov (United States)

    Habib, Komal; Parajuly, Keshav; Wenzel, Henrik

    2015-10-20

    Recovery of resources, in particular, metals, from waste flows is widely seen as a prioritized option to reduce their potential supply constraints in the future. The current waste electrical and electronic equipment (WEEE) treatment system is more focused on bulk metals, where the recycling rate of specialty metals, such as rare earths, is negligible compared to their increasing use in modern products, such as electronics. This study investigates the challenges in recovering these resources in the existing WEEE treatment system. It is illustrated by following the material flows of resources in a conventional WEEE treatment plant in Denmark. Computer hard disk drives (HDDs) containing neodymium-iron-boron (NdFeB) magnets were selected as the case product for this experiment. The resulting output fractions were tracked until their final treatment in order to estimate the recovery potential of rare earth elements (REEs) and other resources contained in HDDs. The results further show that out of the 244 kg of HDDs treated, 212 kg comprising mainly of aluminum and steel can be finally recovered from the metallurgic process. The results further demonstrate the complete loss of REEs in the existing shredding-based WEEE treatment processes. Dismantling and separate processing of NdFeB magnets from their end-use products can be a more preferred option over shredding. However, it remains a technological and logistic challenge for the existing system.

  16. Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

    Science.gov (United States)

    Manrique, Yady J; Sparkes, Arron M; Cichero, Julie A Y; Stokes, Jason R; Nissen, Lisa M; Steadman, Kathryn J

    2016-09-01

    Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification. The effect of a commercial polysaccharide thickener, designed to be added to fluids to promote safe swallowing by dysphagic patients, on rheology and acetaminophen dissolution was tested using crushed immediate-release tablets in water, effervescent tablets in water, elixir and suspension. The inclusion of the thickener, comprised of xanthan gum and maltodextrin, had a considerable impact on dissolution; acetaminophen release from modified medications reached 12-50% in 30 min, which did not reflect the pharmacopeia specification for immediate release preparations. Flow curves reflect the high zero-shear viscosity and the apparent yield stress of the thickened products. The weak gel nature, in combination with high G' values compared to G'' (viscoelasticity) and high apparent yield stress, impact drug release. The restriction on drug release from these formulations is not influenced by the theoretical state of the drug (dissolved or dispersed), and the approach typically used in clinical practice (mixing crushed tablets into pre-prepared thickened fluid) cannot be improved by altering the order of incorporation or mixing method.

  17. HELP (INFORMATION ELECTRONIC RESOURCE "CHRONICLE OF ONU: DATES, FACTS, EVENTS": HISTORY OF UNIVERSITY IN INFORMATION SPACE

    Directory of Open Access Journals (Sweden)

    А. М. Гавриленко

    2016-03-01

    Object of research is the help information resource "The chronicle of the Odessa national university of I. I. Mechnikov: dates, facts, events". The main objective of our article – to state the main methodological bases of creation of information resource. One of advantages of information resource is possibility of continuous updating and replenishment by new information. Main objective of creation of this information resource is systematization of material on stories of the Odessa national university of I. I. Mechnikov from the date of his basis to the present, ensuring interactive access to information on the main dates, the most significant events in life of university. The base of research are sources on the history of university, chronology of historical development, formation of infrastructure, cadres and scientific researches. In information resource the main stages of development, functioning and transformation of the Odessa University are analyzed, information on its divisions is collected. For creation of this information resource in Scientific library the method of work was developed, the main selection criteria of data are allocated. This information resource have practical value for all who is interested in history of university, historians, scientists-researchers of history of science and the city of Odessa.

  18. Tachyarrhythmias triggered by swallowing and belching

    Science.gov (United States)

    Wilmshurst, P

    1999-01-01

    Three cases with supraventricular tachyarrhythmias related to oesophageal transit are reported. A 61 year old man had episodes of atrial tachycardia on each swallow of food but not liquid; this has been reported only rarely. A 55 year old man had atrial fibrillation initiated by drinking ice cold beverages; this has not been described previously although atrial tachycardia triggered by drinking ice cold beverages has been described once. A 68 year old man had supraventricular tachycardia initiated by belching; this has not been described previously. These cases illustrate the diversity of atrial tachyarrhythmias that can be precipitated by oesophageal stimulation and suggest that what is regarded as a very rare phenomenon may be found more commonly when sought.

 Keywords: atrial tachycardia; atrial fibrillation; deglutition; eructation; arrhythmias PMID:10026360

  19. Using devices to upregulate nonnutritive swallowing in typically developing infants.

    Science.gov (United States)

    Hegyi Szynkiewicz, Sarah; Mulheren, Rachel W; Palmore, Kathryn W; O'Donoghue, Cynthia R; Ludlow, Christy L

    2016-10-01

    The role of various sensory stimuli for stimulating swallowing in infants may be of importance for assisting infants to develop oral feeding. We evaluated the swallowing mechanism response to two devices for increasing the rate of nonnutritive swallowing in two typically developing infant age groups, ages 2-4 mo and 7-9 mo. One device was a pacifier familiar to the infant; the other was a small vibrator placed on the skin overlying the thyroid cartilage. The rate of nonnutritive swallowing while infants were awake was compared in three 10-min conditions: at rest without stimulation (spontaneous); during nonnutritive sucking with a pacifier; and over 10 min containing 18 epochs of vibratory stimulation for 10 s each. To assess whether vibration on the throat over the laryngeal area altered respiration, the mean cycle length was compared between 10-min intervals either containing vibratory stimulation or without stimulation at rest. Both the pacifier and laryngeal vibration stimulation doubled the rate of swallowing in the infants with a mean age of 3 mo 16 days and infants with a mean age of 8 mo 8 days. No differences occurred in the mean respiratory cycle length between intervals with and without vibration in either age group. Results suggest that nonnutritive sucking, vibration, or both might be beneficial in enhancing swallowing in young infants. Because vibration on the neck would not interfere with oral transfer of liquid, it might provide additional stimulation for swallowing during oral feeding. Both stimulation types should be evaluated for enhancing swallowing in infants with immature swallowing skills. Copyright © 2016 the American Physiological Society.

  20. Functional Connectivity of the Cortical Swallowing Network in Humans

    Science.gov (United States)

    Babaei, Arash; Ward, B. Douglas; Siwiec, Robert; Ahmad, Shahryar; Kern, Mark; Nencka, Andrew; Li, Shi-Jiang; Shaker, Reza

    2014-01-01

    Introduction Coherent fluctuations of blood oxygenation level dependent (BOLD) signal have been referred as “functional connectivity” (FC). Our aim was to systematically characterize FC of underlying neural network involved in swallowing, and to evaluate its reproducibility and modulation during rest or task performance. Methods Activated seed regions within known areas of the cortical swallowing network (CSN) were independently identified in 16 healthy volunteers. Subjects swallowed using a paradigm driven protocol, and the data analyzed using an event-related technique. Then, in the same 16 volunteers, resting and active state data were obtained for 540 seconds in three conditions: 1) swallowing task; 2) control visual task; and 3) resting state; all scans were performed twice. Data was preprocessed according to standard FC pipeline. We determined the correlation coefficient values of member regions of the CSN across the three aforementioned conditions and compared between two sessions using linear regression. Average FC matrices across conditions were then compared. Results Swallow activated twenty-two positive BOLD and eighteen negative BOLD regions distributed bilaterally within cingulate, insula, sensorimotor cortex, prefrontal and parietal cortices. We found that: 1) Positive BOLD regions were highly connected to each other during all test conditions while negative BOLD regions were tightly connected amongst themselves; 2) Positive and negative BOLD regions were anti-correlated at rest and during task performance; 3) Across all three test conditions, FC among the regions was reproducible (r > 0.96, p<10-5); and 4) The FC of sensorimotor region to other regions of the CSN increased during swallowing scan. Conclusions 1) Swallow activated cortical substrates maintain a consistent pattern of functional connectivity; 2) FC of sensorimotor region is significantly higher during swallow scan than that observed during a non-swallow visual task or at rest. PMID

  1. Decoding human swallowing via electroencephalography: a state-of-the-art review.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  2. Decoding human swallowing via electroencephalography: a state-of-the-art review

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L.; Sejdić, Ervin

    2015-10-01

    Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.

  3. Clock gene variation in Tachycineta swallows

    Science.gov (United States)

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds. Figure 1 Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler. PMID:22408729

  4. Swallowed dentures: Two cases and a review

    Science.gov (United States)

    Gachabayov, Mahir; Isaev, Mubariz; Orujova, Lala; Isaev, Emin; Yaskin, Evgeniy; Neronov, Dmitriy

    2015-01-01

    Introduction Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction. Presentation of cases First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools. Discussion Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer. Conclusion Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible. PMID:26635957

  5. Mis-swallowing of cleaning naphtha: report of three cases.

    Science.gov (United States)

    Kuo, C Y; Lee, C Y

    1990-01-01

    Cleaning naphtha, a product of Chinese Petroleum Corporation, is a complex hydrocarbon mixture which contains mainly aliphatic hydrocarbons. It is used as a cleaning fluid and solvent. Three toddlers mis-swallowed a mouth of cleaning naphtha accidentally. One developed multiple organ failure before death, another completely recovered without sequelae, and the other died very soon after mis-swallowing. Two fatal cases were both induced vomiting with aspiration immediately after mis-swallowing by their parents. Therefore, inducing vomiting should not be encouraged especially at home, and prevention of aspiration is very important in the management of such cases.

  6. Effect of Access to an Electronic Medical Resource on Performance Characteristics of a Certification Examination: A Randomized Controlled Trial.

    Science.gov (United States)

    Lipner, Rebecca S; Brossman, Bradley G; Samonte, Kelli M; Durning, Steven J

    2017-09-05

    Electronic resources are increasingly used in medical practice. Their use during high-stakes certification examinations has been advocated by many experts, but whether doing so would affect the capacity to differentiate between high and low abilities is unknown. To determine the effect of electronic resources on examination performance characteristics. Randomized controlled trial. Medical certification program. 825 physicians initially certified by the American Board of Internal Medicine (ABIM) who passed the Internal Medicine Certification examination or sat for the Internal Medicine Maintenance of Certification (IM-MOC) examination in 2012 to 2015. Participants were randomly assigned to 1 of 4 conditions: closed book using typical or additional time, or open book (that is, UpToDate [Wolters Kluwer]) using typical or additional time. All participants took the same modified version of the IM-MOC examination. Primary outcomes included item difficulty (how easy or difficult the question was), item discrimination (how well the question differentiated between high and low abilities), and average question response time. Secondary outcomes included examination dimensionality (that is, the number of factors measured) and test-taking strategy. Item response theory was used to calculate question characteristics. Analysis of variance compared differences among conditions. Closed-book conditions took significantly less time than open-book conditions (mean, 79.2 seconds [95% CI, 78.5 to 79.9 seconds] vs. 110.3 seconds [CI, 109.2 to 111.4 seconds] per question). Mean discrimination was statistically significantly higher for open-book conditions (0.34 [CI, 0.32 to 0.35] vs. 0.39 [CI, 0.37 to 0.41] per question). A strong single dimension showed that the examination measured the same factor with or without the resource. Only 1 electronic resource was evaluated. Inclusion of an electronic resource with time constraints did not adversely affect test performance and did not change

  7. Identification of behaviour change components in swallowing interventions for head and neck cancer patients: protocol for a systematic review.

    Science.gov (United States)

    Govender, Roganie; Smith, Christina H; Taylor, Stuart A; Grey, Daphne; Wardle, Jane; Gardner, Benjamin

    2015-06-20

    Dysphagia (difficulty in swallowing) is a predictable consequence of head and neck cancer and its treatment. Loss of the ability to eat and drink normally has a devastating impact on quality of life for survivors of this type of cancer. Most rehabilitation programmes involve behavioural interventions that include swallowing exercises to help improve swallowing function. Such interventions are complex; consisting of multiple components that may influence outcomes. These interventions usually require patient adherence to recommended behaviour change advice. To date, reviews of this literature have explored whether variation in effectiveness can be attributed to the type of swallowing exercise, the use of devices to facilitate use of swallowing muscles, and the timing (before, during or after cancer treatment). This systematic review will use a behavioural science lens to examine the content of previous interventions in this field. It aims to identify (a) which behaviour change components are present, and (b) the frequency with which they occur in interventions deemed to be effective and non-effective. Clinical trials of behavioural interventions to improve swallowing outcomes in patients with head and neck cancers will be identified via a systematic and comprehensive search of relevant electronic health databases, trial registers, systematic review databases and Web of Science. To ascertain behaviour change intervention components, we will code the content for its theory basis, intervention functions and specific behaviour change techniques, using validated tools: the Theory Coding Scheme, Behaviour Change Wheel and Behaviour Change Technique Taxonomy v1. Study quality will be assessed for descriptive purposes only. Given the specialisation and focus of this review, a small yield of studies with heterogeneous outcome measures is anticipated. Therefore, narrative synthesis is considered more appropriate than meta-analysis. We will also compare the frequency of

  8. Promoting safe swallowing when puree is swallowed without aspiration but thin liquid is aspirated: nectar is enough.

    Science.gov (United States)

    Leder, Steven B; Judson, Benjamin L; Sliwinski, Edward; Madson, Lindsay

    2013-03-01

    The use of thickened liquids is a common compensatory strategy to improve swallow safety. The purpose of this study was to determine the optimal liquid viscosity to use to promote successful swallowing in a specific subset of dysphagic patients who swallow puree without aspiration but thin liquid with aspiration. A referral-based sample of 84 consecutive inpatients from a large, urban, tertiary-care teaching hospital who met the study criteria was analyzed prospectively. Inclusion criteria were no preexisting dysphagia, a successful pharyngeal swallow without aspiration with puree consistency but pharyngeal dysphagia with aspiration of thin liquid consistency, and stable medical, surgical, and neurological status at the time of transnasal fiberoptic swallow testing and up to 24 h after recommendations for oral alimentation with a modified diet consisting of nectar-like and honey-like thickened liquids. Success with ingesting both nectar-like and honey-like thickened liquids and clinically evident aspiration events were recorded. Care providers were blinded to the study's purpose. All 84 patients were successfully ingesting nectar-like and honey-like thickened liquids at the time of swallow testing and up to 24 h after testing. A specific subset of dysphagic patients who swallowed puree without aspiration but aspirated thin liquid demonstrated 100 % successful swallowing of both nectar-like and honey-like thickened liquids. Therefore, a nectar-like thickened liquid appears to be adequate to promote safe swallowing in these patients and, because of patient preference for the least thick liquid, may enhance compliance and potentially contribute to maintenance of adequate hydration requirements.

  9. Building and Managing Electronic Resources in Digital Era in India with Special Reference to IUCAA and NIV, Pune: A Comparative Case Study

    Science.gov (United States)

    Sahu, H. K.; Singh, S. N.

    2015-04-01

    This paper discusses and presents a comparative case study of two libraries in Pune, India, Inter-University Centre for Astronomy and Astrophysics and Information Centre and Library of National Institute of Virology (Indian Council of Medical Research). It compares how both libraries have managed their e-resource collections, including acquisitions, subscriptions, and consortia arrangements, while also developing a collection of their own resources, including pre-prints and publications, video lectures, and other materials in an institutional repository. This study illustrates how difficult it is to manage electronic resources in a developing country like India, even though electronic resources are used more than print resources. Electronic resource management can be daunting, but with a systematic approach, various problems can be solved, and use of the materials will be enhanced.

  10. Cliff swallow populations in the southern Askinuk Mountains, Alaska

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — During breeding season, cliff swallows are widely distributed throughout Alaska and North America south to Mexico, and they are locally common in western and...

  11. Role of Basal Ganglia in Swallowing Process: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Hamideh Ghaemi

    2016-12-01

    Discussion: Swallowing is a multifaceted performance that needs contribution of the tongue, larynx, pharynx, and esophagus as well as the neurological structures such as neocortex and subcortical regions - BG and brainstem.

  12. Weather-related Tree Swallow Mortality and Reduced Nesting Effort

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report documents the spring 2007 die-off of 216 Tree Swallows in western New York due to a period of unseasonably warm temperatures followed immediately by a...

  13. Automated Detection and Evaluation of Swallowing Using a Combined EMG/Bioimpedance Measurement System

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2014-01-01

    Full Text Available Introduction. Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. Study Design. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09. Method. The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG and bioimpedance (BI to reliably detect swallows was developed. Results. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1% on the basis of these differences. Discussion. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection could in future form the basis for automated diagnosis and treatment (stimulation of swallowing disorders.

  14. Automated detection and evaluation of swallowing using a combined EMG/bioimpedance measurement system.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2014-01-01

    Developing an automated diagnostic and therapeutic instrument for treating swallowing disorders requires procedures able to reliably detect and evaluate a swallow. We tested a two-stage detection procedure based on a combined electromyography/bioimpedance (EMBI) measurement system. EMBI is able to detect swallows and distinguish them from similar movements in healthy test subjects. The study was planned and conducted as a case-control study (EA 1/019/10, and EA1/160/09, EA1/161/09). The study looked at differences in swallowing parameters in general and in the event of penetration during swallows in healthy subjects and in patients with an oropharyngeal swallowing disorder. A two-stage automated swallow detection procedure which used electromyography (EMG) and bioimpedance (BI) to reliably detect swallows was developed. Statistically significant differences between healthy subjects and patients with a swallowing disorder were found in swallowing parameters previously used to distinguish between swallowing and head movements. Our two-stage algorithm was able to reliably detect swallows (sensitivity = 96.1%, specificity = 97.1%) on the basis of these differences. Using a two-stage detection procedure, the EMBI measurement procedure is able to detect and evaluate swallows automatically and reliably. The two procedures (EMBI + swallow detection) could in future form the basis for automated diagnosis and treatment (stimulation) of swallowing disorders.

  15. Swallow syncope caused by third-degree atrioventricular block

    DEFF Research Database (Denmark)

    Roust Aaberg, Anne Marie; Eriksson, Anna Elin; Madsen, Per Lav

    2015-01-01

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker.......We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker....

  16. Changes in Swallowing Symptoms and Esophageal Motility After Thyroid Surgery

    DEFF Research Database (Denmark)

    Sorensen, Jesper Roed; Markoew, Simone; Døssing, Helle

    2018-01-01

    INTRODUCTION: Swallowing difficulties, the pathophysiology behind which is incompletely understood, have been reported in 47-83% of goiter patients referred for thyroidectomy. We aimed at examining the influence of thyroid surgery on swallowing symptoms and esophageal motility. METHODS: Thirty-th...... to esophageal motility disturbances. This information is essential when interpreting dysphagia in patients with nodular goiter, and when balancing patients' expectations to surgical goiter therapy. REGISTRATION NUMBER: NCT03100357 ( www.clinicaltrials.org )....

  17. Observation the swallowing mechanism in elderly patients with pharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    Claudia Ximena Campo-Cañar

    2010-09-01

    Full Text Available Observation of the swallowing dynamics is an issue that demands close attention by the health professionals involved in the diagnosis and management of patients with dysphagia. This article is a review of the literature aimed to enhance the knowledge regarding the speech therapy assessment of pharyngeal dysphagia in elder adults. The disorder of the swallowing is called dysphagia and it is defined as difficulty swallowing. The dysphagia is often caused by affectation of mechanical or neuromuscular components of the swallowing mechanism. This type of disorder is likely to impact the the oral, pharyngeal and esophageal phases of the swallowing. The speech therapist should take into account assessing aspects such as level of consciousness, vital signs, whether or not the patient is ventilator dependent, means of feeding, if intubated what type of cannula, whether or not the patient uses a speaking valve (if a trach tube is present, nutritional status, the patient’s expressive and receptive language, the anatomical and physiological state of the oral motor structures. When assessing swallowing clinicians should also make sure to develop an adequate beside clinical, voice assessment and videofluoroscopy.

  18. Functional magnetic resonance and swallowing: critical literature review,

    Directory of Open Access Journals (Sweden)

    Maíra Santilli de Lima

    2015-12-01

    Full Text Available ABSTRACT INTRODUCTION: Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI. OBJECTIVE: This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing. METHODS: This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded. RESULTS: A total of 649 articles were identified, of which 21 matched the inclusion criteria. CONCLUSION: The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.

  19. Normal erect swallowing. Normal function and incidence of variations.

    Science.gov (United States)

    Curtis, D J; Cruess, D F; Dachman, A H

    1985-10-01

    Of 871 candidates presenting for upper gastrointestinal examinations, 16 met the rigorous criteria established for selecting asymptomatic normal volunteers. Frame-by-frame evaluation of their videorecorded pharyngeal swallow confirmed many observations made previously utilizing cine recording at much higher radiation dosages. In addition, new observations were made: the nasopharynx may not occlude until the bolus is entirely within the pharynx; air mixes with the bolus if the swallow is an "open" type; the epiglottis always inverts in normal individuals regardless of the type of swallow ("open," air filled oro-and hypopharynx into which the swallowed bolus is dropped; "closed," airless oropharynx into which the swallowed bolus is pushed by a continuous peristaltic drive of the tongue and palate, thus reconstituting the pharyngeal space); laryngeal descent may aid in stripping the bolus from the pharynx; the vestibule may not completely close during the swallow and the larynx can still be impervious to the bolus; the peristaltic wave does not begin until the bolus has breeched the cricopharyngeus; the cricopharyngeus may be seen frequently in normal individuals, but does not delay the passage of the bolus; asymmetric flow of the bolus around the larynx is common and may not be the result of epiglottic tilt or head positioning.

  20. Supporting Learning and Information Sharing in Natural Resource Management with Technologies for Electronic Documents

    Science.gov (United States)

    Alem, Leila; McLean, Alistair

    2005-01-01

    Community participation is central to achieving sustainable natural resource management. A prerequisite to informed participation is that community and stakeholder groups have access to different knowledge sources, are more closely attuned to the different issues and viewpoints, and are sufficiently equipped to understand and maybe resolve complex…

  1. MendelWeb: An Electronic Science/Math/History Resource for the WWW.

    Science.gov (United States)

    Blumberg, Roger B.

    This paper describes a hypermedia resource, called MendelWeb that integrates elementary biology, discrete mathematics, and the history of science. MendelWeb is constructed from Gregor Menders 1865 paper, "Experiments in Plant Hybridization". An English translation of Mendel's paper, which is considered to mark the birth of classical and…

  2. Helping Patrons Find Locally Held Electronic Resources: An Interlibrary Loan Perspective

    Science.gov (United States)

    Johnston, Pamela

    2016-01-01

    The University of North Texas Libraries provide extensive online access to academic journals through major vendor databases. As illustrated by interlibrary loan borrowing requests for items held in our databases, patrons often have difficulty navigating the available resources. In this study, the Interlibrary Loan staff used data gathered from the…

  3. QR Codes as Finding Aides: Linking Electronic and Print Library Resources

    Science.gov (United States)

    Kane, Danielle; Schneidewind, Jeff

    2011-01-01

    As part of a focused, methodical, and evaluative approach to emerging technologies, QR codes are one of many new technologies being used by the UC Irvine Libraries. QR codes provide simple connections between print and virtual resources. In summer 2010, a small task force began to investigate how QR codes could be used to provide information and…

  4. Faculty as a community engaged with ongoing curricular development: use of groupware and electronic resources.

    Science.gov (United States)

    Miller, Judy; Koyanagi, Mark; Morgan, Kevin J

    2005-01-01

    This article describes how technology can facilitate faculty engagement in curriculum development, use faculty time efficiently, and ensure program quality. A plan to initiate an accelerated second-degree bachelor of science in nursing option was the impetus for use of groupware electronic strategies to support faculty as valued members of the academic community, engaged in the undergraduate program and its curriculum. This article describes the two Web-based applications (electronic-based strategies) developed: the curriculum development homepage as a collaborative communication tool, and a curricular tracking tool.

  5. Impact of electronic healthcare-associated infection surveillance software on infection prevention resources: a systematic review of the literature.

    Science.gov (United States)

    Russo, P L; Shaban, R Z; Macbeth, D; Carter, A; Mitchell, B G

    2017-09-08

    Surveillance of healthcare-associated infections is fundamental for infection prevention. The methods and practices for surveillance have evolved as technology becomes more advanced. The availability of electronic surveillance software (ESS) has increased, and yet adoption of ESS is slow. It is argued that ESS delivers savings through automation, particularly in terms of human resourcing and infection prevention (IP) staff time. To describe the findings of a systematic review on the impact of ESS on IP resources. A systematic search was conducted of electronic databases Medline and the Cumulative Index to Nursing and Allied Health Literature published between January 1(st), 2006 and December 31(st), 2016 with analysis using the Newcastle-Ottawa Scale. In all, 2832 articles were reviewed, of which 16 studies met the inclusion criteria. IP resources were identified as time undertaken on surveillance. A reduction in IP staff time to undertake surveillance was demonstrated in 13 studies. The reduction proportion ranged from 12.5% to 98.4% (mean: 73.9%). The remaining three did not allow for any estimation of the effect in terms of IP staff time. None of the studies demonstrated an increase in IP staff time. The results of this review demonstrate that adopting ESS yields considerable dividends in IP staff time relating to data collection and case ascertainment while maintaining high levels of sensitivity and specificity. This has the potential to enable reinvestment into other components of IP to maximize efficient use of scarce IP resources. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Survey of the use of electronic information resources by students in ...

    African Journals Online (AJOL)

    For libraries to continue to lead in this industry generally and academic libraries in particular, deliberate effort must be made to bring the IT education to every potential user of the libraries. This however must be done based on available data. This is what this study sought to provide- a survey of the use of electronic ...

  7. Data Resource Profile: Cardiovascular disease research using linked bespoke studies and electronic health records (CALIBER)

    Science.gov (United States)

    Denaxas, Spiros C; George, Julie; Herrett, Emily; Shah, Anoop D; Kalra, Dipak; Hingorani, Aroon D; Kivimaki, Mika; Timmis, Adam D; Smeeth, Liam; Hemingway, Harry

    2012-01-01

    The goal of cardiovascular disease (CVD) research using linked bespoke studies and electronic health records (CALIBER) is to provide evidence to inform health care and public health policy for CVDs across different stages of translation, from discovery, through evaluation in trials to implementation, where linkages to electronic health records provide new scientific opportunities. The initial approach of the CALIBER programme is characterized as follows: (i) Linkages of multiple electronic heath record sources: examples include linkages between the longitudinal primary care data from the Clinical Practice Research Datalink, the national registry of acute coronary syndromes (Myocardial Ischaemia National Audit Project), hospitalization and procedure data from Hospital Episode Statistics and cause-specific mortality and social deprivation data from the Office of National Statistics. Current cohort analyses involve a million people in initially healthy populations and disease registries with ∼105 patients. (ii) Linkages of bespoke investigator-led cohort studies (e.g. UK Biobank) to registry data (e.g. Myocardial Ischaemia National Audit Project), providing new means of ascertaining, validating and phenotyping disease. (iii) A common data model in which routine electronic health record data are made research ready, and sharable, by defining and curating with meta-data >300 variables (categorical, continuous, event) on risk factors, CVDs and non-cardiovascular comorbidities. (iv) Transparency: all CALIBER studies have an analytic protocol registered in the public domain, and data are available (safe haven model) for use subject to approvals. For more information, e-mail s.denaxas@ucl.ac.uk PMID:23220717

  8. Electronic Resources in a Next-Generation Catalog: The Case of WorldCat Local

    Science.gov (United States)

    Shadle, Steve

    2009-01-01

    In April 2007, the University of Washington Libraries debuted WorldCat Local (WCL), a localized version of the WorldCat database that interoperates with a library's integrated library system and fulfillment services to provide a single-search interface for a library's physical and electronic content. This brief will describe how WCL incorporates a…

  9. Use of electronic medical records and biomarkers to manage risk and resource efficiencies

    NARCIS (Netherlands)

    Ryan, Dermot; Blakey, John; Chisholm, Alison; Price, David; Thomas, Mike; Ställberg, Björn; Lisspers, Karin; Kocks, Janwillem W H

    2017-01-01

    The migration from paper to electronic medical records (EMRs) was motivated by the administrative need to record, retrieve and process increasing amounts of clinical data in the 1980s. In the intervening period, there has been growing recognition of the potential of such records for achieving care

  10. Development and use of the professional orientation component of electronic educational resources in the context of a competence-based approach

    OpenAIRE

    Belnitskaya Elena Aleksandrovna

    2015-01-01

    The article deals with the issue of professional orientation of pupils through academic subjects in the information society. The development and use of electronic educational resources for training and professional orientation of pupils are considered in the competence approach context.

  11. The Global Open Knowledgebase (GOKb: open linked data supporting electronic resources management and scholarly communication

    Directory of Open Access Journals (Sweden)

    Kristin Antelman

    2015-03-01

    Full Text Available The Global Open Knowledgebase (GOKb, a partnership between Kuali OLE and Jisc, is an open data repository of information related to e-resources as they are acquired and managed by libraries. Because GOKb tracks change over time – titles, publishers, packages – and can be used to populate other tools with data, it is changing the way that libraries think about the knowledge base. Propagation of authoritative and enhanced data about e-resources has the potential to benefit all actors in the supply chain from publishers to libraries. GOKb can also serve as a platform to explore how open knowledge base data can contribute to the broader scholarly community infrastructure, particularly around open access (OA.

  12. Comment: The Economics of Interdependent Renewable and Non-renewable Resources revisited.

    OpenAIRE

    Viktoria Kahui; Claire W. Armstrong

    2009-01-01

    This work expands upon Swallow's theoretical analysis of interactions between renewable and non-renewable resources. In this comment the interaction is such that the renewable resource prefers the non-renewable environment, as opposed to SwallowÕs (op cit) case of the non-renewable environment being essential to the renewable resource. We find that this difference strongly affects the results, and makes the resources change from being complements to being substitutes, i.e. in the essential ca...

  13. Developing and testing an electronic literacy resource for Arab patients before experiencing radiology procedures.

    Science.gov (United States)

    Abuzaid, Mohamed M; Alnuaimi, Aishah M; Abdi, Asma M; Mohajer, Elika A; Mohamed, Ifrah A; Bilwani, Rawan A; Alhammadi, Shaima B

    2016-09-01

    Radiological examinations require prior preparation that patients should be informed about. Radiologists and radiologic technologists have limited time and resources to do so. Therefore, the internet is a valuable and accessible resource for patient education, but the information may not be reliable, especially that in Arabic language. This study aimed to develop online patient education resources about imaging procedures in Arabic. It also evaluated the understandability and actionability of the source materials. The study was conducted at the University of Sharjah between October 2014 and July 2015. A website containing texts and audiovisuals for 21 medical imaging procedures was created. Bilingual (Arabic and English) radiology experts evaluated the materials with automatic score calculation using the Patient Education Materials Assessment Tool. Two procedures were pilot tested by one evaluator, followed by completion of 28 evaluations by 15 selected experts. Nineteen of 21 procedures were randomly evaluated. For printable materials, the mean understandability score was 92.37 (SD=8.355) and actionability score was 92.11 (SD=13.157). For audiovisual materials, the mean understandability score was 97.63 (SD=13.157) and the percentage for all actionability scores was 100%. The minimum acceptable percentage is 70%. The high percentages scored for the online materials indicate that the evaluators were satisfied with the materials included and that the information would be easy for patients to understand and follow. The higher scores for the audiovisual materials indicate that they were considered more effective for improving patient knowledge patient knowledge.

  14. An Exploratory study on the use of LibAnswers to Resolve, Track and Monitor Electronic Resources Issues: The KAUST Library experience

    KAUST Repository

    Ramli, Rindra M.

    2017-05-03

    An Exploratory study on KAUST library use of LibAnswers in resolving electronic resources questions received in LibAnswers. It describes the findings of the questions received in LibAnswers. The author made suggestions based on the findings to improve the reference services in responding to e-resources questions.

  15. Preference and Use of Electronic Information and Resources by Blind/Visually Impaired in NCR Libraries in India

    Directory of Open Access Journals (Sweden)

    Shailendra Kumar

    2013-06-01

    Full Text Available This paper aims to determine the preference and use of electronic information and resources by blind/visually impaired users in the leading National Capital Region (NCR libraries of India. Survey methodology has been used as the basic research tool for data collection with the help of questionnaires. The 125 in total users surveyed in all the five libraries were selected randomly on the basis of willingness of the users with experience of working in digital environments to participate in the survey. The survey results were tabulated and analyzed with descriptive statistics methods using Excel software and 'Stata version 11'. The findings reveal that ICT have a positive impact in the lives of people with disabilities as it helps them to work independently and increases the level of confidence among them. The Internet is the most preferred medium of access to information among the majority of blind/visually impaired users. The 'Complexity of content available on the net' is found as the major challenge faced during Internet use by blind users of NCR libraries. 'Audio books on CDs/DVDs and DAISY books' are the most preferred electronic resources among the majority of blind/visually impaired users. This study will help the library professionals and organizations/institutions serving people with disabilities to develop effective library services for blind/visually impaired users in the digital environment on the basis of findings on information usage behavior in the study.

  16. Internet and electronic resources for inflammatory bowel disease: a primer for providers and patients.

    Science.gov (United States)

    Fortinsky, Kyle J; Fournier, Marc R; Benchimol, Eric I

    2012-06-01

    Patients with inflammatory bowel disease (IBD) are increasingly turning to the Internet to research their condition and engage in discourse on their experiences. This has resulted in new dynamics in the relationship between providers and their patients, with misinformation and advertising potentially presenting barriers to the cooperative patient-provider partnership. This article addresses important issues of online IBD-related health information and social media activity, such as quality, reliability, objectivity, and privacy. We reviewed the medical literature on the quality of online information provided to IBD patients, and summarized the most commonly accessed Websites related to IBD. We also assessed the activity on popular social media sites (such as Facebook, Twitter, and YouTube), and evaluated currently available applications for use by IBD patients and providers on mobile phones and tablets. Through our review of the literature and currently available resources, we developed a list of recommended online resources to strengthen patient participation in their care by providing reliable, comprehensive educational material. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

  17. Effects of strengthening exercises on swallowing musculature and function in senior healthy subjects; a prospective effectiveness and feasibility study

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Stuiver, M.M.; Teertstra, H.J.; Hilgers, F.J.M.; van den Brekel, M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  18. Effects of Strengthening Exercises on Swallowing Musculature and Function in Senior Healthy Subjects: a Prospective Effectiveness and Feasibility Study

    NARCIS (Netherlands)

    Kraaijenga, S. A. C.; van der Molen, L.; Stuiver, M. M.; Teertstra, H. J.; Hilgers, F. J. M.; van den Brekel, M. W. M.

    2015-01-01

    Head and neck cancer (HNC) patients may develop dysphagia due to muscle atrophy and fibrosis following chemoradiotherapy. Strengthening of the swallowing muscles through therapeutic exercise is potentially effective for improving swallowing function. We hypothesize that a customized Swallow Exercise

  19. Gamma radiation effects on nestling Tree Swallows

    Energy Technology Data Exchange (ETDEWEB)

    Zach, R.; Mayoh, K.R.

    1984-10-01

    The sensitivity of Tree Swallows (Tachycineta bicolor) to the stress of ionizing radiation was investigated with growth analysis. Freshly hatched nestlings were temporarily removed from nests, taken to the laboratory and acutely exposed to 0.9, 2.7, or 4.5 Gy gamma radiation. Some of the unirradiated control nestlings were also taken to the laboratory whereas others were left in the nests. Growth of all the nestlings was measured daily and analyzed by fitting growth models. There was no detectable radiation-induced mortality up to fledgling, approx. = 20 d after irradiation. Radiation exposure did not affect the basic growth pattern; the logistic growth model was most suitable for body mass and foot length, and the von Bertalanffy model for primary-feather length, irrespective of treatment. Parameter values from these models indicated pronounced growth depression in the 2.7-Gy and 4.5-Gy groups, particularly for body mass. Radiation also affected the timing of development. The growth depression of the 2.7-Gy group was similar to that caused by hatching asynchrony in unirradiated nestlings. The 4.5-Cy nestlings grew as well as unexposed nestlings that died from natural causes. Chronic irradiation at approx. = 1.0 Cy/d caused more severe growth effects than acute exposure to 4.5 Gy and may have caused permanent stunting. Growth analysis is a potent tool for assessing man-made environmental stresses. Observed body-mass statistics and model parameters seem to be most sensitive to environmental stresses, but coefficients of variation are not necessarily correlated with sensitivity. 34 references, 2 figures, 4 tables.

  20. Effect of wearing a palatal plate on swallowing function.

    Science.gov (United States)

    Toyoshita, Yoshifumi; Koshino, Hisashi; Hirai, Toshihiro; Matsumi, Tamachi

    2009-10-01

    The purpose of this study was to determine the effect of wearing a palatal plate on swallowing function. The subject group consisted of 10 healthy, fully dentate males. Two experimental palatal plates (EPP) were used in this study: one was 1.4mm thick (EPP1), and the other was 2.8mm thick (EPP2). Tongue movements and swallowing sounds were simultaneously recorded. The position of the surface of the tongue was recorded by using ultrasound diagnostic equipment in the sagittal plane. Swallowing tests were performed under three conditions: without EPP (WOE), with EPP1 (WP1), and with EPP2 (WP2). Swallowing index (SI) and tongue contact time (TCT) was calculated. The value of SI was lowest under WOE, and highest under WP2, with a statistically significant difference. There was no statistical significance, however, between SI under WOE and that under WP1. The value of TCT was longest under WOE, and shortest under WP2, with a statistically significant difference. This investigation suggests that the thickness of a palatal plate influences SI and TCT, which correlate with swallowing function.

  1. Hard to Swallow: Developmental Biological Insights into Pediatric Dysphagia

    Science.gov (United States)

    LaMantia, Anthony-Samuel; Moody, Sally A.; Maynard, Thomas M.; Karpinski, Beverly A.; Zohn, Irene E.; Mendelowitz, David; Lee, Norman H.; Popratiloff, Anastas

    2015-01-01

    Pediatric dysphagia—feeding and swallowing difficulties that begin at birth, last throughout childhood, and continue into maturity—is one of the most common, least understood complications in children with developmental disorders. We argue that a major cause of pediatric dysphagia is altered hindbrain patterning during pre-natal development. Such changes can compromise craniofacial structures including oropharyngeal muscles and skeletal elements as well as motor and sensory circuits necessary for normal feeding and swallowing. Animal models of developmental disorders that include pediatric dysphagia in their phenotypic spectrum can provide mechanistic insight into pathogenesis of feeding and swallowing difficulties. A fairly common human genetic developmental disorder, DiGeorge/22q11.2 Deletion Syndrome (22q11DS) includes a substantial incidence of pediatric dysphagia in its phenotypic spectrum. Infant mice carrying a parallel deletion to 22q11DS patients have feeding and swallowing difficulties. Altered hindbrain patterning, neural crest migration, craniofacial malformations, and changes in cranial nerve growth prefigure these difficulties. Thus, in addition to craniofacial and pharyngeal anomalies that arise independently of altered neural development, pediatric dysphagia may reflect disrupted hindbrain patterning and its impact on neural circuit development critical for feeding and swallowing. The mechanisms that disrupt hindbrain patterning and circuitry may provide a foundation to develop novel therapeutic approaches for improved clinical management of pediatric dysphagia. PMID:26554723

  2. Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD.

    Science.gov (United States)

    Maffei, Carla; Mello, Marçal Motta de; Biase, Noemi Grigoletto de; Pasetti, Lilian; Camargo, Paulo A Monteiro; Silvério, Kelly Cristina Alves; Gonçalves, Maria Inês Rebelo

    2012-01-01

    To study mastication and swallowing disorders in patients with temporomandibular disorders (TMD). To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery. Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration. During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%). TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.

  3. Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients.

    Science.gov (United States)

    Gonzalez Lindh, Margareta; Blom Johansson, Monica; Jennische, Margareta; Koyi, Hirsh

    2017-01-01

    COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity <0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.

  4. Bank Swallow Range - CWHR [ds606

    Data.gov (United States)

    California Department of Resources — Vector datasets of CWHR range maps are one component of California Wildlife Habitat Relationships (CWHR), a comprehensive information system and predictive model for...

  5. Citation Analysis of Engineering Graduate Student Theses Indicates Students Are Using More Electronic Resources

    Directory of Open Access Journals (Sweden)

    Heather MacDonald

    2016-12-01

    Full Text Available A Review of: Becker, D. A., & Chiware, E. R. T. (2015. Citation analysis of masters' theses and doctoral dissertations: Balancing library collections with students' research information needs. Journal of Academic Librarianship, 41(5, 613-620. http://dx.doi.org/10.1016/j.acalib.2015.06.022 Objective – To determine the citation pattern of graduate students’ theses and dissertations. Design – Citation analysis. Setting – An institutional repository at a South African university of technology. Subjects – 201 Engineering Master’s theses and Doctoral dissertations. Methods – A random sample of Master’s theses and Doctoral dissertations from the Faculty of Engineering were analyzed. The theses and dissertations were drawn from the institutional repository covering the period 2005-2014. References were checked for format of the cited items including journal, book, conference proceeding, online item (resource with a URL other than a journal, book or proceeding, and other (anything not in the first four categories. The date of all journal articles was recorded. Journal titles were analyzed in terms of country of origin, language, availability in the library, and online access. Data were categorized by department to determine if there were any differences in the use of materials by department. Data were also analyzed by degree level.

  6. Recent Advances in Sensing Oropharyngeal Swallowing Function in Japan

    Directory of Open Access Journals (Sweden)

    Takahiro Ono

    2009-12-01

    Full Text Available Dysphagia (difficulty in swallowing is an important issue in the elderly because it causes aspiration pneumonia, which is the second largest cause of death in this group. It also causes decline in activities of daily living and quality of life. The oral phase of swallowing has been neglected, despite its importance in the evaluation of dysphagia, because adequate protocols and measuring devices are unavailable. However, recent advances in sensor technology have enabled straightforward, non-invasive measurement of the movement of important swallowing-related organs such as the lips and tongue, as well as the larynx. In this article, we report the present state and possibility of clinical application of such systems developed in Japan.

  7. The effect of dairy farm management regime on swallow (Hirundo rustica) abundance in the Netherlands

    NARCIS (Netherlands)

    Lubbe, S.K.; Snoo, de G.R.

    2007-01-01

    Aim To identify differences in Swallow abundance between organically and conventionally managed dairy farms, by examining three factors: farm buildings, food availability and farmer attitudes to Swallows. Methods Organic and conventional dairy farm holdings were compared in pairwise fashion. On

  8. VIDEOFLUOROSCOPIC SWALLOWING STUDY: esophageal alterations in patients with dysphagia

    Directory of Open Access Journals (Sweden)

    Betina SCHEEREN

    2014-09-01

    Full Text Available Context Videofluoroscopic swallowing study is a dynamic exam and allows the evaluation of the complete swallowing process. However, most published studies have only reported alterations in the oropharynx and pharyngoesophageal transition, leaving the analysis of the esophagus as a secondary goal. Objectives The goal of this study was to investigate the prevalence of alterations in the esophageal phase thorough videofluoroscopic swallowing study in patients with dysphagia. Methods Consecutive patients with dysphagia who underwent videofluoroscopic swallowing study including esophageal analysis between May 2010 and May 2012 had their exams retrospectively reviewed. Patients were classified into two groups: Group I - without a pre-established etiological diagnosis and Group II - with neurological disease. During the exam, the patients ingested three different consistencies of food (liquid, pasty and solid contrasted with barium sulfate and 19 items were analyzed according to a protocol. The esophageal phase was considered abnormal when one of the evaluated items was compromised. Results Three hundred and thirty-three (n = 333 consecutive patients were studied - 213 (64% in Group I and 120 (36% in Group II. Esophageal alterations were found in 104 (31% patients, with a higher prevalence in Group I (36.2%, especially on the items esophageal clearance (16.9% and tertiary contractions (16.4%. It was observed that 12% of individuals in Group I only presented alterations on the esophageal phase. Conclusion Evaluation of the esophageal phase of swallowing during videofluoroscopic swallowing study detects abnormalities in patients with cervical dysphagia, especially in the group without pre-established etiological diagnosis.

  9. Tracking the hyoid bone in videofluoroscopic swallowing studies

    Science.gov (United States)

    Kellen, Patrick M.; Becker, Darci; Reinhardt, Joseph M.; van Daele, Douglas

    2008-03-01

    Difficulty swallowing, or dysphagia, has become a growing problem. Swallowing complications can lead to malnutrition, dehydration, respiratory infection, and even death. The current gold standard for analyzing and diagnosing dysphagia is the videofluoroscopic barium swallow study. In these studies, a fluoroscope is used to image the patient ingesting barium solutions of different volumes and viscosities. The hyoid bone anchors many key muscles involved in swallowing and plays a key role in the process. Abnormal hyoid bone motion during a swallow can indicate swallowing dysfunction. Currently in clinical settings, hyoid bone motion is assessed qualitatively, which can be subject to intra-rater and inter-rater bias. This paper presents a semi-automatic method for tracking the hyoid bone that makes quantitative analysis feasible. The user defines a template of the hyoid on one frame, and this template is tracked across subsequent frames. The matching phase is optimized by predicting the position of the template based on kinematics. An expert speech pathologist marked the position of the hyoid on each frame of ten studies to serve as the gold standard. Results from performing Bland-Altman analysis at a 95% confidence interval showed a bias of 0.0+/-0.08 pixels in x and -0.08+/-0.09 pixels in y between the manually-defined gold standard and the proposed method. The average Pearson's correlation between the gold standard and the proposed method was 0.987 in x and 0.980 in y. This paper also presents a method for automatically establishing a patient-centric coordinate system for the interpretation of hyoid motion. This coordinate system corrects for upper body patient motion during the study and identifies superior-inferior and anterior-posterior motion components. These tools make the use of quantitative hyoid motion analysis feasible in clinical and research settings.

  10. Respiratory phase resetting and airflow changes induced by swallowing in humans.

    Science.gov (United States)

    Paydarfar, D; Gilbert, R J; Poppel, C S; Nassab, P F

    1995-01-01

    1. Relationships between the timing of respiration and deglutition were studied in thirty awake healthy subjects at rest. Deglutition was monitored by submental electromyography, pharyngeal manometry and videofluoroscopy. Respiration was recorded by measurement of oronasal airflow and chest wall movement. Three types of deglutition were studied: injected bolus swallows, spontaneous swallows, and visually cued swallows of boluses previously placed in the mouth. 2. The effect of each swallow on respiratory rhythm was characterized by measurement of cophase, defined as the interval between the onset of deglutitive submental EMG activity to the onset of subsequent rescheduled inspirations. Cophase was determined for swallows initiated at different phases of the respiratory cycle. In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase was largest for swallows initiated near the the inspiratory-expiratory (E-I) transition and smallest for swallows initiated near the expiratory-inspiratory (E-I) transition. The pattern of respiratory resetting by deglutition was topologically classified as type 0. This pattern was shown for swallows induced by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence of spontaneous deglutition was influenced by the position of the swallow in the respiratory cycle. Few spontaneous swallows were initiated near the E-I transition whereas most occurred from late inspiration to mid-expiration. 4. Deglutition caused an abrupt decrease in airflow leading to an interval of apnoea, followed by a period of expiration. The duration of deglutition apnoea for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was unaffected by the respiratory phase of swallow initiation. The period of expiration after swallowing was longest for swallows initiated at the I-E transition, and shortest for E-I swallows. 5. The intervals between bolus injection and the onset of deglutition apnoea, and the

  11. Examining user perceptions of SwallowIT: A pilot study of a new telepractice application for delivering intensive swallowing therapy to head and neck cancer patients.

    Science.gov (United States)

    Wall, Laurelie R; Ward, Elizabeth C; Cartmill, Bena; Hill, Anne J; Porceddu, Sandro V

    2017-01-01

    Consumer feedback and end-user perceptions provide important information regarding the clinical acceptability of new telepractice systems. This pilot investigation aimed to evaluate end-user perceptions of a new asynchronous telepractice application, ' SwallowIT', designed to support patients to remotely complete intensive swallowing therapy during curative chemoradiotherapy (CRT) treatment for head and neck cancer (HNC). Insights were sought from 15 patients with oropharyngeal cancer who used SwallowIT to complete supported home swallowing therapy. Perceptions were evaluated via structured questionnaires, completed following initial orientation to SwallowIT and on completion of CRT. Semi-structured phone interviews were conducted ≥3 months post-treatment. The majority of patients reported positive initial perceptions towards SwallowIT for comfort (87%), confidence (87%), motivation (73%) and support (87%). No statistically significant change in perceptions was observed from baseline to end of CRT ( p > 0.05). Thematic analysis of interviews revealed four main themes: the ease of use of SwallowIT, motivating factors, circumstances which made therapy difficult, and personal preferences for service-delivery models. These preliminary findings demonstrate that SwallowIT was well-perceived by the current group of HNC consumers and suggest that SwallowIT may be well-accepted as an alternate service-delivery model for delivering intensive swallowing therapy during CRT.

  12. Ultrasound of oral and masticatory muscles: Why every neuromuscular swallow team should have an ultrasound machine

    NARCIS (Netherlands)

    Engel-Hoek, L. van den; Lagarde, M.L.J.; Alfen, N. van

    2017-01-01

    Patients with neuromuscular disorders often present with swallowing difficulties due to oral phase problems and pharyngeal residue after swallow. It is important to assess the underlying pathology and cause of the swallowing disturbance in this patient group, such as dystrophic changes in oral and

  13. Green Supply Chain Collaboration for Fashionable Consumer Electronics Products under Third-Party Power Intervention—A Resource Dependence Perspective

    Directory of Open Access Journals (Sweden)

    Jiuh-Biing Sheu

    2014-05-01

    Full Text Available Under third-party power intervention (TPPI, which increases uncertainty in task environments, complex channel power interplays and restructuring are indispensable among green supply chain members as they move toward sustainable collaborative relationships for increased viability and competitive advantage. From the resource dependence perspective, this work presents a novel conceptual model to investigate the influence of political and social power on channel power restructuring and induced green supply chain collaboration in brander-retailer bidirectional green supply chains of fashionable consumer electronics products (FCEPs. An FCEP refers to the consumer electronics product (e.g., personal computers, mobile phones, computer notebooks, and game consoles with the features of a well-known brand associated, a short product lifecycle, timely and fashionable design fit for market trends, and quick responsiveness to the variations of market demands. The proposed model is tested empirically using questionnaire data obtained from retailers in the FCEP brander-retailer distribution channels. Analytical results reveal that as an extension of political and social power, TPPI positively affects the reciprocal interdependence of dyadic members and reduces power asymmetry, thereby enhancing the collaborative relationship of dyadic members and leading to improved green supply chain performance. Therein, reciprocal interdependence underlying collaborative relationship is the key to reducing the external environmental uncertainties in the TPPI context.

  14. A Pilot Study of the Head Extension Swallowing Exercise: New Method for Strengthening Swallowing-Related Muscle Activity.

    Science.gov (United States)

    Oh, Jong-Chi

    2016-10-01

    This pilot study examined the effect of a new head extension swallowing exercise (HESE) on submental muscle activity and tongue strength in healthy volunteers. Fifteen young adults (10 females and 5 males) were instructed to extend their head backwards as much as possible, and while watching the ceiling, swallowed their saliva every 10 s for a duration of 20 min. Twenty-four treatments were performed over 8 weeks. The outcome variables evaluated at baseline, 4 and 8 weeks of training, and 12-week follow-up included mean and peak submental muscle activation amplitudes during normal and effortful swallowing measured via surface electromyography, and anterior and posterior isometric tongue pressures were measured with the Iowa Oral Performance Instrument. Results indicated that the muscle activation amplitudes during effortful swallowing increased significantly at 4 and 8 weeks compared to baseline (p < 0.025). However, the increases in amplitudes during normal swallowing were minor (nonsignificant) after 8 weeks compared to baseline. The isometric pressures of the tongue tip and the posterior part of the oral tongue were significantly higher at 8 weeks compared to baseline (p < 0.025). Thus, the 8-week HESE protocol significantly improved suprahyoid muscle activity during effortful swallowing as well as the isometric tongue pressures. The HESE appears effective in exercising and strengthening the suprahyoid muscles and tongue muscles in healthy participants. Although encouraging, these results need to be replicated in clinical trials for testing the therapeutic effects of the HESE in older adults and patients with dysphagia who present with decreased hyolaryngeal elevation.

  15. The management of online resources and long-term saving of electronic documents by transfer into the digital space

    Directory of Open Access Journals (Sweden)

    Marius Daniel MAREŞ

    2011-12-01

    The electronic archive refers to the electronic storage system, along with the totality of electronic-type stored documents, while using as storage support any environment that can support storing and from which an electronic document can be presented.

  16. Differences in Swallowing between High and Low Concentration Taste Stimuli

    Directory of Open Access Journals (Sweden)

    Ahmed Nagy

    2014-01-01

    Full Text Available Taste is a property that is thought to potentially modulate swallowing behavior. Whether such effects depend on taste, intensity remains unclear. This study explored differences in the amplitudes of tongue-palate pressures in swallowing as a function of taste stimulus concentration. Tongue-palate pressures were collected in 80 healthy women, in two age groups (under 40, over 60, stratified by genetic taste status (nontasters, supertasters. Liquids with different taste qualities (sweet, sour, salty, and bitter were presented in high and low concentrations. General labeled magnitude scale ratings captured perceived taste intensity and liking/disliking of the test liquids. Path analysis explored whether factors of taste, concentration, age group, and/or genetic taste status impacted: (1 perceived intensity; (2 palatability; and (3 swallowing pressures. Higher ratings of perceived intensity were found in supertasters and with higher concentrations, which were more liked/disliked than lower concentrations. Sweet stimuli were more palatable than sour, salty, or bitter stimuli. Higher concentrations elicited stronger tongue-palate pressures independently and in association with intensity ratings. The perceived intensity of a taste stimulus varies as a function of stimulus concentration, taste quality, participant age, and genetic taste status and influences swallowing pressure amplitudes. High-concentration salty and sour stimuli elicit the greatest tongue-palate pressures.

  17. Swallowing Disorders in Parkinson's Disease: Impact of Lingual Pumping

    Science.gov (United States)

    Argolo, Natalie; Sampaio, Marília; Pinho, Patrícia; Melo, Ailton; Nóbrega, Ana Caline

    2015-01-01

    Background: Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This…

  18. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditur.e was ... predict standard metabolic rate (SMR) of the South African cliff swallow and the cost of flight was estimated from ... estimation of the time spent in social activities was made. To calculate the cost of building a nest the time ...

  19. Evaluation of swallowing in infants with congenital heart defect.

    Science.gov (United States)

    Pereira, Karine da Rosa; Firpo, Cora; Gasparin, Marisa; Teixeira, Adriane Ribeiro; Dornelles, Silvia; Bacaltchuk, Tzvi; Levy, Deborah Salle

    2015-01-01

    Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036) and between oral-motor oral feeding readiness and dysphagia (p = 0.014). Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  20. Evaluation of Swallowing in Infants with Congenital Heart Defect

    Directory of Open Access Journals (Sweden)

    Pereira, Karine da Rosa

    2014-11-01

    Full Text Available Introduction Surgical repair of congenital heart disease in the first years of life compromises the coordination of the suction, breathing, and swallowing functions. Objective To describe the alterations in swallowing found in infants with congenital heart defect during their hospitalization. Methods Prospective, cross-sectional study in a reference hospital for heart disease. The sample consisted of 19 postsurgical patients who underwent an evaluation of swallowing. The infants included were younger than 7 months and had a diagnosis of congenital heart defect and suspected swallowing difficulties. Results Of the 19 infants with congenital heart defect, the median age was 3.2 months. A significant association was found between suction rhythm and dysphagia (p = 0.036 and between oral-motor oral feeding readiness and dysphagia (p = 0.014. Conclusions The data suggest that dysphagia often occurs after surgery in infants with congenital heart defect. Infants with congenital heart defect had very similar behavior to preterm infants in terms of oral feeding readiness.

  1. Swallow syncope caused by third-degree atrioventricular block.

    Science.gov (United States)

    Aaberg, Anne Marie Roust; Eriksson, Anna Elin; Madsen, Per Lav; Dixen, Ulrik

    2015-10-27

    We report a case of a patient with more than 30 years of repeated syncopes, always following food intake. The patient was diagnosed with a swallow-related third-degree atrioventricular block and successfully treated with an artificial pacemaker. 2015 BMJ Publishing Group Ltd.

  2. Short communications: White-throated Swallow Hirundo albigularis ...

    African Journals Online (AJOL)

    Short communications: White-throated Swallow Hirundo albigularis in Tanzania. NE Baker, EM Baker. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for ...

  3. Effect of posture on swallowing | Alghadir | African Health Sciences

    African Journals Online (AJOL)

    Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while ...

  4. [Specialties in dentistry. Salivary flow and swallowing in Parkinson's disease

    NARCIS (Netherlands)

    Wierink, C.D.; Spijker, P.C.; Baat, C. de

    2006-01-01

    Parkinson's disease is a slowly progressive and irreversible disorder of the nervous system. Drooling is listed as a secondary symptom of Parkinson's disease. Its cause is insufficiently clear. In the literature 2 possible causes are described: hypersalivation and swallowing abnormalities. These

  5. Time budget of South African cliff swallows during breeding

    African Journals Online (AJOL)

    1973) (see Appendix). The South African cliff swallow spent most of the 24-h day in the nest (Table 1). This included about 9 h spent sleeping in the nest at night. Nest building was a minor component of total activity during the incubation and ...

  6. \\'The snake will swallow you': supernatural snakes and the creation ...

    African Journals Online (AJOL)

    \\'The snake will swallow you': supernatural snakes and the creation of the Khotso legend. Felicity Wood. Abstract. No Abstract. Indilinga: African Journal of Indigenous Knowledge Systems (IAJIKS) Vol. 4(1) 2005: 347-359. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  7. Predictable swallowing function after open horizontal supraglottic partial laryngectomy.

    Science.gov (United States)

    Breunig, Christine; Benter, Philipp; Seidl, Rainer O; Coordes, Annekatrin

    2016-12-01

    After horizontal supraglottic partial laryngectomy, patients have an increased risk of dysphagia as they are not able to close the laryngeal entrance during swallowing, especially if the surgical defect of the tongue base has increased. There is no investigation that studies risk factors for impaired swallow function, or that predicts postoperative swallow outcomes based on radiologically determined tumor dimensions. The present study investigated the impact of the tongue base tumor extension (determined by CT scan in patients undergoing partial laryngectomy) on the recovery rate of swallow function. The retrospective study in a tertiary hospital between 2000 and 2015 included all patients who underwent open horizontal supraglottic partial laryngectomy due to oropharyngeal cancer of the tongue base, or supraglottic laryngeal cancer with tongue base infiltration. All clinicopathological data were collected. The dimension of tongue base infiltration was measured using CT scan. Swallow function was recorded by Fiberoptic Endoscopic Evaluation of Swallowing and determined by evaluating both the duration until nasogastric tube removal and changing of the cuffed tracheostomy tube for an uncuffed speech cannula. The study included 26 patients (44-76 years, median 59 years). The clinical tumor (cT) classification included cT2 and cT3, while the pathologic tumor (pT) classification included pT2 and pT3 in 90% and pT1 and pT4 in 10% respectively. The duration until using the speech cannula was not associated with clinicopathological data, including the investigated radiologic tumor dimensions (biggest tumor diameter, tongue base infiltration depth, width, height, area and volume). The duration until nasogastric tube removal was significantly associated with the tongue base infiltration width (p=0.012), height (p=0.026) and area (pfunction after open horizontal supraglottic partial laryngectomy depends on the tumor extension of the tongue base. The tongue base infiltration

  8. Physiology and Pathophysiology of the Swallowing Area of Human Motor Cortex

    Directory of Open Access Journals (Sweden)

    S. Hamdy

    2001-01-01

    Full Text Available Swallowing problems can affect as many as one in three patients in the period immediately after stroke. Despite this, in the majority of cases, recovery usually occurs to a safe level after a month or two. In this review, we show. how the organization of the cortical projections to swallowing nuscles can account for many of the clinical observations on swallowing after stroke and explain why recovery is common in the long term. In addition, we examine approaches that may be useful in speeding up recovery of swallowing. Swallowing may be a useful model in which to study central nervous reorganization after injury.

  9. Flow and Grit by Design: Exploring Gamification in Facilitating Adherence to Swallowing Therapy.

    Science.gov (United States)

    Constantinescu, Gabriela; Rieger, Jana; Mummery, Kerry; Hodgetts, William

    2017-11-08

    Delivery of swallowing therapy is faced with challenges regarding access to in-clinic services and adherence to prescribed home programs. Mobile health (mHealth) technologies are being developed at a rapid pace to address these difficulties. Whereas some benefits to using these modern tools for therapy are obvious (e.g., electronic reminders), other advantages are not as well understood. One example is the potential for mHealth devices and apps to enhance adherence to treatment regimens. This article introduces a number of psychological concepts that relate to adherence and that can be leveraged by mHealth. Elements that contribute to flow (optimal experience) during an activity and those that reinforce grit (perseverance to achieve a long-term goal) can be used to engage patients in their own rehabilitation. The experience of flow can be targeted by presenting the rehabilitation exercise as an optimally challenging game, one that offers a match between challenge and ability. Grit can be supported by reinforcing routine and by varying the therapy experience using different games. A combination of hardware and software design approaches have the potential to transform uninteresting and repetitive activities, such as those that make up swallowing therapy regimens, into engaging ones. The field of gamification, however, is still developing, and gamified mHealth apps will need to withstand scientific testing of their claims and demonstrate effectiveness in all phases of outcome research.

  10. Radiation doses to children during modified barium swallow studies

    Energy Technology Data Exchange (ETDEWEB)

    Weir, Kelly A. [University of Queensland, Discipline of Paediatrics and Child Health, School of Medicine, Herston, Queensland (Australia); McMahon, Sandra M. [SpeechNet Speech Pathology Services, Brisbane (Australia); Long, Gillian; Bunch, Judith A. [Royal Children' s Hospital, Department of Medical Imaging, Herston (Australia); Pandeya, Nirmala [Queensland Institute of Medical Research, Herston (Australia); Coakley, Kerry S. [Biomedical Technology Services, Royal Brisbane and Women' s Hospital, Herston (Australia); Chang, Anne B. [Royal Children' s Hospital, Department of Respiratory Medicine, Herston (Australia)

    2007-03-15

    There are minimal data on radiation doses to infants and children undergoing a modified barium swallow (MBS) study. To document screening times, dose area product (DAP) and effective doses to children undergoing MBS and to determine factors associated with increased screening times and effective dose. Fluoroscopic data (screening time, DAP, kVp) for 90 consecutive MBS studies using pulse fluoroscopy were prospectively recorded; effective dose was calculated and data were analyzed for effects of behavior, number of swallow presentations, swallowing dysfunction and medical problems. Mean effective dose for the entire group was 0.0826 {+-} 0.0544 mSv, screening time 2.48 {+-} 0.81 min, and DAP 28.79 {+-} 41.72 cGy cm{sup 2}. Significant differences were found across three age groups ({<=}1.0, >1.0-3.0 and >3.0 years) for effective dose (mean 0.1188, 0.0651 and 0.0529 mSv, respectively; P < 0.001), but not for screening time or DAP. Effective dose was correlated with screening time (P = 0.007), DAP (P < 0.001), number of swallow presentations (P = 0.007), lower age (P = 0.017), female gender (P = 0.004), and height (P < 0.001). Screening time was correlated with total number of swallow presentations (P < 0.001) and DAP (P < 0.001). Screening times, DAP, effective dose, and child and procedural factors associated with higher effective doses are presented for children undergoing MBS studies. (orig.)

  11. Innovative direct energy conversion systems using electronic adiabatic processes of electron fluid in solid conductors: new plants of electrical power and hydrogen gas resources without environmental pollutions

    Energy Technology Data Exchange (ETDEWEB)

    Kondoh, Y.; Kondo, M.; Shimoda, K.; Takahashi, T. [Gunma Univ., Dept. of Electronic Engineering, Kiryu, Gunma (Japan)

    2001-07-01

    It is shown that using a novel recycling process of the environmental thermal energy, innovative permanent auto-working direct energy converter systems (PA-DEC systems) from the environmental thermal to electrical and/or chemical potential (TE/CP) energies, abbreviated as PA-TE/CP-DEC systems, can be used for new auto-working electrical power plants and the plants of the compressible and conveyable hydrogen gas resources at various regions in the whole world, with contributions to the world peace and the economical development in the south part of the world. It is shown that the same physical mechanism by free electrons and electrical potential determined by temperature in conductors, which include semiconductors, leads to the Peltier effect and the Seebeck one. It is experimentally clarified that the long distance separation between two {pi} type elements of the heat absorption (HAS) and the production one (HPS) of the Peltier effect circuit system or between the higher temperature side (HTS) and the lower one (LTS) of the Seebeck effect circuit one does not change in the whole for the both effects. By using present systems, we do not need to use petrified fuels such as coals, oils, and natural gases in order to decrease the greenhouse effect by the CO{sub 2} surrounding the earth. Furthermore, we do not need plats of nuclear fissions that left radiating wastes, i.e., with no environmental pollutions. The PA-TE/CP-DEC systems can be applicable for several km scale systems to the micro ones, such as the plants of the electrical power, the compact transportable hydrogen gas resources, a large heat energy container, which can be settled at far place from thermal energy absorbing area, the refrigerators, the air conditioners, home electrical apparatuses, and further the computer elements. It is shown that the simplest PA-TE/CP-DEC system can be established by using only the Seebeck effect components and the resolving water ones. It is clarified that the externally

  12. A comparison between swallowing sounds and vibrations in patients with dysphagia.

    Science.gov (United States)

    Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L; Perera, Subashan; Sejdić, Ervin

    2017-06-01

    The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. This study aims to compare of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who had videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5 ml spoon was given to the participants. A broad feature set was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Differences in brain networks during consecutive swallows detected using an optimized vertex-frequency algorithm.

    Science.gov (United States)

    Jestrović, Iva; Coyle, James L; Sejdić, Ervin

    2017-03-06

    Patients with dysphagia can have higher risks of aspiration after repetitive swallowing activity due to the "fatigue effect". However, it is still unknown how consecutive swallows affect brain activity. Therefore, we sought to investigate differences in swallowing brain networks formed during consecutive swallows using a signal processing on graph approach. Data were collected from 55 healthy people using electroencephalography (EEG) signals. Participants performed dry swallows (i.e., saliva swallows) and wet swallows (i.e., water, nectar-thick, and honey thick swallows). After standard pre-processing of the EEG time series, brain networks were formed using the time-frequency-based synchrony measure, while signals on graphs were formed as a line graph of the brain networks. For calculating the vertex frequency information from the signals on graphs, the proposed algorithm was based on the optimized window size for calculating the windowed graph Fourier transform and the graph S-transform. The proposed algorithms were tested using synthetic signals and showed improved energy concentration in comparison to the original algorithm. When applied to EEG swallowing data, the optimized windowed graph Fourier transform and the optimized graph S-transform showed that differences exist in brain activity between consecutive swallows. In addition, the results showed higher differences between consecutive swallows for thicker liquids. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  14. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    Science.gov (United States)

    Dirven, Steven; Allen, Jacqueline; (Peter Xu, Weiliang; Cheng, Leo K.

    2017-03-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo. It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s-1, as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo.

  15. Submental sEMG and Hyoid Movement during Mendelsohn Maneuver, Effortful Swallow, and Expiratory Muscle Strength Training

    Science.gov (United States)

    Wheeler-Hegland, Karen M.; Rosenbek, John C.; Sapienza, Christine M.

    2008-01-01

    Purpose: This study investigated the concurrent biomechanical and electromyographic properties of 2 swallow-specific tasks (effortful swallow and Mendelsohn maneuver) and 1 swallow-nonspecific (expiratory muscle strength training [EMST]) swallow therapy task in order to examine the differential effects of each on hyoid motion and associated…

  16. Development of an electronic medical record based alert for risk of HIV treatment failure in a low-resource setting.

    Directory of Open Access Journals (Sweden)

    Nancy Puttkammer

    Full Text Available The adoption of electronic medical record systems in resource-limited settings can help clinicians monitor patients' adherence to HIV antiretroviral therapy (ART and identify patients at risk of future ART failure, allowing resources to be targeted to those most at risk.Among adult patients enrolled on ART from 2005-2013 at two large, public-sector hospitals in Haiti, ART failure was assessed after 6-12 months on treatment, based on the World Health Organization's immunologic and clinical criteria. We identified models for predicting ART failure based on ART adherence measures and other patient characteristics. We assessed performance of candidate models using area under the receiver operating curve, and validated results using a randomly-split data sample. The selected prediction model was used to generate a risk score, and its ability to differentiate ART failure risk over a 42-month follow-up period was tested using stratified Kaplan Meier survival curves.Among 923 patients with CD4 results available during the period 6-12 months after ART initiation, 196 (21.2% met ART failure criteria. The pharmacy-based proportion of days covered (PDC measure performed best among five possible ART adherence measures at predicting ART failure. Average PDC during the first 6 months on ART was 79.0% among cases of ART failure and 88.6% among cases of non-failure (p<0.01. When additional information including sex, baseline CD4, and duration of enrollment in HIV care prior to ART initiation were added to PDC, the risk score differentiated between those who did and did not meet failure criteria over 42 months following ART initiation.Pharmacy data are most useful for new ART adherence alerts within iSanté. Such alerts offer potential to help clinicians identify patients at high risk of ART failure so that they can be targeted with adherence support interventions, before ART failure occurs.

  17. Human swallowing simulation based on videofluorography images using Hamiltonian MPS method

    Science.gov (United States)

    Kikuchi, Takahiro; Michiwaki, Yukihiro; Kamiya, Tetsu; Toyama, Yoshio; Tamai, Tasuku; Koshizuka, Seiichi

    2015-09-01

    In developed nations, swallowing disorders and aspiration pneumonia have become serious problems. We developed a method to simulate the behavior of the organs involved in swallowing to clarify the mechanisms of swallowing and aspiration. The shape model is based on anatomically realistic geometry, and the motion model utilizes forced displacements based on realistic dynamic images to reflect the mechanisms of human swallowing. The soft tissue organs are modeled as nonlinear elastic material using the Hamiltonian MPS method. This method allows for stable simulation of the complex swallowing movement. A penalty method using metaballs is employed to simulate contact between organ walls and smooth sliding along the walls. We performed four numerical simulations under different analysis conditions to represent four cases of swallowing, including a healthy volunteer and a patient with a swallowing disorder. The simulation results were compared to examine the epiglottic downfolding mechanism, which strongly influences the risk of aspiration.

  18. The swallowing reflex and its significance as an airway defensive reflex

    Directory of Open Access Journals (Sweden)

    Takashi eNishino

    2013-01-01

    Full Text Available Swallowing function, in humans, is very complex. Swallowing plays, not only an important role in food digestion, but also a major role in preventing the entrance of food and/or other materials into the lower respiratory tract. To achieve this, precise coordination is necessary between breathing and swallowing since the pharynx serves as a common pathway for both respiration and digestion. The swallowing reflex consists of afferent pathways, central integration, and efferent pathways. Any defect or disorder along reflex arc can cause a potential delay or impairment in swallow function. The swallowing reflex can be modulated not only by pathological factors but also by physiological factors. Among these, timing of swallows in relation to the phase of respiration may be the most important factor that determines the occurrence of pulmonary aspiration, since phases of inspiration and the expiration-inspiration transition are the most vulnerable for pulmonary aspiration.

  19. Consumer reports [electronic resource

    National Research Council Canada - National Science Library

    1942-01-01

    ... only. A limited number of selected reports, advice on product selection and safety alerts are freely available, as are a five year listing of product recalls, a listing of major consumer product...

  20. Electronic Information Resources (EIR Adoption in Private University Libraries: The Moderating Effect of Productivity and Relative Advantage on Perceived Usefulness

    Directory of Open Access Journals (Sweden)

    Izuagbe, Roland

    2016-03-01

    Full Text Available The study tested a hybrid model with constructs drawn from the Technology Acceptance Model (TAM and Diffusion of Innovation (DOI theory in order to examine the moderating effect of productivity and relative advantage (RA on perceived usefulness (PU vis-à-vis electronic information resources (EIR adoption in private university libraries in Ogun and Osun States of Nigeria. The descriptive research design was adopted in the study. The population consisted of 61 (55.0% librarians and 50 (45.0% library officers (totaling 116—100% in Babcock University, Bells University, Covenant University, Bowen University, Oduduwa University, and Redeemer's University. Purposive sampling procedure was adopted after which total enumeration was used since the total population is small. The questionnaire was used for data collection. Of the 116 copies of the questionnaire administered, 111 (95.7% were found usable. The instrument was structured based on a 4-point Likert agreement scale of Strongly Agree, Agree, Disagree, and Strongly Disagree. Data were analyzed using descriptive statistics like tables of frequency counts and percentage. The findings revealed that productivity and relative advantage are significant moderators of perceived usefulness of EIR adoption in private university libraries in Ogun and Osun States, Nigeria.

  1. Aging-related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non-invasive measurement techniques.

    Science.gov (United States)

    Wang, Chin-Man; Chen, Ji-Yih; Chuang, Chiung-Cheng; Tseng, Wen-Chun; Wong, Alice M K; Pei, Yu-Cheng

    2015-06-01

    Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated non-invasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle- and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults. © 2014 The Authors. Geriatrics & Gerontology International published by Wiley Publishing Asia Pty Ltd on behalf of Japan Geriatrics Society.

  2. The module of methodical support in system of electronic educational resources as the innovative element of the modern maintenance of formation

    Directory of Open Access Journals (Sweden)

    Ольга Николаевна Крылова

    2009-06-01

    Full Text Available The article introduces some results of research, which were devoted to evaluation of tearches' mobility to introduce innovations in the contents of education. The author considers innovative potential of modules of the methodical support for system of electronic educational resources.

  3. Charting a Course through CORAL: Texas A&M University Libraries' Experience Implementing an Open-Source Electronic Resources Management System

    Science.gov (United States)

    Hartnett, Eric; Beh, Eugenia; Resnick, Taryn; Ugaz, Ana; Tabacaru, Simona

    2013-01-01

    In 2010, after two previous unsuccessful attempts at electronic resources management system (ERMS) implementation, Texas A&M University (TAMU) Libraries set out once again to find an ERMS that would fit its needs. After surveying the field, TAMU Libraries selected the University of Notre Dame Hesburgh Libraries-developed, open-source ERMS,…

  4. The BRIGHTEN Program: Implementation and Evaluation of a Program to Bridge Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking

    Science.gov (United States)

    Emery, Erin E.; Lapidos, Stan; Eisenstein, Amy R.; Ivan, Iulia I.; Golden, Robyn L.

    2012-01-01

    Purpose: To demonstrate the feasibility of the BRIGHTEN Program (Bridging Resources of an Interdisciplinary Geriatric Health Team via Electronic Networking), an interdisciplinary team intervention for assessing and treating older adults for depression in outpatient primary and specialty medical clinics. The BRIGHTEN team collaborates "virtually"…

  5. Fetal swallowing as a protective mechanism against oligohydramnios and polyhydramnios in late gestation sheep.

    Science.gov (United States)

    Brace, Robert A; Anderson, Debra F; Cheung, Cecilia Y

    2013-03-01

    Our objectives were to (1) quantify the relationship between daily swallowed volume and amniotic fluid volume (AF volume) in late gestation ovine fetuses and (2) use the resulting regression equation to explore the role of swallowing in regulating AF volume. Daily swallowed volume ranged from 36 to 1963 mL/d while experimental AF volume ranged from 160 to 6150 mL (n = 115). Swallowed volume was near zero when AF volume was far below normal, a maximum of 635 ± 41 (standard error) mL/d when AF volume was 1682 ± 31 mL and did not increase further with higher AF volumes. Computer simulations predicted that fetal swallowing would (1) return AF volume to normal in 5 to 6 days following an acute volume change in the absence of changes in other amniotic inflows or outflows and (2) stabilize AF volume in 4 to 8 days following sustained alterations in amniotic inflows or outflows other than swallowing. The volume of AF swallowed each day by the fetus is a strong function of AF volume and reaches a maximum when mild polyhydramnios develops. With deviations in AF volume from normal, changes in fetal swallowing protect against oligohydramnios and polyhydramnios because the changes in swallowing over time reduce the extent of the AF volume change. However, with experimental changes in AF volume stabilizing in 1 to 2 days, it appears that swallowing is not the major regulator of AF volume.

  6. Enhancing effects of flavored nutritive stimuli on cortical swallowing network activity

    Science.gov (United States)

    Babaei, Arash; Kern, Mark; Antonik, Stephen; Mepani, Rachel; Ward, B. Douglas; Li, Shi-Jiang; Hyde, James

    2010-01-01

    A better understanding of the central control of the physiology of deglutition is necessary for devising interventions aimed at correcting pathophysiological conditions of swallowing. Positive modulation of the cortical swallowing network can have clinical ramifications in dysphagia due to central nervous system deficits. Our aim was to determine the effect of nutritive sensory input on the cortical swallowing network. In 14 healthy right-handed volunteers, we utilized a paradigm-driven protocol to quantify the number of activated voxels and their signal intensity within the left hemispheric cortical swallowing network by high-resolution functional MRI (fMRI) during five different swallowing conditions. Swallowing conditions included a dry swallow (saliva) and natural water-, lemon-, popcorn-, and chocolate-flavored liquid swallows. Each flavored liquid was presented simultaneously by its image, scent, and taste in random order and tested over three runs. fMRIs were analyzed in a blinded fashion. Average fMRI blood oxygenation level-dependent signal intensity and number of activated voxels during swallowing concurrent with nutritive gustatory, olfactory, and visual stimulations were significantly increased compared with dry/natural water swallows throughout the cortical swallowing network (P < 0.001 and P < 0.05, respectively). Subregion analysis showed the increased activity for flavored liquids in prefrontal, cingulate gyrus, and sensory/motor cortex, but not in precuneus and insula. Concurrent gustatory, olfactory, and visual nutritive stimulation enhances the activity of the cortical swallowing network. This finding may have clinical implications in management of swallowing disorders due to cortical lesions. PMID:20508154

  7. Clinical Characteristics and Lesions Responsible for Swallowing Hesitation After Acute Cerebral Infarction.

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    Saito, Tsukasa; Hayashi, Keisuke; Nakazawa, Hajime; Ota, Tetsuo

    2016-08-01

    Some stroke patients with a unilateral lesion demonstrate acute dysphagia characterized by a markedly prolonged swallowing time, making us think they are reluctant to swallow. In order to clarify the clinical characteristics and causative lesions of delayed swallowing, we conducted a retrospective analysis of 20 right-handed patients without a history of swallowing dysfunction who underwent videofluorography on suspicion of dysphagia after a first ischemic stroke. The oral processing time plus the postfaucial aggregation time required to swallow jelly for patients classified as having delayed swallowing was over 10 s. The time required for swallowing jelly was significantly longer than that without the hesitation (median value, 24.1 vs. 8.9 s, P oral processing time plus the postfaucial aggregation time required for patients with delayed swallowing to swallow thickened water was largely over 5 s and significantly longer than that of patients without swallowing hesitation (median value, 10.2 vs. 3.3 s, P acute unilateral infarction could be separated into two different patterns. Because four of the five patients with a rippling tongue movement in the swallowing hesitation pattern had a lesion in the left primary motor cortex, which induces some kinds of apraxia, swallowing hesitation with a rippling tongue movement seems to be a representative characteristic of apraxia. The patients with swallowing hesitation with a temporary stasis of the tongue in this study tended to have broad lesions in the frontal lobe, especially in the middle frontal gyrus, which is thought to be involved in higher cognition.

  8. Speech and swallowing outcomes in buccal mucosa carcinoma

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    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  9. Innate immune response development in nestling tree swallows

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    Stambaugh, T.; Houdek, B.J.; Lombardo, M.P.; Thorpe, P.A.; Caldwell, Hahn D.

    2011-01-01

    We tracked the development of innate immunity in nestling Tree Swallows (Tachycineta bicolor) and compared it to that of adults using blood drawn from nestlings during days 6, 12, and 18 of the ???20-day nestling period and from adults. Innate immunity was characterized using an in vitro assay of the ability of whole blood to kill Escherichia coli. The ability of whole blood to kill E. coli increased as nestlings matured. Neither this component of innate immunity nor right wing chord length on day18 were as developed as in adults indicating that development of the innate immune system and growth both continued after fledging. Narrow sense heritability analyses suggest that females with strong immune responses produced nestlings with strong immune responses. These data suggest nestling Tree Swallows allocated sufficient energy to support rapid growth to enable fledging by day 18, but that further development of innate immunity occurred post-fledging. ?? 2011 by the Wilson Ornithological Society.

  10. Pain, masticatory performance and swallowing threshold in orthodontic patients

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    Marcos Porto Trein

    2013-12-01

    Full Text Available OBJECTIVE: The aim of this study was to assess pain, masticatory performance and swallowing threshold of patients undergoing orthodontic treatment. METHODS: Ten patients of both genders (mean age of 17.25 ± 5.21 years, with complete permanent dentition, who underwent orthodontic treatment with fixed appliances were evaluated. The masticatory performance and the swallowing threshold were assessed by patient's individual capacity of fragmenting an artificial test food (Optocal which was chewed and had the resulting particles processed by a standardized sieving method, presenting the median particle size (MPS of crushed units. The intensity of pain / discomfort during chewing was evaluated by means of a visual analog scale. All tests were performed at the following times: T0 - before activating the orthodontic appliance; T1 - 24 hours after activation, and T2 - 30 days after activation. RESULTS: The results showed a significant increase in pain at T1 (T0 - 0.60 ± 0.70 mm; T1 - 66.2 ± 34.5 mm, returning to baseline values at T2 (3.20 ± 3.82 mm. Masticatory performance was also reduced in T1 (MPS 10.15 ± 1.1 mm² in comparison to T0 (MPS 7.01 ± 2.9 mm² and T2 (MPS 6.76 ± 1.3 mm². However, particle size was not affected in the swallowing threshold test (T0 - 5.47 ± 2.37 mm²; T1 - 6.19 ± 2.05 mm²; T2 - 5.94 ± 2.36 mm². CONCLUSION: The orthodontic appliances did not interfere in the size of the particles that would be swallowed, even in the presence of pain.

  11. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations

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    Monali Bhosle

    2009-06-01

    Full Text Available Monali Bhosle,1 Joshua S Benner,1 Mitch DeKoven,1 Jeff Shelton21Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA; 2Answers and Insights Market Research, Inc, Indianapolis, IN, USAObjective: To determine the degree to which swallowing valproate (VP tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference.Methods: A quantitative telephone survey of eligible adults (n = 400, ≥18 years old who currently take (n = 236 or previously took (n = 164 VP tablets within the past 6 months was conducted.Results: More than half of the patients indicated that VP tablets were ‘uncomfortable to swallow’ (68.5%, n = 274 and were ‘very interested’ (65.8%, n = 263 in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331 preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40 and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61 were significant predictors of soft gel capsule treatment preference.Conclusion: VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.Keywords: patient preference, valproate formulations, tablet characteristics

  12. Effect of age on proximal esophageal response to swallowing

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    Roberto Oliveira Dantas

    2010-12-01

    Full Text Available CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I, 27 aged 31-50 years (group II, and 22 aged 51-74 years (group III. We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05. The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001. There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.

  13. Pattern of tongue pressure on hard palate during swallowing.

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    Ono, Takahiro; Hori, Kazuhiro; Nokubi, Takashi

    2004-01-01

    Contact of the tongue against the hard palate plays an important role in swallowing. This study aimed to clarify the pattern of contact between the tongue and hard palate by analyzing tongue pressure produced in swallowing 15 ml of water by healthy subjects wearing an experimental palatal plate with seven pressure sensors. Tongue pressure was generated initially by close contact with the anteriomedian part of the hard palate, then with the circumferential part, and finally softly with the posteriomedian part. Tongue pressure reached a peak quickly, then decreased gradually before disappearing almost simultaneously at each measured part of the hard palate. Magnitude and duration were significantly larger in the anteriomedian part compared to the other six parts measured, and was significantly smaller in the posteriomedian part. No laterality was found in tongue pressure produced at the circumferential parts of the hard palate. Our findings indicate that the order of tongue contact against each part of the hard palate as well as duration and magnitude of tongue pressure are coordinated precisely during swallowing. These findings could aid assessment of the tongue movement of dysphagic patients during rehabilitation.

  14. An electrophysiological study of the sequential water swallowing.

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    Gürgör, N; Arıcı, Ş; Kurt Incesu, Tülay; Seçil, Y; Tokuçoğlu, F; Ertekin, C

    2013-06-01

    Sequential water swallowing (SWS) was mostly investigated by the videofluoroscopic and endoscopic methods. However some physiological features of SWS was rarely evaluated by neurophysiological techniques. Our aim was to investigate some neural and muscular changes on sequences of SWS using electromyography (EMG) methods. Fifty-eight normal adults were investigated. SWS was initiated voluntarily with 50ml and 100ml water volumes from a cup. Submental EMG, respiratory signals, heart rate, and sympathetic skin responses (SSR) were measured during SWS. All parameters were increased significantly during the 100ml SWS. During swallowing apnea period, compensatory respiration cycles occurred in 24% and 48% of participants in the 50ml and 100ml SWS, respectively. Heart rate increased during swallowing apnea. SSR were evoked just before and just after the SWS in more than halves of participants. A foreburst EMG in SM muscles at the initiation of SWS was recorded in 86% of normal participants. Older age was associated with a prolonged duration of the apnea period. All parameters of the SWS could be recorded numerically and objectively using electrphysiological methods. These are similar to those obtained by videofluoroscopic and similar methods. The foreburst activity of the initiation of SWS may represents preparatory activity from the activation of the fast cortical descending motor pathway. Increasing heart rate and the prolonged apnea urged that older people and patients could be carefully tested for respiratory and cardiac rhythm disorders. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Thirty years of blackouts: a case report of swallow syncope

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    Irene Lambiris

    2013-04-01

    Full Text Available Deglutition syncope has been demonstrated in isolated case reports, the first being described over 50 years ago. It is thought to be caused by a hypersensitive vagotonic reflex in response to esophageal dilation after swallowing. It can cause syncope due to complete atrioventricular (AV block and acute reduction of cardiac output. Although rare, its lethality is worthy of discussion, as early recognition can offer complete treatment with placement of a pacemaker. A 54-year-old man presented with 30 years of lightheadedness and syncope, followed by disorientation and tremors, after eating sandwiches or drinking carbonated beverages. He initially was evaluated by a neurologist. Work-up included cardiac 2D transthoracic echocardiogram, electroencephalogram, swallow stud, pulmonary function tests, electrocardiogram, and cardiac stress testing. All tests were within normal limits, and it was determined that he was suffering from convulsive syncope and deglutition syncope. Referral to the cardiac electrophysiology department with tilt-table testing accompanied by swallow evaluation was then recommended. The tests demonstrated marked vagal response resulting in sinus bradycardia with second-degree AV block and pauses up to 3.5 seconds. Patient experienced near syncope. A rate-responsive, dual-chamber Boston Scientific pacemaker with DDDR programming was implanted. Patient has remained asymptomatic at follow-up.

  16. Mastication and swallowing: influence of fluid addition to foods

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    Luciano José Pereira

    2007-02-01

    Full Text Available INTRODUCTION: The production of sufficient saliva is indispensable for good chewing. Recent research has demonstrated that salivary flow rate has little influence on the swallowing threshold. OBJECTIVES: The hypothesis examined in the present study was that adding fluids to foods will influence chewing physiology. Materials and METHODS: Twenty subjects chewed on melba toast, cake, carrot, peanut and Gouda cheese. They also chewed on these foods after addition of different volumes of water or alpha-amylase solution. Jaw muscle activity, number of chewing cycles until swallowing and chewing cycle duration were measured. Repeated measures analysis of variance was applied to test the null hypothesis that there would be no statistically significant difference among the results obtained for the various food types and fluids. Subsequently, contrasts were determined to study the levels of intra-subjects factors (food type and fluid volume. Linear regression was used to determine the changes in muscle activity and cycle duration as a function of the chewing cycles. RESULTS: Fluid addition significantly decreased muscle activity and swallowing threshold for melba, cake and peanut (p0.05. Doubling the volume of tap water had a greater effect. CONCLUSIONS: Fluid addition facilitated chewing of dry foods (melba, cake, but did not influence the chewing of fatty (cheese and wet products (carrot. This study is relevant to improve patients' life quality and the management of chewing and feeding disorders caused by hyposalivation.

  17. Suck, swallow and breathing coordination in infants with infantile colic

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    Hanlie Degenaar

    2015-12-01

    Objective: The objective of the study was to explore the suck, swallow and breathing coordination in infants with infantile colic and compare it with infants without the condition. Method: An assessment protocol for suck, swallow and breathing coordination was compiled from literature. This protocol was performed on a research group of 50 infants, independently diagnosed with infantile colic, and a control group of 28 infants without the condition. All participants were from two rural towns in the North–West province, South Africa, selected with a snowball selection method and strict selection criteria. The study followed a static comparison group design. Results: A significant difference in the key components of feeding and the presence of colic in participants of four age categories were found. The correlation between postural control and the presence of infantile colic were sustained in participants from 2–19 weeks old. Conclusion: Suck, swallow and breathing were found to be significantly associated with infantile colic. The findings should be investigated further. It appears that speech-language therapists may play an expanding role in infantile colic. [pdf to follow

  18. Cine-MRI swallowing evaluation after tongue reconstruction

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    Hartl, Dana M. [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)], E-mail: dmhartl@aol.com; Kolb, Frederic; Bretagne, Evelyne [Department of Otolaryngology-Head and Neck Surgery, Institute Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France); Bidault, Francois; Sigal, Robert [Department of Radiology, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex (France)

    2010-01-15

    Objective: To determine the feasibility of cine-MRI for non-invasive swallowing evaluation after surgery for lingual carcinoma with reconstruction using microvascular free flaps. Methods: Ten patients with stage IV carcinoma of the mobile tongue and/or tongue base treated by surgical resection and reconstruction with a free flap were evaluated after an average of 4.3 years (range: 1.5-11 years), using cine-MRI in 'single-shot fast spin echo' (SSFSE) mode. Fiberoptic laryngoscopy of swallowing was performed before MRI to detect aspiration. The tolerance and ability to complete the exam were noted. The mobilities of the oral and pharyngeal structures visualized were evaluated as normal, reduced or increased. Results: Cine-MRI was well tolerated in all cases; 'dry' swallow was performed for the 2 patients with clinical aspiration. Tongue base-pharyngeal wall contact was observed in 5 cases. An increased anterior tongue recoil, increased mandibular recoil, increased posterior oropharyngeal wall advancement and an increased laryngeal elevation were observed in 4 cases. One case of a passive 'slide' mechanism was observed. Conclusions: Cine-MRI is a safe, non-invasive technique for the evaluation of the mobility of oral and oropharyngeal structures after free-flap reconstruction of the tongue. For selected cases, it may be complementary to clinical examination for evaluation of dysphagia after surgery and free-flap reconstruction. Further technical advances will be necessary before cine-MRI can replace videofluoroscopy, however.

  19. Anesthesia and increased hypercarbic drive impair the coordination between breathing and swallowing

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    D'Angelo, Olivia M.; Diaz-Gil, Daniel; Nunn, Danuza; Simons, Jeroen C.P.; Gianatasio, Chloe; Mueller, Noomi; Meyer, Matthew J.; Pierce, Eric; Rosow, Carl; Eikermann, Matthias

    2017-01-01

    Background Coordination between breathing and swallowing helps prevent aspiration of foreign material into the respiratory tract. We examined the effects of anesthesia, and hypercapnia on swallowing-breathing coordination. Methods In a randomized controlled cross-over study, general anesthesia with propofol or sevoflurane was titrated using an up-down method to identify the threshold for suppression of the motor response to electrical stimulation of the forearm. Additional measurements included bispectral index, genioglossus electromyogram, ventilation (pneumotachometer), and hypopharyngeal pressure. During wakefulness and at each level of anesthetic, carbon dioxide was added to increase its end tidal pressure by 4 and 8 mmHg. A swallow was defined as increased genioglossus activity with deglutition apnea and an increase in hypopharyngeal pressure. Spontaneous swallows were categorized as physiological (during expiration or followed by expiration), or pathological (during inspiration or followed by an inspiration). Results A total of 224 swallows were analyzed. Anesthesia increased the proportion of pathological swallows (25.9% versus 4.9%), and decreased the number of swallows per hour (1.7 ± 3.3 versus 28.0 ± 22.3) compared to wakefulness. During anesthesia, hypercapnia decreased hypopharyngeal pressure during inspiration (-14.1±3.7 versus -8.7±2 mmHg), and increased minute ventilation the proportion of pathological swallows (19.1% versus 12.3%), and the number of swallows per hour (5.5 ±17.0. versus 1.3 ± 5.5). Conclusions Anesthesia impaired the coordination between swallowing and respiration. Mild hypercapnia increased the frequency of swallowing during anesthesia and the likelihood of pathological swallowing. During anesthesia, the risk for aspiration may be further increased when ventilatory drive is stimulated. PMID:25275368

  20. Effects of liquid stimuli on dual-axis swallowing accelerometry signals in a healthy population

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    Sejdić Ervin

    2010-02-01

    Full Text Available Abstract Background Dual-axis swallowing accelerometry has recently been proposed as a tool for non-invasive analysis of swallowing function. Although swallowing is known to be physiologically modifiable by the type of food or liquid (i.e., stimuli, the effects of stimuli on dual-axis accelerometry signals have never been thoroughly investigated. Thus, the objective of this study was to investigate stimulus effects on dual-axis accelerometry signal characteristics. Signals were acquired from 17 healthy participants while swallowing 4 different stimuli: water, nectar-thick and honey-thick apple juices, and a thin-liquid barium suspension. Two swallowing tasks were examined: discrete and sequential. A variety of features were extracted in the time and time-frequency domains after swallow segmentation and pre-processing. A separate Friedman test was conducted for each feature and for each swallowing task. Results Significant main stimulus effects were found on 6 out of 30 features for the discrete task and on 5 out of 30 features for the sequential task. Analysis of the features with significant stimulus effects suggested that the changes in the signals revealed slower and more pronounced swallowing patterns with increasing bolus viscosity. Conclusions We conclude that stimulus type does affect specific characteristics of dual-axis swallowing accelerometry signals, suggesting that associated clinical screening protocols may need to be stimulus specific.

  1. Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats.

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    Tsujimura, Takanori; Sakai, Shogo; Suzuki, Taku; Ujihara, Izumi; Tsuji, Kojun; Magara, Jin; Canning, Brendan J; Inoue, Makoto

    2017-05-01

    Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABA A receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABA B receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats. Copyright © 2017 the American Physiological Society.

  2. Spontaneous swallowing frequency has potential to identify dysphagia in acute stroke.

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    Crary, Michael A; Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael F

    2013-12-01

    Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. In a cohort of 63 acute stroke cases, swallow frequency rates (swallows per minute [SPM]) were compared with stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with versus without clinically significant dysphagia. Receiver operating characteristic curve analysis was used to identify the optimal threshold in SPM, which was compared with a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was used to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. Receiver operating characteristic curve analysis yielded a threshold of SPM≤0.40 that identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5- to 10-minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel.

  3. Spontaneous Swallowing Frequency [Has Potential to] Identify Dysphagia in Acute Stroke

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    Carnaby, Giselle D; Sia, Isaac; Khanna, Anna; Waters, Michael

    2014-01-01

    Background and Purpose Spontaneous swallowing frequency has been described as an index of dysphagia in various health conditions. This study evaluated the potential of spontaneous swallow frequency analysis as a screening protocol for dysphagia in acute stroke. Methods In a cohort of 63 acute stroke cases swallow frequency rates (swallows per minute: SPM) were compared to stroke and swallow severity indices, age, time from stroke to assessment, and consciousness level. Mean differences in SPM were compared between patients with vs. without clinically significant dysphagia. ROC analysis was used to identify the optimal threshold in SPM which was compared to a validated clinical dysphagia examination for identification of dysphagia cases. Time series analysis was employed to identify the minimally adequate time period to complete spontaneous swallow frequency analysis. Results SPM correlated significantly with stroke and swallow severity indices but not with age, time from stroke onset, or consciousness level. Patients with dysphagia demonstrated significantly lower SPM rates. SPM differed by dysphagia severity. ROC analysis yielded a threshold of SPM ≤ 0.40 which identified dysphagia (per the criterion referent) with 0.96 sensitivity, 0.68 specificity, and 0.96 negative predictive value. Time series analysis indicated that a 5 to 10 minute sampling window was sufficient to calculate spontaneous swallow frequency to identify dysphagia cases in acute stroke. Conclusions Spontaneous swallowing frequency presents high potential to screen for dysphagia in acute stroke without the need for trained, available personnel. PMID:24149008

  4. The relationship between limit of Dysphagia and average volume per swallow in patients with Parkinson's disease.

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    Belo, Luciana Rodrigues; Gomes, Nathália Angelina Costa; Coriolano, Maria das Graças Wanderley de Sales; de Souza, Elizabete Santos; Moura, Danielle Albuquerque Alves; Asano, Amdore Guescel; Lins, Otávio Gomes

    2014-08-01

    The goal of this study was to obtain the limit of dysphagia and the average volume per swallow in patients with mild to moderate Parkinson's disease (PD) but without swallowing complaints and in normal subjects, and to investigate the relationship between them. We hypothesize there is a direct relationship between these two measurements. The study included 10 patients with idiopathic PD and 10 age-matched normal controls. Surface electromyography was recorded over the suprahyoid muscle group. The limit of dysphagia was obtained by offering increasing volumes of water until piecemeal deglutition occurred. The average volume per swallow was calculated by dividing the time taken by the number of swallows used to drink 100 ml of water. The PD group showed a significantly lower dysphagia limit and lower average volume per swallow. There was a significantly moderate direct correlation and association between the two measurements. About half of the PD patients had an abnormally low dysphagia limit and average volume per swallow, although none had spontaneously related swallowing problems. Both measurements may be used as a quick objective screening test for the early identification of swallowing alterations that may lead to dysphagia in PD patients, but the determination of the average volume per swallow is much quicker and simpler.

  5. Objective Measures of Swallowing Function Applied to the Dysphagia Population: A One Year Experience.

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    Kendall, Katherine A; Ellerston, Julia; Heller, Amanda; Houtz, Daniel R; Zhang, Chong; Presson, Angela P

    2016-08-01

    Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index. Poor pharyngeal constriction (34.5 %) and airway protection deficits (65.5 %) were the most common swallowing abnormalities. Reflux-related dysphagia (36 %), nonspecific pharyngeal dysphagia (24 %), Parkinson disease (16 %), esophageal abnormality (13 %), and brain insult (10 %) were the most common diagnoses. Poor pharyngeal constriction was significantly associated with an esophageal motility abnormality (p < 0.001) and central neurologic insult. In general, dysphagia symptoms as determined by the EAT-10 did not correlate with swallowing function abnormalities. This preliminary study indicates that reflux disease is common in patients with dysphagia and that associated esophageal abnormalities are common in dysphagic populations and may be associated with specific pharyngeal swallowing abnormalities. However, symptom scores from the EAT-10 did not correspond to swallowing pathophysiology.

  6. The importance of the reproducibility of oropharyngeal swallowing in amyotrophic lateral sclerosis. An electrophysiological study.

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    Cosentino, G; Alfonsi, E; Mainardi, L; Alvisi, E; Brighina, F; Valentino, F; Fierro, B; Sandrini, G; Bertino, G; Berlangieri, M; De Icco, R; Fresia, M; Moglia, A

    2017-05-01

    To investigate electrophysiologically the reproducibility of oropharyngeal swallowing in patients with ALS. We enrolled 26 ALS patients, both with and without clinical signs of dysphagia, and 30 age-matched controls. The reproducibility of the electrophysiological signals related to the oral phase (electromyographic activity of the submental/suprahyoid muscles) and the pharyngeal phase (laryngeal-pharyngeal mechanogram) of swallowing across repeated swallows was assessed. To do this we computed two similarity indexes (SI) by using previously described mathematical algorithms. The reproducibility of oropharyngeal swallowing was significantly reduced both in patients with and in those without clinical signs of dysphagia, with more marked alterations being detected in the dysphagic group. The SI of both phases of swallowing, oral and pharyngeal, correlated significantly with dysphagia severity and disease severity. In ALS different pathophysiological mechanisms can alter the stereotyped motor behaviors underlying normal swallowing, thus reducing the reproducibility of the swallowing act. A decrease in swallowing reproducibility could be a preclinical sign of dysphagia and, beyond a certain threshold, a pathological hallmark of oropharyngeal dysphagia. Electrophysiological assessment is a simple and useful tool for the early detection of swallowing abnormalities, and for the management of overt dysphagia in ALS. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  7. Computational Analysis of Pharyngeal Swallowing Mechanics in Patients with Motor Neuron Disease: A Pilot Investigation.

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    Garand, K L; Schwertner, Ryan; Chen, Amy; Pearson, William G

    2017-10-20

    Swallowing impairment (dysphagia) is a common sequela in patients with motor neuron disease (MND). The purpose of this retrospective, observational pilot investigation was to characterize how pharyngeal swallowing mechanics are impacted in patients with MND using a comparison with healthy, non-dysphagic control group. Computational analysis of swallowing mechanics (CASM) was used to determine covariate biomechanics of pharyngeal swallowing from videofluoroscopic assessment in 15 patients with MND and 15 age- and sex-matched healthy controls. Canonical variant analysis with post hoc discriminate function analysis (DFA) was performed on coordinate data mapping functional muscle groups underlying pharyngeal swallowing. Differences in swallowing mechanics associated with group (MND; control), motor neuron predominance (upper; lower), onset (bulbar; spinal), and swallow task (thin, pudding) were evaluated and visualized. Pharyngeal swallowing mechanics differed significantly in patients with MND compared with healthy controls (D = 2.01, p mechanics by motor neuron predominance (D = 5.03, p mechanics of patients with MND differ from and are more heterogeneous than healthy controls. These findings suggest patients with MND may compensate reductions in pharyngeal shortening and tongue base retraction by extending the head and neck and increasing hyolaryngeal excursion. This work and further CASM investigations will lead to further insights into development and evaluation of targeted clinical treatments designed to prolong safe and efficient swallowing function in patients with MND.

  8. Pharyngeal electrical stimulation can modulate swallowing in cortical processing and behavior - magnetoencephalographic evidence.

    Science.gov (United States)

    Suntrup, Sonja; Teismann, Inga; Wollbrink, Andreas; Winkels, Martin; Warnecke, Tobias; Pantev, Christo; Dziewas, Rainer

    2015-01-01

    The act of swallowing is a complex neuromuscular function that is processed in a distributed network involving cortical, subcortical and brainstem structures. Difficulty in swallowing arises from a variety of neurologic diseases for which therapeutic options are currently limited. Pharyngeal electrical stimulation (PES) is a novel intervention designed to promote plastic changes in the pharyngeal motor cortex to aid dysphagia rehabilitation. In the present study we evaluate the effect of PES on cortical swallowing network activity and associated changes in swallowing performance. In a randomized, crossover study design 10min of real (0.2-ms pulses, 5Hz, 280V, stimulation intensity at 75% of maximum tolerated threshold) or sham PES were delivered to 14 healthy volunteers in two separate sessions. Stimulation was delivered via a pair of bipolar ring electrodes mounted on an intraluminal catheter positioned in the pharynx. Before and after each intervention swallowing capacity (ml/s) was tested using a 150ml-water swallowing stress test. Event-related desynchronization (ERD) of cortical oscillatory activity during volitional swallowing was recorded applying whole-head magnetoencephalography before, immediately after and 45min past the intervention. A prominent reduction of ERD in sensorimotor brain areas occurred in the alpha and beta frequency ranges immediately after real PES but not after sham stimulation (pefficiency, which is associated with subtle changes in swallowing function in healthy subjects. Our data contribute evidence that swallowing network organization and behavior can effectively be modulated by PES. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals.

    Science.gov (United States)

    Dudik, Joshua M; Kurosu, Atsuko; Coyle, James L; Sejdić, Ervin

    2015-04-01

    Cervical auscultation with high resolution sensors is currently under consideration as a method of automatically screening for specific swallowing abnormalities. To be clinically useful without human involvement, any devices based on cervical auscultation should be able to detect specified swallowing events in an automatic manner. In this paper, we comparatively analyze the density-based spatial clustering of applications with noise algorithm (DBSCAN), a k-means based algorithm, and an algorithm based on quadratic variation as methods of differentiating periods of swallowing activity from periods of time without swallows. These algorithms utilized swallowing vibration data exclusively and compared the results to a gold standard measure of swallowing duration. Data was collected from 23 subjects that were actively suffering from swallowing difficulties. Comparing the performance of the DBSCAN algorithm with a proven segmentation algorithm that utilizes k-means clustering demonstrated that the DBSCAN algorithm had a higher sensitivity and correctly segmented more swallows. Comparing its performance with a threshold-based algorithm that utilized the quadratic variation of the signal showed that the DBSCAN algorithm offered no direct increase in performance. However, it offered several other benefits including a faster run time and more consistent performance between patients. All algorithms showed noticeable differentiation from the endpoints provided by a videofluoroscopy examination as well as reduced sensitivity. In summary, we showed that the DBSCAN algorithm is a viable method for detecting the occurrence of a swallowing event using cervical auscultation signals, but significant work must be done to improve its performance before it can be implemented in an unsupervised manner. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods.

    Science.gov (United States)

    Prinz, J F; Huntjens, L; de Wijk, R A

    2006-12-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two quantitative methods of describing the coatings, generated by a set of 16 model custards varying in degree of lubrication (fat content) and degree of viscosity (starch concentration) are investigated. In the first method, a trained quantitative descriptive analysis panel (N=8) was instructed to take single mouthfuls of semi-solid foods, swallow and then rinse twice for 5s with water and spit out. The turbidity of the rinse water was then measured. During the same session, sensory assessments of the products were obtained. In the second method the thickness of the coating on the anterior and middle one-thirds of the tongue was quantified using a pair of opto-electronic reflectance sensors mounted on a probe which was placed on the tongue, one sensor measuring the anterior part of the tongue the other the posterior (middle third) of the tongue. Turbidity of the first rinse related strongly to the food's viscosity, as well as to sensory attributes associated with the food's fat content and viscosity, such as perceived thickness, creaminess and fattiness. Turbidity of subsequent rinses related primarily to fat content. These results indicate that turbidity of rinse water is a useful tool in fundamental (e.g., food texture research) as well as applied research (e.g., product development and quality assurance in food industry). Reflectance varied primarily with fat content and did not relate well to sensory attributes.

  11. Unilateral Superior Laryngeal Nerve Lesion in an Animal Model of Dysphagia and Its Effect on Sucking and Swallowing

    Science.gov (United States)

    Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Fukuhara, Takako; Gierbolini-Norat, Estela M.; Thexton, Allan J.; German, Rebecca Z.

    2013-01-01

    We tested two hypotheses relating to the sensory deficit that follows a unilateral superior laryngeal nerve (SLN) lesion in an infant animal model. We hypothesized that it would result in (1) a higher incidence of aspiration and (2) temporal changes in sucking and swallowing. We ligated the right-side SLN in six 2–3-week-old female pigs. Using videofluoroscopy, we recorded swallows in the same pre- and post-lesion infant pigs. We analyzed the incidence of aspiration and the duration and latency of suck and swallow cycles. After unilateral SLN lesioning, the incidence of silent aspiration during swallowing increased from 0.7 to 41.5 %. The durations of the suck containing the swallow, the suck immediately following the swallow, and the swallow itself were significantly longer in the post-lesion swallows, although the suck prior to the swallow was not different. The interval between the start of the suck containing a swallow and the subsequent epiglottal movement was longer in the post-lesion swallows. The number of sucks between swallows was significantly greater in post-lesion swallows compared to pre-lesion swallows. Unilateral SLN lesion increased the incidence of aspiration and changed the temporal relationships between sucking and swallowing. The longer transit time and the temporal coordinative dysfunction between suck and swallow cycles may contribute to aspiration. These results suggest that swallow dysfunction and silent aspiration are common and potentially overlooked sequelae of unilateral SLN injury. This validated animal model of aspiration has the potential for further dysphagia studies. PMID:23417250

  12. The anatomy and physiology of normal and abnormal swallowing in oropharyngeal dysphagia.

    Science.gov (United States)

    Sasegbon, A; Hamdy, S

    2017-11-01

    Eating and drinking are enjoyable activities that positively impact on an individual's quality of life. The ability to swallow food and fluid is integral to the process of eating. Swallowing occupies a dual role being both part of the enjoyment of eating and being a critically important utilitarian activity to enable adequate nutrition and hydration. Any impairment to the process of swallowing can negatively affect a person's perception of their quality of life. The process of swallowing is highly complex and involves muscles in the mouth, pharynx, larynx, and esophagus. The oropharynx is the anatomical region encompassing the oral cavity and the pharynx. Food must be masticated, formed into a bolus and transported to the pharynx by the tongue whereas fluids are usually held within the mouth before being transported ab-orally. The bolus must then be transported through the pharynx to the esophagus without any matter entering the larynx. The muscles needed for all these steps are coordinated by swallowing centers within the brainstem which are supplied with sensory information by afferent nerve fibers from several cranial nerves. The swallowing centers also receive modulatory input from higher centers within the brain. Hence, a swallow has both voluntary and involuntary physiologic components and the term dysphagia is given to difficult swallowing while oropharyngeal dysphagia is difficult swallowing due to pathology within the oropharynx. Problems affecting any point along the complex swallowing pathway can result in dysphagia. This review focuses on the anatomy and physiology behind normal and abnormal oropharyngeal swallowing. It also details the common diseases and pathology causing oropharyngeal dysphagia. © 2017 John Wiley & Sons Ltd.

  13. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

    2014-02-15

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

  14. Fluid mechanics of eating, swallowing and digestion - overview and perspectives.

    Science.gov (United States)

    Engmann, Jan; Burbidge, Adam S

    2013-02-26

    From a very simplistic viewpoint, the human digestive system can be regarded as a long tube (with dramatic variations in diameter, cross-section, wall properties, pumping mechanisms, regulating valves and in-line sensors). We single out a few fluid mechanical phenomena along the trajectory of a food bolus from the mouth to the small intestine and discuss how they influence sensorial perception, safe transport, and nutrient absorption from a bolus. The focus is on lubrication flows between the tongue and palate, the oropharyngeal stage of swallowing and effects of flow on absorption in the small intestine. Specific challenges and opportunities in this research area are highlighted.

  15. Graphic representation of pharyngeal wall motion during swallow: technical note.

    Science.gov (United States)

    Ekberg, O; Borgstrom, P S

    1989-01-01

    Movements of the pharyngeal wall were measured at 12 transverse levels, on consecutive cineradiograms obtained during swallowing of thin, liquid barium, in a single nondysphagic volunteer. By graphic representation of these measurements on the IBM personal computer, it was possible to analyze in detail pharyngeal motor activity in terms of displacement of the pharyngeal wall. The contraction created a fairly steep narrowing of the lumen. The peristaltic wave was more difficult to analyze. Movements of the pharyngeal wall in posteroanterior projection gave good information about the constrictors. Although this technique has several inherent methodologic difficulties, its use may expand our knowledge of pharyngeal peristalsis.

  16. Use of Electronic Resources by M.Sc. Chemistry Students at Arts Science and Commerce College Chopda Dist-Jalgaon

    National Research Council Canada - National Science Library

    Dr.Paithankar Rajeev; R., Mr.Kamble V.R

    2017-01-01

    ... continuously growth in teaching learning process. In the modern era librarian should provide better services to the users for accessing e-resources as like e-books, e-journals, e-databases, e-reports etc...

  17. Barriers to electronic access and delivery of educational information in resource constrained public schools: a case of Greater Tubatse Municipality

    CSIR Research Space (South Africa)

    Pholotho, T

    2016-05-01

    Full Text Available Information and Communication Technologies (ICTs) are capable of expanding access to quality education, educational resources and provide teachers with new skills. Nevertheless, a majority of rural public schools have limited ICTs, mainly due...

  18. Electronic Grey Literature in Accelerator Science and Its Allied Subjects : Selected Web Resources for Scientists and Engineers

    CERN Document Server

    Rajendiran, P

    2006-01-01

    Grey literature Web resources in the field of accelerator science and its allied subjects are collected for the scientists and engineers of RRCAT (Raja Ramanna Centre for Advanced Technology). For definition purposes the different types of grey literature are described. The Web resources collected and compiled in this article (with an overview and link for each) specifically focus on technical reports, preprints or e-prints, which meet the main information needs of RRCAT users.

  19. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer

    NARCIS (Netherlands)

    Langendijk, Johannes A.; Doornaert, Patricia; Rietveld, Derek H. F.; Verdonck-de Leeuw, Irma M.; Leemans, C. Rene; Slotman, Ben J.

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after

  20. A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer.

    NARCIS (Netherlands)

    Langendijk, J.A.; Doornaert, P.A.H.; Rietveld, D.H.F.; de Leeuw, I.M.; Leemans, C.R.; Slotman, B.J.

    2009-01-01

    Introduction: Recently, we found that swallowing dysfunction after curative (chemo) radiation (CH) RT has a strong negative impact on health-related quality of life (HRQoL), even more than xerostomia. The purpose of this study was to design a predictive model for swallowing dysfunction after

  1. Tongue Pressure and Submental Surface Electromyography Measures during Noneffortful and Effortful Saliva Swallows in Healthy Women

    Science.gov (United States)

    Yeates, Erin M.; Steele, Catriona M.; Pelletier, Cathy A.

    2010-01-01

    Purpose: The effortful swallow, a compensatory technique frequently employed by speech-language pathologists for their patients with dysphagia, is still not fully understood in terms of how it modifies the swallow. In particular, although age-related changes are known to reduce maximum isometric tongue pressure, it is not known whether age affects…

  2. Effect of aging on oral and swallowing function after meal consumption.

    Science.gov (United States)

    Hiramatsu, Tetsuya; Kataoka, Hideyuki; Osaki, Mari; Hagino, Hiroshi

    2015-01-01

    Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs). Tongue-palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs) and 23 OA volunteers. There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow) was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption. Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their efforts in mastication and swallowing.

  3. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, A. J.; Weusten, B. L. A. M.; Timmer, R.; Akkermans, L. M. A.; Smout, A. J. P. M.

    2005-01-01

    BACKGROUND: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  4. Relationships between air swallowing, intragastric air, belching and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Bredenoord, AJ; Weusten, BLAM; Timmer, R; Akkermans, LMA; Smout, AJPM

    Background: With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms

  5. Normal swallowing acoustics across age, gender, bolus viscosity, and bolus volume.

    Science.gov (United States)

    Youmans, Scott R; Stierwalt, Julie A G

    2011-12-01

    Cervical auscultation has been proposed as an augmentative procedure for the subjective clinical swallowing examination due to the tangible differences between normal and dysphagic swallowing sounds. However, the research is incomplete regarding cervical auscultation and swallowing acoustics in that the differences between the sounds of normal versus dysphagic swallowing have yet to be fully understood or quantified. The swallows of 96 reportedly healthy adults, balanced for gender and divided into younger, middle, and older age groups, were audio-recorded while ingesting several boluses of varying viscosity and volume. The audio signals were then analyzed to determine their temporal and acoustic characteristics. Results indicated increasing pharyngeal swallowing duration with increasing age, bolus viscosity, and bolus volume. In addition, an increased duration to peak intensity with increasing age was found in one of our two analyses, as well as with some of the more viscous versus less viscous boluses. Men and older persons produced higher peak intensities and peak frequencies than women and younger persons. Thin liquids were produced with more intensity than honey or more viscous boluses, and with greater frequency than mechanical soft solids. Larger volumes resulted in greater peak frequency values. Some of the acoustic measurements appear to be more useful than others, including the duration of the acoustic swallowing signal and the within-subjects peak intensity variable. We noted that differences in swallowing acoustics were more related to changes in viscosity rather than volume. Finally, within-participant observations were more useful than between-participant observations.

  6. Tongue Pressure Modulation during Swallowing: Water versus Nectar-Thick Liquids

    Science.gov (United States)

    Steele, Catriona M.; Bailey, Gemma L.; Molfenter, Sonja M.

    2010-01-01

    Purpose: Evidence of tongue-palate pressure modulation during swallowing between thin and nectar-thick liquids stimuli has been equivocal. This mirrors a lack of clear evidence in the literature of tongue and hyoid movement modulation between nectar-thick and thin liquid swallows. In the current investigation, the authors sought to confirm whether…

  7. The interactions between different tastes on initiation of reflex swallow elicited by electrical stimulation in humans.

    Science.gov (United States)

    Otake, Masanori; Kurose, Masayuki; Uchida, Yoshiaki; Hasegawa, Mana; Yamada, Yoshiaki; Saito, Isao; Yamamura, Kensuke

    2016-09-01

    The act of eating is a source of pleasure for people and is a major factor in maintaining a good quality of life. Several types of products for dysphagia patients are available to decrease aspiration of food that often accompanies daily food intake. The final goal of these products is to improve the ease of forming a food bolus and/or the safety of the swallowing process; however, tastes of products are not a major concern with initiation of swallowing. In the present study, we investigated the effect of bitter taste stimuli (quinine) and the combination of quinine and umami (monosodium glutamate: MSG) applied to the oropharynx on reflex swallows evoked by electrical stimulation to the oropharyngeal mucosa. Each of the distilled water (DW), quinine and quinine-MSG mixture solution (volume of each solutions, 100 µl) was applied 1 s prior to electrical stimulation. No swallow was evoked when each of the solutions was applied without electrical stimulation. The application of DW and lower concentration of quinine (<100 µM) did not affect the latency of reflex swallow, but 100 µM quinine application increased the latency of the reflex swallow. In addition, application of quinine-MSG mixture solution counteracted the increase in latency induced by quinine application alone. These findings suggest that MSG enhances the initiation of swallowing along with its well-known increase in appetite stimulation. Adding MSG might be effective when creating food to promote swallowing.

  8. Prevalence of Auditory Problems in Children with Feeding and Swallowing Disorders

    Science.gov (United States)

    Rawool, Vishakha Waman

    2017-01-01

    Purpose: Although an interdisciplinary approach is recommended for assessment and management of feeding or swallowing difficulties, audiologists are not always included in the interdisciplinary team. The purpose of this study is to report the prevalence of middle ear and hearing problems in children with feeding and swallowing disorders and to…

  9. Prevalence and Severity of Voice and Swallowing Difficulties in Mitochondrial Disease

    Science.gov (United States)

    Read, Jennifer L.; Whittaker, Roger G.; Miller, Nick; Clark, Sue; Taylor, Robert; McFarland, Robert; Turnbull, Douglass

    2012-01-01

    Background: Mutations of mitochondrial DNA (mtDNA) cause a broad spectrum of clinical phenotypes. Anecdotal evidence suggests that voice and swallow problems are a common feature of these diseases. Aims: To characterize accurately the prevalence and severity of voice and swallow problems in a large cohort of patients with mitochondrial disease.…

  10. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions

    Directory of Open Access Journals (Sweden)

    Sejdić Ervin

    2009-10-01

    Full Text Available Abstract Background A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. Methodology To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. Results The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. Conclusion The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  11. Extraction of average neck flexion angle during swallowing in neutral and chin-tuck positions.

    Science.gov (United States)

    Hung, Delbert; Sejdić, Ervin; Steele, Catriona M; Chau, Tom

    2009-10-07

    A common but debated technique in the management of swallowing difficulties is the chin tuck swallow, where the neck is flexed forward prior to swallowing. Natural variations in chin tuck angles across individuals may contribute to the differential effectiveness of the technique. To facilitate the study of chin tuck angle variations, we present a template tracking algorithm that automatically extracts neck angles from sagittal videos of individuals performing chin tuck swallows. Three yellow markers geometrically arranged on a pair of dark visors were used as tracking cues. The algorithm was applied to data collected from 178 healthy participants during neutral and chin tuck position swallows. Our analyses revealed no major influences of body mass index and age on neck flexion angles during swallowing, while gender influenced the average neck angle only during wet swallows in the neutral position. Chin tuck angles seem to be independent of anthropometry and gender in healthy adults, but deserve further study in pathological populations. The proposed neck flexion angle extraction algorithm may be useful in future studies where strict participant compliance to swallowing task protocol can be assured.

  12. [Swallowing after non-surgical treatment (radiation therapy / radiochemotherapy protocol) of laryngeal cancer].

    Science.gov (United States)

    Portas, Juliana; Socci, Claudia Pereira; Scian, Eliana Perissato; Queija, Débora Dos Santos; Ferreira, Alessandra Sampaio; Dedivitis, Rogério Aparecido; Barros, Ana Paula Brandão

    2011-01-01

    Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties. To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors. A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing. All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties. Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.

  13. Population Trends and Management of the Bank Swallow (Riparia riparia) on the Sacramento River, California

    Science.gov (United States)

    Barrett A. Garrison; Ronald W. Schlorff; Joan M. Humphrey; Stephen A. Laymon; Frank J. Michny

    1989-01-01

    Annual monitoring of Bank Swallows (Riparia riparia) along the Sacramento River, California has been conducted since 1986 to determine population trends, evaluate impacts from bank protection and flood control projects, and implement and monitor mitigation efforts. The population of Bank Swallows in a 50-mile river reach remained static over 3...

  14. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  15. Mechanism of Sequential Swallowing during Straw Drinking in Healthy Young and Older Adults

    Science.gov (United States)

    Daniels, Stephanie K.; Corey, David M.; Hadskey, Leslie D.; Legendre, Calli; Priestly, Daniel H.; Rosenbek, John C.; Foundas, Anne L.

    2004-01-01

    Recent research has revealed differences between isolated and sequential swallowing in healthy young adults; however, the influence of normal aging on sequential swallowing has not been studied. Thus, the purpose of this investigation was to examine the effects of normal aging on deglutition during sequential straw drinking. Videofluoroscopic…

  16. Effects of Pacifier and Taste on Swallowing, Esophageal Motility, Transit and Respiratory Rhythm in Human Neonates

    Science.gov (United States)

    Shubert, Theresa R.; Sitaram, Swetha; Jadcherla, Sudarshan R.

    2015-01-01

    Background Pacifier use is widely prevalent globally despite hygienic concerns and uncertain mechanistic effects on swallowing or airway safety. Aims The effects of pacifier and taste interventions on pharyngo-esophageal motility, bolus transit and respiratory rhythms were investigated by determining the upper esophageal sphincter (UES), esophageal body, esophagogastric junction (EGJ) motor patterns as well as deglutition apnea, respiratory rhythm disturbances and esophageal bolus clearance. Methods Fifteen infants (6 males; median gestation 31 wks and birth weight 1.4 kg) underwent high resolution impedance manometry at 43 (41-44) weeks post-menstrual age. Manometric, respiratory, and impedance characteristics of spontaneous swallows, pacifier associated dry swallowing and taste (pacifier dipped in 3% sucrose) associated swallowing were analyzed. Linear mixed and generalized estimating equation models were used. Data are presented as mean ± SEM, %, or median (IQR). Key Results Pharyngo-esophageal motility, respiratory, and impedance characteristics of 209 swallows were analyzed (85 spontaneous swallows, 63 pacifier associated dry swallows, 61 taste associated swallows). Basal UES and EGJ pressures decreased upon pacifier (P<0.05) and taste interventions (P<0.05); however, esophageal motility, respiratory rhythm, and impedance transit characteristics were similar with both interventions. Conclusions and Inferences Oral stimulus with pacifier or taste interventions decreases UES and EGJ basal pressure, but has no effects on pharyngo-esophageal motility, airway interactions, or esophageal bolus transit. A decrease in central parasympathetic-cholinergic excitatory drive is likely responsible for the basal effects. PMID:26727930

  17. Relationship between ease of swallowing and deglutition-related muscle activity in various postures.

    Science.gov (United States)

    Sakuma, T; Kida, I

    2010-08-01

    The purpose of this study was to investigate the relationship between the ease of swallowing and the deglutition-related muscle activity in various body and head postures by surface electromyography (EMG). Bipolar surface electrodes were placed on the right suprahyoid and infrahyoid muscles of nine healthy adults (19-28 years) while swallowing jelly. Ten postures per subject were examined: five body angulations (0 degrees [supine], 30 degrees, 60 degrees, 90 degrees [upright] and 120 degrees from the horizontal) and two head positions (chin-up and chin-down). The duration and amplitude of suprahyoid and infrahyoid muscle activity were measured by an electromyograph, and the ease of swallowing was subjectively determined by using a rating scale (0 = difficult to swallow, 10 = easy to swallow). The group-average duration and amplitude of muscle activity and the group-average rating scales mostly showed insignificant changes with the body angulations independent of the head positions. Interestingly, the duration and amplitude of muscle activity during swallowing were negatively correlated with the rating scales, indicating that a shorter duration and smaller activity of muscle activity corresponds to easier swallowing. Consequently, the duration and amplitude of suprahyoid and infrahyoid muscle activity measured by surface EMG would be a useful indicator of the easy-to-swallow performance.

  18. Respiratory-swallow training in patients with head and neck cancer.

    Science.gov (United States)

    Martin-Harris, Bonnie; McFarland, David; Hill, Elizabeth G; Strange, Charlton B; Focht, Kendrea L; Wan, Zhuang; Blair, Julie; McGrattan, Katlyn

    2015-05-01

    To test a novel intervention to train swallowing to occur in the midexpiratory to low expiratory phase of quiet breathing to improve swallowing safety and efficiency. Safety and efficacy nonrandomized controlled trial with 1-month follow-up. Ambulatory clinics. Patients (N=30) with head and neck cancer (HNC) and chronic dysphagia completed the intervention. Fifteen of these patients participated in a 1-month follow-up visit. Training protocol based on hierarchy of motor skill acquisition to encourage autonomous and optimal respiratory-swallowing coordination. Visual feedback of respiratory phase and volume for swallowing initiation was provided by nasal airflow and rib cage/abdomen signals. Respiratory-swallow phase pattern, Modified Barium Swallow Impairment Profile (MBSImP) scores, Penetration-Aspiration Scale (PAS) scores, and MD Anderson Dysphagia Inventory scores. Using visual feedback, patients were trained to initiate swallows during the midexpiratory phase of quiet breathing and continue to expire after swallowing. This optimal phase patterning increased significantly after treatment (Pdysphagia, with favorable effects on airway protection and bolus clearance. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Leaf anthracnose, a new disease of swallow-worts from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench (synonym=Cynanchum louiseae Kartesz & Gandhi) and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (synonym=Cynanchum rossicum (Kleopow) Borhidi) are invasive plants belonging to the family Apocynaceae and are the targets of biological cont...

  20. New biological information on the invasive swallow-worts (Vincetoxicum spp.)

    Science.gov (United States)

    Vincetoxicum nigrum (L.) Moench [Cynanchum louiseae Kartesz & Gandhi] (black swallow-wort) and V. rossicum (Kleopow) Barbar. [Cynanchum rossicum (Kleopow) Borhidi] (pale swallow-wort) are herbaceous perennial vines in the Apocynaceae native to Europe. Both species are considered invasive in their in...

  1. Leaf anthracnose, a new disease of swallow-worts caused by Colletotrichum lineola from Russia

    Science.gov (United States)

    Black swallow-wort Vincetoxicum nigrum (L.) Moench and pale swallow-wort Vincetoxicum rossicum (Kleopow) Borhidi (family Apocynaceae subfamily Asclepiadoideae) are invasive plants and are the targets of biological control efforts to control their spread in the USA. In 2010, diseased leaves of a rela...

  2. Analysis of the feeding habits of the swallow-tailed hummingbird, Eupetomena macroura (Gmelin, 1788), in an urban park in southeastern Brazil

    OpenAIRE

    Toledo,MCB; Moreira, DM

    2008-01-01

    The aim of this work was to observe and describe the feeding habits and available food resources of the swallow-tailed hummingbird, Eupetomena macroura. The study was carried out in a municipal park located in the city of Taubaté, in the state of São Paulo. The observations took place between December 2003 and October 2004, recording the following variables: 1) the plant species visited for feeding and territorial defense; 2) the kinds of food resources; and 3) the kinds of flight to procure ...

  3. Zeolite-zeolite composite composed of Y zeolite and single-crystal-like ZSM-5 zeolite: Fabricated by a process like “big fish swallowing little one”

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Meng; Li, Peng [Research Centre of Energy Chemical & Catalytic Technology, Taiyuan University of Technology, Taiyuan 030024 (China); Zheng, Jiajun, E-mail: zhengjiajun@tyut.edu.cn [Research Centre of Energy Chemical & Catalytic Technology, Taiyuan University of Technology, Taiyuan 030024 (China); Liu, Yujian [SINOPEC Research Institute of Petroleum Processing, Beijing, 100083 (China); Kong, Qinglan [Research Centre of Energy Chemical & Catalytic Technology, Taiyuan University of Technology, Taiyuan 030024 (China); Tian, Huiping [SINOPEC Research Institute of Petroleum Processing, Beijing, 100083 (China); Li, Ruifeng, E-mail: rfli@tyut.edu.cn [Research Centre of Energy Chemical & Catalytic Technology, Taiyuan University of Technology, Taiyuan 030024 (China)

    2017-06-15

    Zeolite-zeolite composite composed of Y and ZSM-5 zeolite was prepared using depolymerized Y as partial nutrients for the growth of ZSM-5. The as-synthesized samples were characterized by X-ray powder diffraction (XRD), FT-IR, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), transmission electron microscopy (TEM), N{sub 2} adsorption-desorption measurement and Thermogravimetric analysis (TG). Chemical equilibrium at the solution-crystal interface was changed because of the partially depolymerized Y zeolite, the conditions necessary for the growth of ZSM-5 were therefore obtained. ZSM-5 zeolite crystals nucleated and grew on the interface, and Y zeolite crystals were then gradually swallowed by the growing single-crystal-like ZSM-5. - Graphical abstract: Y zeolite crystals in the hydrothermal system were partially depolymerized and an ambience in favor of the formation of ZSM-5 was formed, and ZSM-5 zeolite crystals nucleated and grew up on the external surfaces of Y zeolite crystals. As a consequence, Y zeolite crystals were swallowed by single-crystal-like ZSM-5. - Highlights: • Zeolite composite is composed by Y zeolite and single-crystal-like ZSM-5. • A composite material formed by a process like “big fish swallowing little one”. • Ratio of two zeolites in the as-synthesized sample can be adjusted.

  4. A Mathematical Model for Swallowing of Concentrated Fluids in Oesophagus

    Directory of Open Access Journals (Sweden)

    S. K. Pandey

    2011-01-01

    Full Text Available This model investigates particularly the impact of an integral and a non-integral number of waves on the swallowing of food stuff such as jelly, tomato puree, soup, concentrated fruits juices and honey transported peristaltically through the oesophagus. The fluid is considered as a Casson fluid. Emphasis is on the study of the dependence of local pressure distribution on space and time. Mechanical efficiency, reflux limit and trapping are also discussed. The effect of Casson fluid vis-à-vis Newtonian fluid is investigated analytically and numerically too. The result is physically interpreted as that the oesophagus makes more efforts to swallow fluids with higher concentration. It is observed that the pressure is uniformly distributed when an integral number of waves is there in the oesophagus; but it is non-uniform when a non-integral number of waves is present therein. It is further observed that as the plug flow region widens, the pressure difference increases, which indicates that the averaged flow rate will reduce for a Casson fluid. It is also concluded that Casson fluids are more prone to reflux.

  5. Neural activation of swallowing and swallowing-related tasks in healthy young adults: an attempt to separate the components of deglutition.

    Science.gov (United States)

    Malandraki, Georgia A; Sutton, Bradley P; Perlman, Adrienne L; Karampinos, Dimitrios C; Conway, Charles

    2009-10-01

    Understanding the underlying neural pathways that govern the highly complex neuromuscular action of swallowing is considered crucial in the process of correctly identifying and treating swallowing disorders. The aim of the present investigation was to identify the neural activations of the different components of deglutition in healthy young adults using functional magnetic resonance imaging (fMRI). Ten right-handed young healthy individuals were scanned in a 3-Tesla Siemens Allegra MRI scanner. Participants were visually cued for both a "Swallow" task and for component/control tasks ("Prepare to swallow", "Tap your tongue", and "Clear your throat") in a randomized order (event-related design). Behavioral interleaved gradient (BIG) methodology was used to address movement-related artifacts. Areas activated during each of the three component tasks enabled a partial differentiation of the neural localization for various components of the swallow. Areas that were more activated during throat clearing than other components included the posterior insula and small portions of the post- and pre-central gyri bilaterally. Tongue tapping showed higher activation in portions of the primary sensorimotor and premotor cortices and the parietal lobules. Planning did not show any areas that were more activated than in the other component tasks. When swallowing was compared with all other tasks, there was significantly more activation in the cerebellum, thalamus, cingulate gyrus, and all areas of the primary sensorimotor cortex bilaterally.

  6. Evaluation of an EMG bioimpedance measurement system for recording and analysing the pharyngeal phase of swallowing.

    Science.gov (United States)

    Schultheiss, Corinna; Schauer, Thomas; Nahrstaedt, Holger; Seidl, Rainer O

    2013-07-01

    A neuroprosthetic device for treating swallowing disorders requires an implantable measurement system capable to analysing the timing and quality of the swallowing process in real time. A combined EMG bioimpedance (EMBI) measurement system was developed and is evaluated here. The study was planned and performed as a case-control study. The studies were approved by the Charité Berlin ethics committee in votes EA1/160/09 and EA1/161/09. Investigations were carried out on healthy volunteers in order to examine the usefulness and reproducibility of measurements, the ability to distinguish between swallowing and head movements and the effect of different food consistencies. The correlation between bioimpedance and anatomical and functional changes occurring during the pharyngeal phase of swallowing in non-healthy patients was examined using videofluoroscopy (VFSS). 31 healthy subjects (15♂, 16♀) were tested over the course of 1350 swallows and 19 (17♂, 2♀) non-healthy patients over the course of 54 swallows. The signal curves obtained from both transcutaneous and subcutaneous measurement were similar, characteristic and reproducible (r > 0.5) and correlated with anatomical and functional changes during the pharyngeal phase of swallowing observed using VFSS. Statistically significant differences between head movements and swallowing movements, food volumes and consistencies were found. Neither the conductivity of the food, the sex of the test subject nor the position of the measurement electrodes exerted a statistically significant effect on the measured signal. EMBI is able to reproducibly map the pharyngeal phase of swallowing and changes associated with it both transcutaneously and subcutaneously. The procedure therefore appears to be suitable for use in performing automated evaluation of the swallowing process and for use as a component of an implant.

  7. Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, William G., E-mail: bp1@bu.edu [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States); Hindson, David F. [Department of Radiology, Boston Medical Center, Boston, Massachusetts (United States); Langmore, Susan E. [Department of Otolaryngology, Boston Medical Center, Boston, Massachusetts (United States); Speech and Hearing Sciences, Boston University, Boston, Massachusetts (United States); Zumwalt, Ann C. [Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts (United States)

    2013-03-01

    Purpose: Reduced hyolaryngeal elevation, a critical event in swallowing, is associated with radiation therapy. Two muscle groups that suspend the hyoid, larynx, and pharynx have been proposed to elevate the hyolaryngeal complex: the suprahyoid and longitudinal pharyngeal muscles. Thought to assist both groups is the thyrohyoid, a muscle intrinsic to the hyolaryngeal complex. Intensity modulated radiation therapy guidelines designed to preserve structures important to swallowing currently exclude the suprahyoid and thyrohyoid muscles. This study used muscle functional magnetic resonance imaging (mfMRI) in normal healthy adults to determine whether both muscle groups are active in swallowing and to test therapeutic exercises thought to be specific to hyolaryngeal elevation. Methods and Materials: mfMRI data were acquired from 11 healthy subjects before and after normal swallowing and after swallowing exercise regimens (the Mendelsohn maneuver and effortful pitch glide). Whole-muscle transverse relaxation time (T2 signal, measured in milliseconds) profiles of 7 test muscles were used to evaluate the physiologic response of each muscle to each condition. Changes in effect size (using the Cohen d measure) of whole-muscle T2 profiles were used to determine which muscles underlie swallowing and swallowing exercises. Results: Post-swallowing effect size changes (where a d value of >0.20 indicates significant activity during swallowing) for the T2 signal profile of the thyrohyoid was a d value of 0.09; a d value of 0.40 for the mylohyoid, 0.80 for the geniohyoid, 0.04 for the anterior digastric, and 0.25 for the posterior digastric-stylohyoid in the suprahyoid muscle group; and d values of 0.47 for the palatopharyngeus and 0.28 for the stylopharyngeus muscles in the longitudinal pharyngeal muscle group. The Mendelsohn maneuver and effortful pitch glide swallowing exercises showed significant effect size changes for all muscles tested, except for the thyrohyoid. Conclusions

  8. Factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation for acute lung injury.

    Science.gov (United States)

    Brodsky, Martin B; González-Fernández, Marlís; Mendez-Tellez, Pedro A; Shanholtz, Carl; Palmer, Jeffrey B; Needham, Dale M

    2014-12-01

    Endotracheal intubation is associated with postextubation swallowing dysfunction, but no guidelines exist for postextubation swallowing assessments. We evaluated the prevalence, patient demographic and clinical factors, and intensive care unit (ICU) and hospital organizational factors associated with swallowing assessment after oral endotracheal intubation and mechanical ventilation in patients with acute lung injury (ALI). We performed a secondary analysis of a prospective cohort study in which investigators evaluated 178 eligible patients with ALI who were mechanically ventilated via oral endotracheal tube. The patients were recruited from 13 ICUs at four teaching hospitals in Baltimore, Maryland. Patient demographic and clinical factors, types of ICU, and hospital study sites were evaluated for their association with completion of a swallowing assessment both in the ICU and after the ICU stay before hospital discharge. Factors significantly associated with a swallow assessment were evaluated in a multivariable logistic regression model. Before hospital discharge, 79 (44%) patients completed a swallowing assessment, among whom 59 (75%) had their assessments initiated in ICU and 20 (25%) had their assessments initiated on the hospital ward. Female sex (odds ratio [OR] = 2.01; 95% confidence interval [95% CI] = 1.03-3.97), orotracheal intubation duration (OR = 1.13 per day; 95% CI = 1.05-1.22), and hospital study site (Site 3: OR = 2.41; 95% CI = 1.00-5.78) were independently associated with swallowing assessment. Although Site 3 had a twofold increase in swallowing assessments in the ICU, there was no significant difference between hospitals in the frequency of swallowing assessments completed after ICU discharge (P = 0.287) or in the proportion of patients who failed a swallowing assessment conducted in the ICU (P = 0.468) or on the ward (P = 0.746). In this multisite prospective study, female sex, intubation duration, and

  9. Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier

    Directory of Open Access Journals (Sweden)

    Nikjoo Mohammad S

    2011-11-01

    Full Text Available Abstract Background Swallowing accelerometry has been suggested as a potential non-invasive tool for bedside dysphagia screening. Various vibratory signal features and complementary measurement modalities have been put forth in the literature for the potential discrimination between safe and unsafe swallowing. To date, automatic classification of swallowing accelerometry has exclusively involved a single-axis of vibration although a second axis is known to contain additional information about the nature of the swallow. Furthermore, the only published attempt at automatic classification in adult patients has been based on a small sample of swallowing vibrations. Methods In this paper, a large corpus of dual-axis accelerometric signals were collected from 30 older adults (aged 65.47 ± 13.4 years, 15 male referred to videofluoroscopic examination on the suspicion of dysphagia. We invoked a reputation-based classifier combination to automatically categorize the dual-axis accelerometric signals into safe and unsafe swallows, as labeled via videofluoroscopic review. From these participants, a total of 224 swallowing samples were obtained, 164 of which were labeled as unsafe swallows (swallows where the bolus entered the airway and 60 as safe swallows. Three separate support vector machine (SVM classifiers and eight different features were selected for classification. Results With selected time, frequency and information theoretic features, the reputation-based algorithm distinguished between safe and unsafe swallowing with promising accuracy (80.48 ± 5.0%, high sensitivity (97.1 ± 2% and modest specificity (64 ± 8.8%. Interpretation of the most discriminatory features revealed that in general, unsafe swallows had lower mean vibration amplitude and faster autocorrelation decay, suggestive of decreased hyoid excursion and compromised coordination, respectively. Further, owing to its performance-based weighting of component classifiers, the static

  10. Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.

    Directory of Open Access Journals (Sweden)

    Martha Ingrid Preddie

    2008-03-01

    Full Text Available Objective – To determine if electronic information resources selected by primary care physicians improve their ability to answer simulated clinical questions.Design – An observational study utilizing hour‐long interviews and think‐aloud protocols.Setting – The offices and clinics of primary care physicians in Canada and the United States.Subjects – Twenty‐five primary care physicians of whom 4 were women, 17 were from Canada, 22 were family physicians,and 24 were board certified.Methods – Participants provided responses to 23 multiple‐choice questions. Each physician then chose two questions and looked for the answers utilizing information resources of their own choice. The search processes, chosen resources and search times were noted. These were analyzed along with data on the accuracy of the answers and certainties related to the answer to each clinical question prior to the search.Main results – Twenty‐three physicians sought answers to 46 simulated clinical questions. Utilizing only electronic information resources, physicians spent a mean of 13.0 (SD 5.5 minutes searching for answers to the questions, an average of 7.3(SD 4.0 minutes for the first question and 5.8 (SD 2.2 minutes to answer the second question. On average, 1.8 resources were utilized per question. Resources that summarized information, such as the Cochrane Database of Systematic Reviews, UpToDate and Clinical Evidence, were favored 39.2% of the time, MEDLINE (Ovid and PubMed 35.7%, and Internet resources including Google 22.6%. Almost 50% of the search and retrieval strategies were keyword‐based, while MeSH, subheadings and limiting were used less frequently. On average, before searching physicians answered 10 of 23 (43.5% questions accurately. For questions that were searched using clinician‐selected electronic resources, 18 (39.1% of the 46 answers were accurate before searching, while 19 (42.1% were accurate after searching. The difference of

  11. Analyzing the Academic Research Trends by Using University Digital Resources: A Bibliometric Study of Electronic Commerce in China

    Science.gov (United States)

    Fatima, Anam; Abbas, Asad; Ming, Wan; Zaheer, Ahmad Nawaz; Akhtar, Masood-ul-Hassan

    2017-01-01

    Technology plays a vital role in every field of life especially in business and education. Electronic commerce (EC) begins in the year of 1991 right after internet was introduced for commercial use. It is known to be the 12th five years' plan (2011 to 2015) of Chinese Ministry of Industry and Information Technology. The main "objective"…

  12. Swallowing of bolus types by postsurgical head and neck cancer patients.

    Science.gov (United States)

    Stachler, R J; Hamlet, S L; Mathog, R H; Jones, L; Heilbrun, L K; Manov, L J; O'Campo, J M

    1994-01-01

    Clinically, head and neck cancer patients with anterior resections have better postoperative outcomes than do patients with posterior resections. Videofluoroscopy was used to study the swallowing characteristics in postsurgery head and neck cancer patients and normal controls. Most patients received post-operative radiotherapy and chemotherapy, and no cancer recurrence was noted at the time of study, 4-8 months posttreatment. Bolus types included: 3 mL and 10 mL liquid barium, barium paste, and barium-coated cookie. Temporal measurements and a count of the number of swallows required to ingest each material were made from the videotaped data. Statistical analysis using an unbalanced univariate repeated measures ANOVA was performed. The major differences were found between bolus types, with few differences noted between surgical groups (anterior vs posterior resections) and normal controls. Patients took longer to ingest viscous material, accomplishing this by multiple piecemeal and clearing swallows. Coordination of mastication and swallowing of the cookie was different between normal and patient groups. Patients who are able to swallow reasonably well postoperatively maintain normal coordination and timing of swallowing activity and do not vary these parameters to compensate for structural inadequacy. Instead, repeated swallows are used.

  13. Natural capsaicinoids improve swallow response in older patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2013-09-01

    There is no pharmacological treatment for oropharyngeal dysphagia (OD). The aim of this study was to compare the therapeutic effect of stimulation of oropharyngeal transient receptor potential vanilloid type 1 (TRPV1) with that of thickeners in older patients with OD. A clinical videofluoroscopic non-randomised study was performed to assess the signs of safety and efficacy of swallow and the swallow response in (1) 33 patients with OD (75.94 ± 1.88 years) while swallowing 5, 10 and 20 ml of liquid (20.4 mPa.s), nectar (274.4 mPa.s), and pudding (3930 mPa.s) boluses; (2) 33 patients with OD (73.94 ± 2.23 years) while swallowing 5, 10 and 20 ml nectar boluses, and two series of nectar boluses with 150 μM capsaicinoids and (3) 8 older controls (76.88 ± 1.51 years) while swallowing 5, 10 and 20 ml nectar boluses. Increasing bolus viscosity reduced the prevalence of laryngeal penetrations by 72.03% (p capsaicinoids reduced both, penetrations by 50.% (p capsaicinoids strongly improved safety and efficacy of swallow and shortened the swallow response in older patients with OD. Stimulation of TRPV1 might become a pharmacologic strategy to treat OD.

  14. Effect of oral piperine on the swallow response of patients with oropharyngeal dysphagia.

    Science.gov (United States)

    Rofes, Laia; Arreola, Viridiana; Martin, Alberto; Clavé, Pere

    2014-12-01

    Oropharyngeal dysphagia (OD) is a major gastrointestinal motility disorder that causes severe nutritional and respiratory complications in elderly and neurological patients. In an earlier study, we found that stimulation of pharyngeal sensory neurons by capsaicinoids acting on transient receptor potential vanilloid 1 (TRPV1) improved the swallow response of dysphagic patients. The aim of this study was to explore the effect of piperine, a dual TRPV1/TRPA1 agonist, on the swallow response of dysphagic patients. A videofluoroscopic study was performed to assess the signs of impaired safety and efficacy of swallow and the swallow response of 40 dysphagic patients while swallowing one series of nectar control boluses and two series of nectar boluses supplemented with piperine. Patients were randomized into two groups: one group received 150 μM piperine and the other group received 1 mM. Piperine improved the safety of swallow by: (a) reducing the prevalence of unsafe swallows by -34.48% (P = 0.004) at 150 μM and -57.19% (P sensory neurons is a very promising neurostimulation strategy for dysphagic patients.

  15. Characterizing Dysphagia and Swallowing Intervention in the Traumatic Spinal Injury Population

    Science.gov (United States)

    Valenzano, Teresa J.; Waito, Ashley A.; Steele, Catriona M.

    2016-01-01

    Dysphagia is reported to be a common secondary complication for individuals with traumatic spinal injuries. Different etiologies of traumatic spinal injuries may lead to different profiles of swallowing impairment. We conducted a systematic review to determine the characteristics of dysphagia after traumatic spinal injury and to describe interventions currently used to improve swallowing function in this population. A comprehensive multi-engine literature search identified 137 articles of which 5 were judged to be relevant. These underwent review for study quality, rating for level of evidence, and data extraction. The literature describing dysphagia after traumatic spinal injury was comprised predominantly of low level evidence and single case reports. Aspiration, pharyngeal residue, and decreased/absent hyolaryngeal elevation were found to be common characteristics of dysphagia in this population. The most commonly used swallowing interventions included tube feeding, compensatory swallowing strategies, and steroids/antibiotics. Improvement in swallowing function following swallowing intervention was reported in all studies, however there was no control for spontaneous recovery. The results demonstrate a need for high-quality research to profile the pathophysiology of dysphagia after traumatic spinal injury and controlled studies to demonstrate the efficacy of swallowing interventions in this population. PMID:27412004

  16. Evaluation of Swallow Function in Patients with Craniofacial Microsomia: A Retrospective Study.

    Science.gov (United States)

    van de Lande, Lara S; Caron, Cornelia J J M; Pluijmers, Britt I; Joosten, Koen F M; Streppel, Marloes; Dunaway, David J; Koudstaal, Maarten J; Padwa, Bonnie L

    2017-11-04

    Craniofacial microsomia (CFM) is characterized by underdevelopment of the structures derived from the first and second pharyngeal arches resulting in aesthetic, psychological, and functional problems including feeding and swallowing difficulties. The aim of this study is to gain more insight into swallowing difficulties in patients with CFM. A retrospective study was conducted in the population of patients diagnosed with CFM at three major craniofacial units. Patients with feeding difficulties and those who underwent video fluoroscopic swallow (VFS) studies were included for further analyses. The outcome of the VFS-studies was reviewed with regard to the four phases of swallowing. In our cohort, 13.5% of the 755 patients were diagnosed with swallowing difficulties. The outcome of the VFS-studies of 42 patients showed difficulties in the oral and pharyngeal phases with both thin and thick liquids. Patients with more severe mandibular hypoplasia showed more difficulties to form an appropriate bolus compared to patients who were less severely affected. This is the first study to document swallowing problems in patients with CFM. Difficulties were seen in both the oral and pharyngeal phases. We recommend routine screening for swallowing issues by a speech and language therapist in all patients with CFM and to obtain a VFS-study in patients with a type III mandible.

  17. Therapeutic singing as an early intervention for swallowing in persons with Parkinson's disease.

    Science.gov (United States)

    Stegemöller, E L; Hibbing, P; Radig, H; Wingate, J

    2017-04-01

    For persons with Parkinson's disease (PD), secondary motor symptoms such as swallow impairment impact the quality of life and are major contributors to mortality. There is a present need for therapeutic interventions aimed at improving swallow function during the early stages of PD. The purpose of this pilot study was to examine the effects of a group therapeutic singing intervention on swallowing in persons with PD with no significant dysphagia symptoms. Cohort study. University in the United States. Twenty-four participants with PD. Eight weeks of group therapeutic singing. Electromyography (EMG) was used to assess muscle activity associated with swallow pre and post the group singing intervention. Swallow quality of life (SWAL-QOL) and the Unified Parkinson's Disease Rating Scale (UPDRS) were also obtained pre- and post-intervention. Participants reported minimal difficulty with swallowing, yet results revealed a significant increase in EMG outcome measures, as well as significant improvement in UPDRS total and UPDRS motor scores. No significant differences were revealed for SWAL-QOL. Increases in EMG timing measures may suggest that group singing results in the prolongation of laryngeal elevation, protecting the airway from foreign material for longer periods of time during swallow. Combined with the improvement in UPDRS clinical measures, therapeutic singing may be an engaging early intervention strategy to address oropharyngeal dysphagia while also benefiting additional clinical symptoms of PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Assessment of swallowing and its disorders—A dynamic MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Vijay Kumar, K.V., E-mail: vijaykumarkv@yahoo.in [Department of Speech, Language and Hearing Sciences, SRU (India); Shankar, V., E-mail: drshankarv@yahoo.co.in [Department of Neurology, SRU (India); Santosham, Roy, E-mail: santoshamroy@yahoo.com [Department of Radiology and Imaging Sciences, SRU (India)

    2013-02-15

    Magnetic resonance imaging overcomes the limitations of videofluoroscopy in assessing without radiation exposure. The clinical utility of dynamic MRI for swallowing disorders is not well documented. This study demonstrates the feasibility of using dynamic MRI in assessment of swallowing disorders. Ten normal and three brainstem lesion patients participated in this study. GE Signa HDxt 1.5 Tesla MRI scanner with head-and-neck coil as a receiver and fast imaging employing steady state acquisition sequence was used. The swallow was analyzed in terms of symmetry and amplitude of movements of velum, faucial pillars, tongue, epiglottis and cricopharyngeous and images from the sagittal, coronal and axial planes. In sagittal plane posterior movement of tongue and its compression on velum, elevation of hyoid bone, elevation of larynx and lid action of epiglottis, in the coronal view the symmetrical movements of the faucial pillars and pharyngeal constrictor muscles and in axial plane three anatomical landmarks were targeted based on their role in swallowing, viz. velum, epiglottis and cricopharyngeous were studied. In brainstem lesion individuals, posterior movement of tongue, and elevation of larynx were not seen. Asymmetrical movements of faucial pillars and cricopharyngeous muscle were appreciated in the dynamic MRI. This demonstrates that, dynamic MRI is an efficient tool to understand the swallowing physiology and helps the speech language pathologist in modifying the swallowing maneuvers. Dynamic MRI is an effective tool in assessing swallowing and its disorders. This muscle specific information is not appreciated in videofluoroscopy and this information is necessary to modify the therapy maneuvers.

  19. Influence of the cuff pressure on the swallowing reflex in tracheostomized intensive care unit patients.

    Science.gov (United States)

    Amathieu, R; Sauvat, S; Reynaud, P; Slavov, V; Luis, D; Dinca, A; Tual, L; Bloc, S; Dhonneur, G

    2012-10-01

    Because recovery of an efficient swallowing reflex is a determining factor for the recovery of airway protective reflexes, we have studied the influence of the tracheostomy tube cuff pressure (CP) on the swallowing reflex in tracheotomized patients. Twelve conscious adult intensive care unit (ICU) patients who had been weaned from mechanical ventilation were studied. Simultaneous EMG of the submental muscles with measurement of peak activity (EMGp) and amplitude of laryngeal acceleration (ALA) were performed during reflex swallows elicited by pharyngeal injection of distilled water boluses during end expiration. After cuff deflation, characteristics of the swallowing reflex (latency time: LaT, EMGp, and ALA) were measured at CPs of 5, 10, 15, 20, 25, 30, 40, 50, and 60 cm H(2)O. LaT and CP were linearly related (P<0.01). CP was inversely correlated (P<0.01) to both ALA and EMGp. We demonstrated that LaT, EMGp, and ALA of the swallowing reflex were influenced by tracheostomy tube CP. The swallowing reflex was progressively more difficult to elicit with increasing CP and when activated, the resulting motor swallowing activity and efficiency at elevating the larynx were depressed.

  20. Pre-emptive swallowing stimulation in long-term intubated patients.

    Science.gov (United States)

    Hwang, Chang Ho; Choi, Kyoung Hyo; Ko, Yoon Suk; Leem, Chae Man

    2007-01-01

    To evaluate the effect of pre-emptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2004 were randomly divided into two groups. Fifteen patients of mean age 55.39+/-17.9 years were stimulated (experimental group) and 18 patients of mean age 61.39+/-13.5 years were not stimulated (control group). The duration of intubation was 15.59+/-6.7 days in the experimental group and 15.79+/-6.5 days in the control group. Duration of stimulation in the experimental group was 7.39+/-3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallow study. There were no statistically significant differences in the percentage of aspiration and the swallowed volume between the two groups. However, oral transit time in the experimental group (0.379+/-0.07 seconds) was significantly shorter than that of the control group (0.839+/-0.10 seconds), and the oropharyngeal swallowing efficiency of the experimental group (73.39+/-17.4%/s) was significantly higher than that of the control group (50.19+/-13.0%/s). Pre-emptive swallowing stimulation during intubation assists in the recovery of swallowing function in long-term intubated patients.

  1. Effect of carrot puree in vegetable juice on linguapalatal swallowing pressure.

    Science.gov (United States)

    Moritaka, Hatsue; Mineki, Machiko; Kobayashi, Makoto; Ono, Takahiro; Hori, Kazuhiro

    2017-12-11

    This study aimed to ascertain the influence of various amounts (0-30%) of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure in healthy volunteers. Twenty healthy women (age range: 20-22 years) swallowed a 17-ml drink in a natural state, and linguapalatal swallowing pressure was measured using a special sensor sheet. Peak magnitude (maximum pressure of the tongue pushing on the hard palate), integrated values of linguapalatal swallowing pressure on the waveform, and duration of linguapalatal swallowing pressure were increased with increases in CP concentrations. The total integrated value for 30% CP vegetable juice was larger than that of vegetable juice with no CP. The apparent viscosity of the vegetable juice with a low CP concentration was smaller than that with a high CP concentration at the same shear rate. These results suggest that vegetable juice containing CP affects mechanoreceptor activity in the mouth and generates a neuromotor response. This study aimed to ascertain the influence of various amounts of carrot puree (CP) in vegetable juice on linguapalatal swallowing pressure measured by using a special sensor sheet in healthy volunteers. Obtained results of this study clearly showed that vegetable juice containing CP affects the movement of the tongue in maneuvering the bolus. Moreover, the results demonstrated that this effect depended on the concentration of CP in the vegetable juice. These findings are expected to provide clinically valuable data on the effect of mechanical stimulation during the oral stage of swallowing. © 2017 Wiley Periodicals, Inc.

  2. Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.

    Science.gov (United States)

    Garguilo, Marine; Lejaille, Michèle; Vaugier, Isabelle; Orlikowski, David; Terzi, Nicolas; Lofaso, Frédéric; Prigent, Hélène

    2016-01-01

    Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV. Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order. NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort. ClinicalTrials.gov NCT01519388.

  3. Evaluation of normal swallowing functions by using dynamic high-density surface electromyography maps.

    Science.gov (United States)

    Zhu, Mingxing; Yu, Bin; Yang, Wanzhang; Jiang, Yanbing; Lu, Lin; Huang, Zhen; Chen, Shixiong; Li, Guanglin

    2017-11-21

    Swallowing is a continuous process with substantive interdependencies among different muscles, and it plays a significant role in our daily life. The aim of this study was to propose a novel technique based on high-density surface electromyography (HD sEMG) for the evaluation of normal swallowing functions. A total of 96 electrodes were placed on the front neck to acquire myoelectric signals from 12 healthy subjects while they were performing different swallowing tasks. HD sEMG energy maps were constructed based on the root mean square values to visualize muscular activities during swallowing. The effects of different volumes, viscosities, and head postures on the normal swallowing process were systemically investigated by using the energy maps. The results showed that the HD sEMG energy maps could provide detailed spatial and temporal properties of the muscle electrical activity, and visualize the muscle contractions that closely related to the swallowing function. The energy maps also showed that the swallowing time and effort was also explicitly affected by the volume and viscosity of the bolus. The concentration of the muscular activities shifted to the opposite side when the subjects turned their head to either side. The proposed method could provide an alternative method to physiologically evaluate the dynamic characteristics of normal swallowing and had the advantage of providing a full picture of how different muscle activities cooperate in time and location. The findings from this study suggested that the HD sEMG technique might be a useful tool for fast screening and objective assessment of swallowing disorders or dysphagia.

  4. Swallowing function after laryngeal cleft repair: more than just fixing the cleft.

    Science.gov (United States)

    Osborn, Alexander J; de Alarcon, Alessandro; Tabangin, Meredith E; Miller, Claire K; Cotton, Robin T; Rutter, Michael J

    2014-08-01

    To evaluate and describe the swallowing function in children after laryngeal cleft repair. Ten-year (2002-2012) retrospective chart review. Academic tertiary care pediatric otolaryngology practice. Records of 60 children who had surgical repair of laryngeal cleft (ages 2 weeks-14 years) and postoperative functional endoscopic evaluation of swallowing or videofluoroscopic swallow studies were examined retrospectively. Twenty-nine children had one postoperative swallow evaluation, 19 children had two, 4 children had three, 5 children had four, and 3 children had five. Median time to the first evaluation was 10.8 weeks (interquartile range [IQR]: 36.5, 231). On the final swallow evaluation, 34 (57%) children demonstrated normal swallowing parameters, 12 (20%) children showed penetration, and 14 (23%) children showed aspiration. Forty-three (72%) children were able to take everything by mouth normally or with minor behavioral modifications, 11 (18%) children required thickened fluids, and six (10%) children were kept nil per os (NPO). Mean improvement on the penetration-aspiration (pen-asp) scale was 2.13. On multivariable analysis, neurodevelopmental issues and gastronomy tube use were associated with the need for NPO status. Despite a high rate of surgical success, a substantial minority of children have persistent swallowing dysfunction after laryngeal cleft repair. Swallowing dysfunction after repair is multifactorial and arises from concomitant neurologic, anatomic, or other comorbidities that contribute to oropharyngeal and pharyngeal dysphagia. Based on our results, we recommend a testing schedule for postoperative swallowing evaluations after cleft repair. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  5. The prevalence of pediatric voice and swallowing problems in the United States.

    Science.gov (United States)

    Bhattacharyya, Neil

    2015-03-01

    Determine the prevalence of pediatric voice and swallowing problems in the United States. The 2012 National Health Interview Survey pediatric voice and language module was analyzed, identifying children reporting a voice or swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for voice or swallowing problems, diagnoses given, and severity of voice or swallowing problem were analyzed. An estimated 839 ± 89 thousand children (1.4% ± 0.1%) reported a voice problem. Overall, 53.5% ± 1.9% were given a diagnosis for the voice problem and 22.8% ± 4.6% received voice services. Laryngitis (16.6% ± 5.5%) and allergies (10.4% ± 4.0%) were the most common diagnoses. A total of 16.4% graded the voice problem as a "big" or "very big" problem. An estimated 569 ± 63 thousand children (0.9% ± 0.1%) reported a swallowing problem. A total of 12.7% ± 3.8% received swallowing services and 13.4% ± 1.6% were given a diagnosis for their swallowing problem. Neurological problems were the most common diagnoses (11.1% ± 4.5%). A total of 17.9% graded the swallowing problem as a "big" or "very big" problem. These data provide the first insight into the prevalence of childhood voice and swallowing problems, which affect approximately 1% of children annually. A relative minority seek care for their problem, despite the disease impact. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  6. Swallowing transit times and valleculae residue in stable chronic obstructive pulmonary disease

    Science.gov (United States)

    2014-01-01

    Background Breathing and swallowing are physiologically linked to ensure effortless gas exchange during oronasal breathing and to prevent aspiration during swallowing. Studies have indicated consistent aspiration in chronic obstructive pulmonary disease, mainly related to delayed swallowing reflex and problems with lingual propulsion and pharyngeal peristalsis as a result of bilateral weakness and incoordination of the related muscles. The purpose of the present study was to evaluate swallowing transit times and valleculae residue characteristics of stable COPD patients who have no swallowing complaints. Methods Our study population included 20 stable patients with COPD and no swallowing complaints and 20 healthy controls. Swallowing was assessed through videofluoroscopic examination and involved the analysis of the following parameters: (1) pharyngeal stages of deglutition; (2) the duration of bolus movement through the oral cavity and pharynx (i.e. transit times); (3) valleculae residue ratio; (4) penetration/aspiration. Results Participants of the study did not present any signs of penetration-aspiration for any of the tested consistencies. Patients with COPD presented longer pharyngeal transit times during the ingestion of the liquid consistency and during the ingestion of the paste consistency. Regarding the duration of tongue base contact with the posterior pharyngeal wall, COPD patients also presented longer durations for the liquid and paste consistencies. No significant difference was observed for the distribution of individuals among the different valleculae residue severity levels. Conclusions Our study suggests that stable COPD patients may present physiological adaptations as a protective swallowing maneuver to avoid aspiration/penetration of pharyngeal contents. Moreover, valleculae residue cannot be seen as an isolated factor when trying to explain swallowing alterations in this population. PMID:24739506

  7. [Clinical characterisation and course following therapeutic intervention for swallowing disorders in hospitalised paediatric patients].

    Science.gov (United States)

    Salinas-Valdebenito, Luis; Núñez-Farias, Alicia C; Milagros, Angeli; Escobar-Henríquez, Raúl G

    Swallowing disorders are common in hospitalised patients and are an added difficulty when it comes to discharging them from hospital. Suitable characterisation performed by means of assessments conducted by a neurologist and a speech and language therapist allows for more accurate therapeutic decision-making. To describe swallowing disorders from the speech and language therapy evaluation performed on admission until discharge in paediatric patients and their relation with the therapeutic intervention that was implemented. We performed a retrospective analysis consisting in the examination of the medical records of 38 paediatric patients hospitalised between May 2007 and June 2008. Functional clinical evaluation was carried out in 100% of patients, and a video swallow study was conducted in 34%. Swallowing disorders were characterised as mild, moderate and severe, according to the stage that was altered and aspiratory risk to the airway. A speech therapist provided therapeutic intervention, and parents and caregivers were given special training. Swallowing disorders were chiefly associated to prematurity. The most frequently used therapeutic techniques were: tactile stimulation, providing patterns and training of parents. In the speech and language therapy evaluation performed on admission, 37% of disorders were severe, 21% were moderate and 42% were mild disorders. In most of the newborn infants, progress was favourable, as shown by a shift to normal swallowing in 48% and to mild in 8%. In the 17 preterm newborn infants, there was a change to normal swallowing in 65% and to mild in 12%. Swallowing disorders in this group of patients is mainly associated to prematurity. Systematic therapeutic intervention would help in the recovery from swallowing disorders, especially in preterm newborn infants.

  8. Implication of the vagus nerve in breathing pattern during sequential swallowing in rats.

    Science.gov (United States)

    Ouahchi, Yacine; Duclos, Celia; Marie, Jean Paul; Verin, Eric

    2017-10-01

    The ventilatory pattern during sequential swallowing is influenced by the vagal activity. As the vagus nerve is paired and mixed, we aimed (1) to determine if vagal implication in swallowing and breathing coordination is symmetric. (2) to study the importance of vagal afferences in swallowing and breathing coordination. Sixty two Wistar rats (7-11weeks, 260-400g) were studied by barometric plethysmography. In the first part of the study, we determined the effects of a right cervical vagotomy and the effects of a left cervical vagotomy on ventilatory pattern at rest and during sequential swallowing (14 rats with right vagotomy, 14 rats with left vagotomy and 14 rats with sham surgery). Comparisons of ventilatory variables were made between right and left vagotomized animals. Thereafter, we determined the effects of electrical vagus nerve stimulation (VNS) on ventilatory pattern at rest and during sequential swallowing (10 rats with electrical VNS and 10 rats with sham VNS). We showed that a right or a left cervical vagotomy does not alter ventilation at rest, but induces during sequential swallowing a decrease in respiratory rate (RR) (p0.05). Electrical VNS had no effect on ventilation at rest, but it minimized during sequential swallowing a decrease in RR related to a local alteration of the vagus nerve after placement of the electrodes as shown following sham VNS. In conclusion, the implication of vagus nerve in breathing pattern during sequential swallowing seems symmetric and influenced by activation of the vagal afferent pathway. These data can be useful when testing electrical VNS in swallowing disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Share and share alike: encouraging the reuse of academic resources through the Scottish electronic Staff Development Library

    Directory of Open Access Journals (Sweden)

    Lorna M. Campbell

    2001-12-01

    Full Text Available The Scottish electronic Staff Development Library (http://www.sesdl.scotcit.acuk is an ongoing collaborative project involving the Universities of Edinburgh, Paisley and Strathclyde which has been funded by SHEFC as part of their current ScotCIT Programme (http:llwww.scotcit.ac.uk. This project is being developed in response to the increasing demand for flexible, high-quality staff development materials.

  10. FUNCTIONS OF ELECTRONIC LEARNING RESOURCES IN THE PROCESS OF PROFESSION-ORIENTED ORAL SPEECH TRAINING OF FUTURE TEACHERS OF FRENCH LANGUAGE

    Directory of Open Access Journals (Sweden)

    E. Yakovenko-Glushenkova

    2014-07-01

    Full Text Available The article analyzes the use of information and communication technologies in the formation of profession-oriented competence in listening and speaking (monologic, dialogic speech of future teachers of French language in the initial school (I and II years. In order to assure the effective use of ICT in the formation of profession-oriented oral speech competence of future teachers of French language in terms of analyzing, systematizing and summarizing of scientific references the following criterion of the selection of electronic resources as the educational material were identified by the author: relevance (modernity; originality; thoroughness; topicality; informative value; applicability; availability; suitability to communicative needs of future teachers of French language, to their intelligence level and interests; professionally informative significancy; interactivity; contextuality; media intension; social and cultural value; educational value. In turn, the functional use of ICT in formation of profession-oriented oral speech competence of future teachers of French language is represented by the classification, according to which all electronic resources according to their functions are divided into communicative, share, documentation, generative and interactive that is demonstrated by the corresponding examples.

  11. Fiberoptic endoscopic evaluation of swallowing in swallowing disorders – fees-. Case report at Popayán, Colombia.

    Directory of Open Access Journals (Sweden)

    Rodrigo Molina-García

    2011-09-01

    Full Text Available Dysphagia is a frequently pathological condition in pa­tients with stroke and carries a substantial risk of dehy­dration, malnutrition and aspiration pneumonia. So far there are two methods for diagnosis; Videofluoroscopy (VFC and Fiberoptic Endoscopic Evaluation of Swa­llowing (FEES. The first is considered the gold standard method, with a high cost, radiation exposure that requires the transfer of the patient to radiology, the patient’s abili­ty to follow simple commands and time required to com­plete. VFC does not replicate physiological conditions in which the patient is routinely, so it is considered that its representation is limited, the second test is an alternative procedure to be more economical, safe, well tolerated, wi­dely available, lasting approximately 20 minutes and with the possibility of doing it in the patient’s bed. Unlike FVC, to evaluate the presence of pharyngeal, this correlates with the risk of aspiration. Clinical report: The objective of this report is to present a male patient, 33 years old, who admitted to a health institution because it presents a clini­ cal picture compatible with stroke, as findings found right hemiplegia and swallowing disorder, as required gastros­tomy tubes. We performed Fiberoptic Endoscopic Evalua­tion of Swallowing (FEES as a diagnostic method, which allowed visualization of the anatomic and functional en­vironment, the type of food consistency could be secure in their feeding process, thus avoiding silent aspirations and insights that could lead an aspiration pneumonia. It also allowed the group to make recommendations for nutritio­nal support, physiotherapy and speech therapy for ambu­latory management of the patient.

  12. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Wiesner, W.; Steinbrich, W. [Institute of Diagnostic Radiology, University Hospital of Basel (Switzerland); Wetzel, S.G.; Radue, E.W. [Institute of Neuroradiology, University Hospital Basel (Switzerland); Kappos, L.; Hoshi, M.M. [Department of Neurology, University Hospital of Basel (Switzerland); Witte, U. [Section of Logopedia, University Hospital of Basel (Switzerland)

    2002-04-01

    The purpose of this study was to evaluate if subjective symptoms indicating an impaired deglutition correlate with videofluoroscopic findings in patients with multiple sclerosis (MS). Videofluoroscopic examinations of 18 MS patients were analyzed by a radiologist and a logopedist and compared with the symptoms of these patients. Four patients complained about permanent dysphagia. Six patients reported mild and intermittent difficulties in swallowing, but were asymptomatic at the time of videofluoroscopy. Eight patients had no symptoms regarding their deglutition. All patients (n=4) who complained of permanent dysphagia showed aspiration. All patients (n=6) with mild and intermittent difficulties in swallowing showed undercoating of the epiglottis and/or laryngeal penetration. Of those 8 patients without any swallowing symptoms, only 2 had a normal videofluoroscopy. Swallowing abnormalities seem to be much more frequent in patients with MS than generally believed and they may easily be missed clinically as long as the patients do not aspirate. (orig.)

  13. SWALLOWING DISORDERS IN CLINICAL PRACTICE: FUNCTIONAL ANATOMY, ASSESSMENT AND REHABILITATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    STANESCU Ioana

    2014-09-01

    Full Text Available Swallowing is a complex process consisting in transporting food from mouth to the stomach; it involves voluntary and reflex activity of more than 30 nerves and muscles, requiring complex neuromuscular coordination and brainstem and cortical centers for controle. Dysphagia is defined as a alteration in the swallowing process, which cause difficulty in transporting saliva and aliments from the mouth trough the pharynx and esophagus into the stomach . It is a frequent symptom, affecting especially old people, people with neurological diseases, cancers of head and neck or severe reflux . Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus, which could e caused by neurological conditions. Dysphagia carries serious health risks: malnutrition, dehydration, increase risk of infections. Effective dysphagia management requires an interdisciplinary approach; the goal of rehabilitation is to identify and treat abnormalities of swallowing while maintaining safe and efficient nutrition. KEY WORDS: swallowing, dysphagia, functional anatomy, rehabilitation, neuroplasticity

  14. Lost and found…Tracking a swallowed denture: Role of radiology

    Directory of Open Access Journals (Sweden)

    Yogita Khalekar

    2017-01-01

    Full Text Available Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, and anesthesiologists for prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscous necrosis, perforation, and penetration to neighbouring organs leading to fistulae, bleeding and obstruction. Here, we present the case of a 65 year old female patient who swallowed the denture, which was detected by barium swallow and removed by endoscopy. Hence, the management of swallowed denture needs a multidisciplinary approach with the help of a dentist, otolaryngologist and anesthesiologists. Dentists should recommend patients to visit them for planned check ups or revisit them in case of denture dislodgement or loosening as soon as possible to prevent such life threatening events.

  15. Time-Frequency Analysis and Hermite Projection Method Applied to Swallowing Accelerometry Signals

    Directory of Open Access Journals (Sweden)

    Ervin Sejdić

    2010-01-01

    Full Text Available Fast Hermite projections have been often used in image-processing procedures such as image database retrieval, projection filtering, and texture analysis. In this paper, we propose an innovative approach for the analysis of one-dimensional biomedical signals that combines the Hermite projection method with time-frequency analysis. In particular, we propose a two-step approach to characterize vibrations of various origins in swallowing accelerometry signals. First, by using time-frequency analysis we obtain the energy distribution of signal frequency content in time. Second, by using fast Hermite projections we characterize whether the analyzed time-frequency regions are associated with swallowing or other phenomena (vocalization, noise, bursts, etc.. The numerical analysis of the proposed scheme clearly shows that by using a few Hermite functions, vibrations of various origins are distinguishable. These results will be the basis for further analysis of swallowing accelerometry to detect swallowing difficulties.

  16. Randomized trial of two swallowing assessment approaches in patients with acquired brain injury

    DEFF Research Database (Denmark)

    Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H.

    2014-01-01

    OBJECTIVE: To examine whether patients assessed for initiation of oral intake only by Facial-Oral Tract Therapy had a greater risk of developing aspiration pneumonia during neurorehabilitation than patients assessed by Fibreoptic Endoscopic Evaluation of Swallowing. DESIGN: Randomized controlled ...

  17. Contribution of the lateral lemniscus to the control of swallowing in decerebrate cats.

    Science.gov (United States)

    Ota, R; Takakusaki, K; Katada, A; Harada, H; Nonaka, S; Harabuchi, Y

    2013-12-19

    Lateral lemniscus, a relay nucleus of auditory sensation, is involved in the control of phonatory movements such as human speech and vocalization of animals. The present study was designed to test whether neurons in the lateral lemniscus contributed to the control of swallowing, one of non-phonic oro-pharyngolaryngeal movements. In acutely decerebrated cats (n=15), swallowing was induced by electrical stimulation (20-80μA at 10Hz for 20s with rectangular pulses of 0.2ms duration) delivered to the superior laryngeal nerve (SLN). Repetitive electrical stimulation (30-50μA at 50Hz for 10-20s) applied to the dorsal nucleus of the lateral lemniscus (LLD) increased the number and reduced the latency to the onset of the SLN-induced swallowing. On the other hand, stimulation of the ventral nucleus of the lateral lemniscus and the paralemniscal area, corresponding to the ventrolateral part of the parabrachial nucleus and the Kölliker-Fuse nucleus, often suppressed the SLN-induced swallowing. Microinjection of NMDA (0.1-0.15μl, 5.0-10mM) into the LLD through a stereotaxically placed glass micropipette facilitated the SLN-induced swallowing, i.e., the number was increased and the latency of swallowing was reduced. We also injected muscimol (a gamma amino-butyric acid (GABA)A receptor agonist), bicuculline (a GABAA receptor antagonist) and baclofen (a GABAB receptor agonist) into the LLD (0.1-0.15μl and 5.0mM for each substance). It was observed that an injection of muscimol suppressed the SLN-induced swallowing. However, an injection of bicuculline facilitated the swallowing. An injection of baclofen did not alter the swallowing. These results suggest the presence of functional topography in the lateral lemniscus and the paralemniscal area in relation to the control of swallowing. The facilitatory LLD-effects on swallowing are modulated by glutamatergic and GABAergic receptors on neurons in the LLD. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

  18. Accumulation of PCB congeners in nestling tree swallows (Tachycineta bicolor) on the Hudson River, New York

    Science.gov (United States)

    Echols, Kathy R.; Tillitt, Donald E.; Nichols, John W.; Secord, Anne L.; McCarty, John P.

    2004-01-01

    Tree swallows (Tachycineta bicolor) were used as a sentinel species to monitor the contamination and bioavailability of polychlorinated biphenyls (PCBs) in the Hudson River watershed. Several tree swallow nest box colonies around and downstream from Hudson Falls, NY, were studied. Tree swallow eggs, adults, and 5-, 10-, and 15-day-old nestlings were collected and analyzed for 103 PCB congeners. Emergent insects collected by net (primarily Odonata) or as a food bolus (primarily Diptera) taken from the mouths of adult tree swallows returning to the nest were analyzed in the same manner. Total PCB concentrations (wet weight) in eggs from two contaminated sites ranged from 9000 to 25 000 ng/g and accumulated to 32 000 and 96 000 ng/g in 15-day-old nestling at two contaminated sites. The congener patterns of PCBs in eggs, nestlings, and adults were compared to those found in emergent insects (Odonata and Diptera) using principal components analysis. The PCB patterns of the biota differed from that of Aroclor technical mixtures. PCB patterns in adult tree swallows were similar to those in eggs, while the patterns in dietary insects were similar to nestling tree swallows. Uptake rate constants were determined for tree swallow nestlings and compared between the two contaminated sites. The estimated PCB congener uptake rate constants were 0.008-0.02 d-1 based on uptake in nestlings until day 15 post-hatch. The rate constants were comparable between the two study areas and may be used to predict nestling contamination at other locations. Our studies confirm the utility of nestling tree swallows to evaluate localized PCB contamination.

  19. Deleterious sucking habits and atypical swallowing in children with otitis media with effusion.

    Science.gov (United States)

    Ralli, Giovanni; Ruoppolo, Giovanni; Mora, Renzo; Guastini, Luca

    2011-10-01

    The aim of this study was to investigate the possible correlation between otitis media with effusion, bad sucking habits and atypical swallowing in children affected by otitis media with effusion. 65 children, aged from 7 to 12 years, observed in the ENT Department of the "La Sapienza" University of Rome, were enrolled in the study group (group A). All children were affected by otitis media with effusion for more than 3 months. As control group, 60 healthy children, aged from 7 to 12 years were identified (group B). All the children underwent medical history, with evaluation of the sucking habits, ENT examination, tympanometry, orthodontic examination and evaluation of swallowing. In the orthodontic examination the variables analyzed were: maximum mouth opening, right and left mandibular lateral movements and mandibular protrusion. Atypical swallowing was considered to occur when lip activity produced strong tension in the perioral musculature, and/or the tip of the tongue was placed or pushed against the anterior teeth during swallowing. In the group A, atypical swallowing was found in 33/65 subjects out of the 65 children (50.7%). In the control group (group B) 16/60 children (26.6%) showed atypical swallowing. Compared with group B, deleterious sucking habits were significantly higher (phabits were present in almost all children with atypical swallowing (28/33 in group A and 12/16 in group B). Our data suggest a correlation between otitis media with effusion, deleterious sucking habits and prevalence of atypical swallowing. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Effect of aging on oral and swallowing function after meal consumption

    Directory of Open Access Journals (Sweden)

    Hiramatsu T

    2015-01-01

    Full Text Available Tetsuya Hiramatsu,1,2 Hideyuki Kataoka,3 Mari Osaki,4 Hiroshi Hagino3,4 1Department of Speech Pathology and Audiology, Matsue Co-medical College, Matsue, Japan; 2Graduate School of Medical Sciences, Tottori University, 3School of Health Science, Faculty of Medicine, Tottori University, 4Rehabilitation Division, Tottori University Hospital, Yonago, Japan Background/purpose: Dysphagia may worsen due to fatigue of the infrahyoid and suprahyoid muscle groups as a result of repetitive swallowing during a meal. We investigated the hypothesis that meal consumption may reduce tongue strength and endurance in older adults (OAs.Methods: Tongue–palate pressure, oral diadochokinesis, repetitive saliva swallowing, and surface electromyography activity before and after a meal were measured in 23 young adults (YAs and 23 OA volunteers.Results: There was a statistically significant difference in both tongue pressure and the number of voluntary swallows between YAs and OAs. Peak tongue pressure was significantly lower in OAs than YAs both before and after meal consumption. The most notable finding was that the first time interval (the time from test initiation to the beginning of the first swallow was prolonged after meal consumption only in OAs, whereas the first time interval showed no difference between YAs and OAs before meal consumption with reference to the repetitive saliva swallowing test. The initiation of swallowing was prolonged by both meal consumption and aging; there was a significant interaction between these two factors. The number of repetitions of the monosyllable/pa/was statistically similar between YAs and OAs before meal consumption, but it was significantly lower in OAs after meal consumption.Conclusion: Aging leads to declining tongue pressure and motor function of the lips. It is possible that swallowing function declines in older individuals when meal consumption is prolonged, especially at the end of mealtime, as a result of their

  1. Swallowing dysfunction among patients with laryngeal cleft: More than just aspiration?

    Science.gov (United States)

    Strychowsky, Julie E; Dodrill, Pamela; Moritz, Ethan; Perez, Jennifer; Rahbar, Reza

    2016-03-01

    The Modified Barium Swallow (MBS) is the most widely utilized instrumental assessment of swallowing disorders in children; however, the exact role in the evaluation of laryngeal clefts remains controversial. This study was an IRB-approved retrospective review on patients diagnosed with laryngeal cleft from 2002 to 2014. The objective was to describe the range of swallowing dysfunction that may be present in patients with laryngeal clefts both pre- and post-intervention (conservative management versus surgery). A speech-language pathologist reviewed MBS studies and medical records to determine Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) scores. One hundred seventy-five patients who underwent laryngeal cleft repair during the study period (type 1, n=111; type 2, n=54; type 3, n=9; type 4, n=1) were included. Fifty patients who were managed conservatively (type 1) were also included. Swallowing impairment was demonstrated in all phases of swallowing for all cleft types. Oral phase impairment ranged from 27-67% pre-intervention to 19-75% post-intervention, triggering impairment from 24-42% pre-intervention to 24-75% post-intervention, and pharyngeal phase impairment (laryngeal penetration and aspiration) from 57-100% pre-intervention to 40-100% post-intervention. Laryngeal penetration and aspiration on thin and thick liquids, silent aspiration, PAS, and FOIS scores are reported. Significant improvements in swallowing function (p<0.05) were documented in all of the conservatively and surgically managed sub-groups. The MBS study is a useful tool for evaluating swallowing function in patients with laryngeal cleft and provides information beyond the lack or presence of aspiration. Understanding impairments in all phases of swallowing may be beneficial for perioperative management. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Age-related Differences in Tongue-Palate Pressures for Strength and Swallowing Tasks

    OpenAIRE

    Fei, Tiffany; Polacco, Rebecca Cliffe; Hori, Sarah E.; Molfenter, Sonja M.; Peladeau-Pigeon, Melanie; Tsang, Clemence; Steele, Catriona M.

    2013-01-01

    The tongue plays a key role in the generation of pressures for transporting liquids and foods through the mouth in swallowing. Recent studies suggest that there is an age-related decline in tongue strength in healthy adults. However, whether age-related changes occur in tongue pressures generated for the purpose of swallowing remains unclear. Prior literature in this regard does not clearly explore the influence of task on apparent age-related differences in tongue pressure amplitudes. Furthe...

  3. Favorable Swallowing Outcomes following Vagus Nerve Sacrifice for Vagal Schwannoma Resection.

    Science.gov (United States)

    Patel, Mira A; Eytan, Danielle F; Bishop, Justin; Califano, Joseph A

    2017-02-01

    Objective To determine the impact of unilateral vagal sacrifice for vagal schwannoma on postoperative swallowing function. Study Design Case series, chart review. Setting Academic medical institution. Subjects and Methods Ten patients underwent vagus nerve sacrifice for vagal schwannoma resection. Archived pathology records dating from 1985 through 2012 at our institution were retrospectively queried for cases of vagal schwannoma with vagus nerve sacrifice. Medical records were abstracted for demographic and disease information as well as cranial nerve and swallowing function. Preoperative and postoperative cranial nerve function, subjective and objective measures of swallowing function, Functional Oral Intake Scale (FOIS) level, and need for vocal fold medialization were variables collected. Data were analyzed with summary statistics. Results The patients who underwent vagal sacrifice for vagal schwannoma at our institution had a mean age of 42.3 years (median, 44 years; range, 15-63 years) and follow-up of 35.6 months (median, 9 months; range, 1-115 months). Most presented with no preoperative cranial nerve deficit or difficulty swallowing. Immediately postoperatively, 90% had a vagus nerve deficit, but 50% had no subjective difficulty swallowing, and 70% had a FOIS level of 7 at postoperative hospital discharge. Within 1 month after surgery, 70% had normal swallowing function according to a modified barium swallow study. A full diet was tolerated by mouth within an average of 2.7 days (median, 2 days; range, 1-6 days) after surgery in this cohort. Seventy percent required vocal fold medialization postoperatively for incomplete glottic closure. Conclusion Vagal nerve sacrifice during resection of vagal schwannoma can be performed with normal postoperative swallowing function.

  4. Impact of rhythmic oral activity on the timing of muscle activation in the swallow of the decerebrate pig.

    Science.gov (United States)

    Thexton, Allan J; Crompton, A W; Owerkowicz, Tomasz; German, Rebecca Z

    2009-03-01

    The pharyngeal swallow can be elicited as an isolated event but, in normal animals, it occurs within the context of rhythmic tongue and jaw movement (RTJM). The response includes activation of the multifunctional geniohyoid muscle, which can either protract the hyoid or assist jaw opening; in conscious nonprimate mammals, two bursts of geniohyoid EMG activity (GHemg) occur in swallow cycles at times consistent with these two actions. However, during experimentally elicited pharyngeal swallows, GHemg classically occurs at the same time as hyoglossus and mylohyoid activity (short latency response) but, when the swallow is elicited in the decerebrate in the absence of RTJM, GHemg occurs later in the swallow (long latency response). We tested the hypothesis that it was not influences from higher centers but a brain stem mechanism, associated with RTJM, which caused GHemg to occur earlier in the swallow. In 38 decerebrate piglets, RTJM occurred sporadically in seven animals. Before RTJM, GHemg had a long latency, but, during RTJM, swallow related GHemg occurred synchronously with activity in hyoglossus and mylohyoid, early in the swallow. Both early and late responses were present during the changeover period. During this changeover period, duplicate electrodes in the geniohyoid could individually detect either the early or the late burst in the same swallow. This suggested that two sets of geniohyoid task units existed that were potentially active in the swallow and that they were differentially facilitated or inhibited depending on the presence or absence of rhythmic activity originating in the brain stem.

  5. Stable carbon and nitrogen isotopes of tree swallows influenced by oil sands aquatic reclamation

    Energy Technology Data Exchange (ETDEWEB)

    Farwell, A.; Dixon, D. [Waterloo Univ., ON (Canada); Harms, J. [Saskatchewan Univ., Saskatoon, SK (Canada); Smits, J. [Calgary Univ., AB (Canada)

    2010-07-01

    This presentation reported on a study in which tree swallows (Tachycineta bicolor) were studied to evaluate reclamation strategies used by oil sand operators in Alberta. Wetland reclamation involves the transformation of tailings water and solids into functioning aquatic ecosystems. Naphthenic acids (NAs) and polycyclic aromatic compounds (PACs) in tailing/reclamation material are toxic constituents that pose concern for growth rate, reproductive function and immune function in tree swallows. Exposure to xenobiotics from these tailings-based sites was determined by increased detoxification enzyme (EROD) activity. The dietary exposure of tree swallows to oil sands constituents was determined through stable isotope analysis. Previous studies revealed trends of 13C depletion and 15N enrichment in benthic invertebrates from reclaimed wetlands on the oil sands. Since most food consumed by tree swallow nestlings is aquatic, the isotope signatures in tree swallows should provide evidence of exposure to oil sands constituents. Tree swallow feather and muscle tissues were examined in this study to determine if stable isotopes could be used to identify dietary contributions from oil sands reclamation sites versus reference sites containing no tailings materials.

  6. Cine MRI of swallowing in patients with advanced oral or oropharyngeal carcinoma: a feasibility study.

    Science.gov (United States)

    Kreeft, Anne Marijn; Rasch, Coen R N; Muller, Sara H; Pameijer, Frank A; Hallo, Eeke; Balm, Alfons J M

    2012-06-01

    Treatment of oral and oropharyngeal cancer may cause dysphagia. Purpose is to examine whether cine magnetic resonance imaging (MRI) yields additional information compared to standard examination in the evaluation of posttreatment dysphagia and mobility of oral and oropharyngeal structures. Thirty-four cine MRIs were made in 23 patients with advanced oral and oropharyngeal cancer, consisting of an MR image every 800 ms during swallowing which is compared to videofluoroscopy and quality of life questionnaires. A scoring system was applied to assess mobility on cine MR and videofluoroscopy leading to a score ranging from 9 to 17. Cine MRI of the swallowing in a midsagittal plane visualized the tumor (if located in the same plane), important anatomic structures and surgical reconstructions. Posttreatment mobility on cine MRI and videofluoroscopy was significantly diminished compared to pretreatment, mean pretreatment cine MRI score was 10.8 and posttreatment 12.4 (p = 0.017). Impaired mobility on cine MRI was significantly correlated to more swallowing problems (Spearman's correlation coefficient 0.73, p = 0.04), on videofluoroscopy not. Cine MRI is a promising new technique as an adjunct to standard examinations for evaluation of swallowing in patients with oral and oropharyngeal cancer. Cine MRI directly visualizes the dynamics of swallowing and allows evaluation of pre- and posttreatment differences. Abnormal findings are significantly correlated with subjective swallowing complaints of patients.

  7. A model experiment to study swallowing of spherical and elongated particles

    Science.gov (United States)

    Marconati, Marco; Raut, Sharvari; Charkhi, Farshad; Burbidge, Adam; Engmann, Jan; Ramaioli, Marco

    2017-06-01

    Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force). Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  8. Intensive swallowing and orofacial contracture rehabilitation after severe burn: A pilot study and literature review.

    Science.gov (United States)

    Clayton, Nicola A; Ward, Elizabeth C; Maitz, Peter K

    2017-02-01

    Dysphagia following severe burns can be significant and protracted, yet there is little evidence describing the rehabilitation principles, process or outcomes. Outline current evidence and detail the clinical outcomes of two cases who underwent a multifaceted intensive treatment programme aimed at rehabilitating dysphagia by strengthening swallow function and minimising orofacial contractures after severe head and neck burns. Two men (54 and 18 years) with full-thickness head and neck burns and inhalation injury underwent intensive orofacial scar management and dysphagia rehabilitation. Therapy was prescribed, consisting of scar stretching, splinting and pharyngeal swallow tasks. Horizontal and vertical range of movement (HROM; VROM), physiological swallow features, functional swallowing outcomes and related distress, were collected at baseline and routinely until dysphagia resolution and scar stabilisation. At presentation, both cases demonstrated severely reduced HROM and VROM, profound dysphagia and moderate dysphagia related distress. Therapy adherence was high. Resolution of dysphagia to full oral diet, nil physiological swallowing impairment, and nil dysphagia related distress was achieved by 222 and 77 days post injury respectively. VROM and HROM achieved normal range by 237 and 204 days. Active rehabilitation achieved full functional outcomes for swallowing and orofacial range of movement. A protracted duration of therapy can be anticipated in this complex population. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  9. Development of a Portable Non-Invasive Swallowing and Respiration Assessment Device

    Directory of Open Access Journals (Sweden)

    Wann-Yun Shieh

    2015-05-01

    Full Text Available Dysphagia is a condition that happens when a person cannot smoothly swallow food from the mouth to the stomach. It causes malnourishment in patients, or can even cause death due to aspiration pneumonia. Recently, more and more researchers have focused their attention on the importance of swallowing and respiration coordination, and the use of non-invasive assessment systems has become a hot research trend. In this study, we aimed to integrate the timing and pattern monitoring of respiration and swallowing by using a portable and non-invasive approach which can be applied at the bedside in hospitals or institutions, or in a home environment. In this approach, we use a force sensing resistor (FSR to detect the motions of the thyroid cartilage in the pharyngeal phase. We also use the surface electromyography (sEMG to detect the contraction of the submental muscle in the oral phase, and a nasal cannula to detect nasal airflow for respiration monitoring during the swallowing process. All signals are received and processed for swallowing event recognition. A total of 19 volunteers participated in the testing and over 57 measurements were made. The results show that the proposed approach can effectively distinguish the swallowing function in people of different ages and genders.

  10. Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer.

    Science.gov (United States)

    Burnip, E; Owen, S J; Barker, S; Patterson, J M

    2013-11-01

    Treatment for advanced laryngeal cancer includes surgery, and/or chemoradiotherapy or radiotherapy. Each of these treatments results in major changes to the swallowing mechanism. Dysphagia is strongly correlated with poorer quality of life. A good understanding of outcomes is needed for well-informed treatment decisions. This study reports on patients' swallowing outcomes following surgical and non-surgical treatments based on the results of three different swallowing tests. A total of 123 data sets were collected in out-patient clinics across two hospitals in North East England. There were no significant differences between treatment groups for patient-reported swallowing outcomes or swallowing performance. However, patients who had undergone chemoradiotherapy or radiotherapy (with or without laryngectomy) had significantly more diet restrictions than other groups. Long-term dysphagia is a common outcome of treatment for advanced laryngeal cancer. Patients treated with chemoradiotherapy and laryngectomy reported the worst overall outcomes. More longitudinal prospective research with large treatment groups is needed to investigate swallowing outcomes following different treatment methods.

  11. Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma.

    Science.gov (United States)

    Dworkin, James Paul; Hill, Samuel L; Stachler, Robert J; Meleca, Robert J; Kewson, Danny

    2006-01-01

    The purposes of this study were to (1) evaluate swallowing function using both subjective and objective measures in patients treated nonsurgically for stages III and IV laryngeal squamous cell carcinoma, (2) assess the effect of time from treatment completion on swallowing function, and (3) assess sequelae associated with modality of treatment. To achieve these objectives, a retrospective study of 14 patients was conducted. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and evaluated by three independent judges for seven functional criteria: standing secretions, valleculae spillage, valleculae residue, postcricoid residue, laryngeal penetration, aspiration, and cough. Patient interviews were performed to establish patient perception of swallowing and his/her current posttreatment diet. Results revealed that each patient exhibited swallowing abnormalities in at least one of the seven objective functional categories studied. Ten patients suffered from variable degrees of dysphagia, ranging from mild to severe, on all measures. No significant differences were noted between those patients with less than or greater than 12 months posttreatment. Common treatment sequelae included PEG tube placement for nutritional supplementation, tracheostomy placement for airway security and/or pulmonary toilet, repeated episodes of aspiration pneumonia requiring hospital admission, and radiation-induced oropharyngeal stricture. Further studies using subjective and objective swallowing function measures for patients treated with alternative chemoradiation regimens versus surgery (with or without adjuvant therapies) for advanced stage laryngeal cancer are needed.

  12. A model experiment to study swallowing of spherical and elongated particles

    Directory of Open Access Journals (Sweden)

    Marconati Marco

    2017-01-01

    Full Text Available Swallowing disorders are not uncommon among elderly and people affected by neurological diseases. For these patients the ingestion of solid grains, such as pharmaceutical oral solid formulations, could result in choking. This generally results in a low compliance in taking solid medications. The effect of the solid medication size on the real or perceived ease of swallowing is still to be understood from the mechanistic viewpoint. The interplay of the inclusion shape and the rheology of the liquid being swallowed together with the medication is also not fully understood. In this study, a model experiment was developed to study the oropharyngeal phase of swallowing, replicating the dynamics of the bolus flow induced by the tongue (by means of a roller driven by an applied force. Experiments were performed using a wide set of solid inclusions, dispersed in a thick Newtonian liquid. Predictions for a simple theory are compared with experiments. Results show that an increase in the grain size results in a slower dynamics of the swallowing. Furthermore, the experiments demonstrated the paramount role of shape, as flatter and more streamlined inclusions flow faster than spherical. This approach can support the design of new oral solid formulations that can be ingested more easily and effectively also by people with mild swallowing disorders.

  13. Swallowing Disorders after Oral Cavity and Pharyngolaryngeal Surgery and Role of Imaging

    Directory of Open Access Journals (Sweden)

    Caterina Giannitto

    2017-01-01

    Full Text Available Head and neck squamous cell carcinoma is the sixth most common cancer diagnosed worldwide and the eighth most common cause of cancer death. Malignant tumors of the oral cavity, oropharynx, and larynx can be treated by surgical resection or radiotheraphy with or without chemotheraphy and have a profound impact on quality of life functions, including swallowing. When surgery is the chosen treatment modality, the patient may experience swallowing impairment in the oral and pharyngeal phases of deglutition. A videofluoroscopic study of swallow enables the morphodynamics of the pharyngeal-esophageal tract to be accurately examined in patients with prior surgery. These features allow an accurate tracking of the various phases of swallowing in real time, identifying the presence of functional disorders and of complications during the short- and long-term postoperative recovery. The role of imaging is fundamental for the therapist to plan rehabilitation. In this paper, the authors aim to describe the videofluoroscopic study of swallow protocol and related swallowing impairment findings in consideration of different types of surgery.

  14. Viscosity threshold that allows safe swallow in elderly with post-stroke dysphagia

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    Rodolfo Peña

    2017-08-01

    Full Text Available Objective: To determine the viscosity threshold that allows safe swallowing in older adults with post-stroke dysphagia. Method: Cross-sectional analytical study. 6 patients over 60 years old with dysphagia participated. Were given six viscosities (50mPa s, 110mPa s, 170mPa s, 230mPa s, 290mPa s and 350mPa s made from no carbonated water and a corn starch-based thickener. Swallowing safety signs (wet voice, cough and oxygen saturation were assessed in each viscosity by Fiberoptic Endoscopic Evaluation of Swallowing (FEES. Viscosities’ performances in swallowing safety signs were compared in order to know which viscosity would be the safest. Results: 100% of swallowing safety signs did not appear in any viscosity assessed. Conclusions: It is not possible to determine the viscosity threshold that allows safe swallowing in patients with post-stroke dysphagia in the viscosities assessed. We discuss about multiple factors that had had affect our results: size sample, use of FEES to assess low viscosities, and viscosities’ intervals used.

  15. Efficacy of EMG/bioimpedance-triggered functional electrical stimulation on swallowing performance

    Directory of Open Access Journals (Sweden)

    Corinna Schultheiss

    2016-08-01

    Full Text Available In order to support swallowing, the efficacy of functional electrical stimulation for different stimulation settings of the submental musculature has been investigated. The stimulation was administrated at rest and synchronously to voluntary initiated swallows. The onset of a swallow was detected in real-time by a combined electromyography/ bioimpedance measurement at the neck in order to trigger the stimulation. The amplitude and speed of larynx elevation caused by the FES has been assessed by the observed change in bioimpedance whereas a reduction of bioimpedance corresponds to an increase in larynx elevation. Study results from 40 healthy subjects revealed that 73% of the subjects achieved a larger and faster larynx elevation during swallowing with triggered FES and therefor a better protection of their airways. However, we also observed a decrease in larynx elevation compared to normal swallowing in 11 out of the 40 subjects what might not benefit from such a treatment. The largest improvement of larynx elevation and speed during swallowing could be achieved with three stimulation channels formed by four electrodes in the submental region.

  16. Contemporary management of voice and swallowing disorders in patients with advanced lung cancer.

    Science.gov (United States)

    Brady, Grainne C; Carding, Paul N; Bhosle, Jaishree; Roe, Justin W G

    2015-06-01

    Advanced lung cancer can cause changes to swallowing and communication function. Direct tumour invasion, dyspnoea and deconditioning can all impact on swallowing function and communication. Cancer treatment, if administered, may cause or compound symptoms. In this study, the nature of swallowing and communication difficulties in patients with advanced lung cancer will be discussed, and management options including medical management, speech and language therapy (SLT) intervention, and surgical interventions will be considered. Advanced lung cancer can result in voice and swallowing difficulties, which can increase symptom burden and significantly impact on quality of life (QOL). There is a growing evidence base to support the use of injection laryngoplasty under local anaesthetic to offer immediate improvement in voice, swallowing and overall QOL. There is limited literature on the nature and extent of voice and swallowing impairment in patients with lung cancer. Well designed studies with robust and sensitive multidimensional dysphagia and dysphonia assessments are required. Outcome studies examining interventions with clearly defined treatment goals are required. These studies should include both functional and patient-reported outcome measures to develop the evidence base and to ensure that interventions are both timely and appropriate.

  17. Taste and Temperature in Swallowing Transit Time after Stroke

    Directory of Open Access Journals (Sweden)

    Paula C. Cola

    2012-09-01

    Full Text Available Background: Oropharyngeal dysphagia is common in individuals after stroke. Taste and temperature are used in dysphagia rehabilitation. The influence of stimuli, such as taste and temperature, on swallowing biomechanics has been investigated in both healthy individuals and in individuals with neurological disease. However, some questions still remain unanswered, such as how the sequence of offered stimuli influences the pharyngeal response. The goal of the present study was to determine the influence of the sequence of stimuli, sour taste and cold temperature, on pharyngeal transit time during deglutition in individuals after stroke. Methods: The study included 60 individuals with unilateral ischemic stroke, 29 males and 31 females, aged 41–88 years (mean age: 66.2 years examined 0–50 days after ictus (median: 6 days, with mild to moderate oropharyngeal dysphagia. Exclusion criteria were hemorrhagic stroke patients, patients with decreased level of consciousness, and clinically unstable patients, as confirmed by medical evaluation. The individuals were divided into two groups of 30 individuals each. Group 1 received a nonrandomized sequence of stimuli (i.e. natural, cold, sour, and sour-cold and group 2 received a randomized sequence of stimuli. A videofluoroscopic swallowing study was performed to analyze the pharyngeal transit time. Four different stimuli (natural, cold, sour, and sour-cold were offered. The images were digitalized and specific software was used to measure the pharyngeal transit time. Since the values did not present regular distribution and uniform variances, nonparametric tests were performed. Results: Individuals in group 1 presented a significantly shorter pharyngeal transit time with the sour-cold stimulus than with the other stimuli. Individuals in group 2 did not show a significant difference in pharyngeal transit time between stimuli. Conclusions: The results showed that the sequence of offered stimuli influences

  18. Utility of the electronic information resource UpToDate for clinical decision-making at bedside rounds.

    Science.gov (United States)

    Phua, J; See, K C; Khalizah, H J; Low, S P; Lim, T K

    2012-02-01

    Clinical questions often arise at daily hospital bedside rounds. Yet, little information exists on how the search for answers may be facilitated. The aim of this prospective study was, therefore, to evaluate the overall utility, including the feasibility and usefulness of incorporating searches of UpToDate, a popular online information resource, into rounds. Doctors searched UpToDate for any unresolved clinical questions during rounds for patients in general medicine and respiratory wards, and in the medical intensive care unit of a tertiary teaching hospital. The nature of the questions and the results of the searches were recorded. Searches were deemed feasible if they were completed during the rounds and useful if they provided a satisfactory answer. A total of 157 UpToDate searches were performed during the study period. Questions were raised by all ranks of clinicians from junior doctors to consultants. The searches were feasible and performed immediately during rounds 44% of the time. Each search took a median of three minutes (first quartile: two minutes, third quartile: five minutes). UpToDate provided a useful and satisfactory answer 75% of the time, a partial answer 17% of the time and no answer 9% of the time. It led to a change in investigations, diagnosis or management 37% of the time, confirmed what was originally known or planned 38% of the time and had no effect 25% of the time. Incorporating UpToDate searches into daily bedside rounds was feasible and useful in clinical decision-making.

  19. Regaining water swallowing function in the rehabilitation of critically ill patients with intensive-care-unit acquired muscle weakness.

    Science.gov (United States)

    Thomas, Simone; Sauter, Wolfgang; Starrost, Ulrike; Pohl, Marcus; Mehrholz, Jan

    2017-03-21

    Treatment in intensive care units (ICUs) often results in swallowing dysfunction. Recent longitudinal studies have described the recovery of critically ill people, but we are not aware of studies of the recovery of swallowing function in patients with ICU-acquired muscle weakness. This paper aims to describe the time course of regaining water swallowing function in patients with ICU-acquired weakness in the post-acute phase and to describe the risks of regaining water swallowing function and the risk factors involved. This cohort study included patients with ICU-acquired muscle weakness in our post-acute department, who were unable to swallow. We monitored the process of regaining water swallowing function using the 3-ounce water swallowing test. We included 108 patients with ICU-acquired muscle weakness. Water swallowing function was regained after a median of 12 days (interquartile range =17) from inclusion in the study and after a median of 59 days (interquartile range= 36) from the onset of the primary illness. Our multivariate Cox Proportional Hazard model yielded two main risk factors for regaining water swallowing function: the number of medical tubes such as catheters at admission to the post-acute department (adjusted hazard ratio [HR] = 1.282; 95% confidence interval [CI]: 1.099-1.495) and the time until weaning from the respirator in days (adjusted HR =1.02 per day; 95%CI: 0.998 to 1.008). We describe a time course for regaining water swallowing function based on daily tests in the post-acute phase of critically ill patients. Risk factors associated with regaining water swallowing function in rehabilitation are the number of medical tubes and the duration of weaning from the respirator. Implications for rehabilitation Little guidance is available for the management of swallowing dysfunction in the rehabilitation of critically ill patients with intensive-care-units acquired muscle weakness. There is a time dependent pattern of recovery from

  20. Swallowing and respiratory distress in hospitalized patients with bronchiolitis.

    Science.gov (United States)

    Maffey, Alberto; Moviglia, Teresita; Mirabello, Catalina; Blumenthal, Lidia; Gentile, Luis; Niremberg, Mabel; Gilligan, Guillermo; Teper, Alejandro

    2013-12-01

    The aim of this study was to evaluate the risk of airway and/or pulmonary food or saliva aspiration in infants with moderate respiratory distress who are hospitalized with respiratory syncytial virus (RSV) bronchiolitis. This prospective, descriptive study was conducted during two epidemic RSV seasons at the Ricardo Gutiérrez Children's Hospital in Buenos Aires, Argentina. Included were otherwise healthy infants in their first wheezing episode with a modified Tal clinical score between 5 and 9. Swallowing was evaluated using a dynamic technetium-99 m colloid radionuclide salivagram using a gamma camera, followed by video fluoroscopy using nonionic and ionic contrast material. Fifteen patients (7 boys) were included. Age at evaluation (mean ± SD) was 4.3 ± 1.5 months; clinical score was 7.5 ± 1.4. Patients required (mean ± SD) supplemental oxygen and hospitalization 7.5 ± 3.7 and 8.8 ± 4.3 days, respectively. All technetium-99 m salivagram (10/10, as the gamma camera equipment was out of service during part of the study) and video fluoroscopy (15/15) studies were normal. No episodes of aspiration or laryngeal penetration were detected in any patient. Our study found that infants hospitalized with moderate respiratory distress due to RSV bronchiolitis did not show aspiration.

  1. Severe breathing and swallowing difficulties during routine restorative dentistry.

    Science.gov (United States)

    Lococo, Filippo; Trabucco, Laura; Leuzzi, Giovanni; Salvo, Fulvio; Paci, Massimiliano; Sgarbi, Giorgio; Ferrari, Anna Maria

    2015-04-30

    Although sporadically reported after dental examination, subcutaneous emphysema may be erroneously confused with an allergic, or anaphylactic, reaction. We herein report a case of a 57-year-old Caucasian woman who came to our attention after restorative treatment for a carious mandibular right second primary molar. During dental examination, an air driven hand-piece was used to restore occlusal caries. Suddenly, swallowing and breathing difficulties and a facial swelling involving the neck and, partially, the face occurred. She was urgently transported to the Emergency Department with the suspicious of allergic reaction. Clinical examination revealed palpable crepitus at the level of the head, neck and pre-sternal region but no inflammation, trismus or fluid collection was detected. A Chest X-ray first and a computed tomography scan later showed air in the deeper regions from the peri-mandibular and retro-mandibular spaces to the sub-maxillary and latero-cervical area along the vascular sulcus and retropharyngeal space descending into the mediastinal space. So, the patient was admitted for respiratory monitoring and started intravenous administration of largespectrum antibiotics and analgesics. Her hospital course was unremarkable and 5 days later she was discharged after regression of symptoms and complete radiological resolution. Three months after discharge, the patient was clinically free of recurrence. Dental care, Pneumomediastinum, Restorative dentistry.

  2. [Functional endoscopic evaluation of swallowing in infants with deglutition disorders].

    Science.gov (United States)

    Partida-Justo, I; Israel Grijalva-Otero, J E; Ramírez-Figueroa, J L; Sepúlveda-Vildosola, A C; Zurita-Cruz, J N

    2017-10-25

    Functional endoscopic evaluation of swallowing (FEES) is a recognized method for Deglutition Disorders (DD) in adults, with anecdotal experience in children, obtaining not conclusive results. To compare the accuracy of test FEES in infants with high suspicion of altered DD seen in a third level hospital with the gold standard Videofluoroscopic (VF). The results and findings by FEES and VF of 66 children with clinical diagnosis of DD were compared. An estimate of the sensitivity and specificity of FEES was performed. As well as calculating positive predictive value (PPV), negative predictive value (NPV) and likelihood ratios. 60 patients enrolled, 4 and FEES showed high sensitivity to identify the presence of aspiration and penetration (9 98%) and high specificity for the arrest of spillage and waste (94% and 95%). Gastroesophageal reflux to make the diagnosis of DD with FEES had a sensitivity of 80% and specificity of 84%. Spill and penetration had the highest agreement with respect to the gold standard of 0.81. FEES in infants diagnosed with DD had a sensitivity of 80.8% and specificity 85.3%. 0696 concordance regarding to the VFD in the diagnosis of DD, and to identify suction stroke had a kappa of 0815.

  3. Swallowing performance after radiation therapy for carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    O' Rourke, I.C.; Tiver, K.; Bull, C.; Gebski, V.; Langlands, A.O.

    1988-05-15

    The purpose of the study reported in this article was to tabulate the incidence and etiologic factors of importance in the development of strictures after radiotherapy for carcinoma of the esophagus and to analyze the outcome of patients who develop such strictures. Eighty patients were treated with radiotherapy, 50 having radical and 30 having palliative treatment. Sixty-nine patients had squamous cell carcinoma, four had adenocarcinoma, one had sarcoma, one had mucoepidermoid carcinoma, and five had undifferentiated tumors. Forty percent developed no stricture, 30% had benign fibrotic stricture, and 28% developed malignant stricture. The etiologic factors analysed included age, pretreatment swallowing score, histology and length (size) of tumor; stage of disease, dose of radiotherapy, and use of chemotherapy. None of these factors were shown to be of etiologic importance. The survival of patients who developed benign strictures was found to be significantly longer (1-year survival 88%) than those who developed no stricture (50%) or malignant stricture (19%). Using a success score for palliation of dysphagia, it was found that the majority of patients (71%) who developed a benign stricture had a moderately successful outcome--they were able to tolerate a full or soft diet and required dilatation with a median duration between dilatations of 5 months. Patients who developed a malignant stricture were palliated poorly by dilatation alone, and most required esophageal intubation.

  4. The mechanics and behavior of cliff swallows during tandem flights.

    Science.gov (United States)

    Shelton, Ryan M; Jackson, Brandon E; Hedrick, Tyson L

    2014-08-01

    Cliff swallows (Petrochelidon pyrrhonota) are highly maneuverable social birds that often forage and fly in large open spaces. Here we used multi-camera videography to measure the three-dimensional kinematics of their natural flight maneuvers in the field. Specifically, we collected data on tandem flights, defined as two birds maneuvering together. These data permit us to evaluate several hypotheses on the high-speed maneuvering flight performance of birds. We found that high-speed turns are roll-based, but that the magnitude of the centripetal force created in typical maneuvers varied only slightly with flight speed, typically reaching a peak of ~2 body weights. Turning maneuvers typically involved active flapping rather than gliding. In tandem flights the following bird copied the flight path and wingbeat frequency (~12.3 Hz) of the lead bird while maintaining position slightly above the leader. The lead bird turned in a direction away from the lateral position of the following bird 65% of the time on average. Tandem flights vary widely in instantaneous speed (1.0 to 15.6 m s(-1)) and duration (0.72 to 4.71 s), and no single tracking strategy appeared to explain the course taken by the following bird. © 2014. Published by The Company of Biologists Ltd.

  5. Swallow-induced esophageal shortening in patients without hiatal hernia is associated with gastroesophageal reflux.

    Science.gov (United States)

    Masuda, T; Singhal, S; Akimoto, S; Bremner, R M; Mittal, S K

    2017-12-21

    Longitudinal esophageal body shortening with swallow-induced peristalsis has been reported in healthy individuals. Esophageal shortening is immediately followed by esophageal re-elongation, and the lower esophageal sphincter (LES) returns to the baseline position. High-resolution manometry (HRM) allows for objective assessment of extent of shortening and duration of shortening. In patients without hiatal hernia at rest, swallow-induced esophageal shortening can lead to transient hiatal hernia (tHH) which at times may persist after the completion of swallow. This manometric finding has not been investigated in the literature, but a question arises whether this swallow-induced transient herniation can effect on the likelihood of gastroesophageal reflux. This study aims to assess the relationship between gastroesophageal reflux and the subtypes of swallow-induced esophageal shortening, i.e. tHH and non-tHH, in patients without hiatal hernia at rest. After Institutional Review Board (IRB) approval, we queried a prospectively maintained database to identify patients who underwent HRM evaluation and 24-hour pH study between January to December 2015. Patients with type-I esophagogastric junction (EGJ) morphology (i.e. no hiatal hernia) according to the Chicago classification v3.0 were included. The patterns of the esophageal shortening with swallows were divided into two subtypes, i.e. tHH and non-tHH. tHH was defined as an EGJ double high-pressure zones (≥1 cm) at the second inspiration after the termination of swallow-induced esophageal body contraction. The number of episodes of tHH was counted per 10 swallows and tHH size was measured for each patient. In total, 41 patients with EGJ morphology Type-I met the inclusion criteria. The mean age was 47.2 years, 35 patients (85.4%) were women, and the mean body mass index was 33.9 kg/m2. The mean number of tHH episodes was 3 out of 10 swallows; mean maximal tHH size was 1.3 cm. Patients who had tHH in ≥3 out of 10

  6. SU-D-BRA-01: Feasibility Study for Swallowing Prediction Using Pressure Sensors

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    Cho, M; Kim, T; Kim, D; Kang, S; Kim, K; Shin, D; Noh, Y; Suh, T [The Catholic University of Korea College of Medicine, Department of Biomedical Engineering, Research Institute of Biomedical Engineering, Seoul (Korea, Republic of); Kim, S [Virginia Commonwealth University, Richmond, VA (United States)

    2016-06-15

    Purpose: To develop a swallowing prediction system (SPS) using force sensing sensors and evaluate its feasibility. Methods: The SPS developed consists of force sensing sensor units, a thermoplastic mask, a signal transport device and a control PC installed with an in-house software. The SPS is designed to predict the pharyngeal stage of swallowing because it is known that internal organ movement occurs in pharyngeal stage. To detect prediction signal in the SPS, the force sensing sensor units were attached on both the submental muscle region and thyroid cartilage region of the thermoplastic mask. While the signal from the thyroid cartilage region informs the action of swallowing, the signal from the submental muscle region is utilized as a precursor for swallowing. Since the duration of swallowing is relatively short, using such precursor (or warning) signals for machine control is considered more beneficial. A volunteer study was conducted to evaluate the feasibility of the system. In this volunteer study, we intended to verify that the system could predict the pharyngeal stage of the swallowing. We measured time gaps between obtaining the warning signals in the SPS and starting points of the pharyngeal stage of swallowing. Results: The measured data was examined whether the time gaps were in reasonable order to be easily utilized. The mean and standard deviation values of these time gaps were 0.550 s ± 0.183 s. in 8 volunteers. Conclusion: The proposed method was able to predict the on-set of swallowing of human subjects inside the thermoplastic mask, which has never been possible with other monitoring systems such as camera-based monitoring system. With the prediction ability of swallowing incorporated into the machine control mechanism (in the future), beam delivery can be controlled to skip swallowing periods and significant dosimetric gain is expected in head & neck cancer treatments. This work was supported by the Radiation Technology R&D program (No. 2015M

  7. Comprehensive evaluation of electronic medical record system use and user satisfaction at five low-resource setting hospitals in ethiopia.

    Science.gov (United States)

    Tilahun, Binyam; Fritz, Fleur

    2015-05-25

    Electronic medical record (EMR) systems are increasingly being implemented in hospitals of developing countries to improve patient care and clinical service. However, only limited evaluation studies are available concerning the level of adoption and determinant factors of success in those settings. The objective of this study was to assess the usage pattern, user satisfaction level, and determinants of health professional's satisfaction towards a comprehensive EMR system implemented in Ethiopia where parallel documentation using the EMR and the paper-based medical records is in practice. A quantitative, cross-sectional study design was used to assess the usage pattern, user satisfaction level, and determinant factors of an EMR system implemented in Ethiopia based on the DeLone and McLean model of information system success. Descriptive statistical methods were applied to analyze the data and a binary logistic regression model was used to identify determinant factors. Health professionals (N=422) from five hospitals were approached and 406 responded to the survey (96.2% response rate). Out of the respondents, 76.1% (309/406) started to use the system immediately after implementation and user training, but only 31.7% (98/309) of the professionals reported using the EMR during the study (after 3 years of implementation). Of the 12 core EMR functions, 3 were never used by most respondents, and they were also unaware of 4 of the core EMR functions. It was found that 61.4% (190/309) of the health professionals reported over all dissatisfaction with the EMR (median=4, interquartile range (IQR)=1) on a 5-level Likert scale. Physicians were more dissatisfied (median=5, IQR=1) when compared to nurses (median=4, IQR=1) and the health management information system (HMIS) staff (median=2, IQR=1). Of all the participants, 64.4% (199/309) believed that the EMR had no positive impact on the quality of care. The participants indicated an agreement with the system and information

  8. Impact of proprioception during the oral phase on initiating the swallowing reflex.

    Science.gov (United States)

    Takeda, Hikaru; Saitoh, Kazuya

    2016-07-01

    We hypothesized that proprioceptive signals during the oral phase play a pivotal role in the initiation of pharyngeal phase during volitional swallowing. Therefore, we tested if swallowing could be modified by changing the amount of proprioceptive feedback from a number of different receptors while holding a food bolus in the mouth and clenching. Basic research. Surface electromyography (sEMG) recordings of the masticatory muscles were obtained during volitional swallowing movements from seven healthy adults with no clinical history of swallowing difficulties. The swallowing procedure involved holding 5 ml of jelly on the tongue before swallowing it completely, according to visual cues on a computer display. Initiation of the swallowing reflex was detected by an anterior shift of the thyroid cartilage using a laser displacement sensor and by submental sEMG signals. To vary the proprioceptive input, the participants were instructed to occlude their teeth at various intensities (weak, intermediate, and strong) while holding the 5-ml jelly bolus on the tongue. Rectified and integrated sEMG (iEMG) signals obtained from the submental area showed two upward deflections. Contractile forces of the masseter muscles showed significant negative values for Pearson correlation coefficient against time intervals from the onset of the second submental iEMG deflection to the onset of the anterior shift of the thyroid cartilage in six of the seven participants (average -0.534, standard deviation 0.176). Contractile forces of the masseter muscles during occlusion tended to correlate negatively with electromechanical delays on suprahyoid muscle contraction. NA Laryngoscope, 126:1595-1599, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke.

    Science.gov (United States)

    Bakhtiyari, Jalal; Sarraf, Payam; Nakhostin-Ansari, Noureddin; Tafakhori, Abbas; Logemann, Jeri; Faghihzadeh, Soghrat; Harirchian, Mohammad Hossein

    2015-07-06

    Dysphagia is common after stroke. The onset time of swallowing rehabilitation following stroke has an important role in the recovery of dysphagia and preventing of its complications, but it was either highly variable or was not stated in previous trials. The aim of this study was investigation effects of onset time of swallowing therapy on recovery from dysphagia following stroke. Sixty dysphagia patients due to stroke range of age 60-74 (67.1 ± 3.8), participated in this randomized clinical trial study. The patients allocated in Early, Medium and Late groups, on the base of initiation of swallowing therapy after the stroke. After basic clinical and video fluoroscopic swallowing study assessments, traditional swallowing therapy was initiated 3 times per week for 3 months. The outcome measures were North-Western dysphagia patient check sheet, functional oral intake scale, video fluoroscopy, and frequency of pneumonia. Statistical analysis was done by repeated measure ANOVA, Bonferroni and χ(2) tests. Three groups of patients in terms of demographic and clinical characteristics were similar in the pre-treatment P > 0.050. Onset time of swallowing therapy after stroke was effective on swallowing recovery on the main outcome variables. So that in first group patients, recovery was rather than other groups P < 0.050. Furthermore, the frequency of pneumonia in the early group was less than other groups and in the early group no patients experienced pneumonia P = 0.002. Our data suggested that early interventions for dysphagia in stroke have an important role in recovery from dysphagia and prevention of complications like aspiration pneumonia.

  10. Comparison of ease of swallowing of dietary supplement products for age-related eye disease.

    Science.gov (United States)

    Brotherman, Donald P; Bayraktaroglu, Tolgar O; Garofalo, Renee J

    2004-01-01

    To examine patients' perceptions on the relative importance of the physical characteristics and appearance of dietary supplements, and to evaluate two supplements with the same combination of vitamins and minerals used in the Age-Related Eye Disease Study (AREDS) with respect to ease of swallowing and other features in elderly patients. A single-site, single-visit, crossover design, subject-masked comparison of two dietary supplements (ICaps AREDS Formula--Alcon; Ocuvite PreserVision-Bausch & Lomb). Ophthalmology practice. 50 patients aged 50 years or older. Patients ranked the importance of eight physical characteristics of a vitamin tablet or capsule (ease of swallowing, size, shape, color, smell, coating, texture, and taste) irrespective of the test products used in the study and then took both test products randomly and were asked to indicate which product they preferred based on the same eight characteristics. Overall patient preference and preference for swallowing two tablets at once. The highest rated (most important) characteristic in a vitamin supplement was ease of swallowing, with a median score of 9.0 on a 0-10 visual analogue scale. The characteristic of least importance was tablet color, with the lowest median score of 1.0. Statistically significant differences were detected between the products with regard to preferences for ease of swallowing, swallowing two tablets at once, size, and coating (P preferred the ICaps AREDS formula to Ocuvite PreserVision with respect to these characteristics and overall preference (P preferences. Based on the results of this study, ease of swallowing is the most important characteristic of dietary supplement tablets for elderly patients, followed by taste, size, and smell. Significant differences in preference exist between the study products, which contain similar formulations but have different physical characteristics.

  11. Effects of coal fly ash on tree swallow reproduction in Watts Bar Reservoir, Tennessee.

    Science.gov (United States)

    Walls, Suzanne J; Meyer, Carolyn B; Iannuzzi, Jacqueline; Schlekat, Tamar H

    2015-01-01

    Coal-fly ash was released in unprecedented amounts (4.1 × 10(6) m(3) ) into the Emory River from the Tennessee Valley Authority Kingston Fossil Plant on Watts Bar Reservoir in Tennessee. Tree swallows were exposed to ash-related constituents at the ash release via their diet of emergent aquatic insects, whose larval forms can accumulate constituents from submerged river sediments. Reproduction of tree swallow colonies was assessed over a 2-year period by evaluating whether 1) ash constituent concentrations were elevated in egg, eggshell, and nestling tissues at colonies near ash-impacted river reaches compared to reference colonies, 2) production of fledglings per nesting female was significantly lower in ash-impacted colonies versus reference colonies, and 3) ash constituent concentrations or diet concentrations were correlated with nest productivity measures (clutch size, hatching success, and nestling survival, and fledglings produced per nest). Of the 26 ash constituents evaluated, 4 (Se, Sr, Cu, and Hg) were significantly elevated in tissues potentially from the ash, and 3 (Se, Sr, and Cu) in tissues or in swallow diet items were weakly correlated to at least one nest-productivity measure or egg weight. Tree swallow hatching success was significantly reduced by 12%, but fledgling production per nest was unaffected due to larger clutch sizes in the impacted than reference colonies. Bioconcentration from the ash to insects in the diet to tree swallow eggs appears to be low. Overall, adverse impacts of the ash on tree swallow reproduction were not observed, but monitoring is continuing to further ensure Se from the residual ash does not adversely affect tree swallow reproduction over time. Integr Environ Assess Manag 2015;11:56-66. © 2014 SETAC. © 2014 SETAC.

  12. Voluntary Modulation of Hemodynamic Responses in Swallowing Related Motor Areas: A Near-Infrared Spectroscopy-Based Neurofeedback Study.

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    Silvia Erika Kober

    Full Text Available In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS. During seven training sessions, participants received either feedback of concentration changes in oxygenated hemoglobin (oxy-Hb group, N = 10 or deoxygenated hemoglobin (deoxy-Hb group, N = 10 over the inferior frontal gyrus (IFG during motor imagery of swallowing. Before and after the training, we assessed cortical activation patterns during motor execution and imagery of swallowing. The deoxy-Hb group was able to voluntarily increase deoxy-Hb over the IFG during imagery of swallowing. Furthermore, swallowing related cortical activation patterns were more pronounced during motor execution and imagery after the training compared to the pre-test, indicating cortical reorganization due to neurofeedback training. The oxy-Hb group could neither control oxy-Hb during neurofeedback training nor showed any cortical changes. Hence, successful modulation of deoxy-Hb over swallowing related brain areas led to cortical reorganization and might be useful for future treatments of swallowing dysfunction.

  13. Randomized Controlled Trial of Electronic Care Plan Alerts and Resource Utilization by High Frequency Emergency Department Users with Opioid Use Disorder

    Directory of Open Access Journals (Sweden)

    Niels Rathlev, MD

    2016-01-01

    Full Text Available Introduction: There is a paucity of literature supporting the use of electronic alerts for patients with high frequency emergency department (ED use. We sought to measure changes in opioid prescribing and administration practices, total charges and other resource utilization using electronic alerts to notify providers of an opioid-use care plan for high frequency ED patients. Methods: This was a randomized, non-blinded, two-group parallel design study of patients who had 1 opioid use disorder and 2 high frequency ED use. Three affiliated hospitals with identical electronic health records participated. Patients were randomized into “Care Plan” versus “Usual Care groups”. Between the years before and after randomization, we compared as primary outcomes the following: 1 opioids (morphine mg equivalents prescribed to patients upon discharge and administered to ED and inpatients; 2 total medical charges, and the numbers of; 3 ED visits, 4 ED visits with advanced radiologic imaging (computed tomography [CT] or magnetic resonance imaging [MRI] studies, and 5 inpatient admissions. Results: A total of 40 patients were enrolled. For ED and inpatients in the “Usual Care” group, the proportion of morphine mg equivalents received in the post-period compared with the pre-period was 15.7%, while in the “Care Plan” group the proportion received in the post-period compared with the pre-period was 4.5% (ratio=0.29, 95% CI [0.07-1.12]; p=0.07. For discharged patients in the “Usual Care” group, the proportion of morphine mg equivalents prescribed in the post-period compared with the pre-period was 25.7% while in the “Care Plan” group, the proportion prescribed in the post-period compared to the pre-period was 2.9%. The “Care Plan” group showed an 89% greater proportional change over the periods compared with the “Usual Care” group (ratio=0.11, 95% CI [0.01-0.092]; p=0.04. Care plans did not change the total charges, or, the numbers

  14. Swallowing disorders in nursing home residents: how can the problem be explained?

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    Nogueira D

    2013-02-01

    Full Text Available Dália Nogueira,1 Elizabeth Reis21Speech Therapy Department, Escola Superior de Saúde de Alcoitão, Estoril, Portugal; 2Department of Quantitative Methods, Lisbon University Institute ISCTE/IUL, Lisbon, PortugalBackground: The swallowing mechanism changes significantly as people age, even in the absence of chronic diseases. Presbyphagia, a term that refers to aging-related changes in the swallowing mechanism, may be linked to many health conditions and presents itself in distinct ways. Swallowing disorders are also identified as a major problem amongst the elderly population living in nursing homes.Methods: The study sought to determine the prevalence of swallowing disorders in nursing home residents, to identify the relationship between self-perceived swallowing disorders, cognitive functions, autonomy, and depression, and also to analyze which variables explain the score of the Dysphagia Self-Test (DST. For this purpose, the researchers chose to apply a survey conveying questions on demographic aspects, general health, eating and feeding, as well as instruments to assess functional performance and the 3 ounce Water Swallow Test.Results: The sample consisted of 272 elderly people living in eight nursing homes in Portugal. Six did not sign the informed consent form. Of the total, 29% were totally dependent, 33% were depressed, 45% had cognitive impairment, and 38% needed help with feeding. About 43% of the individuals reported having problems related to eating. Regarding the DST, 40% showed signs of dysphagia. With respect to the 3 ounce Water Swallow Test, 38% revealed at least one of the symptoms, wet voice being the most prevalent. Correlation measures showed that age had no linear association with the DST score although correlation with the Barthel Index and Mini Mental State Examination was found to be significant. A linear regression model was estimated with the DST score as the dependent variable and the MMSE and BI scores, gender, age

  15. A trade-off between reproduction and feather growth in the barn swallow (Hirundo rustica.

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    Nicola Saino

    Full Text Available Physiological trade-offs mediated by limiting energy, resources or time constrain the simultaneous expression of major functions and can lead to the evolution of temporal separation between demanding activities. In birds, plumage renewal is a demanding activity, which accomplishes fundamental functions, such as allowing thermal insulation, aerodynamics and socio-sexual signaling. Feather renewal is a very expensive and disabling process, and molt is often partitioned from breeding and migration. However, trade-offs between feather renewal and breeding have been only sparsely studied. In barn swallows (Hirundo rustica breeding in Italy and undergoing molt during wintering in sub-Saharan Africa, we studied this trade-off by removing a tail feather from a large sample of individuals and analyzing growth bar width, reflecting feather growth rate, and length of the growing replacement feather in relation to the stage in the breeding cycle at removal and clutch size. Growth bar width of females and length of the growing replacement feather of both sexes were smaller when the original feather had been removed after clutch initiation. Importantly, in females both growth bar width and replacement feather length were negatively predicted by clutch size, and more strongly so for large clutches and when feather removal occurred immediately after clutch completion. Hence, we found strong, coherent evidence for a trade-off between reproduction, and laying effort in particular, and the ability to generate new feathers. These results support the hypothesis that the derived condition of molting during wintering in long-distance migrants is maintained by the costs of overlapping breeding and molt.

  16. On the Physiology of Normal Swallowing as Revealed by Magnetic Resonance Imaging in Real Time

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    Arno Olthoff

    2014-01-01

    Full Text Available The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI. Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second. Intermeasurement variation was analyzed and comparisons between real-time MRI and FEES were performed. Twelve distinct swallowing events could be quantified by real-time MRI (start time, end time, and duration. These included five valve functions: oro-velar opening, velo-pharyngeal closure, glottal closure, epiglottic retroflexion, and esophageal opening; three bolus transports: oro-velar transit, pharyngeal delay, pharyngeal transit; and four additional events: laryngeal ascent, laryngeal descent, vallecular, and piriform sinus filling and pharyngeal constriction. Repetitive measurements confirmed the general reliability of the MRI method with only two significant differences for the start times of the velo-pharyngeal closure (t(8=-2.4, P≤0.046 and laryngeal ascent (t(8=-2.6, P≤0.031. The duration of the velo-pharyngeal closure was significantly longer in real-time MRI compared to FEES (t(8=-3.3, P≤0.011. Real-time MRI emerges as a simple, robust, and reliable tool for obtaining comprehensive functional and anatomical information about the swallowing process.

  17. Analysis of oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with Parkinson's disease.

    Science.gov (United States)

    Correa-Flores, Melissa; Arch-Tirado, Emilio; Villeda-Miranda, Alicia; Rocha-Cacho, Karina Elizabeth; Verduzco-Mendoza, Antonio; Hernández-López, Xochiquetzal

    2012-01-01

    Parkinson's disease (PD) has a high incidence in Mexico and is estimated at approximately 500,000 patients. One of the main clinical manifestations of PD is dysphagia, which is the difficult passage of food from the mouth to the stomach. The aim of this study was to assess oropharyngeal dysphagia through fibroendoscopy evaluation of swallowing in patients with PD. We conducted a census sample of patients with PD: 17 males and 10 females, aged >49 years. Clinical history, physical examination and neurological evaluation of swallowing fibroendoscopy were carried out. Of the symptomatic patients, 16 patients (59.25%) reported dysphagia. Fibroendoscopic evaluation demonstrated swallowing disorders in 25 patients (92.59%). The main findings were poor bolus control in 19 patients (70.37%), deficits in bolus propulsion in 25 patients (92.59%), impaired swallowing in 14 patients (51.85%), fractional swallowing in 11 patients (40.74%), reduced epiglottic tilting in 11 patients (48.14%), food residue in vallecula in 24 patients (88.88%) and piriform sinus in 19 patients (70.37%). There was no correlation between duration of PD and degree of involvement of oropharyngeal dysphagia. Oropharyngeal dysphagia in patients with PD is a common symptom and can range from the oral cavity to the upper esophageal sphincter. Early onset of severe dysphagia is exceptional in this disease and should alert the clinician to the diagnostic possibility of parkinsonism.

  18. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough.

    Science.gov (United States)

    Nin, Carlos Shuler; Marchiori, Edson; Irion, Klaus Loureiro; Paludo, Artur de Oliveira; Alves, Giordano Rafael Tronco; Hochhegger, Daniela Reis; Hochhegger, Bruno

    2013-01-01

    To assess the routine use of barium swallow study in patients with chronic cough. Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks) were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons. The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6%) of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6%) of the patients, whereas the treatment was ineffective in 1 (8.4%). We observed no complications related to barium swallow, such as contrast aspiration. Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  19. Application of Kinesio Taping method for newborn swallowing difficultly: A case report and literature review.

    Science.gov (United States)

    Lin, Chien-Lin; Wu, Wei-Ting; Chang, Ke-Vin; Lin, Hong-Yi; Chou, Li-Wei

    2016-08-01

    Preterm infants are at an increased risk of sucking problems, swallowing difficulty, and poor nourishment. During the neonatal period, the neurobehavioral organization of a preterm baby is poor compared with that of appropriate gestational age infants. Kinesio Taping has been widely used for edema control, joint protection, and proprioception training. With the help of augmentation of the sensory input for muscle facilitation and inhibition through tapping, the coordination of the target muscle groups can be improved. Until now, no research is available on the use of Kinesio Taping for the swallowing difficulty of infant. We reported a preterm infant suffering from brain edema at birth and swallowing difficultly until 40 weeks. The swallowing reflex was delayed. Moreover, lip closure and rooting reflex combined with the dysfunction grade of jaw movement were poor. We performed KT methods on the baby under the theory of the direction of the tape for facilitate or inhibit the muscle. After the Kinesio Taping treatment, the sucking function was improved with good lip closure.One week later, the baby was discharged without the use of an oral gastric tube. Kinesio Taping contributed significantly to the improvement of impaired sucking and swallowing and could be implemented as a regular rehabilitative approach for infants suffering from these difficulties.

  20. Experimental infection of cliff swallows (Petrochelidon pyrrhonota) with varying doses of West Nile virus

    Science.gov (United States)

    Oesterle, P.T.; Nemeth, N.M.; VanDalen, Kaci K.; Sullivan, H.; Bentler, K.T.; Young, G.R.; McLean, R.G.; Clark, L.; Smeraski, C.; Hall, Jeffrey S.

    2009-01-01

    Cliff swallows (Petrochelidon pyrrhonota) were inoculated with differing doses of West Nile virus (WNV) to evaluate their potential role as reservoir hosts in nature. Swallows often nest in large colonies in habitats and months associated with high mosquito abundance and early WNV transmission in North America. Additionally, cliff swallow diet consists of insects, including mosquitoes, leading to an additional potential route of WNV infection. The average peak viremia titer among infected cliff swallows was 106.3 plaque-forming units (PFU)/mL serum and the reservoir competence index was 0.34. There was no correlation between dose and probability of becoming infected or viremia peak and duration. Oral shedding was detected from 2 to 14 days post-inoculation with an average peak titer of 1044 PFU/swab. These results suggest that cliff swallows are competent reservoir hosts of WNV and therefore, they may play a role in early seasonal amplification and maintenance of WNV. Copyright ?? 2009 by The American Society of Tropical Medicine and Hygiene.

  1. Barium swallow study in routine clinical practice: a prospective study in patients with chronic cough

    Directory of Open Access Journals (Sweden)

    Carlos Shuler Nin

    2013-12-01

    Full Text Available OBJECTIVE: To assess the routine use of barium swallow study in patients with chronic cough.METHODS: Between October of 2011 and March of 2012, 95 consecutive patients submitted to chest X-ray due to chronic cough (duration > 8 weeks were included in the study. For study purposes, additional images were obtained immediately after the oral administration of 5 mL of a 5% barium sulfate suspension. Two radiologists systematically evaluated all of the images in order to identify any pathological changes. Fisher's exact test and the chi-square test for categorical data were used in the comparisons.RESULTS: The images taken immediately after barium swallow revealed significant pathological conditions that were potentially related to chronic cough in 12 (12.6% of the 95 patients. These conditions, which included diaphragmatic hiatal hernia, esophageal neoplasm, achalasia, esophageal diverticulum, and abnormal esophageal dilatation, were not detected on the images taken without contrast. After appropriate treatment, the symptoms disappeared in 11 (91.6% of the patients, whereas the treatment was ineffective in 1 (8.4%. We observed no complications related to barium swallow, such as contrast aspiration.CONCLUSIONS: Barium swallow improved the detection of significant radiographic findings related to chronic cough in 11.5% of patients. These initial findings suggest that the routine use of barium swallow can significantly increase the sensitivity of chest X-rays in the detection of chronic cough-related etiologies.

  2. Impacts of palatal coverage on bolus formation during mastication and swallowing and subsequent adaptive changes.

    Science.gov (United States)

    Sato, T; Furuya, J; Tamada, Y; Kondo, H

    2013-10-01

    Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing. © 2013 John Wiley & Sons Ltd.

  3. Swallowing rehabilitation of dysphagic tracheostomized patients under mechanical ventilation in intensive care units: a feasibility study.

    Science.gov (United States)

    Rodrigues, Katia Alonso; Machado, Flávia Ribeiro; Chiari, Brasília Maria; Rosseti, Heloísa Baccaro; Lorenzon, Paula; Gonçalves, Maria Inês Rebelo

    2015-01-01

    The aim of the present study was to assess the feasibility of the early implementation of a swallowing rehabilitation program in tracheostomized patients under mechanical ventilation with dysphagia. This prospective study was conducted in the intensive care units of a university hospital. We included hemodynamically stable patients under mechanical ventilation for at least 48 hours following 48 hours of tracheostomy and with an appropriate level of consciousness. The exclusion criteria were previous surgery in the oral cavity, pharynx, larynx and/or esophagus, the presence of degenerative diseases or a past history of oropharyngeal dysphagia. All patients were submitted to a swallowing rehabilitation program. An oropharyngeal structural score, a swallowing functional score and an otorhinolaryngological structural and functional score were determined before and after swallowing therapy. We included 14 patients. The mean duration of the rehabilitation program was 12.4 ± 9.4 days, with 5.0 ± 5.2 days under mechanical ventilation. Eleven patients could receive oral feeding while still in the intensive care unit after 4 (2 - 13) days of therapy. All scores significantly improved after therapy. In this small group of patients, we demonstrated that the early implementation of a swallowing rehabilitation program is feasible even in patients under mechanical ventilation.

  4. Sensory and instrumental analysis for slipperiness and compliance of food during swallowing.

    Science.gov (United States)

    Seo, H-S; Hwang, I K; Han, T R; Kim, I S

    2007-11-01

    In spite of its importance, there have been few attempts to evaluate the sensory attributes of the food bolus during swallowing. In the current study, the slipperiness, the degree of slide for the food bolus through the mucosal surface of the oro-pharynx, and the compliance, how easily the shape of a food bolus can be transformed for automatic and comfortable swallowing, were derived among several sensory attributes related to the swallowing. Therefore, the study aims were twofold: (1) to develop the methods of sensory and instrumental analyses for determining the slipperiness and compliance of the food bolus during swallowing and (2) to examine the appropriateness of the newly designed devices by correlating the data between the sensory and instrumental analyses. Six commercial food products were evaluated by 10 trained panelists for each attribute. The devices for assessing each attribute were developed in consideration of the oro-pharyngeal movements. The sensory and instrumental analyses showed high correlation and regression coefficients as well as intensity differences of the 6 samples for each attribute. In conclusion, the slipperiness and the compliance were suitable for acquiring a better understanding of the sensory attributes of the food bolus during swallowing, and the newly developed devices showed a high potential for determining those attributes.

  5. Multisensor classification system for triggering FES in order to support voluntary swallowing

    Directory of Open Access Journals (Sweden)

    Benjamin Riebold

    2016-08-01

    Full Text Available In dysphagia the ability of elevating the larynx and hyoid is usually impaired. Electromyography (EMG and Bioimpedance (BI measurements at the neck can be used to trigger functional electrical stimulation (FES of swallowing related muscles. Nahrstaedt et al.1 introduced an algorithm to trigger the stimulation in phase with the voluntary swallowing to improve the airway closure and elevation speed of the larynx and hyoid. However, due to non-swallow related movements like speaking, chewing or head turning, stimulations might be unintentionally triggered. So far a switch was used to enable the BI/EMG-triggering of FES when the subject was ready to swallow, which is inconvenient for practical use. In this contribution, a range image camera system is introduced to obtain data of head, mouth, and jaw movements. This data is used to apply a second classification step to reduce the number of false stimulations. In experiments with healthy subjects, the amount of potential false stimulations could be reduced by 47% while 83% of swallowing intentions would have been correctely supported by FES.

  6. There is a Relationship between Resource Expenditures and Reference Transactions in Academic Libraries. A Review of: Dubnjakovic, A. (2012. Electronic resource expenditure and the decline in reference transaction statistics in academic libraries. Journal of Academic Librarianship, 38(2, 94-100. doi:10.1016/j.acalib.2012.01.001

    Directory of Open Access Journals (Sweden)

    Annie M. Hughes

    2013-03-01

    Full Text Available Objective – To provide an analysis of the impact of expenditures on electronic resourcesand gate counts on the increase or decrease in reference transactions.Design – Analysis of results of existing survey data from the National Center for Educational Statistics (NCES 2006 Academic Library Survey(ALS.Setting – Academic libraries in the United States.Subjects – 3925 academic library respondents.Methods – The author chose to use survey data collected from the 2006 ALS conducted bythe NCES. The survey included data on various topics related to academic libraries, but in the case of this study, the author chose to analyze three of the 193 variables included. The three variables: electronic books expenditure, computer hardware and software, and expenditures on bibliographic utilities, were combined into one variable called electronic resource expenditure. Gate counts were also considered as a variable. Electronic resource expenditure was also split as a variable into three groups: low, medium, and high. Multiple regression analysis and general linear modeling, along with tests of reliability, were employed. Main Results – The author determined that low, medium, and high spenders with regard to electronic resources exhibited differences in gate counts, and gate counts have an effect on reference transactions in any given week. Gate counts tend to not have much of an effect on reference transactions for the higher spenders, and higher spenders tend to have a higher number of reference transactions overall. Low spenders have lower gate counts and also a lower amount of reference transactions.Conclusion – The findings from this study show that academic libraries spending more on electronic resources also tend to have an increase with regard to reference transactions. The author also concludes that library spaces are no longer the determining factor with regard to number of reference transactions. Spending more on electronic resources is

  7. Global application of disorders of sex development-related electronic resources: e-learning, e-consultation and e-information sharing.

    Science.gov (United States)

    Muscarella, Miriam; Kranenburg-van Koppen, Laura; Grijpink-van den Biggelaar, Kalinka; Drop, Stenvert L S

    2014-01-01

    The past 20 years have seen proliferation of electronic (e) resources that promote improved understanding of disorders of sex development (DSD): e-learning for physicians and trainees, e-consultation between clinicians, and e-information for families and affected individuals. Recent e-learning advances have emerged from the European Society for Pediatric Endocrinology's online learning portal for current physicians and trainees. Developed with attention to developing clinical competencies incorporating learning theory, and presenting material that represents international best practice, this e-learning portal offers advances in training, making information more accessible for clinicians and trainees. Multiple levels of instruction, authentic case examples, collaborative forums for physicians and trainees, individualized feedback and user-friendly tools represent advances in trainee and physician learning that can take place in any location. e-consultation is an emerging tool that aims to connect physicians with specialists experienced in DSD care. Although it faces logistical challenges, e-consultation carries the potential to improve DSD care, especially in remote areas with limited access to DSD specialists. e-information for families and patients of all ages is widely accessible online, often with focus on DSD biology, medical care, and psychological and social support. e-information tools aid self-management and support of those affected by DSD. Efforts to improve these resources should aim to map information to individual users, incorporate optimally clear nomenclature, and continue as a 'shared enterprise' of clinicians, affected individuals, families and researchers. Improving the quality of DSD-related e-learning and e-information and developing e-consultation carries the potential to transform DSD care and support for patients, families and physicians worldwide. © 2014 S. Karger AG, Basel.

  8. Ranking Medical Terms to Support Expansion of Lay Language Resources for Patient Comprehension of Electronic Health Record Notes: Adapted Distant Supervision Approach.

    Science.gov (United States)

    Chen, Jinying; Jagannatha, Abhyuday N; Fodeh, Samah J; Yu, Hong

    2017-10-31

    Medical terms are a major obstacle for patients to comprehend their electronic health record (EHR) notes. Clinical natural language processing (NLP) systems that link EHR terms to lay terms or definitions allow patients to easily access helpful information when reading through their EHR notes, and have shown to improve patient EHR comprehension. However, high-quality lay language resources for EHR terms are very limited in the public domain. Because expanding and curating such a resource is a costly process, it is beneficial and even necessary to identify terms important for patient EHR comprehension first. We aimed to develop an NLP system, called adapted distant supervision (ADS), to rank candidate terms mined from EHR corpora. We will give EHR terms ranked as high by ADS a higher priority for lay language annotation-that is, creating lay definitions for these terms. Adapted distant supervision uses distant supervision from consumer health vocabulary and transfer learning to adapt itself to solve the problem of ranking EHR terms in the target domain. We investigated 2 state-of-the-art transfer learning algorithms (ie, feature space augmentation and supervised distant supervision) and designed 5 types of learning features, including distributed word representations learned from large EHR data for ADS. For evaluating ADS, we asked domain experts to annotate 6038 candidate terms as important or nonimportant for EHR comprehension. We then randomly divided these data into the target-domain training data (1000 examples) and the evaluation data (5038 examples). We compared ADS with 2 strong baselines, including standard supervised learning, on the evaluation data. The ADS system using feature space augmentation achieved the best average precision, 0.850, on the evaluation set when using 1000 target-domain training examples. The ADS system using supervised distant supervision achieved the best average precision, 0.819, on the evaluation set when using only 100 target

  9. Longitudinal study on a rehabilitative model for correction of atypical swallowing.

    Science.gov (United States)

    Giuca, M R; Pasini, M; Pagano, A; Mummolo, S; Vanni, A

    2008-12-01

    The aim of the study is to analyse the prevalence of anomalous function of the orofacial muscles and their aetiological factors in a small sample of paediatric patients, to evaluate the correlation between anomalous functions of the orofacial muscles and malocclusions, and finally to verify the effects of a myofunctional protocol, composed of a series of exercises aimed at correcting the anomalous function and position of the tongue. The protocol that has been used in this research is a re-elaboration of the diagnostic and therapeutic methods set by two authors, Daniel Garliner and Aurelio Levrini. A group of 57 children (aged 5 to 13, mean age 8.2) with atypical swallowing diagnosis, has been treated for almost 3 years. Physiologic swallowing was achieved in 47% of the children treated. The results show the benefits of the myofunctional therapy in the treatment of children with abnormal swallowing.

  10. Anatomy and Physiology of Feeding and Swallowing – Normal and Abnormal

    Science.gov (United States)

    Matsuo, Koichiro; Palmer, Jeffrey B.

    2008-01-01

    SYNOPSIS Eating and swallowing are complex behaviors involving volitional and reflexive activities of more than 30 nerves and muscles. They have two crucial biological features: food passage from the oral cavity to stomach and airway protection. The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid. Dysphagia can result from a wide variety of functional or structural deficits of the oral cavity, pharynx, larynx or esophagus. The goal of dysphagia rehabilitation is to identify and treat abnormalities of feeding and swallowing while maintaining safe and efficient alimentation and hydration. PMID:18940636

  11. Simulation of swallowing dysfunction and mechanical ventilation after a Montgomery T-tube insertion.

    Science.gov (United States)

    Trabelsi, O; Malvè, M; Mena Tobar, A; Doblaré, M

    2015-01-01

    The Montgomery T-tube is used as a combined tracheal stent and airway after laryngotracheoplasty, to keep the lumen open and prevent mucosal laceration from scarring. It is valuable in the management of upper and mid-tracheal lesions, while invaluable in long and multisegmental stenting lesions. Numerical simulations based on real-patient-tracheal geometry, experimental tissue characterization, and previous numerical estimation of the physiological swallowing force are performed to estimate the consequences of Montgomery T-tube implantation on swallowing and assisted ventilation: structural analysis of swallowing is performed to evaluate patient swallowing capacity, and computational fluid dynamics simulation is carried out to analyze related mechanical ventilation. With an inserted Montgomery T-tube, vertical displacement (Z-axis) reaches 8.01 mm, whereas in the Y-axis, it reaches 6.63 mm. The maximal principal stress obtained during swallowing was 1.6 MPa surrounding the hole and in the upper contact with the tracheal wall. Fluid flow simulation of the mechanical ventilation revealed positive pressure for both inhalation and exhalation, being higher for inspiration. The muscular deflections, considerable during normal breathing, are nonphysiological, and this aspect results in a constant overload of the tracheal muscle. During swallowing, the trachea ascends producing a nonhomogeneous elongation. This movement can be compromised when prosthesis is inserted, which explains the high incidence of glottis close inefficiency. Fluid simulations showed that nonphysiological pressure is established inside the trachea due to mechanical ventilation. This may lead to an overload of the tracheal muscle, explaining several related problems as muscle thinning or decrease in contractile function.

  12. Adapting human videofluoroscopic swallow study methods to detect and characterize dysphagia in murine disease models.

    Science.gov (United States)

    Lever, Teresa E; Braun, Sabrina M; Brooks, Ryan T; Harris, Rebecca A; Littrell, Loren L; Neff, Ryan M; Hinkel, Cameron J; Allen, Mitchell J; Ulsas, Mollie A

    2015-03-01

    This study adapted human videofluoroscopic swallowing study (VFSS) methods for use with murine disease models for the purpose of facilitating translational dysphagia research. Successful outcomes are dependent upon three critical components: test chambers that permit self-feeding while standing unrestrained in a confined space, recipes that mask the aversive taste/odor of commercially-available oral contrast agents, and a step-by-step test protocol that permits quantification of swallow physiology. Elimination of one or more of these components will have a detrimental impact on the study results. Moreover, the energy level capability of the fluoroscopy system will determine which swallow parameters can be investigated. Most research centers have high energy fluoroscopes designed for use with people and larger animals, which results in exceptionally poor image quality when testing mice and other small rodents. Despite this limitation, we have identified seven VFSS parameters that are consistently quantifiable in mice when using a high energy fluoroscope in combination with the new murine VFSS protocol. We recently obtained a low energy fluoroscopy system with exceptionally high imaging resolution and magnification capabilities that was designed for use with mice and other small rodents. Preliminary work using this new system, in combination with the new murine VFSS protocol, has identified 13 swallow parameters that are consistently quantifiable in mice, which is nearly double the number obtained using conventional (i.e., high energy) fluoroscopes. Identification of additional swallow parameters is expected as we optimize the capabilities of this new system. Results thus far demonstrate the utility of using a low energy fluoroscopy system to detect and quantify subtle changes in swallow physiology that may otherwise be overlooked when using high energy fluoroscopes to investigate murine disease models.

  13. Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior

    Science.gov (United States)

    Sazonov, Edward; Schuckers, Stephanie; Lopez-Meyer, Paulo; Makeyev, Oleksandr; Sazonova, Nadezhda; Melanson, Edward L.; Neuman, Michael

    2008-01-01

    A methodology of studying of ingestive behavior by non-invasive monitoring of swallowing (deglutition) and chewing (mastication) has been developed. The target application for the developed methodology is to study the behavioral patterns of food consumption and producing volumetric and weight estimates of energy intake. Monitoring is non-invasive based on detecting swallowing by a sound sensor located over laryngopharynx or by a bone conduction microphone and detecting chewing through a below-the-ear strain sensor. Proposed sensors may be implemented in a wearable monitoring device, thus enabling monitoring of ingestive behavior in free living individuals. In this paper, the goals in the development of this methodology are two-fold. First, a system comprised of sensors, related hardware and software for multimodal data capture is designed for data collection in a controlled environment. Second, a protocol is developed for manual scoring of chewing and swallowing for use as a gold standard. The multi-modal data capture was tested by measuring chewing and swallowing in twenty one volunteers during periods of food intake and quiet sitting (no food intake). Video footage and sensor signals were manually scored by trained raters. Inter-rater reliability study for three raters conducted on the sample set of 5 subjects resulted in high average intra-class correlation coefficients of 0.996 for bites, 0.988 for chews, and 0.98 for swallows. The collected sensor signals and the resulting manual scores will be used in future research as a gold standard for further assessment of sensor design, development of automatic pattern recognition routines, and study of the relationship between swallowing/chewing and ingestive behavior. PMID:18427161

  14. MRI of the Swallow Tail Sign: A Useful Marker in the Diagnosis of Lewy Body Dementia?

    Science.gov (United States)

    Shams, S; Fällmar, D; Schwarz, S; Wahlund, L-O; van Westen, D; Hansson, O; Larsson, E-M; Haller, S

    2017-09-01

    There are, to date, no MR imaging diagnostic markers for Lewy body dementia. Nigrosome 1, containing dopaminergic cells, in the substantia nigra pars compacta is hyperintense on SWI and has been called the swallow tail sign, disappearing with Parkinson disease. We aimed to study the swallow tail sign and its clinical applicability in Lewy body dementia and hypothesized that the sign would be likewise applicable in Lewy body dementia. This was a retrospective cross-sectional multicenter study including 97 patients (mean age, 65 ± 10 years; 46% women), consisting of the following: controls (n = 21) and those with Lewy body dementia (n = 19), Alzheimer disease (n = 20), frontotemporal lobe dementia (n = 20), and mild cognitive impairment (n = 17). All patients underwent brain MR imaging, with susceptibility-weighted imaging at 1.5T (n = 46) and 3T (n = 51). The swallow tail sign was assessed independently by 2 neuroradiologists. Interrater agreement was moderate (κ = 0.4) between raters. An abnormal swallow tail sign was most common in Lewy body dementia (63%; 95% CI, 41%-85%; P Lewy body dementia with an odds ratio of 9 (95% CI, 3-28; P Lewy body dementia showed a sensitivity of 63%, a specificity of 79%, a negative predictive value of 89%, and an accuracy of 76%; values were higher on 3T compared with 1.5T. The usefulness of the swallow tail sign was rater-dependent with the highest sensitivity equaling 100%. The swallow tail sign has diagnostic potential in Lewy body dementia and may be a complement in the diagnostic work-up of this condition. © 2017 by American Journal of Neuroradiology.

  15. Hybrid fuzzy logic committee neural networks for recognition of swallow acceleration signals.

    Science.gov (United States)

    Das, A; Reddy, N P; Narayanan, J

    2001-02-01

    Biological signals are complex and often require intelligent systems for recognition of characteristic signals. In order to improve the reliability of the recognition or automated diagnostic systems, hybrid fuzzy logic committee neural networks were developed and the system was used for recognition of swallow acceleration signals from artifacts. Two sets of fuzzy logic-committee networks (FCN) each consisting of seven member networks were developed, trained and evaluated. The FCN-I was used to recognize dysphagic swallow from artifacts, and the second committee FCN-II was used to recognize normal swallow from artifacts. Several networks were trained and the best seven were recruited into each committee. Acceleration signals from the throat were bandpass filtered, and several parameters were extracted and fed to the fuzzy logic block of either FCN-I or FCN-II. The fuzzified membership values were fed to the committee of neural networks which provided the signal classification. A majority opinion of the member networks was used to arrive at the final decision. Evaluation results revealed that FCN correctly identified 16 out of 16 artifacts and 31 out of 33 dysphagic swallows. In two cases, the decision was ambiguous due to the lack of a majority opinion. FCN-II correctly identified 24 out of 24 normal swallows, and 28 out of 29 artifacts. In one case, the decision was ambiguous due to the lack of a majority opinion. The present hybrid intelligent system consisting of fuzzy logic and committee networks provides a reliable tool for recognition and classification of acceleration signals due to swallowing.

  16. A new subfascial approach in open thyroidectomy: efficacy for postoperative voice, sensory, and swallowing symptoms. A randomized controlled study.

    Science.gov (United States)

    Jung, Seung Pil; Kim, Sung Hoon; Bae, Soo Youn; Lee, Se Kyung; Kim, Sangmin; Choi, Min-Young; Kim, Jiyoung; Kim, Minkuk; Kil, Won Ho; Choe, Jun-Ho; Kim, Jung-Han; Nam, Seok Jin; Kim, Jee Soo

    2013-11-01

    After open thyroidectomy, patients usually complain of voice, sensory, and swallowing symptoms. We approached the thyroid via the subfascial method to reduce these symptoms and compared postthyroidectomy symptoms with the conventional subplatysmal method. Eighty-six patients undergoing thyroidectomy were recruited and randomized into either a conventional subplatysmal approach group (subplatysmal, 42 patients) group or a subanterior fascia of strap muscle approach group (subfascial, 44 patients). Voice symptoms were assessed using the Voice Handicap Index questionnaire and acoustic voice analysis. Sensory alterations were evaluated by the light touch and pain touch methods. Swallowing symptoms were assessed using the Swallowing Impairment Score (SIS) questionnaire, barium swallowing time, and hyoid bone movement range. Each variable was measured preoperatively, and at 2 weeks and 3 months after thyroidectomy. In both groups, the subjective symptoms of voice, sensation, and swallowing were significantly worsened at 2 weeks after operation, but improved 3 months after operation. Patients in the subplatysmal group had worse SIS scores than patients in the subfascial group (p = 0.016) and delayed barium swallowing time 2 weeks after operation (p = 0.008 compared to preoperative level). In the cohort over 50 years of age, SIS score did not recover to preoperative levels in the subplatysmal group 3 months after operation (p = 0.005 compared to preoperative level). The subfascial approach may be an effective method for reducing postthyroidectomy swallowing symptoms based on swallowing impairment score, especially in patients over 50 years of age.

  17. Changes in Swallowing after Anterior Cervical Discectomy and Fusion with Instrumentation: A Presurgical versus Postsurgical Videofluoroscopic Comparison

    Science.gov (United States)

    Muss, Lydia; Wilmskoetter, Janina; Richter, Kerstin; Fix, Constanze; Stanschus, Soenke; Pitzen, Tobias; Drumm, Joerg; Molfenter, Sonja

    2017-01-01

    Purpose: The purpose of this study was to explore the impact of anterior cervical discectomy and fusion (ACDF) with anterior instrumentation on swallowing function and physiology as measured on videofluoroscopic swallowing studies. Method: We retrospectively analyzed both functional measures (penetration-aspiration, residue) and…

  18. Nitric Oxide and Histamine Signal Attempts to Swallow: A Component of Learning that Food Is Inedible in "Aplysia"

    Science.gov (United States)

    Katzoff, Ayelet; Miller, Nimrod; Susswein, Abraham J.

    2010-01-01

    Memory that food is inedible in "Aplysia" arises from training requiring three contingent events. Nitric oxide (NO) and histamine are released by a neuron responding to one of these events, attempts to swallow food. Since NO release during training is necessary for subsequent memory and NO substitutes for attempts to swallow, it was suggested that…

  19. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans

    Science.gov (United States)

    Jafari, Samah; Prince, Rebecca A; Kim, Daniel Y; Paydarfar, David

    2003-01-01

    During swallowing, the airway is protected from aspiration of ingested material by brief closure of the larynx and cessation of breathing. Mechanoreceptors innervated by the internal branch of the superior laryngeal nerve (ISLN) are activated by swallowing, and connect to central neurones that generate swallowing, laryngeal closure and respiratory rhythm. This study was designed to evaluate the hypothesis that the ISLN afferent signal is necessary for normal deglutition and airway protection in humans. In 21 healthy adults, we recorded submental electromyograms, videofluoroscopic images of the upper airway, oronasal airflow and respiratory inductance plethysmography. In six subjects we also recorded pressures in the hypopharynx and upper oesophagus. We analysed swallows that followed a brief infusion (4–5 ml) of liquid barium onto the tongue, or a sip (1–18 ml) from a cup. In 16 subjects, the ISLN was anaesthetised by transcutaneous injection of bupivacaine into the paraglottic compartment. Saline injections using the identical procedure were performed in six subjects. Endoscopy was used to evaluate upper airway anatomy, to confirm ISLN anaesthesia, and to visualise vocal cord movement and laryngeal closure. Comparisons of swallowing and breathing were made within subjects (anaesthetic or saline injection vs. control, i.e. no injection) and between subjects (anaesthetic injection vs. saline injection). In the non-anaesthetised condition (saline injection, 174 swallows in six subjects; no injection, 522 swallows in 20 subjects), laryngeal penetration during swallowing was rare (1.4 %) and tracheal aspiration was never observed. During ISLN anaesthesia (16 subjects, 396 swallows), all subjects experienced effortful swallowing and an illusory globus sensation in the throat, and 15 subjects exhibited penetration of fluid into the larynx during swallowing. The incidence of laryngeal penetration in the anaesthetised condition was 43 % (P deglutition, especially for

  20. Electronic bolus design impacts on administration.

    Science.gov (United States)

    Hentz, F; Umstätter, C; Gilaverte, S; Prado, O R; Silva, C J A; Monteiro, A L G

    2014-06-01

    Electronic identification of animals has become increasingly important worldwide to improve and ensure traceability. In warm and hot climates, such as Brazil, boluses can have advantages over ear tags as the internal devices reduce the risks of ear tag losses, tissue damage, and lesions on the ear. Electronic boluses, however, are often perceived as having negative characteristics, including reported difficulties of administration in small ruminants. This paper describes the factors associated with bolus design that affect the swallowing of a bolus in sheep. Other factors that might influence bolus swallowing time have also been considered. In addition, the effect of bolus design on its performance was evaluated. A total of 56 Suffolk ewes were used to assess the ease of administration and retention of 3 types of electronic ruminal boluses (mini, 11.5 × 58.0 mm and 21.7 g; small, 14.8 × 48.5 mm and 29.5 g; standard, 19.3 × 69.8 mm and 74.4 g) during a whole productive year, including pregnancy and lamb suckling. Ewe age (5.6 ± 2.3 yr) and weight (85.07 ± 8.2 kg BW) were recorded, as well as time for bolus swallowing. The deglutition of the bolus and any resulting blockages in the esophagus were monitored by visual observations. Retention and readability of the boluses were regularly monitored for d 1, wk 1, mo 1, and every mo until 1 yr. Time for bolus swallowing differed substantially with bolus type and was greater (P 0.05). The bolus o.d. and length were positively correlated with swallowing time (P electronic boluses showed 100% retention rate, and at 12 mo, bolus retention was 100%, 94.5%, and 100% for mini, small, and standard boluses, respectively (P > 0.05). At 12 mo, all boluses showed 100% readability, except for small boluses, which had a readability of 94.5%. In conclusion, bolus design affected swallowing time and bolus readability. A reduction in boluses length and o.d. needs to be carried out to provide ease of administration and for boluses to

  1. Swallowing and speech function after intraoral soft tissue reconstruction with lateral upper arm free flap and radial forearm free flap.

    Science.gov (United States)

    Hara, I; Gellrich, N-C; Duker, J; Schön, R; Fakler, O; Smelzeisen, R; Honda, T; Satoru, O

    2003-06-01

    Swallowing, speech, and morbidity were assessed postoperatively in 25 patients, 18 of whom had had intraoral defects reconstructed by lateral upper arm free flaps (LUFF) and 7 by radial forearm free flaps (RFFF). Video fluoroscopy was used to assess swallowing, the Freiburger audiometric test to assess speech; and measurement of arm circumference to assess donor site morbidity. A questionnaire was used to evaluate swallowing, speech, and donor site morbidity subjectively. The degree of impairment in swallowing depended on the site of resection. Anterior and posterior resections affected swallowing more than lateral resections. Anterior resection and the use of LUFFs reduced intelligibility. There was no significant difference in impairment between LUFF and RFFF. We conclude that the LUFFs are superior to RFFFs because they can be closed primary and the incidence of donor site morbidity is slight.

  2. Political Unrest and Educational Electronic Resource Usage in a Conflict Zone, Kashmir (Indian Administered Kashmir): Log Analysis as Politico Analytical Tool=Hindistan Tarafından Yönetilen Keşmir Anlaşmazlık Bölgesi’nde Siyasi Karışıklık ve Eğitimle İlgili Elektronik Kaynakların Kullanımı: Siyasi Analiz Aracı Olarak Log Analizleri

    OpenAIRE

    Sumeer Gul; Samrin Nabi; Samina Mushtaq; Tariq Ahmad Shah; Suhail Ahmad

    2013-01-01

    Electronic resource usage has proved as one of the best decision making tools in the library setups. Electronic resource usage in relation to the political disturbance can act as one of the tools to highlight the impact of political disturbance on educational setups in general and the electronic resource usage in particular. The study takes a serious look in the electronic resource usage in Kashmir and the impact of unrest on it. The paper highlights a relational platform between educat...

  3. Prospective clinical study on long-term swallowing function and voice quality in advanced head and neck cancer patients treated with concurrent chemoradiotherapy and preventive swallowing exercises.

    Science.gov (United States)

    Kraaijenga, Sophie A C; van der Molen, Lisette; Jacobi, Irene; Hamming-Vrieze, Olga; Hilgers, Frans J M; van den Brekel, Michiel W M

    2015-11-01

    Concurrent chemoradiotherapy (CCRT) for advanced head and neck cancer (HNC) is associated with substantial early and late side effects, most notably regarding swallowing function, but also regarding voice quality and quality of life (QoL). Despite increased awareness/knowledge on acute dysphagia in HNC survivors, long-term (i.e., beyond 5 years) prospectively collected data on objective and subjective treatment-induced functional outcomes (and their impact on QoL) still are scarce. The objective of this study was the assessment of long-term CCRT-induced results on swallowing function and voice quality in advanced HNC patients. The study was conducted as a randomized controlled trial on preventive swallowing rehabilitation (2006-2008) in a tertiary comprehensive HNC center with twenty-two disease-free and evaluable HNC patients as participants. Multidimensional assessment of functional sequels was performed with videofluoroscopy, mouth opening measurements, Functional Oral Intake Scale, acoustic voice parameters, and (study specific, SWAL-QoL, and VHI) questionnaires. Outcome measures at 6 years post-treatment were compared with results at baseline and at 2 years post-treatment. At a mean follow-up of 6.1 years most initial tumor-, and treatment-related problems remained similarly low to those observed after 2 years follow-up, except increased xerostomia (68%) and increased (mild) pain (32%). Acoustic voice analysis showed less voicedness, increased fundamental frequency, and more vocal effort for the tumors located below the hyoid bone (n = 12), without recovery to baseline values. Patients' subjective vocal function (VHI score) was good. Functional swallowing and voice problems at 6 years post-treatment are minimal in this patient cohort, originating from preventive and continued post-treatment rehabilitation programs.

  4. Relationship between swallow-specific quality of life and fiber-optic endoscopic evaluation of swallowing findings in patients with head and neck cancer.

    Science.gov (United States)

    Florie, Michelle; Baijens, Laura; Kremer, Bernd; Kross, Kenneth; Lacko, Martin; Verhees, Femke; Winkens, Bjorn

    2016-04-01

    The purpose of this study was to determine the relationship between swallow-specific quality of life (QOL) using the MD Anderson Dysphagia Inventory (MDADI) and the swallowing function using a standardized fiber-optic endoscopic evaluation of swallowing (FEES) protocol in patients with dysphagia with head and neck cancer. Sixty-three patients with dysphagia and head and neck cancer were enrolled in the study. Patients completed the MDADI questionnaire and underwent a standardized FEES examination. Ordinal FEES variables were measured. Descriptive statistics and 1-way analysis of variance tests were carried out. For all FEES variables, the observer agreement level was sufficient (kappa ≥0.7).These preliminary results show statistically significant mean differences of MDADI subscales between the ordinal scale levels for several FEES variables. The MDADI questionnaire can be used to assess the impact of dysphagia on the patients' health-related QOL. Despite clear trends, it remains unclear if the MDADI questionnaire can be used as an indicator for the severity of oropharyngeal dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1848-E1856, 2016. © 2015 Wiley Periodicals, Inc.

  5. KERENTANAN AIRTANAH TERHADAP PENCEMARAN DAERAH IMBUHAN PONOR DI KARST GUNUNG SEWU (STUDI DI DAERAH ALIRAN SUNGAI BAWAH TANAH BRIBIN (Ground Water Vulnerability to Contamination of Swallow Holes Recharge Area at Gunung Sewu Karst (Study in Bribin

    Directory of Open Access Journals (Sweden)

    M. Widyastuti

    2012-07-01

    Full Text Available ABSTRAK Airtanah karst merupakan salah satu sumbedaya alam yang potensial di kawasan karst Gunung Sewu. Di sisi lain, akuifer karst sangat rentan terhadap pencemaran. Sungai Bawah Tanah Bribin menjadi sumber air utama untuk masyarakat khususnya untuk mendukung kebutuhan air di musim kemarau. Tujuan pene1itian ini adalah: 1 mengetahui karakteristik daerah imbuhan ponor me1alui identifikasi variabel kerentanan (kondisi ponor, lereng, vegetasi, tanah dan batuan; dan 2 mengetahui tingkat kerentanan airtanah terhadap pencemaran dengan metode COP. Ponor, gua, dan dolin diidentifikasi melalui sensus, sedangkan pengambilan sampel tanah secara purposive berdasarkan unit seri tanah. Proses pengolahan data mendasarkan metode COP, yang merupakan akronim C (concentration offlowkonsentrasi aliran, 0 (overlaying layerllapisan pelindung and P (precipitation/curah hujan. Setiap variabel dan sub variabel mempunyai nilai di setiap ke1as dan dihitung melalui operasi perkalian dan penjumlahan. Hasil menunjukkan bahwa karakteristik daerah imbuhan ponor bervariasi menurut aspekjumlah, ukuran, lokasi dan kondisi ponor; lereng dan vegetasi, jenis tanah dan batuan serta ketebalannya. Tingkat kerentanan airtanah terhadap pencemaran sebagain besar sangat rentan. Faktor yang mempunyai pengaruh besar adalah konsentrasi aliran. Jumlah ponor sebagai imbuhan terkonsentrasi (titik dari aliran permukaan menyebabkan sangat rentan. ABSTRACT Karst groundwater is one of the potential natural resources in the Gunung Sewu karst area. On the other hand, karst aquifers are highly vulnerable to contamination. Bribin underground river become the main water source for the community, especially to support the water demand in the dry season. The purposes of this study are: 1 to know the characteristics of the swallow holes recharge area through identifiying vulnerability variables (swallow hole condition, slope, vegetation, soil and rock, and 2 to assess the level of groundwater vulnerability

  6. A Continent-Wide Migratory Divide in North American Breeding Barn Swallows (Hirundo rustica.

    Directory of Open Access Journals (Sweden)

    Keith A Hobson

    Full Text Available Populations of most North American aerial insectivores have undergone steep population declines over the past 40 years but the relative importance of factors operating on breeding, wintering, or stopover sites remains unknown. We used archival light-level geolocators to track the phenology, movements and winter locations of barn swallows (Hirdundo rustica; n = 27 from populations across North America to determine their migratory connectivity. We identified an east-west continental migratory divide for barn swallows with birds from western regions (Washington State, USA (n = 8 and Saskatchewan, Canada (n = 5 traveling shorter distances to wintering areas ranging from Oregon to northern Colombia than eastern populations (Ontario (n = 3 and New Brunswick (n = 10, Canada which wintered in South America south of the Amazon basin. A single swallow from a stable population in Alabama shared a similar migration route to eastern barn swallows but wintered farther north in northeast Brazil indicating a potential leap frog pattern migratory among eastern birds. Six of 9 (67% birds from the two eastern populations and Alabama underwent a loop migration west of fall migration routes including around the Gulf of Mexico travelling a mean of 2,224 km and 722 km longer on spring migration, respectively. Longer migration distances, including the requirement to cross the Caribbean Sea and Gulf of Mexico and subsequent shorter sedentary wintering periods, may exacerbate declines for populations breeding in northeastern North America.

  7. Variability of NTCP prediction of swallowing organs at risk, due to variation in delineation guidelines

    NARCIS (Netherlands)

    Gort, E.M.; Brouwer, C.L.; Lotz, H.T.; Steenbakkers, R.J.H.M.; Wopken, K.; Van Der Laan, H.P.; Langendijk, J.A.

    2012-01-01

    Purpose/Objective: In daily practice, several different delineation guidelines can be used for the delineation of organs at risk that are involved in swallowing (SWOARs). Based on these delineation guidelines, predictive models have been developed for the different aspects of post treatment

  8. Predictive modelling for swallowing dysfunction after primary (chemo)radiation : Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, Miranda E M C; Schilstra, Cornelis; Beetz, Ivo; Muijs, C.T.; Chouvalova, Olga; Burlage, Fred R.; Doornaert, P.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.; van der Laan, B.F.; Slotman, B.J.; Verdonck-de Leeuw, I.M.; Bijl, Hendrik P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  9. Predictive modelling for swallowing dysfunction after primary (chemo)radiation: Results of a prospective observational study

    NARCIS (Netherlands)

    Christianen, M.E.M.C.; Schilstra, C.; Beetz, I.; Muijs, C.T.; Chouvalova, O.; Burlage, F.R.; Doornaert, P.A.H.; Koken, P.W.; Leemans, C.R.; Rinkel, R.N.P.M.; de Bruijn, M.J.; de Bock, G.H.; Roodenburg, J.L.N.; van Laan, B.F.A.M.; Slotman, B.J.; de Leeuw, I.M.; Bijl, H.P.; Langendijk, J.A.

    2012-01-01

    Background and purpose: The purpose of this large multicentre prospective cohort study was to identify which dose volume histogram parameters and pre-treatment factors are most important to predict physician-rated and patient-rated radiation-induced swallowing dysfunction (RISD) in order to develop

  10. Recent advances in laryngeal sensorimotor control for voice, speech and swallowing.

    Science.gov (United States)

    Ludlow, Christy L

    2004-06-01

    This article reviews advances in knowledge on laryngeal sensorimotor control affecting the assessment, understanding, and treatment of laryngeal motor control disorders in voice, speech, and swallowing. Three topics are covered: new knowledge on laryngeal innervation and central nervous system control from basic research studies, the role of laryngeal sensation in normal swallowing and dysphagia in patients, and new approaches to the restoration of laryngeal motor control after recurrent laryngeal nerve disorders. A significant advance this year was tracing the efferent pathways from the cortex to the brainstem in monkeys. This provided new information on subcortical and brainstem connections in the laryngeal efferent pathways. Laryngeal sensory feedback continued to receive attention, and the role of sensory feedback in the control of the pharyngeal phase of swallowing is now well established. Further developments in neuromotor monitoring of the recurrent laryngeal nerve during thyroidectomy were seen, and a large case series recommended that these techniques become standard practice for surgery for thyroid benign recurrence or malignancy. Finally, the first tissue engineering papers in the field of vocal fold tissue and nerve restoration were published this year, beginning an exciting new approach to restoration of laryngeal motor control. Considerable attention has been given to laryngeal muscle physiology, denervation, and sensation in neurolaryngology. Relatively limited understanding is available regarding the central nervous system integrative control of laryngeal function for speech, respiration, and swallowing.

  11. Swallowing sounds in speech therapy practice: a critical analysis of the literature.

    Science.gov (United States)

    Ferrucci, Juliana Lopes; Mangilli, Laura Davison; Sassi, Fernanda Chiarion; Limongi, Suelly Cecilia Olivan; Andrade, Claudia Regina Furquim de

    2013-12-01

    This study aimed to investigate international scientific papers published on the subject of cervical auscultation and its use in speech therapy. The study involved a qualitative review of the literature spanning the last 10 years. Articles were selected from the PubMed database using the following keywords: cervical auscultation, swallowing and swallowing disorders. Research was included that was conducted on adult humans (over 18 years of age) and was written in English. Each citation retrieved from the database was analyzed independently by each of the study researchers to ascertain its relevance for inclusion in the study. The methodology involved formulating the research question, locating and selecting studies and critically evaluating the articles according to the precepts of the Cochrane Handbook. As a result, 35 studies were identified; 13 articles were analyzed because they allowed access to the full text and were related directly to the subject. We found that the studies were performed with groups of healthy subjects and subjects with different types of base pathology. Some studies compared the patterns found in the different groups. Some of the research sought to study the pattern of swallowing sounds with different factors - evaluator experience, the specificity and sensitivity of the method and how to improve the technique of cervical auscultation through the use of instruments other than the stethoscope. The conclusion of this critical analysis is that cervical auscultation is an important tool to be used in conjunction with other assessment methods in the routine clinical evaluation of swallowing.

  12. Swallows Rugby Football Club, South Africa: The story of a century ...

    African Journals Online (AJOL)

    Swallows Rugby Football Club, South Africa: The story of a century, 1911-2011. ... Limited secondary sources pertinent to the topic were accessed and analysed for the purpose of cross-referencing the emerging \\facts. from the interviews and primary sources. Content analysis was administered on the collected data; ...

  13. Occurrence of communication and swallowing problems in neurological disorders: analysis of forty patients.

    Science.gov (United States)

    Jani, Mansi Pankaj; Gore, Geeta Bharat

    2014-01-01

    Communication and swallowing problems are common as a result of neurological conditions like stroke, traumatic brain injury, neoplasms of the nervous systems, viral encephalitis, diseases affecting neuromuscular junction and neuro degenerative conditions. The most frequently encountered problems are dysarthria, aphasia, dysphagia and apraxia of speech. Although these disorders are mentioned in literature, very few studies describing the occurrence in different neurological conditions are available in Indian context. Hence, a need was felt to carry out such a study. A heterogenous group of forty patients with neurological conditions were assessed for presence of speech, language and swallowing problems. A percent analysis was carried out to determine the occurrence of aphasia, dysarthria and dysphagia in general, in specific diseases and also to describe type of aphasia and dysarthria according to the characteristics presented. It was seen that the most frequently occurring disorder was dysarthria (60%), followed by dysphagia (55%) and aphasia (18%). It was also noted that dysarthria and dysphagia co-existed in around 45% patients with neurological diseases. It can be concluded that speech, language and swallowing problems are frequent in individuals with neurological conditions. Speech language pathologist plays an important role as a member of the rehabilitation team in a neurological setup with respect to identifying these problems and initiating intervention at the earliest. Hence, it is necessary for speech language pathologist to be well versed with the features each disorder may present with in terms of communication and swallowing.

  14. Surface Electromyography for Speech and Swallowing Systems: Measurement, Analysis, and Interpretation

    Science.gov (United States)

    Stepp, Cara E.

    2012-01-01

    Purpose: Applying surface electromyography (sEMG) to the study of voice, speech, and swallowing is becoming increasingly popular. An improved understanding of sEMG and building a consensus as to appropriate methodology will improve future research and clinical applications. Method: An updated review of the theory behind recording sEMG for the…

  15. Development of a system to monitor laryngeal movement during swallowing using a bend sensor.

    Directory of Open Access Journals (Sweden)

    Qiang Li

    Full Text Available BACKGROUND: Swallowing dysfunction (also known as dysphagia, which results in a deterioration of nutritional intake, slows rehabilitation and causes aspiration pneumonia, is very common following neurological impairments. Although videofluorographic (VF examination is widely used for detecting aspiration, an objective and non-invasive method for assessing swallowing function has yet to be established because of a lack of adequate devices and protocols. In this paper, a bend sensor whose resistance is altered by bending was introduced to monitor swallowing-related laryngeal movement. METHODS: Six healthy male volunteers were recruited in the present study. Specific time points on the signal waveform produced by the bend sensor were defined to describe laryngeal movement by differential analysis. Additionally, the physiological significance of the obtained waveform was confirmed by analyzing the sequential correlations between the signal waveform from the bend sensor and hyoid bone kinetics simultaneously recorded by VF. RESULTS: Seven time points were successfully defined on the signal waveform to reference laryngeal movement. Each time point was well correlated with certain VF events, with evidence of no significant time lags, and there were positive correlations between waveform time points and matched VF events. Furthermore, obvious similarities were noticed between the duration of each phase on the signal waveform and the duration of the matched hyoid bone activity. CONCLUSIONS: The present monitoring system using a bend sensor might be useful for observing the temporal aspects of laryngeal movement during swallowing, and it was well coordinated with hyoid bone movement.

  16. A study of brain networks associated with swallowing using graph-theoretical approaches.

    Directory of Open Access Journals (Sweden)

    Bo Luan

    Full Text Available Functional connectivity between brain regions during swallowing tasks is still not well understood. Understanding these complex interactions is of great interest from both a scientific and a clinical perspective. In this study, functional magnetic resonance imaging (fMRI was utilized to study brain functional networks during voluntary saliva swallowing in twenty-two adult healthy subjects (all females, [Formula: see text] years of age. To construct these functional connections, we computed mean partial correlation matrices over ninety brain regions for each participant. Two regions were determined to be functionally connected if their correlation was above a certain threshold. These correlation matrices were then analyzed using graph-theoretical approaches. In particular, we considered several network measures for the whole brain and for swallowing-related brain regions. The results have shown that significant pairwise functional connections were, mostly, either local and intra-hemispheric or symmetrically inter-hemispheric. Furthermore, we showed that all human brain functional network, although varying in some degree, had typical small-world properties as compared to regular networks and random networks. These properties allow information transfer within the network at a relatively high efficiency. Swallowing-related brain regions also had higher values for some of the network measures in comparison to when these measures were calculated for the whole brain. The current results warrant further investigation of graph-theoretical approaches as a potential tool for understanding the neural basis of dysphagia.

  17. Time budget of South African cliff swallows during breeding | Earlé ...

    African Journals Online (AJOL)

    The use of time by the South African cliff swallow was determined and use of energy calculated by using equations for predicting standard metabolic rate and the cost of flight. The highest daily energy expenditure was during the feeding of nestlings when 9,22 h were spent foraging. The cost of 127 kJ for building a nest is ...

  18. Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity into Clinically Oriented Evidence

    Science.gov (United States)

    Robbins, JoAnne; Butler, Susan G.; Daniels, Stephanie K.; Gross, Roxann Diez; Langmore, Susan; Lazarus, Cathy L.; Martin-Harris, Bonnie; McCabe, Daniel; Musson, Nan; Rosenbek, John

    2008-01-01

    Purpose: This review presents the state of swallowing rehabilitation science as it relates to evidence for neural plastic changes in the brain. The case is made for essential collaboration between clinical and basic scientists to expand the positive influences of dysphagia rehabilitation in synergy with growth in technology and knowledge. The…

  19. Barium versus Nonbarium Stimuli: Differences in Taste Intensity, Chemesthesis, and Swallowing Behavior in Healthy Adult Women

    Science.gov (United States)

    Nagy, Ahmed; Steele, Catriona M.; Pelletier, Cathy A.

    2014-01-01

    Purpose: The authors examined the impact of barium on the perceived taste intensity of 7 different liquid tastant stimuli and the modulatory effect that these differences in perceived taste intensity have on swallowing behaviors. Method: Participants were 80 healthy women, stratified by age group (60) and genetic taste status…

  20. [Cine-MRI contribution to assess swallowing mechanism and oro-pharyngeal dysphagia].

    Science.gov (United States)

    Fauvet, F; Charpiot, A; Schultz, P; Riehm, S; Vetter, D; Veillon, F; Hémar, P; Debry, C

    2008-01-01

    This study aimed at evaluating the performance of Cine-MRI to assess swallowing in patients previously treated for head and neck cancer. 10 healthy control subjects and a cohort of 10 patients with 8 partial glossectomies, 1 total laryngectomy and 1 glossolaryngectomy underwent imaging from October 2005 to February 2007. The MRI examinations were performed on a 1.5 Tesla system (Siemens Avanto), with True-Fisp sequences (TR = 170 ms, TE = 1 ms, slice thickness = 10 mm) at a rate of 8 pictures per second, during dry swallowing. Results are relevant for real-time spatial resolution from lips to larynx and dynamic motions analyses of tongue, velum, posterior pharyngeal wall and larynx during dry swallowing. Oro-pharyngo-laryngeal occlusion deficiency induces aspiration in case of partial glossectomy. Total laryngectomy modifies tongue, velum and pharynx landmarks. Cine-MRI i) provides functional insight from the oral cavity to the larynx, ii) gives accurate informations about impairments due to the pathology and its treatment, iii) completes others investigations like fiberoptic endoscopy or transit time, iiii) allows a precise analysis of the muscular movements involved in the deficient swallowing mechanism, in order to optimize rehabilitative strategies and results.

  1. Biomechanical events of swallowing are determined more by bolus consistency than by age or gender

    NARCIS (Netherlands)

    J. Hendriks; Bert de Swart; Alexander Geurts; L. van den Engel-Hoek; B. Gorissen; E. Esser; I. Groot

    2012-01-01

    The biomechanics of swallowing saliva and substances of different consistencies were investigated in healthy children and adults. To this end, the duration and mean amplitude value (MAV) of surface electromyography (sEMG) of the submental muscle group (SMG) activity, the maximum anterior tongue

  2. Expiratory muscle strength training improves swallowing and respiratory outcomes in people with dysphagia: a systematic review.

    Science.gov (United States)

    Brooks, Marinda; McLaughlin, Emma; Shields, Nora

    2017-11-01

    To investigate the effects of expiratory muscle strength training on communication and swallowing outcomes in adults with acquired motor based communication and/or swallowing difficulties of any aetiology. A systematic review was conducted. Six databases (CINAHL, MEDLINE, EMBASE, SPEECHBYTE, AMED and PUBMED) were searched from inception until end of May 2016. Randomised and non-randomised controlled studies and pre-test/post-test studies published in English that investigated the effects of expiratory muscle strength training were included. Study quality was assessed using the PEDro scale. Data were analysed descriptively and effect sizes and associated 95% confidence intervals were calculated. Seven articles reporting data from five studies were included. Preliminary data suggests expiratory muscle strength training improved airway safety during swallowing in people with dysphagia and increased the strength of the expiratory muscles in all patient groups. There was little evidence to suggest changes in communication outcomes after expiratory muscle strength training. Speech-language pathologists might consider using expiratory muscle strength training to improve airway safety in adults with swallowing disorders.

  3. Quantitative Lingual, Pharyngeal and Laryngeal Ultrasonography in Swallowing Research: A Technical Review

    Science.gov (United States)

    Chi-Fishman, Gloria

    2005-01-01

    Because of its distinct advantage in radiation-free soft tissue imaging, ultrasonography has been widely used to study lingual, pharyngeal, hyoid, laryngeal, and even esophageal action during swallowing in individuals of all ages. Qualitative ultrasonographic observations have made considerable contributions to our understanding of deglutition.…

  4. Neurorehabilitation strategies for poststroke oropharyngeal dysphagia: from compensation to the recovery of swallowing function.

    Science.gov (United States)

    Cabib, Christopher; Ortega, Omar; Kumru, Hatice; Palomeras, Ernest; Vilardell, Natalia; Alvarez-Berdugo, Daniel; Muriana, Desirée; Rofes, Laia; Terré, Rosa; Mearin, Fermín; Clavé, Pere

    2016-09-01

    Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition. The integrity of oropharyngeal-cortical afferent pathways can be assessed by electroencephalography through sensory-evoked potentials by pharyngeal electrical stimulation, while corticopharyngeal efferent pathways can be characterized by electromyography through motor-evoked potentials by transcranial magnetic stimulation. Dysfunction in both cortico-mediated evoked responses is associated with delayed swallow response and aspiration. Studies have reported hemispherical asymmetry on motor control of swallowing and the relevance of impaired oropharyngeal sensitivity on aspiration. Advances in treatment include improvements in compensatory strategies but are mainly focused on (1) peripheral stimulation strategies and (2) central, noninvasive stimulation strategies with evidence of their clinical benefits. Characterization of poststroke OD is evolving from the assessment of impaired biomechanics to the sensorimotor integration processes involved in deglutition. Treatment is also changing from compensatory strategies to promoting brain plasticity, both to recover swallow function and to improve brain-related swallowing dysfunction. © 2016 New York Academy of Sciences.

  5. Movie MRI at five frames a second for evaluation of speech and swallowing

    Science.gov (United States)

    Kumada, Masanobu; Mori, Koichi; Nakajima, Yasoichi; Nozaki, Seiji

    2004-05-01

    Magnetic resonance imaging (MRI) is a noninvasive imaging method that is widely used in the medical field. One of the limitations of MRI is its low time-resolution images of MRI are usually obtained as still images. Here we introduced a newly developed method of ``movie'' MRI with high time-resolution at five images a second. Its good application would include study and evaluation of speech and swallowing. Instrument: MRT-2001 XG with Software ver.5.5. (Toshiba). Coil: head QD coil for the tongue; CTL ARRY coil (3ch) for the neck, Imaging condition: sagital FFE2D; TR=2.8 ms TE=1.2 ms FA=10 deg Matrix=64×128 ST=10 mm NAQ=1 AV FOV=23×35 ; ROAFI; sequential acquisition. Maximum imaging length=51 s. A healthy Japanese male (Tokyo dialect speaker, 39 years). Task: Repetitive utterance of /tenten.../ and intentional swallowing of saliva. Results: In the task of /tenten..../, we could detect, in temporal order, velopharyngeal (VP) closure, opening of the tongue-palate (TP) closure, VP opening, TP closure, VP closure, and so on. In the swallowing task of saliva, we could detect movement of the tongue for conveying saliva to the pharynx, VP closure, backward movement of the tongue root, elevation and descent of the larynx in this temporal order. Our ``Movie MRI'' seemed promising for the noninvasive evaluation of speech and deglutition. Appropriate materials for swallowing evaluation will be presented.

  6. Peer-Mediated Procedures to Induce Swallowing and Food Acceptance in Young Children.

    Science.gov (United States)

    Greer, R. Douglas; And Others

    1991-01-01

    A peer modeling procedure was shown to induce swallowing in a young child with dysphagia, and to increase food acceptance in a young child who consistently declined food. A peer-mediated procedure, consisting of rotated opportunities to consume food with a peer, increased consumption more than did modeling alone. (Author/JDD)

  7. Swallowing Mechanics Associated with Artificial Airways, Bolus Properties, and Penetration-Aspiration Status in Trauma Patients

    Science.gov (United States)

    Dietsch, Angela M.; Rowley, Christopher B.; Solomon, Nancy Pearl; Pearson, William G., Jr.

    2017-01-01

    Purpose: Artificial airway procedures such as intubation and Sare common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in…

  8. Functional results of speech and swallowing after oral microvascular free flap reconstruction.

    Science.gov (United States)

    Archontaki, Maria; Athanasiou, Athanasios; Stavrianos, Spyros D; Korkolis, Dimitris P; Faratzis, Gregory; Papadopoulou, Flora; Kokkalis, Georgios; Rapidis, Alexander D

    2010-11-01

    To study speech and swallowing in patients who underwent microvascular free flap reconstruction after major surgery of the oral cavity. Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videofluoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the floor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed. Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have significant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively. Microvascular free flap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients.

  9. Impact of Hypena opulenta on invasive swallow-worts (Vincetoxicum spp.) under different light environments

    Science.gov (United States)

    Pale and black swallow-wort (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae) are European viny milkweeds that have become invasive in many habitats in the northeastern U.S.A. and southeastern Canada. A defoliating moth from the Ukraine, Hypena opulenta (Christoph) (Lepid...

  10. Towards biological control of swallow-worts: the good, the bad and the ugly

    Science.gov (United States)

    Native from Eurasia, the ugly swallow-worts (Vincetoxicum rossicum and V. nigrum - Apocynaceae) invaded forested landscapes and prevent native plant regeneration in eastern North America. We first aimed to understand where do the invasive populations of both species come from, then we evaluated the ...

  11. Impact of Abrostola asclepiadis and plant competition on invasive swallow-worts (Vincetoxicum spp.)

    Science.gov (United States)

    Pale and black swallow-wort (Vincetoxicum rossicum and V. nigrum; Apocynaceae, subfamily Asclepiadoideae) are perennial vines from Europe that have become invasive in various terrestrial habitats in the northeastern USA and southeastern Canada. A classical weed biological control program has been in...

  12. The Invasive Swallow-worts: What Do We Know About Their Biology and Management?

    Science.gov (United States)

    The swallow-worts [Vincetoxicum rossicum (Kleopow) Barbar. and V. nigrum (L.) Moench] are nonnative, perennial, herbaceous vines in the Apocynaceae that are invading natural areas in the northeastern U.S.A. and southeastern Canada. The species form dense monospecific stands across a wide range of mo...

  13. Instrumental and sensory quantification of oral coatings retained after swallowing semi-solid foods

    NARCIS (Netherlands)

    Prinz, J.F.; Huntjens, L.; Wijk, de R.A.

    2006-01-01

    After a mouthful of food has been swallowed, some food material is always retained in the mouth. With semi-solid foods this is in the form of a coating that adheres to the oral mucosa. The amount and location of this material may play an important role in food sensations. In this study two

  14. Swallowing performance in patients with head and neck cancer: a simple clinical test.

    Science.gov (United States)

    Patterson, Joanne M; McColl, Elaine; Carding, Paul N; Kelly, Charles; Wilson, Janet A

    2009-10-01

    Few simple clinical measures are available to monitor swallowing performance in head and neck cancer. Water swallow tests (WST) have been used as a part of clinical assessments in neurological dysphagia. The aim of this paper is to evaluate the utility of the 100 mL WST in head and neck cancer patients. The 100 mL WST was performed on 167 head and neck cancer patients. Measures were compared with respect to tumor site/stage, gender and age. The cohort was compared with published healthy controls. The test was quick to administer with excellent compliance. Patients had significantly poorer swallows than the published control group (mean reduction 1.6 mL/s). Function worsened with increased tumor stage and for patients with pharyngeal tumors. The 100 mL WST is an effective swallowing performance measure and is easily incorporated into a clinical examination. This paper provides benchmark data on the 100 mL WST for individuals with head and neck cancer.

  15. Effect of IQoro(R) training in hiatal hernia patients with misdirected swallowing and esophageal retention symptoms.

    Science.gov (United States)

    Hägg, Mary; Tibbling, Lita; Franzén, Thomas

    2015-07-01

    Misdirected swallowing can be triggered by esophageal retention and hiatal incompetence. The results show that oral IQoro(R) screen (IQS) training improves misdirected swallowing, hoarseness, cough, esophageal retention, and globus symptoms in patients with hiatal hernia. The present study investigated whether muscle training with an IQS influences symptoms of misdirected swallowing and esophageal retention in patients with hiatal hernia. A total of 28 adult patients with hiatal hernia suffering from misdirected swallowing and esophageal retention symptoms for more than 1 year before entry to the study were evaluated before and after training with an IQS. The patients had to fill out a questionnaire regarding symptoms of misdirected swallowing, hoarseness, cough, esophageal retention, and suprasternal globus, which were scored from 0-3, and a VAS on the ability to swallow food. The effect of IQS traction on diaphragmatic hiatus (DH) pressure was recorded in 12 patients with hiatal hernia using high resolution manometry (HRM). Upon entry into the study, misdirected swallowing, globus sensation, and esophageal retention symptoms were present in all 28 patients, hoarseness in 79%, and cough in 86%. Significant improvement was found for all symptoms after oral IQS training (p < 0.001). Traction with an IQS resulted in a 65 mmHg increase in the mean HRM pressure of the DH.

  16. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding.

    Science.gov (United States)

    Goldfield, Eugene C; Richardson, Michael J; Lee, Kimberly G; Margetts, Stacey

    2006-10-01

    This prospective study compared the coordination of sucking, swallowing, and breathing and its relationship to oxygen saturation in infants during breast-feeding and bottle-feeding. After 4 to 6 wk of exclusive breast-feeding, infants began bottle-feedings of expressed human milk using one of two systems: a soft-walled bottle and nipple (system 1, Playtex) or a hard-walled bottle and nipple (system 2, Avent). Infants' sucking, swallowing, breathing, and oxygenation were measured during breast-feeding and bottle-feeding, and coordination of these activities during breast-feeding and bottle-feeding were compared. During breast-feeding, swallowing occurred nonrandomly between breaths and did not interfere with breathing. The same distribution of swallowing occurred in infants fed with system 1, while swallowing occurred randomly in infants fed with system 2. Swallowing significantly increased during bottle-feeding among infants using system 2, but decreased among infants using system 1. Infants using system 2 also had a greater instability in the coordination of sucking, swallowing, and breathing and more perturbation of breathing. Oxygen saturation was significantly higher in infants fed with system 1 compared with system 2. These results suggest that the overall feeding pattern and oxygenation of system 1 are closer to the physiologic norm than system 2.

  17. Altered Cortical Swallowing Processing in Patients with Functional Dysphagia: A Preliminary Study

    Science.gov (United States)

    Wollbrink, Andreas; Warnecke, Tobias; Winkels, Martin; Pantev, Christo; Dziewas, Rainer

    2014-01-01

    Objective Current neuroimaging research on functional disturbances provides growing evidence for objective neuronal correlates of allegedly psychogenic symptoms, thereby shifting the disease concept from a psychological towards a neurobiological model. Functional dysphagia is such a rare condition, whose pathogenetic mechanism is largely unknown. In the absence of any organic reason for a patient's persistent swallowing complaints, sensorimotor processing abnormalities involving central neural pathways constitute a potential etiology. Methods In this pilot study we measured cortical swallow-related activation in 5 patients diagnosed with functional dysphagia and a matched group of healthy subjects applying magnetoencephalography. Source localization of cortical activation was done with synthetic aperture magnetometry. To test for significant differences in cortical swallowing processing between groups, a non-parametric permutation test was afterwards performed on individual source localization maps. Results Swallowing task performance was comparable between groups. In relation to control subjects, in whom activation was symmetrically distributed in rostro-medial parts of the sensorimotor cortices of both hemispheres, patients showed prominent activation of the right insula, dorsolateral prefrontal cortex and lateral premotor, motor as well as inferolateral parietal cortex. Furthermore, activation was markedly reduced in the left medial primary sensory cortex as well as right medial sensorimotor cortex and adjacent supplementary motor area (pdysphagia - a condition with assumed normal brain function - seems to be associated with distinctive changes of the swallow-related cortical activation pattern. Alterations may reflect exaggerated activation of a widely distributed vigilance, self-monitoring and salience rating network that interferes with down-stream deglutition sensorimotor control. PMID:24586948

  18. Cortical processing of swallowing in ALS patients with progressive dysphagia--a magnetoencephalographic study.

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    Inga K Teismann

    Full Text Available Amyotrophic lateral sclerosis (ALS is a rare disease causing degeneration of the upper and lower motor neuron. Involvement of the bulbar motor neurons often results in fast progressive dysphagia. While cortical compensation of dysphagia has been previously shown in stroke patients, this topic has not been addressed in patients suffering from ALS. In the present study, we investigated cortical activation during deglutition in two groups of ALS patients with either moderate or severe dysphagia. Whole-head MEG was employed on fourteen patients with sporadic ALS using a self-paced swallowing paradigm. Data were analyzed by means of time-frequency analysis and synthetic aperture magnetometry (SAM. Group analysis of individual SAM data was performed using a permutation test. We found a reduction of cortical swallowing related activation in ALS patients compared to healthy controls. Additionally a disease-related shift of hemispheric lateralization was observed. While healthy subjects showed bilateral cortical activation, the right sensorimotor cortex was predominantly involved in ALS patients. Both effects were even stronger in the group of patients with severe dysphagia. Our results suggest that bilateral degeneration of the upper motor neuron in the primary motor areas also impairs further adjusted motor areas, which leads to a strong reduction of 'swallowing related' cortical activation. While both hemispheres are affected by the degeneration a relatively stronger activation is seen in the right hemisphere. This right hemispheric lateralization of volitional swallowing observed in this study may be the only sign of cortical plasticity in dysphagic ALS patients. It may demonstrate compensational mechanisms in the right hemisphere which is known to predominantly coordinate the pharyngeal phase of deglutition. These results add new aspects to our understanding of the pathophysiology of dysphagia in ALS patients and beyond. The compensational

  19. Cliff swallows Petrochelidon pyrrhonota as bioindicators of environmental mercury, Cache Creek Watershed, California

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    Hothem, Roger L.; Trejo, Bonnie S.; Bauer, Marissa L.; Crayon, John J.

    2008-01-01

    To evaluate mercury (Hg) and other element exposure in cliff swallows (Petrochelidon pyrrhonota), eggs were collected from 16 sites within the mining-impacted Cache Creek watershed, Colusa, Lake, and Yolo counties, California, USA, in 1997-1998. Nestlings were collected from seven sites in 1998. Geometric mean total Hg (THg) concentrations ranged from 0.013 to 0.208 ??g/g wet weight (ww) in cliff swallow eggs and from 0.047 to 0.347 ??g/g ww in nestlings. Mercury detected in eggs generally followed the spatial distribution of Hg in the watershed based on proximity to both anthropogenic and natural sources. Mean Hg concentrations in samples of eggs and nestlings collected from sites near Hg sources were up to five and seven times higher, respectively, than in samples from reference sites within the watershed. Concentrations of other detected elements, including aluminum, beryllium, boron, calcium, manganese, strontium, and vanadium, were more frequently elevated at sites near Hg sources. Overall, Hg concentrations in eggs from Cache Creek were lower than those reported in eggs of tree swallows (Tachycineta bicolor) from highly contaminated locations in North America. Total Hg concentrations were lower in all Cache Creek egg samples than adverse effects levels established for other species. Total Hg concentrations in bullfrogs (Rana catesbeiana) and foothill yellow-legged frogs (Rana boylii) collected from 10 of the study sites were both positively correlated with THg concentrations in cliff swallow eggs. Our data suggest that cliff swallows are reliable bioindicators of environmental Hg. ?? Springer Science+Business Media, LLC 2007.

  20. Spatiotemporal Patterns in Nest Box Occupancy by Tree Swallows Across North America

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    Dave Shutler

    2012-06-01

    Full Text Available Data from the North American Breeding Bird Survey (BBS suggest that populations of aerial insectivorous birds are declining, particularly in northeastern regions of the continent, and particularly since the mid-1980s. Species that use nest boxes, such as Tree Swallows (Tachycineta bicolor, may provide researchers with large data sets that better reveal finer-scale geographical patterns in population trends. We analyzed trends in occupancy rates for ca. 40,000 Tree Swallow nest-box-years from 16 sites across North America. The earliest site has been studied intensively since 1969 and the latest site since 2004. Nest box occupancy rates declined significantly at five of six (83% sites east of -78° W longitude, whereas occupancy rates increased significantly at four of ten sites (40% west of -78° W longitude. Decreasing box occupancy trends from the northeast were broadly consistent with aspects of a previous analysis of BBS data for Tree Swallows, but our finding of instances of increases in other parts of the continent are novel. Several questions remain, particularly with respect to causes of these broad-scale geographic changes in population densities of Tree Swallows. The broad geographic patterns are consistent with a hypothesis of widespread changes in climate on wintering, migratory, or breeding areas that in turn may differentially affect populations of aerial insects, but other explanations are possible. It is also unclear whether these changes in occupancy rates reflect an increase or decrease in overall populations of Tree Swallows. Regardless, important conservation steps will be to unravel causes of changing populations of aerial insectivores in North America.