Neurogene orofaringealne disfagije su vrlo čest simptom i posljedica akutnih i kroničnih neuroloških bolesti, posebice cerebrovaskularnih, ekstrapiramidnih i demijelinizacijskih bolesti. Poremećaj ...gutanja uzrokuje niz sekundarnih komplikacija - malnutriciju, dehidraciju i aspiracijsku pneumoniju - ali i one suptilnije, često nedovoljno osviještene, psihološke i socijalne posljedice koje dugoročno utječu na kvalitetu života bolesnika. Prepoznavanje i liječenje bolesnika s poremećajem gutanja nerijetko je izazov, zato se cjelokupan postupak odvija u okviru multidisciplinarnog tima. Klinički logoped je sastavni dio multidisciplinarnog tima koji dijagnosticira i liječi poremećaje gutanja, svojim znanjem i kompetencijama utječe na povoljan rezultat liječenja. Logoped, kao član multidisciplinarnog tima, prilagođava konzistenciju hrane koju će uzimati bolesnik s neurogenom disfagijom i omogućuje sigurno hranjenje terapijskim postupcima. Logoped inicijalno provodi testove procjene gutanja, kojima prepoznaje bolesnike s rizičnim čimbenicima za aspiraciju. Ako je kod bolesnika uočen nesiguran obrazac gutanja, provodi se detaljna logopedska dijagnostika kojom se utvrđuje dalji način prehrane, kako bi se bolesniku omogućilo sigurno gutanje. Logoped odabire jednu ili više rehabilitacijskih tehnika koje će primijeniti, ovisno o bolesnikovu općem zdravstvenom stanju, suradljivosti i mogućnosti korištenja naučenim tehnikama nakon otpusta iz bolnice. Ovaj rad daje uvid u načine na koje se logoped brine o bolesnicima s poremećajem gutanja – od primitka do otpusta iz bolnice – i naglašava važnost logopeda u multidisciplinarnom timu, koji se bavi neurogenom disfagijom.
Neurogenic oropharyngeal dysphagia is a common symptom and the repercussion of acute and chronic
neurological diseases especialy cerebrovascular, extrapyramidal and demyelinating diseases. Swallowing
difficulties cause all kinds of secundary complications such as malnutrition, dehydration and pneumonia
caused by aspiration. They also affect patient's overall quality of life disturbing its psychological and
social well-being. Screening for patients with swallowing difficulties is often a challenge and therefore
diagnostics demands working in a multidisciplinary team. Clinical Speech and Language Pathologist
(SLP) should be a part of a multidisciplinary team that diagnoses and treats patients with dysphagia. By
doing that, SLPs help provide positive treatment outcomes with their specific knowledge and
competencies. As members of a multidisciplinary team, SLPs adjust food consistency that patients with
neurogenic dysphagia consume and enable safe feeding with therapeutic methods. The role of SLPs is to
provide that kind of nutrition. Initialy, SLPs do a brief swallowing screening that singles out patients with
risk factors for aspiration. If an unsafe swallowing pattern is recognised, SLPs perform overall
diagnostics to determine the way of future food and liquid intake to ensure safe swallowing. Moreover,
SLPs choose one or more rehabilitation techniques to use with patients according to their health
condition, cooperation and ability to use the technique outside of the hospital. This paper provides a
review of ways that Speech and Language Pathologists care for patients with swallowing difficulties from
the admission to the hospital till their discharge. Also, it emphasises the importance of SLPs in a
multidisciplinary team that deals with patients with neurogenic dysphagia.
Verbal fluency tests are useful measures of acquired language impairment and cognitive decline of various etiologies. The aim of this study was to provide normative data for the Swedish population on ...the three verbal fluency tests, FAS, Animals and Verbs. A group of 165 healthy participants ranging from 16 to 89 years of age were assessed with the verbal fluency tests and tests of level of intellectual functioning. The sample was stratified by education, age and gender. Level of education had a substantial influence on the performance on verbal fluency, most clearly so in FAS and Verbs. Intellectual level had a positive and significant correlation with all measures of word fluency. Moreover, there was an interaction between age and gender such that women aged between 30 and 64 years outperformed elderly men on FAS and Verbs. Guidelines for instructions and scoring in Swedish are given in the article.
Summary The area of vocal registers is still unclarified. In a previous investigation, dynamic real-time magnetic resonance imaging (MRI), which is able to produce up to 10 frames per second, was ...successfully applied for examinations of vocal tract modifications in register transitions in male singers. In the present study, the same MRI technique was used to study vocal tract shapes during four professional young sopranos' lower and upper register transitions. The subjects were asked to sing a scale on the vowel /a/ across their transitions. The transitions were acoustically identified by four raters. In neither of these transitions, clear vocal tract changes could be ascertained. However, substantial changes, that is, widening of the lips, opening of the jaw, elevation of the tongue dorsum, and continuous widening of the pharynx, were observed when the singers reached fundamental frequencies that were close to the frequency of the first formant of the vowel sung. These findings suggest that in these subjects register transition was not primarily the result of modifications of the vocal tract.
Objective: Tenor singers may reach their top pitch range either by shifting from modal to falsetto register or by using their so-called ‘voix mixte’. Material and Methods: In this study, dynamic ...real-time MRI of 8 frames per second was used to analyze the vocal tract profile in 10 professional opera tenors, who sang an ascending scale from C4 (262 Hz) to A4 (440 Hz) on the vowel /a/. The scale included their register transition and the singers applied both register techniques in different takes. Results: Modal to falsetto register changes were associated with only minor vocal tract modifications, including elevation and tilting of the larynx and a lifted tongue dorsum. Transitions to voix mixte, by contrast, were associated with major vocal tract modifications. Under these conditions, the subjects widened their pharynges, their lip and jaw openings, and increased their jaw protrusion. These modifications were stronger in more ‘heavy’ tenors than in more ‘light’ tenors. The acoustic consequences of these articulatory changes are discussed.
Zadovoljstvo poslom je procjena karakteristike posla i emocionalnog iskustva na poslu. Smatra se kako zadovoljstvo poslom čini skup stavova o pojedinim dijelovima posla. Najčešće spomenuti izvori ...zadovoljstva su općenito direktan rad s ljudima, nezavisnost posla, prilika raditi posao u skladu sa svojim unutrašnjim vrijednostima i dobri međuljudski odnosi na radnome mjestu. Brojna istraživanja upućuju na povezanost zadovoljstva poslom i emocionalne i fizičke dobrobiti pojedinca, kao i općega zadovoljstva životom. Iako su istraživanja zadovoljstva poslom prvenstveno provođena u industrijskom kontekstu, zadnjih se godina sve više istražuju činitelji koji dovode do zadovoljstva/nezadovoljstva poslom osoba koje profesionalno pomažu drugim ljudima. Na osnovi dosadašnjih istraživanja, socijalna podrška utječe na zadovoljstvo poslom i doživljaj smislenosti posla. Povezanost zadovoljstva poslom i smislenosti posla potvrđeno je istraživanjem Grive i Joekesa (2003), gdje na taj odnos utječu i sociodemografski čimbenici. Cilj ovog istraživanjaje utvrditi stupanj zadovoljstva poslom logopeda u odnosu na njihove sociodemografske podatke, kao i utvrđivanje povezanosti socijalne podrške i doživljaja smislenosti posla sa zadovoljstvom poslom logopeda u Republici Hrvatskoj. Predmet istraživanja su zadovoljstvo poslom, smislenost posla i socijalna podrška u logopedskoj profesiji. U istraživanju je sudjelovalo 117 logopeda. Najpozitivnije odgovore ispitanici su imali na skalama zadovoljstva poslom iskali smislenosti posla, što ide u prilog tome dasu logopedi u Hrvatskoj zadovoljni poslom, te svoj posao smatraju smislenim. Nešto slabiji rezultat ostvaren je na skali socijalne podrške, koja se pokazala prediktivnom za doživljaj smislenosti posla. Rezultati pokazuju povezanost istraživanih konstrukata, te da zadovoljstvo poslom potpuno posreduje odnosu između socijalne podrške i doživljaja smislenosti posla.
We studied expressive and receptive language, oral motor ability, attention, memory, and intelligence in 20 6‐year‐ old children with epilepsy (14 females, six males; mean age 6y 5mo, range 6y–6y ...11mo) without learning disability, cerebral palsy (CP), and/or autism, and in 30 reference children without epilepsy (18 females, 12 males; mean age 6y 5mo, range 6y–6y 11mo). Ten children had partial, six primarily generalized, and four unclassified epilepsy. Fourteen were having monotherapy and six were taking two or more antiepileptic drugs; 13 children were free from seizures 3 months before the assessment. Results show no statistically significant difference between the groups concerning Verbal IQ, expressive and receptive grammar, and receptive vocabulary. The children with epilepsy had a significantly lower Performance IQ and lower scores in tests of oral motor ability, articulation, emerging literacy, auditory attention, short‐term memory, and rapid word retrieval. Parent ratings revealed no significant difference in communicative ability. Polytherapy and early onset of epilepsy influenced some results. Preschool children with epilepsy without learning disability, CP, and/or autism may have receptive verbal ability within the normal range but visuoperceptual, auditory attentional, and speech‐language difficulties that could affect school achievement. Careful testing of children with epilepsy who appear to be functioning within the normal range is needed because this may reveal specific impairments that require appropriate professional input.
The aim was to develop a comprehensive screening instrument for evaluation of orofacial dysfunction that was easy to perform for different health professionals without special equipment. The Nordic ...Orofacial Test--Screening (NOT-S), consisting of a structured interview and clinical examination,was developed with a picture manual illustrating the different tasks in the examination. It was first tested in a Swedish version, and later translated to other Nordic languages, and to English. The interview reflected six domains, (I) Sensory function, (II) Breathing, (III) Habits, (IV) Chewing and swallowing, (V) Drooling, and (VI) Dryness of the mouth, and the examination included six domains representing (1) The face at rest, and tasks regarding (2) Nose breathing, (3) Facial expression, (4) Masticatory muscle and jaw function, (5) Oral motor function, and (6) Speech. One or more "yes" for impairment in a domain resulted in one point (maximum NOT-S score 12 points). The mean NOT-S score (+/- SD) in 120 patients (3-86 yr), referred to five centers for specialized dental care or speech and language pathology in Sweden, Norway and Denmark, was 4.1 +/- 2.6, and 0.4 +/- 0.6 in 60 control subjects (3-78 yr). The screening was easy to administer and the time spent 5-13 min. The scores from the clinic-referred sample differed significantly from the controls, and the sensitivity of the screening was 0.96 and specificity 0.63. Repeated evaluations of videotapes of 200 patients by 3 examiners, speech-language pathologists and dentists, with at least two-week intervals, showed inter- and intraexaminer agreement on the points given in the domains at respectively 83% and 92-95% which increased after recalibration to 85% and 95-99%. Kappa values for interexaminer agreement on the NOT-S scores were 0.42-0.44 (i.e. fair), and the method error was 5.3%. To conclude, NOT-S gave a reliable and valid screening for orofacial dysfunction.
Djeca i osobe sa složenim komunikacijskim potrebama, ali i one s razvojnim jezičnim poremećajem suočene su s različitim ograničenjima u svakodnevnom funkcioniranju. Važnu ulogu u komunikaciji i ...stjecanju znanja kod osoba s teškoćama imaju okolina i različiti oblici asistivne tehnologije (AT). Posljednjih godina bilježi se procvatu području visokotehnoloških uređaja namijenjenih komunikaciji, kao jednog od brojnih rješenja unutar asistivne tehnologije. Razvoj takvih visokotehnoloških pomagala i sustava bio bi nemoguć bez napretka informacijskih i komunikacijskih tehnologija (IKT), koje u današnje vrijeme svoju primjenu pronalaze u područjima logopedske procjene i podrške. U Hrvatskoj se posljednjih godina sve više pozornosti posvećuje primjeni IKT-a u okviru logopedskog rada. Budući da postoji malo istraživanja o stvarnoj uporabi IKT-a među logopedima u Hrvatskoj, provedeno je istraživanje čiji je cilj bio ispitati osviještenost i stavove hrvatskih logopeda o primjeni IKT-a. Osim osviještenosti, ujedno je ispitana osposobljenost logopeda za primjenu IKT-a, trenutni trendovi u korištenju IKT-a među logopedima, kao i prepreke njenoj većoj primjeni. Za tu svrhu napravljen je online upitnik namijenjen diplomiranim logopedima iz Hrvatske. U istraživanju je sudjelovalo ukupno 120 logopeda. Analizom prikupljenih podataka može se zaključiti da su logopedi u Hrvatskoj dobro osviješteni o mogućnostima i prednostima IKT-a u radu s korisnicima, generalno imaju pozitivne stavove. No, izdvajaju se i neki aspekti koji nisu u potpunosti zadovoljavajući i koje bi trebalo unaprijediti, te promjene koje bi trebalo uvesti kako bi se prednosti i mogućnosti IKT-a bolje prepoznale i iskoristile. Dobit će se uvid u vrste IKT-a koje logopedi koriste, kao i njihova perspektiva u odnosu na primjenu IKT-a.
Children and adults with complex communication needs, as well as those with developmental language disorder experience various limitations every day. In the life of an individual with disability, the important role is played by the environment together with the assistive technology (AT). Over the last years big progress has been marked in the domain of high-tech devices focused on communication which are one of many AT solutions. The development of such devices and systems would be impossible without the development of information communication technology (ICT) which has been gaining more and more recognition in speech and language pathology (SLP) assessment as well as intervention. The application of ICT in SLP services in Croatia has been getting more attention over the last years. Since there are only few studies on the actual application of ICT among SLP professionals in Croatia, we conducted a study to gain an insight into the awareness and attitudes towards the application of ICT among SLP professionals in Croatia. Furthermore, the aim was to investigate competence, current trends in ICT application and barriers to better ICT use. An online questionnaire was designed and filled out by 120 graduate speech and language pathologists from Croatia. Data analysis suggests that SLP professionals in Croatia are aware of the opportunities and benefits of ICT application, and they generally show positive attitudes. However, some negative and unsatisfying aspects have been revealed so improvement and changes should be introduced with the purpose of greater recognition of ICT potential and its wider application. This paper provides information on ICT forms which SLP professionals use in their work as well as their perspective on the application of ICT.
We assessed verb fluency vs. noun and letter-based fluency in 199 subjects referred for cognitive complaints including Subjective Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer’s ...disease. ANCOVAs and factor analyses identified verb, noun, and letter-based fluency as distinct tasks. Verb fluency performance in Mild Cognitive Impairment differed significantly from Subjective Cognitive Impairment and Alzheimer’s disease. Reduced verb fluency thus appears to be a linguistic marker for incipient dementia. One possibility is that the verb fluency deficit in Mild Cognitive Impairment results from degenerative processes known to occur in the parahippocampal region.
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