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Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/22
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Item Development and feasibility of a Swallowing intervention Package (SiP) for patients receiving radiotherapy treatment for head and neck cancer—the SiP study protocol(BMC, 2016-08-04) Wells, Mary; King, Emma; Toft, Kate; MacAulay, Fiona; Patterson, Joanne; Dougall, Nadine; Hulbert-Williams, Nick; Boa, Sally; Slaven, Eleanor; Cowie, Julie; McGarva, John; Niblock, Patricia Gail; Philp, Julie; Roe, JustinBackground: Head and neck cancer (HNC) is the sixth most common cancer worldwide, and the functional, psychological and social consequences of HNC cancer and its treatment can be severe and chronic. Dysphagia (swallowing problems) affects up to two thirds of patients undergoing combined chemoradiotherapy. Recent reviews suggest that prophylactic swallowing exercises may improve a range of short- and long-term outcomes; however, the importance of psychological and behavioural factors on adherence to swallowing exercises has not been adequately studied. This study aims to develop and test the feasibility of a Swallowing intervention Package (SiP) designed in partnership with patients, speech and language therapists (SLTs) and other members of the head and neck multi-disciplinary team (MDT), for patients undergoing chemoradiotherapy (CRT) or radiotherapy (RT) for head and neck cancer. Methods/design: This feasibility study uses quantitative and qualitative research methods, within a quasi-experimental design, to assess whether patients will tolerate and adhere to the SiP intervention, which aspects of the intervention can be implemented and which cannot, whether treatment fidelity can be achieved across different contexts, whether study processes and outcome measures will be feasible and acceptable and to what extent the intervention is likely to have an impact on swallowing dysfunction and quality of life. Patients are being recruited from five sites in Scotland and England (three interventions and two usual care). The SLT based in the relevant intervention centre teaches the exercise programme and provides supporting materials. A combination of patient-reported outcome measures (PROMs), adherence measures and clinical swallowing assessments are used prior to intervention (baseline), at the end of treatment, 3 and 6 months post-treatment. Discussion: This collaborative study has taken a unique approach to the development of a patient-centred and evidence-based swallowing intervention. The introduction of an e-SiP app provides an exploration of the use of technology in delivering this intervention. The study provides an opportunity to examine the feasibility of delivering and participating in a supported swallowing intervention across several different NHS sites and will provide the evidence needed to refine intervention and study processes for a future trial. Trial registration: NCRI portfolio, 18192 & 20259Item Behaviour change technique taxonomy: A method of describing head and neck cancer dysphagia intervention delivery(Wolters Kluwer, 2017) Toft, Kate; Stringer, HelenPurpose of review The purpose of the review is to examine the current state of the art of dysphagia intervention delivery description and to propose use of a new tool to facilitate this: the behaviour change technique taxonomy version 1 (BCTTv1). Recent findings Describing intervention delivery is difficult, and published research in the field of speech and language therapy (SLT) does not include detail on this key aspect of research protocols. Interventions themselves are often poorly delineated, and a way is needed of classifying how these interventions are delivered in practice. Summary Use of the BCTTv1 would facilitate clarity and transparency in intervention delivery description and have positive implications for research, clinical practice and undergraduate teaching if employed by the SLT profession.Item Feasibility and outcomes of fibreoptic endoscopic evaluation of swallowing following prophylactic swallowing rehabilitation in head and neck cancer(Wiley, 2019-03-20) Patterson, Joanne; Toft, Kate; McAuley, Fiona; King, Emma; McLachlan, Kirsty; Roe, Justin W. G.; Wells, MaryObjectives: Investigate the feasibility and outcomes of fibreoptic endoscopic evalua‐tion of swallowing (FEES) following a programme of prophylactic swallowing exer‐cises in head and neck cancer (HNC) patients treated with radiotherapy.Design: Prospective, single cohort, feasibility study.Setting: Three head and neck cancer centres in Scotland.Participants: Pre‐radiotherapy HNC patients who consented to participate in a pro‐phylactic swallowing intervention.Outcome measures: Fibreoptic endoscopic evaluation of swallowing recruitment and retention rates, assessment acceptability and compliance, qualitative process evaluation.Results: Higher rates of recruitment and retention were achieved in centres where FEES equipment was available on‐site. Travel and anticipated discomfort were barri‐ers to recruitment. Data completion was high for all rating scales, with good reliabil‐ity. Following radiotherapy, swallowing safety significantly deteriorated for liquid boluses (P = 0.005‐0.03); pharyngeal residue increased for liquid and semi‐solid bo‐luses. Pharyngo‐laryngeal oedema was present pre‐treatment and significantly in‐creased post‐radiotherapy (P = 0.001). Patients generally reported positive experience of FEES for their own learning and establishing a baseline.Conclusions: Fibreoptic endoscopic evaluation of swallowing is an acceptable method of assessing patients for a prophylactic swallowing intervention and offers some ad‐ditional information missing from VF. Barriers have been identified and should be taken into account in order to maximise recruitment for future trials.Item Towards ordinal classification of voice quality features with acoustic parameters(ESSV, 2019-03-09) Schaeffler, Felix; Eichner, Matthias; Beck, Janet M.The human voice is capable of fine-grained variation that results in listener attributions of various psychological, social and biological factors. The complexity of this process is reflected in the number and richness of terms that are used to describe human voices. In this paper we argue that any application that attempts a mapping of the acoustic voice signal onto voice descriptor labels would benefit from an intermediate auditory-phonetic level. As a point of departure we explore the relationships between acoustic parameters and some specific perceptual features derived from Vocal Profile Analysis (VPA), a phonetically motivated voice quality analysis scheme. Perceptual analysis of voice samples from 133 speakers was carried out using VPA for three key phonation features (creakiness, whisperiness, harshness). We extracted eleven acoustic parameters from the samples and used stepwise linear regression to identify acoustic parameters with predictive value. Samples from female speakers were used to derive regression equations which were then used to predict VPA ratings of male voices. Results show significant predictors for all three phonation features and indicate that predictions for the three phonation types rely mainly on different parameters. If a tolerance of ± 1 scalar degree for the perceptual analysis is accepted, then classification accuracy lies at or above 90% for all three phonation features.Item What should we call children with unexplained language difficulties? A practical perspective(Wiley, 2014-08-20) Clark, Ann; Carter, GlennThis commentary reflects on Bishop's discussion of possible diagnostic terms for children with unexplained language problems. We discuss each of her four proposed terms in turn, commenting on their potential use in clinical and educational contexts by speech and language therapists and other professionals.Item Syntax(J & R Press, 2014-08-31) Bates, S.; Clark, Ann; Whitworth, Nicole; Knight, Rachael-AnneItem Prosodic development in atypical populations(John Benjamins Publishing Company, 2018-05-24) Peppé, Sue J. E.; Prieto, Pilar; Esteve-Gibert, NúriaThis chapter concerns various atypical conditions in children and how the development of prosody may be affected in them. Methods for evaluating prosodic ability are considered, taking into account receptive and expressive ability. Brief summaries of research into several conditions in which prosodic development is affected are given, including hearing impairment, language disorder, Down syndrome, childhood onset fluency disorder, Williams syndrome and a more detailed treatment of autism spectrum disorder. The chapter concludes with a brief summary of current strategies for rehabilitation.Item Systematic review of ultrasound visual biofeedback in intervention for speech sound disorders(Wiley, 2019-06-10) Sugden, Eleanor; Lloyd, Susan; Lam, Jenny; Cleland, JoanneBackground As cost and access barriers to ultrasound technology have decreased, interest in using ultrasound visual biofeedback (U-VBF) as a tool for remediating speech sound disorders (SSD) has increased. A growing body of research has investigated U-VBF in intervention for developmental SSD; however, diversity in study design, participant characteristics, clinical methods and outcomes complicate the interpretation of this literature. Thus, there is a need for a synthesis and review of the evidence base for using U-VBF in intervention for SSD.Item The impact of aphasia on Internet and technology use(Taylor & Francis, 2019-04-13) Menger, Fiona; Morris, Julie; Salis, ChristosPurpose: This study compared Internet use post-stroke in people with aphasia (n = 25) and without aphasia (n = 17). The purpose was to understand how people with aphasia were using the Internet and to investigate the impact of aphasia on their use. Materials and methods: A face-to-face supported questionnaire explored the use of technologies, types of Internet use, traditional and Internet communication, the perception of abilities, and possible barriers to acquiring or improving Internet skills. Descriptive and inferential statistics were used to analyze the data. Results: Internet use ranged from fully independent to by proxy across both groups. Most participants perceived their aphasia as a barrier, but for the majority, it was not the sole reason for failing to acquire or improve skills. Aphasia was related to difficulties with technology-based written communication. Educational attainment was related to participant’s feelings about their own skills. Whilst aphasia was important, analysis revealed that age was a stronger predictor of Internet use per se. Conclusions: It is clear that aphasia often negatively affects Internet use and proficiency. However, this research clearly demonstrates that it is important to consider the influence of factors such as age, proxy use, education, and previous technology use and experience. Implications for rehabilitation Post-stroke aphasia contributes negatively to Internet use, particularly in the use of online communication tools such as email and messaging services. Sub-groups of people with aphasia are likely to be more vulnerable to exclusion from the benefits of the Internet; specifically, older people and those with lower levels of educational attainment. It is common for both older adults with and without aphasia to use the Internet via a proxy. Independent use may not always be the desired goal within rehabilitation. People with aphasia may perceive their age and disability as barriers to using the Internet and may lack confidence in their own ability or potential.Item The dynamics of voiceless sibilant fricative production in children between 7 and 13 years old: An ultrasound and acoustic study(Acoustical Society of America (ASA), 2018-09-19) Zharkova, Natalia; Hardcastle, William J.; Gibbon, Fiona E.This study reports on dynamic tongue shape and spectral characteristics of sibilant fricatives /s/ and /ʃ/ in Scottish English speaking children aged between 7 and 13 years old. The sequences /əCa/ and /əCi/ were produced by 40 children, with ten participants in each age group, and two-year intervals between successive groups. Productions of the same sequences by ten adults were used for comparison with the children's data. Quantitative dynamic analyses were carried out on spectral information and on ultrasound imaging data on tongue shape. All age groups differentiated between the two consonants in the fricative centroid and in tongue shape. Vowel-on-consonant effects showed consonant-specific patterns across age groups without a consistent increase or decrease in the extent of coarticulation with increasing age. The extent of discriminability between the two fricatives increased with age on both acoustic and articulatory measures. Younger speakers were generally more variable than older speakers. Complementary findings from the centroid and tongue shape measures suggest that age-related differences are due to the ongoing maturation of controlling the tongue in coordination with other articulators, particularly the jaw, throughout childhood.