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Simulation is a safe, supported, and accessible learning method for students to gain skills and experience, especially in difficult to access range of practice areas such as voice. The study aimed to explore change in students' perceptions of knowledge, confidence, anxiety, and clinical readiness for assessment and management of an adult with a voice disorder after participation in simulation-based learning activities. Participants (N = 113) were students enrolled in a mandatory course dedicated to the voice and voice disorders. Students completed 32 hours of academic coursework which included lectures and tutorials and two 30-minute simulation-based learning activities with a standardized patient playing the role of an adult with a voice disorder. The impact of the simulation-based learning activities on student perceptions of their knowledge, confidence, anxiety, and clinical readiness for work within the area of voice were surveyed at three time points: (1) pre lectures, (2) post lectures but pre simulation, and (3) post simulation. Change across time was analyzed using repeated measures analysis of variance with post hoc Bonferroni adjustment. All students perceived significant (P ≤ 0.001) positive changes in knowledge and confidence across time points for all activities, except for writing an assessment report. Anxiety related to the management of a client with a voice disorder fluctuated significantly (P ≤ 0.001) throughout the program. Overall, the majority (>90%) of students agreed or strongly agreed that the simulation-based learning activities were useful and helped them to develop clinical skills, apply content taught in lectures, and gain confidence and interest in voice. This study supports incorporation of simulation-based learning as part of students' clinical preparation for the assessment and management of voice disorders. [ABSTRACT FROM AUTHOR]

This systematic review aims to identify instruments used to evaluate treatment outcomes for people with spasmodic dysphonia. Electronic database (PubMed, Cochrane Library, Embase, and CINAHL) searches and hand-searching identified studies that evaluated treatment approaches for spasmodic dysphonia which included pre and post outcome data. A total of 4714 articles were retrieved from searching databases; 1165 were duplicates. Titles and abstracts of 3549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through hand-searching of reference lists. Data was extracted from 125 studies, identifying 220 outcome measures. As per the World Health Organization's International Classification of Functioning (ICF), the majority measured body functions (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes towards communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a paradigm outside of the scope of the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives were identified. Currently there is no unified approach to the measurement of outcomes in SD treatment research. Development and implementation of a core outcome set is recommended to facilitate improved understanding of the efficacy of current and new treatment options. [ABSTRACT FROM AUTHOR]

• There is high variability in assessment practices for non-progressive dysarthria. • Informal measures of assessment are most commonly used. • A greater focus on impairment and intelligibility measures exists. This aim of this study was to identify assessment practices for non-progressive dysarthria used by Australian speech-language pathologists (SLPs) and to describe these practices within the framework of the World Health Organization's International Classification of Functioning Disability, and Health (ICF). A 23-item online survey was distributed to Australian SLPs, with 56 responses suitable for data analysis. The majority of SLPs prescribed 'high importance' to the assessment of impairment to speech function (96%, n = 54), activity limitations (91%, n = 51) and participation in society (91%, n = 51) in non-progressive dysarthria. However, reported assessment selection for non-progressive dysarthria focused largely on impairment and intelligibility, with assessments addressing participation restrictions being under-utilised. There was also a preference for informal assessment tools across all ICF domains. Over half (69%, n = 37) indicated that current assessment tools for non-progressive dysarthria generally do not meet their needs, with key issues being time-factors and inadequate sensitivity. There was variability in the use of outcome measures for non-progressive dysarthria, with workplace setting, time constraints and a perceived lack of relevance being the most commonly reported barriers to implementation. [ABSTRACT FROM AUTHOR]

Purpose: To explore international practices of speech-language pathology (SLP) within burn care in order to provide direction for education, training and clinical practice of the burns multidisciplinary team (MDT).Method(s): A 17-item online survey was designed by two SLPs experienced in burn care with a range of dichotomous, multiple choice and open-ended response questions investigating the availability and scope of practice for SLPs associated with burn units. The survey was distributed via professional burn association gatekeepers. All quantitative data gathered were analysed using descriptive statistics and qualitative data were analysed using content analysis.Result(s): A total of 240 health professionals, from 6 different continents (37 countries) participated within the study. All continents reported access to SLP services. Referral criteria for SLP were largely uniform across continents. The most dominant area of SLP practice was assessment and management of dysphagia, which was conducted in concert with other members of the MDT.Conclusion: SLP has an international presence within burn care that is currently still emerging. [ABSTRACT FROM AUTHOR]

Objectives. (1) To quantify acute changes in acoustic parameters of the voices of group fitness instructors (GFIs) before and after exercise instruction. (2) To determine whether these changes are discernible perceptually by the instructor. Study Design. This is a pilot prospective cohort study. Methods. Participants were six female GFIs, based in Brisbane, Australia. Participants performed a series of vocal tasks before and after instruction of a 60-minute exercise class. Data were obtained pertaining to fundamental frequency (pitch), intensity (volume), jitter, shimmer, harmonic-to-noise ratio (HNR), maximum duration of sustained phonation (MDSP), and pitch range. Additionally, self-ratings of voice quality were obtained before and after instruction. Data were analyzed using the Wilcoxon signed rank test. Results. Significant increases (P ⩾ 0.05) were found in fundamental frequency and intensity after instruction. No significant changes in jitter, shimmer, HNR, or MDSP were found before and after instruction. For the group, no significant change in self-ratings of voice quality occurred before and after instruction. Conclusions. Statistically significant changes in pitch and volume were found on acoustic analysis. However, these subtle changes remained within the limits of what is considered normal and representative of the participant's age and gender. Further research into the effects of exercise instruction on the voice is needed. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: The objective of this study was to prospectively evaluate the validity and reliability of a risk factor model developed for use in predicting dysphagia risk within the first 24h after injury/hospitalisation in patients with thermal burns. Method(s): Three hundred and fifty six patients with thermal burns, with or without inhalation injury, who were consecutively admitted to and received management at a quaternary state-wide burn center over a 12 month period, were included. Patients were reviewed for dysphagia risk by nursing staff using an established set of predictive factors. If risk factors for dysphagia were present, referral to speech-language pathology was initiated to investigate swallow function. Result(s): Of the 356 admissions, 83 patients were identified as meeting one or more risk criteria for dysphagia after burn.Of these, 24.9% (n =30; 8.42% of the total cohort) presented with dysphagia. Using these criteria, sensitivity and specificity for detection of dysphagia risk were high (100% and 83.74%, respectively). The criteria over identify patients who may be at risk of dysphagia and who require dysphagia assessment (positive predictive value=36.14%). However, as a set of predictors of dysphagia risk when thermal burn is the only complaint, a negative result reassures that a patient does not have dysphagia (negative predictive value=100%). Conclusion: Overall, the risk factor model provided a valid measure for predicting dysphagia risk. Incorporating these criteria into a dysphagia screening assessment can ensure an evidence-based pathway for early detection and timely referral to speech-language pathology for patients at risk of dysphagia after thermal burns. [Copyright &y& Elsevier]

A preliminary investigation to explore (1) the influence of different exercise conditions on the prevalence and nature of reported sensory and auditory-perceptual voice symptoms, and (2) whether type of self-reported laryngeal behaviors used during weightlifting are related to report of laryngeal symptoms in weightlifting athletes. Prospective self-completion questionnaire design. A total of 89 people (36 males, 53 females) who self-identified as individuals who regularly partook in exercise completed a self-report questionnaire administered using Qualtrics software. Weightlifting was part of 78.7% (n = 70/89) of participants' workout routine. Nearly half (46%, n = 12/26) of self-identified weightlifting athletes reported suffering from at least one laryngeal symptom (throat pain, change in voice, or globus sensation), which was significantly higher (P = 0.008) than that reported by the cardiovascular group (14%, n = 4/29). The most prevalent laryngeal symptom reported by 25.3% (n = 17) of participants after weightlifting was the presence of a globus sensation (ie, the feeling of something stuck in their throat). Throat pain after heavy lifting and a change in voice quality after weightlifting was reported by 22.9% (n = 16) and 11.4% (n = 8) of participants respectively. There were no significant differences (P > 0.05) between reported laryngeal symptoms and the self-reported laryngeal behaviors used during weightlifting (ie, breath hold during the lift, simultaneous release of breath during the lift, or grunting/yelling during the lift). As weightlifting increases in popularity, many participants may find themselves experiencing throat pain or hoarseness after heavy lifts. Whilst a particular cause of these symptoms in weightlifters cannot be identified from this study, the reported presence of pain, globus sensation, and change in voice by this group indicates the need for further research. [ABSTRACT FROM AUTHOR]

The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. [ABSTRACT FROM AUTHOR]

Summary Objectives This study aimed to provide a descriptive summary of (1) group fitness instructors' (GFIs') experiences of occupational voice use and education, and (2) the content and mode of delivery desired by GFIs in an education and training program. Study Design This is a qualitative inductive approach using a semi-structured interview. Method Semi-structured interviews were conducted with eight GFIs recruited via self-selection sampling. Participants were asked to comment on their experiences of voice use, voice education, and their preferences for future education and training. Result Participants reported experiencing occupational voice difficulties, and cited inadequate voice education, faulty equipment, and apathetic fitness industry attitudes as core barriers to vocal health. Content focusing on vocal hygiene, safe occupational voice use, use of amplification equipment, and addressing industry attitudes to voice was desired by participants. A combination of face-to-face, web-based, and app-based delivery options was suggested. Conclusion The data from this study should be considered when designing a vocal education and training package tailored to the needs of GFIs and the fitness industry. [ABSTRACT FROM AUTHOR]

Summary: Objectives: To determine the anatomical and physiological nature of voice problems and their treatment in those group fitness instructors (GFIs) who have sought a medical diagnosis; the impact of voice disorders on quality of life and their contribution to activity limitations and participation restrictions; and the perceived attitudes and level of support from the industry at large in response to instructor's voice disorders and need for treatment. Study Design: Prospective self-completion questionnaire design. Methods: Thirty-eight individuals (3 males and 35 females) currently active in the Australian fitness industry who had been diagnosed with a voice disorder completed an online self-completion questionnaire administered via SurveyMonkey. Results: Laryngeal pathology included vocal fold nodules (N = 24), vocal fold cysts (N = 2), vocal fold hemorrhage (N = 1), and recurrent chronic laryngitis (N = 3). Eight individuals reported vocal strain and muscle tension dysphonia without concurrent vocal fold pathology. Treatment methods were variable, with 73.68% (N = 28) receiving voice therapy alone, 7.89% (N = 3) having voice therapy in combination with surgery, and 10.53% (N = 4) having voice therapy in conjunction with medication. Three individuals (7.89%) received no treatment for their voice disorder. During treatment, 82% of the cohort altered their teaching practices. Half of the cohort reported that their voice problems led to social withdrawal, decreased job satisfaction, and emotional distress. Greater than 65% also reported being dissatisfied with the level of industry and coworker support during the period of voice recovery. Conclusions: This study identifies that GFIs are susceptible to a number of voice disorders that impact their social and professional lives, and there is a need for more proactive training and advice on voice care for instructors, as well as those in management positions within the industry to address mixed approaches and opinions regarding the importance of voice care. [Copyright &y& Elsevier]

Objectives. To determine the prevalence and nature of both acute and chronic voice problems experienced by group fitness instructors (GFIs) and gather information about the level of education currently being received by fitness professionals, the source of their education, and their opinion on mandatory voice training to highlight potential training needs. Study design. Prospective self-completion questionnaire design. Methods. A total of 361 GFIs (81 males and 280 females), aged between 18 and 67 years currently active in the Australian fitness industry completed a self-report questionnaire distributed via SurveyMonkey. Results. The prevalence of self-reported acute and chronic voice symptoms was high at 78.95% and 70.91%, respectively. Partial voice loss and hoarseness while instructing was experienced most often (57.62%), followed by partial voice loss and hoarseness immediately after instructing (46.81%). Aphonia after teaching was less frequently reported (9.97%). Over 25% of the total cohort reported chronic voice symptoms of increased hoarseness (39.61%), difficulty with high notes (31.58%), strained voice (32.13%), and limited singing range (27.7%). Only 30% of GFIs reported having received any voice education, with even fewer respondents (10%) receiving any practical voice training, despite 98.06% agreeing that formal voice education should be covered as a standard topic in all official GFI training. Conclusions. The results of this study confirm that voice problems represent a significant occupational hazard for GFIs. Speech-language pathologists and other voice professionals should consider taking a proactive stance in understanding the vocal demands of the profession and engage in training for instructors to prevent both acute and chronic voice problems. [ABSTRACT FROM AUTHOR]