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OBJECTIVES: We have previously characterized the main osteoimmunological events that occur during ligature periodontitis. This study aims to determine the polymicrobial community shifts that occur during disease development. METHODS: Periodontitis was induced in C57BL/6 mice using the ligature-induced periodontitis model. Healthy oral mucosa swabs and ligatures were collected every 3-days from 0 to 18 days post-ligature placement. Biofilm samples were evaluated by 16SrRNA gene sequencing (Illumina MiSeq) and QIIME. Timecourse changes were determined by relative abundance, diversity, and rank analyses (PERMANOVA, Bonferroni-adjusted). RESULTS: Microbial differences between health and periodontal inflammation were observed at all phylogenic levels. An evident microbial community shift occurred in 25 genera during the advancement of “gingivitis” (3–6d) to periodontitis (9–18d). From day 0–18, dramatic changes were identified Streptococcus levels, with an overall decrease (54.04–0.02%) as well an overall increase of Enterococcus and Lactobacillus (23.7–73.1% and 10.1%−70.2%, respectively). Alpha-diversity decreased to its lowest at 3d, followed by an increase in diversity as disease advancement. Beta-diversity increased after ligature placement, indicating that bone loss develops in response to a greater microbial variability (p=0.001). Levels of facultative and strict anaerobic bacteria augmented over the course of disease progression, with a total of 8 species significantly different during the 18-day period. CONCLUSION: The data supports that murine gingival inflammation and alveolar bone loss develop in response to microbiome shifts. Bacterial diversity increased during progression to bone loss. These findings further support the utilization of the periodontitis ligature model for microbial shift analysis under different experimental conditions.

To describe the development and determine the diagnostic accuracy of the Brisbane Evidence-Based Language Test in detecting aphasia. Consecutive acute stroke admissions ( = 100; mean = 66.49y) participated in a single (assessor) blinded cross-sectional study. Index assessment was the ∼45 min Brisbane Evidence-Based Language Test. The Brisbane Evidence-Based Language Test is further divided into four 15-25 min Short Tests: two Foundation Tests (severe impairment), Standard (moderate) and High Level Test (mild). Independent reference standard included the Language Screening Test, Aphasia Screening Test, Comprehensive Aphasia Test and/or Measure for Cognitive-Linguistic Abilities, treating team diagnosis and aphasia referral post-ward discharge. Brisbane Evidence-Based Language Test cut-off score of ≤157 demonstrated 80.8% (LR+ =10.9) sensitivity and 92.6% (LR- =0.21) specificity. All Short Tests reported specificities of ≥92.6%. Foundation Tests I (cut-off ≤61) and II (cut-off ≤51) reported lower sensitivity (≥57.5%) given their focus on severe conditions. The Standard (cut-off ≤90) and High Level Test (cut-off ≤78) reported sensitivities of ≥72.6%. The Brisbane Evidence-Based Language Test is a sensitive assessment of aphasia. Diagnostically, the High Level Test recorded the highest psychometric capabilities of the Short Tests, equivalent to the full Brisbane Evidence-Based Language Test. The test is available for download from brisbanetest.org.Implications for rehabilitationAphasia is a debilitating condition and accurate identification of language disorders is important in healthcare.Language assessment is complex and the accuracy of assessment procedures is dependent upon a variety of factors.The Brisbane Evidence-Based Language Test is a new evidence-based language test specifically designed to adapt to varying patient need, clinical contexts and co-occurring conditions.In this cross-sectional validation study, the Brisbane Evidence-Based Language Test was found to be a sensitive measure for identifying aphasia in stroke.

To examine the inter-rater reliability, intra-rater reliability, internal consistency and practice effects associated with a new test, the Brisbane Evidence-Based Language Test. Reliability estimates were obtained in a repeated-measures design through analysis of clinician video ratings of stroke participants completing the Brisbane Evidence-Based Language Test. Inter-rater reliability was determined by comparing 15 independent clinicians' scores of 15 randomly selected videos. Intra-rater reliability was determined by comparing two clinicians' scores of 35 videos when re-scored after a two-week interval. Intraclass correlation coefficient (ICC) analysis demonstrated almost perfect inter-rater reliability (0.995; 95% confidence interval: 0.990-0.998), intra-rater reliability (0.994; 95% confidence interval: 0.989-0.997) and internal consistency (Cronbach's α = 0.940 (95% confidence interval: 0.920-1.0)). Almost perfect correlations (0.998; 95% confidence interval: 0.995-0.999) between face-to-face and video ratings were obtained. The Brisbane Evidence-Based Language Test demonstrates almost perfect inter-rater reliability, intra-rater reliability and internal consistency. High correlation coefficients and narrow confidence intervals demonstrated minimal practice effects with scoring or influence of years of clinical experience on test scores. Almost perfect correlations between face-to-face and video scoring methods indicate these reliability estimates have direct application to everyday practice. The test is available from brisbanetest.org.Implications for RehabilitationThe Brisbane Evidence-Based Language Test is a new measure for the assessment of acquired language disorders.The Brisbane Evidence-Based Language Test demonstrated almost perfect inter-rater reliability, intra-rater reliability and internal consistency.High reliability estimates and narrow confidence intervals indicated that test ratings vary minimally when administered by clinicians of different experience levels, or different levels of familiarity with the new measure.The test is a reliable measure of language performance for use in clinical practice and research.

This study evaluated the feasibility and outcomes of a telerehabilitation adaptation of the

Secondary schools in Maine and New Hampshire have been involved in a citizen science pro-gram called “All About Arsenic” aimed at addressing arsenic contamination of well water, one of the most pressing public health issues in both states. Nearly half of the population of Maine and New Hampshire derive their drinking water from private wells which often have arsenic levels above the EPA limit of 10 ppb. Arsenic exposure can cause cancer, adverse cardiovascular ef-fects, and other health problems. Addressing this issue in schools provides context and motivation for students to engage in scientific inquiry and acquire data literacy skills. This project involves students collecting well water samples for arsenic analysis, entering their data into an online citi-zen science data portal, Anecdata, and using Tuva online software tools to visualize and interpret their data. Students present their data at public meetings to inform community members of their findings with the goal of moving “data to action”. The COVID-19 pandemic presented multiple chal-lenges for teachers engaging their students in this citizen science project. We adapted our pro-gram and implemented a series of interventions aimed at supporting teachers in their continued efforts to engage their students the “All About Arsenic” project.

Contaminated drinking water is an important public health consideration in New England where well water is often found to contain arsenic and other metals such as cadmium, lead, and uranium. Chronic or high level exposure to these metals have been associated with multiple acute and chronic diseases, including cancers and impaired neurological development. While individual metal levels are often regulated, adverse health effects of metal mixtures, especially at concentrations considered safe for human consumption remain unclear. Here, we utilized a multivariate analysis that examined behavioral outcomes in the zebrafish model as a function of multiple metal chemical constituents of 92 drinking well water samples, collected in Maine and New Hampshire. To collect these samples, a citizen science approach was used, that engaged local teachers, students, and scientific partners. Our analysis of 4016 metal-mixture combinations shows that changes in zebrafish behavior are highly mixture dependent, and indicate that certain combinations of metals, especially those containing arsenic, cadmium, lead, and uranium, even at levels considered safe in drinking water, are significant drivers of behavioral toxicity. Our data emphasize the need to consider low-level chemical mixture effects and provide a framework for a more in-depth analysis of drinking water samples. We also provide evidence for the efficacy of utilizing citizen science in research, as the broader impact of this work is to empower local communities to advocate for improving their own water quality.

Purpose Existing studies examining the effect of carbonated fluids on swallow physiology under videofluoroscopy (videofluoroscopic swallowing studies [VFSSs]) have significant variability across the fluids tested and limited consideration of the stability of the carbonation or fluid palatability. This study compared the effervescence behavior, carbonation intensity (sour, bite, bubble), palatability, and sip volumes of carbonated liquids as used in VFSSs and control samples. Method Forty-two healthy women (20 supertasters, 22 nontasters; 20–61 years old) took sips of 4 different liquids (water, carbonated water, barium sulfate with sodium bicarbonate granules, and barium sulfate with carbonated water) across 2 time conditions (on preparation and 5 min postpreparation). The 8 conditions were presented in 100-ml amounts, in randomized order. At presentation of each fluid, participants immediately rated effervescence via visual inspection. Then after sips of each fluid, participants rated perceived intensity of sour, “bubbles” and “bite,” and palatability. Sip size was derived from residual volumes. Participant perceptions of fluids were also collected. Results The effervescence of barium sulfate with sodium bicarbonate granules, as used in the majority of published studies, was most impacted by time ( p < .05), rated poorly for palatability, and had the largest impact on sip size ( p < .05). Participant comments regarding the VFSS fluids were grouped in 4 themes: (a) adverse/other reactions, (b) awareness of sensory properties, (c) physiological reactions, and (d) swallow changes. Conclusions The significant differences between liquids regarding effervescence behavior, impact of preparation time, palatability, impact on naturalistic sipping, and patient perceptions warrant consideration when testing carbonated fluids during videofluoroscopy.

The Anecdata website and its corresponding mobile app provide unique features to meet the needs of a wide variety of diverse citizen science projects from across the world. The platform has been developed with the help of continuous feedback from community partners, project leaders, and website users and currently hosts more than 200 projects. Over 8,000 registered users have contributed more than 30,000 images and over 50,000 observations since the platform became open to the public in 2014. From its inception, one of the core tenets of Anecdata's mission has been to make data from citizen science projects freely accessible to project participants and the general public, and in the platform's first few years, it followed a completely open data access model. As the platform has grown, hosting ever more projects, we have found that this model does not meet all project needs, especially where endangered species, property access rights, participant safety in the field, and personal privacy are concerned. We first introduced features for data and user privacy as part of “All About Arsenic,” a National Institutes of Health (NIH)/National Institute of General Medical Sciences (NIGMS) Science Education Partnership Award (SEPA)-funded project at MDI Biological Laboratory, which engages middle and high school teachers and students from schools across Maine and New Hampshire in sampling their home well water for analysis of arsenic and other heavy metals. In order to host this project on Anecdata, we developed features for spatial privacy or “geoprivacy” to conceal the coordinates of samplers' homes, partial data redaction tools we call “private fields” to withhold certain sample registration questions from public datasets, and “participant anonymity” to conceal which user account uploaded an observation. We describe the impetus for the creation of these features, challenges we encountered, and our technical approach. While these features were originally developed for the purposes of a public health and science literacy project, they are now available to all project leaders setting up projects on Anecdata.org and have been adopted by a number of projects, including Mass Audubon's Eastern Meadowlark Survey, South Carolina Aquarium's SeaRise, and Coastal Signs of the Seasons (SOS) Monitoring projects.

This chapter tackles the debate on the role of sustainable tourism as a possible means to promote social innovation in peripheral rural areas. According to this perspective, the organization of the local tourist offer could be an opportunity to address social problems related to territorial and economic marginality, aimed at improving the livability of the towns. The issue is addressed in both theoretical and empirical terms through the analysis of the role of young entrepreneurs that have invested in innovative projects in pursuit of their “own life.” A state-of-the-art theoretical review about the tourist transition in peripheral areas is provided, and the results from fieldwork in Southern Italy are presented in order to offer the readers a more descriptive overview. The methodology is based on a case study research design and organizes the results according to both quantitative data of the tourist offer and qualitative data collected from participant observation and interviews with local tourist entrepreneurs and administrators. The findings show the impact of the changes in terms of increase in the offer of beds as well as in the development of a more open culture of hospitality within the local communities.

From the end of 1970s and the neo-liberal shift in world politics and economics, inner areas of Italy have faced an apparently endless crisis. However, the sudden outbreak of the Covid-19 crisis could provoke an unexpected U-turn. Nowadays, the physical and social remoteness of inner areas work as an attraction for people in search for authentic experiences in food, nature and cultural heritage, outside the standard tourist offer and within the framework of “under-tourism”. However, the “imagined remoteness” that drives the public and academic conversation towards the tourist seduction of the inner areas could be misleading for the simple fact that it is “imagined”. Not many people know what it means to live in a remote area, where social and physical distances are huge and the basic services scarce. Thus, the success of post-lockdown tourism strategies centered on inner areas would depend on the positive matching between the needs of the “new” tourism business and the ones of “new” destinations. In this article, we propose a possible interpretation of the above-mentioned challenge, based on the elaboration of data collected during a three-month field work conducted in several small towns of the Basilicata and Calabria regions (Piccole Dolomiti Lucane Regional Park and the Pollino National Park). Our analysis aims to give a more realistic picture of the notions of emptiness and remoteness by assessing the degree of compatibility and the semantic distance between the expectation of the tourism business and the needs of the inner areas., Fuori Luogo. Rivista di Sociologia del Territorio, Turismo, Tecnologia, V. 7 N. 1 (2020): Rischio globale e distanziamento sociale durante gli eventi pandemici da Covid-19

Purpose: There are no examples in the literature of successful long-term hospital-wide implementation of nurse-led dysphagia screening. This article aims to describe strategies used to implement hospital-wide dysphagia screening in a large acute tertiary teaching hospital in Australia. It reports on compliance, accuracy and nursing staff satisfaction using the validated Royal Brisbane and Women’s Hospital Dysphagia Screening Tool (RBWH DST). Method: A retrospective observational study of audit data was conducted to examine hospital-wide compliance and accuracy of dysphagia screen completion. A nursing staff survey measured staff satisfaction. Implementation included: (1) utilisation of validated tool (RBWH DST); (2) key stakeholder engagement and strong governance; (3) policy development; (4) education; and (5) review and monitoring processes. Result: Audits conducted over a 9-year period (n = 3726) showed an average hospital-wide compliance rate of 74% and an accuracy rate of 82%. A nurse satisfaction survey (n = 109) showed high levels of satisfaction associated with using the RBWH DST. Conclusion: The RBWH DST was implemented in a large acute tertiary teaching hospital with acceptable compliance and accuracy rates and favourable nursing staff satisfaction. Further study is required to objectively evaluate patient health and cost benefits associated with using the RBWH DST.

Sensory enhancement techniques, like other compensatory strategies, aim to reduce dysphagia symptoms. The use of carbonated liquids has been proposed as a possible sensory technique, however to date, there is limited information of its efficacy or guidance for clinical implementation. A narrative synthesis was completed to determine the quality and strength of the evidence base for use of carbonation as a compensatory strategy in dysphagia rehabilitation.From 101 articles initially identified, 14 articles met the study criteria. Eleven papers described the effects of carbonation on swallowing in healthy participants whereas three described the impact of carbonation in dysphagic populations. A narrative synthesis of papers was undertaken given the diversity of identified studies.Synthesis of findings was challenging given the exploratory phase of most research activity with diverse populations described and extensive differences in research methodologies. There is currently weak, but potentially positive evidence to support using carbonation as a compensatory technique in dysphagia rehabilitation.Despite future potential, existing evidence fails to provide clear direction for the clinical implementation of carbonation. Validation of carbonation use with the dysphagic population requires further research with consistent, controlled methodologies, and larger cohorts of participants to inform potential for dysphagia rehabilitation. Implications for Rehabilitation The use of carbonated liquids has been proposed as a possible sensory enhancement technique which may facilitate changes to swallow physiology. However to date, there is limited information to direct clinical implementation. This paper provides a narrative synthesis of existing knowledge and highlights possible limitations of findings reported. Research to date has used disparate research methodologies in varied populations making synthesis of current findings challenging.

Background: The need for effective compensatory strategies in neurogenic dysphagia management has led to the exploration of sensory enhancement strategies (SES), such as carbonated liquids. Despite some positive findings, evidence related to the efficacy of carbonation as an SES is limited. Aims: To determine if carbonated thin liquids reduced dysphagia symptoms and to explore clinical factors associated with response to carbonation. Methods & Procedures: Participants (n = 29) with neurogenic dysphagia demonstrating deep penetration or aspiration on thin liquids during videofluoroscopic swallow studies (VFSS) completed a set protocol: discrete sips of non-carbonated thin fluids (DS-NC) followed by discrete sips of carbonated thin fluids (DS-C) and then consecutive sips of carbonated fluids (CS-C). The impact of carbonation was identified through changes to swallow physiology (videofluoroscopy dysphagia scale—VDS) and depth of airway compromise (penetration-aspiration scale—PAS). Demographic variables including genetic taste type, cranial nerve function and key results from the VDS were examined for association with carbonation response using both individual parameter analysis and exploratory cluster analysis. Outcomes & Results: Significant (p < 0.05) improvements in PAS scores were noted in DS-C and CS-C conditions compared with DS-NC. Total VDS score was also significantly (p < 0.05) reduced (i.e., improved function) in the DS-NC condition. Individual variability in response to carbonation was noted and no clear clinical factors associated with carbonation response in the current set of parameters were identified. Conclusion & Implications: Findings support that carbonated thin fluids sometimes result in neurogenic dysphagia symptom reduction. However, identifying the clinical characteristics of patients who may benefit from trials of carbonation needs further investigation.

Anecdata.org is a free online platform and mobile app developed by the Community Lab at the MDI Biological Laboratory which any group or individual can use to host citizen science projects, crowdsource information, and manage, and share observations of our changing environment. While other platforms have been created for citizen scientists to share observations, these have typically been limited to biodiversity surveys or bird counts; projects that require more versatile data collection capability and use paper datasheets or costly custom-made online data collection systems. Anecdata is designed to help projects managers develop data collection solutions by offering a far broader scope of data collection options; data collected may include measurements from water, snow, or air samples, beach debris tallies, species presence or absence reports, photographs, or written field notes. The site currently supports several projects related to sea level rise. We are building new tools to help project managers and participants in these communities to address climate change issues and develop climate resilience strategies.

In this “Power of the Crowd” workshop, attendees will receive a crash course on citizen science and how they can turn their marine data collection, archiving, and sharing needs into live projects on Anecdata.org.

The majority of task-based fMRI studies examining the neural mechanisms of aphasia recovery have been in the chronic phase, where people with aphasia typically employ both intact language areas, as well as recruiting additional areas within the left hemisphere and right hemisphere language homologues (Turkeltaub, Messing, Norise, & Hamilton, 2011). However, recovery from post-stroke aphasia (or language impairment) occurs in a number of stages, each underpinned by distinct neural mechanisms (Kiran, 2012, Saur et al., 2006). Compared to the acute stage, recovery in the subacute stage is less rapid and consists primarily of neural reorganisation leading to new alternative networks and changes in the efficacy of synaptic connections (Lazar & Antoniello, 2008). Recovery during this phase is thought to be associated with the normalisation over time of dysfunctional brain activity in areas remote or distant to the lesion (see Carrera and Tononi (2014) for a full review), perilesional restitution (Thompson and den Ouden, 2008, Warburton et al., 1999), or a functional transfer to the right hemisphere homologue (Saur et al., 2006)...

Oxygenic photosynthesis supplies organic carbon to the modern biosphere, but it is uncertain when this metabolism originated. It has previously been proposed1,2 that photosynthetic reaction centres capable of splitting water arose by about 3billion years ago on the basis of the inferred presence of manganese oxides in Archaean sedimentary rocks. However, this assumes that manganese oxides can be produced only in the presence of molecular oxygen3, reactive oxygen species4,5 or by high-potential photosynthetic reaction centres6,7. Here we show that communities of anoxygenic photosynthetic microorganisms biomineralize manganese oxides in the absence of molecular oxygen and high-potential photosynthetic reaction centres. Microbial oxidation of Mn(II) under strictly anaerobic conditions during the Archaean eon would have produced geochemical signals identical to those used to date the evolution of oxygenic photosynthesis before the Great Oxidation Event1,2. This light-dependent process may also produce manganese oxides in the photic zones of modern anoxic water bodies and sediments.

The laboratory strain of Pseudomonas aeruginosa , PAO1, activates genes for catabolism of adenosine using quorum sensing (QS). However, this strain is not well-adapted for growth on adenosine, with doubling times greater than 40 h. We previously showed that when PAO1 is grown on adenosine and casein, variants emerge that grow rapidly on adenosine. To understand the mechanism by which this adaptation occurs, we performed whole-genome sequencing of five isolates evolved for rapid growth on adenosine. All five genomes had a gene duplication-amplification (GDA) event covering several genes, including the quorum-regulated nucleoside hydrolase gene, nuh , and PA0148, encoding an adenine deaminase. In addition, two of the growth variants also exhibited a nuh promoter mutation. We recapitulated the rapid growth phenotype with a plasmid containing six genes common to all the GDA events. We also showed that nuh and PA0148, the two genes at either end of the common GDA, were sufficient to confer rapid growth on adenosine. Additionally, we demonstrated that the variant nuh promoter increased basal expression of nuh but maintained its QS regulation. Therefore, GDA in P. aeruginosa confers the ability to grow efficiently on adenosine while maintaining QS regulation of nucleoside catabolism. IMPORTANCE Pseudomonas aeruginosa thrives in many habitats and is an opportunistic pathogen of humans. In these diverse environments, P. aeruginosa must adapt to use myriad potential carbon sources. P. aeruginosa PAO1 cannot grow efficiently on nucleosides, including adenosine; however, it can acquire this ability through genetic adaptation. We show that the mechanism of adaptation is by amplification of a specific region of the genome and that the amplification preserves the regulation of the adenosine catabolic pathway by quorum sensing. These results demonstrate an underexplored mechanism of adaptation by P. aeruginosa , with implications for phenotypes such as development of antibiotic resistance.

Background and aims Stroke clinical guidelines recommend that “All patients should be screened for communication deficits using a screening tool that is valid and reliable” (p.90). Current speech pathology practice does not meet this recommendation instead relying on clinical experience or informal language screeners which have not undergone validation by clinical research. This research involves the development of the Brisbane Evidence-Based Language Test (Brisbane EBLT), a reliable, valid diagnostic test for the identification of acute post-stroke language disorders. Methods Brisbane EBLT diagnostic accuracy was determined in a prospective blinded cross-sectional study (n=100 patients) comparing acute stroke patient (

The first Team Haemophilia Education (THE) Meeting was held on 7-8 May 2015 in Amsterdam, The Netherlands. It aimed to promote the optimal care of patients with haemophilia through education of the multidisciplinary treatment team. This was achieved by reviewing the latest developments in haemophilia management, considering how these can be implemented in the clinic to improve patient care and providing a platform for networking and debate for all haemophilia treatment team members. The second THE Meeting was held on 19-20 May in Frankfurt, Germany, and participants included doctors, nurses, physiotherapists, patient representatives and data management staff from 20 different countries. Topics covered the role of the multidisciplinary team in delivering the best haemophilia care, challenges in the management of haemophilia across Europe, available clotting factor treatments, future treatments and the use of genetics in advising carriers of haemophilia. This report is a summary of the key developments in haemophilia care presented by various investigators and healthcare professionals at THE Meeting 2016. info:eu-repo/semantics/publishedVersion

Whilst some research evidence supports the potential benefits of sensory enhancement strategies (SES) in dysphagia management, there is limited understanding of how SES are used in clinical services and the influencing drivers involved in selection during instrumental assessment. SES include modification of temperature, flavour, texture, chemesthetic qualities and bolus size of food/fluid. This study aimed to explore the use of SES within Australian Videofluoroscopic Swallow Study (VFSS) clinics providing adult services, via a qualitative methodology. Maximum variation sampling was used to select a cross section of speech-language pathologists (SLPs) with a range of experience working within 16 VFSS clinics across metropolitan and regional settings to participate in semi-structured, focus group or individual teleconference interviews. Content analysis of interview transcripts was conducted, with four themes emerging as influencing drivers of SES use, including: Patient factors influence SES use; Clinician factors influence SES use; Trials of SES require planning and organisation, and; Organisational barriers impact on SES use. These four themes were all connected through a single integrative theme: Extensive variations of SES procedures exist across clinical settings. Findings indicate that achieving alignment of clinical purpose and implementation of practices amongst VFSS clinicians will be complex given current diversity in SES use. Organisational issues and clinician training need to be addressed, and more research is needed to provide a stronger evidence base to inform clinical practice in this emerging area of dysphagia management.

Background and Purpose— Most studies comparing different levels of aphasia treatment intensity have not controlled the dosage of therapy provided. Consequently, the true effect of treatment intensity in aphasia rehabilitation remains unknown. Aphasia Language Impairment and Functioning Therapy is an intensive, comprehensive aphasia program. We investigated the efficacy of a dosage-controlled trial of Aphasia Language Impairment and Functioning Therapy, when delivered in an intensive versus distributed therapy schedule, on communication outcomes in participants with chronic aphasia. Methods— Thirty-four adults with chronic, poststroke aphasia were recruited to participate in an intensive (n=16; 16 hours per week; 3 weeks) versus distributed (n=18; 6 hours per week; 8 weeks) therapy program. Treatment included 48 hours of impairment, functional, computer, and group-based aphasia therapy. Results— Distributed therapy resulted in significantly greater improvements on the Boston Naming Test when compared with intensive therapy immediately post therapy ( P =0.04) and at 1-month follow-up ( P =0.002). We found comparable gains on measures of participants’ communicative effectiveness, communication confidence, and communication-related quality of life for the intensive and distributed treatment conditions at post-therapy and 1-month follow-up. Conclusions— Aphasia Language Impairment and Functioning Therapy resulted in superior clinical outcomes on measures of language impairment when delivered in a distributed versus intensive schedule. The therapy progam had a positive effect on participants’ functional communication and communication-related quality of life, regardless of treatment intensity. These findings contribute to our understanding of the effect of treatment intensity in aphasia rehabilitation and have important clinical implications for service delivery models.

High-quality fluoroscopy images are required for accurate interpretation of videofluoroscopic swallow studies (VFSS) by speech pathologists and radiologists. Consequently, integral to developing any system to conduct VFSS remotely via telepractice is ensuring that the quality of the VFSS images transferred via the telepractice system is optimized. This study evaluates the extent of change observed in image quality when videofluoroscopic images are transmitted from a digital fluoroscopy system to (a) current clinical equipment (KayPentax Digital Swallowing Workstation, and b) four different telepractice system configurations. The telepractice system configurations consisted of either a local C20 or C60 Cisco TelePresence System (codec unit) connected to the digital fluoroscopy system and linked to a second remote C20 or C60 Cisco TelePresence System via a network running at speeds of either 2, 4 or 6 megabits per second (Mbit/s). Image quality was tested using the NEMA XR 21 Phantom, and results demonstrated some loss in spatial resolution, low contrast detectability and temporal resolution for all transferred images when compared to the fluoroscopy source. When using higher capacity codec units and/or the highest bandwidths to support data transmission, image quality transmitted through the telepractice system was found to be comparable if not better than the current clinical system. This study confirms that telepractice systems can be designed to support fluoroscopy image transfer and highlights important considerations when developing telepractice systems for VFSS analysis to ensure high-quality radiological image reproduction.

The present study examined the effects of neurosurgical management of Parkinson’s disease (PD), including the procedures of pallidotomy, thalamotomy, and deep-brain stimulation (DBS) on perceptual speech characteristics, speech intelligibility, and oromotor function in a group of 22 participants with PD. The surgical participant group was compared with a group of 25 non-neurologically impaired individuals matched for age and sex. In addition, the study investigated 16 participants with PD who did not undergo neurosurgical management to control for disease progression. Results revealed that neurosurgical intervention did not significantly change the surgical participants’ perceptual speech dimensions or oromotor function despite significant postoperative improvements in ratings of general motor function and disease severity. Reasons why neurosurgical intervention resulted in dissimilar outcomes with respect to participants’ perceptual speech dimensions and general motor function are proposed.

Background. Nonspeech investigations of tongue function in persons with Parkinson's disease (PD) have generally reported impaired tongue strength, endurance, and fine force control. However, these investigations did not specifically evaluate the relative contribution of age effects to the deficits in tongue function observed. Furthermore, the relationship between these nonspeech measures of tongue function and the speech disorder present in PD remains equivocal. Therefore, the current study investigated the strength, rate of repetitive movement, fine force control, and endurance of the tongue in three groups of participants. Methods. Participants in the study included 14 older adults with PD and imprecise consonant articulation, 11 neurologically healthy older adults, and 15 neurologically healthy young adults. All participants were assessed using a comprehensive nonspeech assessment battery of tongue function. Results. The results of the investigation revealed similar levels of tongue strength, rate of repetitive movement, and endurance between the persons with PD and the older control participants. Significant age effects were noted, with both groups demonstrating significantly reduced functioning on those measures when compared to young control participants. However, the three participant groups had similar levels of fine force control. No relationship was found between the nonspeech measures of tongue function employed and the severity of consonant imprecision. Conclusion. The nonspeech measures used failed to provide useful diagnostic information regarding the physiologic basis of perceived articulatory dysfunction in the persons with PD who were examined.

To evaluate whether speech function is vulnerable to early involvement in ALS, the differential onset of dysarthria and dysphagia was investigated in a small series of consecutive patients ( n = 39) from the Royal Brisbane and Women’s Hospital ALS clinic...