Search

Background: With a rapidly aging population in mainland China, dysphagia has become one of the common geriatric disorders which creates a huge demand on speech and language therapists (SLTs). The major challenge is the shortage of SLTs in China. In addition, frontline practitioners in mainland China may not be well equipped with the knowledge and practical skills in dysphagia management due to lack of systematic training and the work nature. Aims: This study evaluates the self-perceived effectiveness and feasibility of an online training program that aims to enhance the self-assessed knowledge and skills of SLTs providing dysphagia care in residential aged care homes. Methods and Procedures: Sixteen SLTs working in a residential aged care homes in mainland China attended a three-hour pilot online training program which consists of didactic lecture and practical skills activity components. A total of 10 participants completed an online questionnaire one month after the training to evaluate the feasibility and effectiveness of this online training program. Outcomes and Results: The preliminary results demonstrated participants' self-perception of high training effectiveness in theoretical knowledge and practical skills. A majority of the participants perceived that the training enhanced their theoretical knowledge and all of them perceived that they acquired practical skills. All respondents were satisfied with the online training approach. They also highlighted the advantage and challenges of the online training approach. Conclusions and Implications: Online training is an effective and feasible approach for theoretical knowledge and practical skills transfer in SLT training and could ultimately benefit the delivery of services for individuals with dysphagia in mainland China.

This study examined the early pragmatic language skills in typically developing (TD) preschool-age children, children with language impairment (LI) and children with autism spectrum disorder (ASD). Two hundred and sixty-two TD children, 73 children with LI, and 16 children with ASD were compared on early pragmatics through direct assessment (DA). Post hoc analysis revealed that children in two clinical groups displayed significant pragmatic language deficits. Children in the ASD group who were older exhibited comparable degree of impairments as their LI peers, suggesting a relatively stagnant development of pragmatic language skills in children with ASD. Findings also supported the use of DA in identifying pragmatic language deficits, which have implications for the adoption of this assessment approach in clinical settings.

Crossing over is essential for chromosome segregation during meiosis. Protein modification by SUMO is implicated in crossover control, but pertinent targets have remained elusive. Here we identify Msh4 as a target of SUMO-mediated crossover regulation. Msh4 and Msh5 constitute the MutSγ complex, which stabilizes joint-molecule (JM) recombination intermediates and facilitates their resolution into crossovers. Msh4 SUMOylation enhances these processes to ensure that each chromosome pair acquires at least one crossover. Msh4 is directly targeted by E2 conjugase Ubc9, initially becoming mono-SUMOylated in response to DNA double-strand breaks, then multi/poly-SUMOylated forms arise as homologs fully engage. Mechanistically, SUMOylation fosters interaction between Msh4 and Msh5. We infer that initial SUMOylation of Msh4 enhances assembly of MutSγ in anticipation of JM formation, while secondary SUMOylation may promote downstream functions. Regulation of Msh4 by SUMO is distinct and independent of its previously described stabilization by phosphorylation, defining MutSγ as a hub for crossover control.

Background: The status of the velopharyngeal mechanism can be inferred from perceptual ratings of specified speech parameters. Several studies have proposed the measure of an overall velopharyngeal composite score based on these perceptual ratings and have reported good validity. The Cleft Audit Protocol for Speech--Augmented (CAPS-A) is a validated and reliable perceptual framework for the assessment of cleft speech and velopharyngeal function used by all Regional Cleft Services in the UK and Ireland. An overall velopharyngeal composite summary score based on the CAPS-A would serve as an important surgical outcome measure of speech. Aims: To develop and validate a velopharyngeal composite summary score based on perceptual ratings made on the CAPS-A (CAPS-A VPC-Sum) using data from a maxillary osteotomy (MO) study. Methods & Procedures: There were two surgical groups--a cleft lip and palate (CLP) (N = 20) group and a non-CLP group (N = 10), and a normal control group (N = 20). Participants in groups 1 and 2 were seen for perceptual and instrumental assessments of speech and velopharyngeal function preoperatively (T1), 3 months (T2) and 12 months (T3) postoperatively. Perceptual speech data were collected and rated by independent listeners using CAPS-A. Outcomes & Results: Moderate to strong interrater reliability for perceptual data (r[subscript s] = 0.503-1.000, all p < 0.01) and strong to very strong reliability for videofluoroscopic measurements (r[subscript s] = 0.746-0.947) were found. Construct validity of the CAPS-A VPC-Sum was shown by an increase in postoperative scores for the CLP group only [kappa][superscript 2](2) = 9.769, p = 0.008 and significant differences between the CLP and the other two groups at T2 and T3 using independent "t"-tests. Convergent and divergent validity was indicated by a positive moderate correlation with related parameters (e.g., hypernasality r[subscript s] = 0.869, p < 0.01) and a weak correlation with unrelated parameters (e.g., amount of forward advancement r[subscript s] = 0.160, p = 0.526). Criterion validity was found by a moderate correlation between closure ratio r[subscript s] = -0.541, p = 0.020 and CAPS-A VPC-Sum. Conclusions & Implications: A velopharyngeal composite score based on perceptually rated parameters serves as an important surgical speech outcome measure. The CAPS-A VPC-Sum is a useful, reliable and valid outcome measure of velopharyngeal function. There are added positive implications for other clinicians using geographically and language-specific adapted versions of the CAPS-A internationally.

The purpose of this study was to examine the experience of Senior Companions with telephone reassurance program training delivered via Zoom and the feasibility of using teleconferencing as a platform for training older adult volunteers during the COVID-19 pandemic. Volunteers were recruited from a local Senior Companion Program. We assessed training enrollment and participation rates. We also examined the overall participant experience with the program training by asking structured/semi-structured questions and analyzed the data using content analysis. The average age of the volunteers was 72.5 (n=20). During the first recruitment, 39 Senior Companions expressed their interest in the program. As a result, 20 out of 39 volunteers (51.3%) successfully completed the teleconference training (18 joined over the phone & 2 joined online). Findings from this pilot study suggest that the teleconferencing training was feasible for older adult volunteers and the volunteers discussed that the program training would benefit and support their volunteer roles. The findings of this study provide insight for gerontological researchers and educators related to potential strategies for completing research and training in the midst of COVID-19. The use of teleconferencing training that incorporates best practices for older adults' learning may offer promise for the potential scalability and sustainability of volunteer trainings during and after COVID-19.

Introduction: This study aimed at exploring the feasibility of applying a computer-based language test to young children aged 2–4 years. Methods: Thirty-two Cantonese-speaking children, aged 2–4 years, were recruited from local kindergartens. All participants underwent an assessment using both the computer-based and paper-pencil versions of the Macau Cantonese Language Screening Scale for Preschool Children, following a crossover study design. A short break of 15–30 min was provided between the two assessments. The data were analysed at three levels: the overall test, subcategory, and individual item levels. At the overall test and subcategory levels, data were analysed using the paired samples t-test and ICC. At the item level, the percentage of agreement and Cohen's kappa value were selected to assess the agreement of the two test formats. Results: Excellent agreement was found for the overall test level, and good agreement was observed for four of the five subcategories. At the individual item level, 28 of the 35 items showed more than 80% agreement, and 16 items showed substantial to almost perfect agreement. Conclusion: These results suggest that the two test formats give similar total scores and subcategory scores for children aged 2–4. For children older than 2 years and 6 months, the agreement for matching items is as high as 83.68% (1,318/1,575). The computer-based test is thus highly recommended for this group of children. For children younger than 2 years and 6 months, a modified computer-based test is suggested to accommodate their needs. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, older adults were considered one of the most vulnerable groups as they faced obstacles when traveling for daily activities. This study examined the impact of the pandemic on travel behaviors among older adults, aiming to shed light on the challenges they faced and potential strategies for support. Methods: We conducted semi-structured, individual interviews with older adults. The data were analyzed using thematic analysis. In addition, their trip frequencies and usage of different transportation modes were descriptively analyzed. Results: While the participants reduced overall trip frequency during the pandemic, they were more observant when discussing essential needs. Study participants emphasized their reliance on family members for rides to essential destinations. Non-drivers faced added stressors and fears, particularly regarding safety measures and hygiene protocols on public transportation. Several individuals embraced ride-hailing services as a viable transportation solution, indicating benefits such as reduced exposure to crowded public transit and increased convenience. Conclusions: Macro-level efforts should include supplementary technological and transportation assistance services, along with increased awareness of safety protocols within public transit. These initiatives are expected to enhance the accessibility of existing mobility systems for older adults. [ABSTRACT FROM AUTHOR]

Seasoned geriatric community health workers offered valuable data that will inform educators and community health workers working with older persons. Geriatric community health workers' views about retirement and about facilitators and barriers that keep them engaged with older adults during retirement were identified. Twenty geriatric community health workers participated in semi-structured, qualitative interviews conducted by the research team. Sixty percent of the participants (N = 12) reported plans not to work during retirement, although 40% (N = 8) expressed interest in full- or part-time employment post-retirement. When asked about their expectations to stay in the field of aging or gerontology in some capacity during retirement, 30% (N = 6) expected to stay in gerontology during retirement. The findings from this research will help organizations and educational institutions create programs and resources that will encourage geriatric community health workers to continue working in the field of aging during retirement.

Social work educators are increasingly exploring how to effectively use technology in their classrooms. The purpose of this study was to explore how a technology-enhanced active learning classroom influenced social work students' engagement and overall learning experiences. An online survey was conducted with 125 social work students from micro and macro courses. When compared to macro courses, students from micro social work courses more positively reported active participation, effective teaching, and technical skills as benefits of the classroom. Furthermore, the dynamic learning environment and instructors' effective teaching significantly affected students' positive learning experience. Social work programs should develop various teaching methods for active learning classrooms to develop students' practice skills that can be transferred to the real world.

Purpose: The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years. Method: Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong--10 CI users implanted at or before 2 years of age ("early" CI group), 13 CI users implanted after 2 years of age ("late" CI group), and 18 individuals with NH. The mean age at implantation of the early CI group was 1.5 years (SD = 0.3), and for the late CI group, it was 4.3 years (SD = 2.1). Participants were a mean of 13.3 years of age (SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories. Results: Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later. Conclusions: The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages.

In 2008, the Ministry of Education of South Korea planned to develop a domestic, standardized language test called the National English Ability Test (NEAT) as part of sweeping reforms designed to democratize and improve the Korean education system. On many levels, NEAT was an innovative initiative. From a financial perspective, NEAT was designed to curb private spending on English education and to divert money from international standardized English tests. Educationally, NEAT was groundbreaking in that it introduced speaking and writing into English assessment and was meant to replace the English section on the College Scholastic Ability Test of Korea. In addition, NEAT was a two-track English test for high school students intended to meet the differing needs of students and colleges. After about five years, including a trialing period and a new presidential administration, plans for implementing NEAT were abandoned officially in 2013. The present paper examines the educational, sociopolitical, and economic factors that led to the rise and demise of NEAT from a critical language testing perspective. Following the tenets of critical language testing, this paper addresses the responsibility of the language testers to create an assessment that fairly measures test-takers' language proficiency. A review and an inductive interpretation of policy documents and recent NEAT research demonstrate the discrepancies among the original intentions of NEAT, the unintended outcomes, and overlooked issues of practicality. Findings also reveal that the two tracks of NEAT negatively branded both students and universities, deepening instead of alleviating the English divide.

Background and Objectives Although East Asian American family caregivers are known to underutilize formal support services, there is a lack of evidence regarding the associations of formal service utilization with caregivers' well-being. This study examined the prevalence of different types of home-and community-based formal service utilization among Korean and Chinese American family caregivers of persons with dementia and how utilization of such services was associated with their well-being. We also explored their overall experience in accessing and utilizing formal dementia support services and programs. Research Design and Methods We employed a convergent mixed-methods study design. In a convenience sampling method, we recruited 62 family caregivers. Logistic regression and thematic analysis were utilized to analyze data. Results The results showed in-home services were mostly utilized among family caregivers of these ethnic groups. Out of 9 different support services, those who utilized nutrition programs and case management were more likely to report higher overall well-being. Four themes were developed: (1) awareness of formal support services but uncertainty on how to access them, (2) language barriers imposing additional challenges in accessing formal support services, (3) traveling to access culturally appropriate services, and (4) desire for culturally tailored medical and long-term care services. Discussion and Implications Findings from this study suggest the importance of case management services to overcome barriers to accessing and utilizing a wide range of formal support services and provision of culturally appropriate food in formal support services to increase East Asian American family caregivers' utilization of long-term care services. [ABSTRACT FROM AUTHOR]

The research team developed a community-based, intergenerational intervention, the Spanish-language Healthy Buddy Program to alleviate transportation barriers experienced by Latinx older adults. College students were paired with Latinx older adults and helped them identify transportation- and health-related resources in their communities. During COVID-19, the program was implemented in Hillsborough County, Florida, and Dallas-Fort Worth Metroplex and San Antonio, Texas. This paper reports the study process and outcomes using quantitative and qualitative data collected in Texas (n = 25). Individual interviews indicated older adult participants were receptive to the program model and appreciated the roles student buddies played to help improve their mobility. [ABSTRACT FROM AUTHOR]

Background: Exercise‐based swallowing training (EBST) and transcutaneous neuromuscular electrical stimulation (TNMES) are common modalities used to treat late dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). We aimed to investigate and compare the efficacies of EBST and TNMES as proactive treatments administered early after radiotherapy. Methods: Patients with early post‐radiotherapy NPC (n = 120) underwent either TNMES or EBST. Flexible endoscopic evaluation of swallowing (FEES), quality of life (QOL), and swallowing function questionnaires were completed before the intervention as well as immediately, 6, and 12 months after the intervention. Outcome measures included the scores for the swallowing function score (SFS), penetration and aspiration scale (PAS), dynamic imaging grade of swallowing toxicity (DIGEST), functional oral intake scale (FOIS), swallowing performance status scale (SPSS), pharyngeal motor impairment (PMI), pharyngeal function impairment (PFI), and functional assessment after cancer therapy–nasopharyngeal (FACT‐NP) questionnaire. Results: Three months after radiotherapy, 31 and 34 patients underwent TNMES and EBST, respectively, and completed swallowing assessments at all four assessment timepoints. All patients showed post‐radiotherapy impairments in the SFS, PAS, DIGEST, PMI, and PFI. Compared with the EBST group, the TNMES group showed significant improvements in the PFI and PMI scores, with small‐to‐medium effect sizes. Additionally, compared with the EBST group, the TNMES group demonstrated a trend toward slightly better improvements in the PAS, DIGEST, FOIS, and SPSS scores immediately and 6 months after the intervention. The SFS scores improved from baseline in both groups; however, the TNMES group showed an earlier improvement. Finally, the TNMES group showed better QOL according to the FACT‐NP than the EBST group. Conclusion: Proactive TMNES and EBST are safe and feasible modalities for improving swallowing in patients with NPC when administered early after radiotherapy. Although TNMES showed better results than EBST, these results should be interpreted with caution given the study limitations. Level of evidence: 1B. [ABSTRACT FROM AUTHOR]

GαS, the stimulatory G protein α‐subunit that raises intracellular cAMP levels by activating adenylyl cyclase, plays a vital role in bone development, maintenance, and remodeling. Previously, using transgenic mice overexpressing GαS in osteoblasts (GS‐Tg), we demonstrated the influence of osteoblast GαS level on osteogenesis, bone turnover, and skeletal responses to hyperparathyroidism. To further investigate whether alterations in GαS levels affect endochondral bone repair, a postnatal bone regenerative process that recapitulates embryonic bone development, we performed stabilized tibial osteotomy in male GS‐Tg mice at 8 weeks of age and examined the progression of fracture healing by micro‐CT, histomorphometry, and gene expression analysis over a 4‐week period. Bone fractures from GS‐Tg mice exhibited diminished cartilage formation at the time of peak soft callus formation at 1 week post‐fracture followed by significantly enhanced callus mineralization and new bone formation at 2 weeks post‐fracture. The opposing effects on chondrogenesis and osteogenesis were validated by downregulation of chondrogenic markers and upregulation of osteogenic markers. Histomorphometric analysis at times of increased bone formation (2 and 3 weeks post‐fracture) revealed excess fibroblast‐like cells on newly formed woven bone surfaces and elevated osteocyte density in GS‐Tg fractures. Coincident with enhanced callus mineralization and bone formation, GS‐Tg mice showed elevated active β‐catenin and Wntless proteins in osteoblasts at 2 weeks post‐fracture, further substantiated by increased mRNA encoding various canonical Wnts and Wnt target genes, suggesting elevated osteoblastic Wnt secretion and Wnt/β‐catenin signaling. The GS‐Tg bony callus at 4 weeks post‐fracture exhibited greater mineral density and decreased polar moment of inertia, resulting in improved material stiffness. These findings highlight that elevated GαS levels increase Wnt signaling, conferring an increased osteogenic differentiation potential at the expense of chondrogenic differentiation, resulting in improved mechanical integrity. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]