Pilot Date on Swallow Function in Nondysphagic Patients Requiring a Tracheotomy Tube

Objective. To evaluate the effects of occlusion status (i.e., open, finger, capped) of the tracheotomy tube and removal of the tracheotomy tube that may have upon bolus flow and durational measurements in nondysphagic persons requiring a tracheotomy tube. Study Design. Prospective, single subject, repeated measure design. Methods. Participants had their swallow evaluated with 5 mL pureed boluses using nasal endoscopy with the tracheotomy tube in place, removed, and under the following occlusion conditions: open, finger, and capped. The order of occlusion condition was randomized. Results. Aspiration was never observed but laryngeal penetration was a common finding. Durational measurements for swallow initiation and duration of white out were not significantly different by occlusion status or after removal of the tracheotomy tube. Conclusion. This study provides corroborating evidence demonstrating the lack of a relationship between a tracheotomy tube and swallowing dysfunction

An exploration of professional and practice-based perspectives on supporting birth parents towards reunification with their children.

Abstract An exploration of professional and practice-based perspectives on supporting birth parents towards reunification with their children. When children are placed in out-of-home care (e.g. foster care; hereafter ‘care’), it is the State’s duty to work with the children’s birth parents and ensure that systems and supports are in place to enable parents to resume caring for their children (i.e. for reunification to take place), when it is in the best interest of the child to do so. In Ireland, there is a dearth of data, research, policy and practice guidance regarding the process of reunification. There is also limited research on the experiences of birth parents whose children are in care in Ireland. This paper draws on data gathered as part of a study of professional and practice-based perspectives on reunification of children in care in Ireland. Semi-structured interviews were carried out with 12 respondents from various professional backgrounds including social workers and social care workers. . In this paper, we examine the perspectives of participants regarding how birth parents might be better supported to work towards reunification. Findings suggest there is limited scope to work with and support parents of children in care in the current system. More focus is required to ensure parents are informed of their rights and empowered to remain present in the lives of their children and to work towards reunification. Suggestions are also made for exploration of a specialised service or team, as in other jurisdictions, to work with parents to promote family reunification

Improving the Culture of Safety on a High‐Acuity Inpatient Child/Adolescent Psychiatric Unit by Mindfulness‐Based Stress Reduction Training of Staff

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109622/1/jcap12091.pd

Practical considerations for estimating clinical trial accrual periods: application to a multi-center effectiveness study

Abstract Background Adequate participant recruitment is vital to the conduct of a clinical trial. Projected recruitment rates are often over-estimated, and the time to recruit the target population (accrual period) is often under-estimated. Methods This report illustrates three approaches to estimating the accrual period and applies the methods to a multi-center, randomized, placebo controlled trial undergoing development. Results Incorporating known sources of accrual variation can yield a more justified estimate of the accrual period. Simulation studies can be incorporated into a clinical trial's planning phase to provide estimates for key accrual summaries including the mean and standard deviation of the accrual period. Conclusion The accrual period of a clinical trial should be carefully considered, and the allocation of sufficient time for participant recruitment is a fundamental aspect of planning a clinical trial.</p

RELEVANCE OF ORAL LANGUAGE SKILLSThe Relevance of Oral Language Skills to Performance on State Literacy Testing

Purpose: Investigated correspondences between performance on an array of literacy and oral language abilities with the proficiency ratings on the reading portion of the New England Common Assessment Program (NECAP). Method: Tested 106 fifth-grade students on measures of word-level reading and oral language (i.e., vocabulary, syntax, discourse) near the time when students completed the NECAP assessment. Analyses of performance were conducted with three NECAP outcome groups (Above Proficient, Proficient, Nonproficient (combination of Partially Proficient and Substantially Below groups). Results: Large effect sizes were obtained for differences in oral language and word-level reading skills among the three groups. Decoding, syntax and discourse each accounted for significant variance in state reading scores and differentiated NECAP reading proficiency groupings. Notably, students at all levels varied in their patterns of skills. The majority of Nonproficient students had low scores on word-level reading skills; yet 100% had weaknesses in syntax and/or discourse. Similarly, many students ranked as Proficient had word-level deficits; even more had oral language weaknesses. Conclusions: Treatment of students’ reading weaknesses should be differentiated according to the specific needs of individual pupils. This practice should apply to all critical components of reading comprehension, including oral language skills in syntax and discourse