EVIDENCE-BASED ASSESSMENT OF VOICE DISORDERS: A THEORETICAL OVERVIEW AND MODEL

This article deals with the current paradigm of evidence-based practices of the Speech Therapy (Speech language pathology), especially diagnosing based on evidences of voice disorders. One of the main goals of this article is to define voice disorders according to the World Health Organization’s ICF multidimensional concept. Using a comparative method, this study attempts to prove that traditionally, the assessment outcomes of voice disorders in the Speech Therapy have been largely based on the speech therapist’s point of view and never on the client’s position. The research insists on establishing and adopting definitive gold standards, with respect to voice assessment and therapy in Bulgaria

Overview of Evidence-Based Treatment of Stuttering in Bulgaria and in the USA and Canada

Introduction: The move towards evidence-based practice (EBP) requires speech-language pathologists (logopedists) to understand the types of studies that build an evidence base for the field as well as the standards for assessing the quality of evidence. Objectives: This article discusses the conceptual and methodological issues associated with EBP in Bulgaria, the USA, and Canada related to clinical stuttering intervention. This article discusses how the movement towards the current high-level standards of practice established in North America may challenge some of the traditional Bulgarian beliefs regarding stuttering treatment. Method: Theoretical overview and analysis of the existing literature data sources including systematic meta-analysis articles on EBP on stuttering. Results: The study outlines the steps of EBP accepted in SLP. Thirteen systematic reviews and meta-analyses are discussed concerning the application of research evidence to clinical decision making. These issues remain problematic for Bulgarian logopedists who received their training before or during the recent professional shift from a special education subspecialty to a health profession specialty as represented by speech-language pathology (SLP). Conclusions: The professional bodies that govern clinical practice in the Bulgarian health fields are not currently guided by EBP concepts. In Bulgaria, there is no evidence-based framework for the prevention, diagnosis, and treatment of stuttering as there is in the USA and Canada. In Bulgaria EBP stands as a fundamental way to promote changes appropriate for SLP as a health profession

Comparison Of The Efficiency Of Brushes Dr. Barman`S Toothbrushes For Dental Plaque Biofilm Control For 6-Year-Old Children

Увод: Зъбната плака е пример за микробен биофилм с разнообразен микробен състав.Цел: Да се оцени състоянието на първоначалната орална хигиена при деца на възраст 6 години и да се сравни с оралнохигиенното им състояние след извършване на индивидуална орална хигиена с приложение на четките на Dr. Barman,s в сравнение с обикновени четки за зъби и дозирани флуорни пасти спрямо възрастта на децата.Материал и методи: Проучването включва 200 деца на 6-годишна възраст. Определяне нивото на оралната хигиена. За установяване на оралнохигиенния статус се използват оралнохигиенните индекси, OHI-S Greene & Vermillion и I. Silness, H. Loe (1967). Проучването се реализира във Факултет по дентална медицина, МУ-Варна. Период на проучването - 2016-2017 г. Изработва се профилактична програма.Резултати: Сравнението на резултатите от оралната профилактика 0,98 към 0,79 показа, че съответно конвенционалните четки имат по-добри резултати в изследваната група в сравнение с четките на Dr. Barman,s. Намаляване на стойностите на OHI-S за децата на 6 години се установява от 1,22 до 0,43 за групата, прилагаща четките на Dr. Barman,s. При децата от контролната група на възраст от 6 години OHI-S се намалява от 1,68 до 0,69.Изводи: 1. В контролната група деца на възраст 6 години, прилагайки конвенционалните четки и пасти за зъби, съдържащи флуорид от 1450 ppm F, участниците са оценени с по-добри хигиенни резултати в сравнение с експерименталната група. 2. При децата с висок риск от кариес профилактичната програма трябва да оптимизира и хранителния режим. 3. По-висока ефективност на отстраняване на плаковия биофилм след индивидуална орална хигиена показаха конвенционалните четки, следвани с висока ефективност, получена от четките на Dr. Barman,s.Introduction: Dental plaque is an example of microbial biofilm with a diverse microbial composition.Aim: The aim of this article is to assess the initial oral hygiene in children aged 6 and compare it with their oral hygiene status after performing individual oral hygiene with Dr. Barman,s toothbrushes compared to ordinary toothbrushes and fluoride toothpastes dosed in accordance with the age of the children.Materials and Methods: The study included 200 children at the age of 6. The level of oral hygiene, Oral-Hygiene Indexes, OHI-S Greene & Vermillion, and I. Silness, H. Loe (1967) were used to establish Oral Hygiene status. The study was conducted in the Faculty of Dental Medicine of the Medical University of Varna. The study period was 2016-2017. A prevention program is being developed.Results: The comparison of oral prophylaxis scores of 0.98 to 0.79 showed that conventional toothbrushes had better results in the study group compared to Dr. Barman`s. The reduction in OHI-S for 6-year-old chil-dren was found to be between 1.22 and 0.43 for the Dr. Barman`s toothbrush group. In children in the 6-year-old control group, OHI-S decreased from 1.68 to 0.69.Conclusion: 1. In the control group of children aged 6, using conventional teeth brushes and toothpastes containing fluoride amount of 1450 ppm F, participants were assessed with better hygiene scores than the experimental group. 2. In children with high risk of caries, the prophylactic program should also be optimized for the diet. 3. Higher removal efficiency of plaque biofilm after individual oral hygiene was shown by conventional brushes followed by high performance brushes of Dr. Barman,s

Smile line - assessment and variations in relation to age and sex

Линията на усмивката е от значение при оценка на естетичния риск за пародонтално хирургично и имплантатно лечение, планирано в естетичната зона на горната челюст. Освен морфологичните характеристики на твърдите зъбни тъкани, важен компонент за цялостната естетика на усмивката е също формата, позицията и контура на меките гингивални тъкани. Линията на усмивката най-често се класифицира като ниска, средна и висока. Най-голямо количество гингивални тъкани са видими в случаите на висока линия на усмивката. Линията на усмивката е изследвана при общо 219 индивиди (79 мъже и 140 жени), като за целта е използвана класификацията на Tyan (1984).За статистическа обработка на резултатите е използван дискриптивен анализ, извършен с помощта на софтуер на програмата IBM SPSS Statistic version 19.По отношение линия на усмивката, полът и възрастта имат значение при прогнозиране и оценка на естетичния риск от денталната пародонтална и имплантатна терапия.Smile line has a decisive meaning for the assessment of the aesthetic risk of dental periodontal and implant therapy, especially in the aesthetic zone of the maxilla. The position and outline of marginal gingival tissues are very important for the aesthetics of the smile, as well as the morphological characteristics of hard dental tissues. Generally, the smile line is classified as low, medium and high. Мost gingival tisuues are visible in the case of a high smile line.The smile line was assessed in 219 participants (79 males and 140 females) according to the Tyan`s classification (1984). The descriptive statistical analysis was performed by IBM SPSS Statistic version 19 softwаre.When it comes to the smile line, sex and age are important factors in assessing the aesthetic risk of periodontal and implant therapy

Microplastic pollution – are there potential toxic threats for aquatic animals in Bulgaria?

Microplastic (MPs) pollution and its negative effects is a growing, yet poorly studied problem in Bulgaria. In the present review we aimed to summarize the available data on MPs contamination of surface waters and sediments, and its impact on aquatic animals in Bulgaria

MULTIDIMETIONAL OUTCOME AND LONG-TERM EVALUATION OF NON-AVOIDANCE STUTTERUNG THERAPY

nternational Classification of Functioning, Disability, and Health (ICF, WHO, 2001) is a constructive framework for quality assessment and treatment in Logopedics (Speech Language Therapy). The current research study makes an attempt to introduce this standard into logopedical practice and applied research to measure the quality of life of persons with fluency disorders, such as stuttering. The quality of life is a modern multidimensional construct that covers health-medical, psychological, social and economic factors. Good level of communication and stabilized fluency is of key importance to improve the quality of life of persons who stutter. The purpose of the study was to show a model of assessment, treatment and evaluation of the efficacy of the non-avoidance approach in adult stuttering therapy. According to the results of the Index of disability, 47% of the people with multiple sclerosis have limited independence in providing daily activities leading up to 31% of the examinees with rare participation in the everyday social activities, the result obtained by the Frenchay Index of activities. We can conclude that the Index of disability is higher with older respondents and it is often followed by a drop of the daily activity frequency. Methods: CharlesVan Riper’s non-avoidance approach for an intensive therapy. Participants were 15 adults who stutter with an average age 25.2 years. Results: Specific significant decreasing of the two main parameters: index of dysfluencies immediately after the intensive therapy as well as duration of disfluences in seconds. The changes in speech fluency before and after the intensive therapy as well as 3 years after this therapy were obtained regarding the duration of disfluencies and index of dysfluency. Conclusion: The present model of an intensive non-avoidance therapy format for adults with stuttering disorders was successfully applied for the Bulgarian conditions. Improved fluency is an important factor for quality of life improvement of persons with stuttering disorder

Intensive non-avoidance group therapy with stutterer adults: preliminary results

PURPOSE: The purpose of the present study was to evaluate and document the use and efficacy of intensive non-avoidance group treatment for Bulgarian adults who stutter (AWS), to specify that changes are adopted in different speech situations (in the stabilization phase), and to demonstrate that changes are maintained after intensive therapy. METHODS: Participants were AWS (n=15, 12 males) with an average age of 25.2 years) Bulgarian native-speakers. Twelve participants were University students and three were clients with tertiary education in different areas. All participants were enrolled in First (overall effect) and Second (interim effect) Stages of Intensive Non-Avoidance Treatment for Stuttering. Van Riper's stuttering modification therapy approach was employed; the latter considers a non-avoidance treatment for stuttering. The treatment was conducted in participants' native Bulgarian language. RESULTS: AWS, as a group (n=15), significantly decreased the number of stuttered utterances after intensive treatment; findings were consistent for participants with moderate as well as severe stuttering. Likewise, there was a significant decrease in duration (in seconds) of disfluencies after treatment; findings were consistent for participants with moderate as well as severe stuttering. Eighty percent of AWS used cancellation immediately and six months after treatment, 65% mastered preparatory sets immediately and six months after treatment, 35% exhibited pull-outs immediately after treatment and 55%, six months post-treatment. CONCLUSION: These preliminary findings were taken to suggest that intensive non-avoidance treatment for stuttering can be successfully employed with Bulgarian adults who stutter. Special focus was on the positive fluency changes that occurred during the course of therapy regarding the duration of disfluencies in seconds, and index of disfluencies

Rehabilitacja poudarowa oraz rehabilitacja afazji. Studium porównawcze międzynarodowych wytycznych

Cerebrovascular diseases are the leading cause of morbidity and mortality worldwide. Unfortunately, Bulgaria leads most countries in its incidence of stroke. Furthermore, a substantial number of Bulgarian patients post-stroke present with persisting communication disorders, especially aphasia. The main purpose of the present study is to conduct an evidence-based theoretical review of leading international guidelines for treatment and rehabilitation of adult stroke patients. In particular, this theoretical overview compares the current Bulgarian guidelines with those developed by the United States of America, Europe, Australia, Canada, the United Kingdom, and New Zealand. The Bulgarian guidelines for the prevention, diagnosis, and treatment of cerebrovascular diseases strongly recommends pharmacological treatment, which is commensurate with international standards. Nationally, a range of different language tests are currently used in post-stroke aphasia.Choroby naczyniowo-mózgowe należą do najczęstszych przyczyn zgonów na świecie. Bułgaria nie jest w tej kwestii wyjątkiem. Po przebytym udarze znaczna liczba Bułgarów i Bułgarek zmaga się z nieustępującymi zaburzeniami komunikacji, a zwłaszcza z afazją. W artykule dokonano przeglądu wiodących, międzynarodowych wytycznych określających leczenie oraz rehabilitację osób po przebytym udarze mózgu. W szczególności skupiono się na porównaniu wytycznych stosowanych obecnie w Bułgarii z tymi funkcjonującymi w innych krajach Europy, w Stanach Zjednoczonych, Kanadzie, Australii i Nowej Zelandii. Jak się okazuje, wytyczne bułgarskie – oparte na prewencji, diagnostyce oraz leczeniu chorób naczyniowo-mózgowych – obejmują przede wszystkim leczenie farmakologiczne. Znajduje to odbicie w standardach przyjętych w innych krajach. Istotną funkcję pełni także szeroka gama testów w różnych językach stosowana w leczeniu afazji poudarowej

The History of Logopaedics in Bulgaria: Challenges from a Global European Union Perspective

The present article summarises the specialised literature related to foundation of logopaedics and the key stages of its development in Bulgaria. Five main stages in development have been identified: the first “pseudo-medical” period, the second period marked by first individual steps, the third period of formative years (<1900–1945), the processing period (1945–1989), and the contemporary transition period (1989–present). Challenges from a Global European Union Perspective are also described and analysed. Students training in the field of logopaedics as well as research and international collaboration are an essential part of the article. It could be said that the history of the discipline and education in logopaedics in Bulgaria is a relatively young yet dynamic and growing field