Impact of a moulded pureed diet on taste, appearance, recognisability, and overall liking among patients in an acute hospital

IntroductionHospital meals potentially influence patients’ nutritional, physical, and emotional well-being during their admission. Patients on pureed diets report poorer meal satisfaction, due to taste, appearance, and recognisability, potentially impacting on their nutritional status. This study compared whether a moulded pureed diet made from modified maize starch led to improved taste, appearance, recognisability, and overall liking, compared to an unmoulded pureed diet made from potato starch in an acute hospital.MethodsPatients on texture-modified diets were recruited and presented with two pureed diets – unmoulded and moulded. Participants were asked to identify meat and vegetable dishes prior to eating. After the meal, participants indicated their diet preference in terms of appearance, taste, and overall liking.Results145 participants were recruited, of which 126 completed data collection. 86% correctly identified moulded meat dishes, 69% correctly identified moulded vegetable dishes, with an overall 77% accuracy in identifying moulded puree side dishes. On unmoulded puree side dishes, participants correctly identified 25% of meat dishes, 4% of vegetable dishes, with an overall accuracy of 14%. In terms of preference, the moulded puree was preferred, with 81% for appearance, 76% for taste and 75% for overall preference. When participants had differing preferences for appearance and taste (e.g., prefers unmoulded puree appearance and moulded puree taste), 95% of them subsequently aligned their overall preference with their taste preference (i.e., overall preferred moulded pureed diet). This suggests that taste has a stronger influence on overall preference compared to appearance.DiscussionFindings indicate that a moulded pureed diet made from modified maize starch led to improved recognisability, taste, appearance, and overall liking compared to an unmoulded pureed diet made from potato starch. Taste had a stronger influence on overall preference compared to appearance. These findings capture patient preferences and may have implications on how hospital pureed diets may be improved, potentially improving patient nutrition and health outcomes

Aphasia Assessment in Singapore

This research provides novel insight into the field of aphasia in Singapore. The aims were to (a) investigate the current state of aphasia practice in Singapore including the use of functional outcome and remote assessments in practice (Part One) and, (b) investigate the validity of two assessment tools for use with Singaporeans with aphasia which would enable functional outcomes of aphasia to be captured (Part Two), and (c) examine remote assessment of aphasia in the Singapore context (Part Three). Part One, Chapter One provides an overview of aphasia assessment, while Chapter Two provides an overview of the methods used in the study. Chapter Three describes the current speech pathology practices in Singapore for aphasia. The findings of this study provided justification for the subsequent parts of the thesis. Part Two, Chapter Four, describes the validation of the Stroke and Aphasia Quality of Life (SAQOL-39g) and its Mandarin adaptation, the SAQOL-CSg, in generic stroke patients. This study resulted in two separate papers, one examining the reliability and validity of the SAQOL-39g and SAQOL-CSg and the other examining sensitivity to change and responsiveness of the SAQOL-39g/SAQOL-CSg. Chapter Five describes the validation of the Assessment of Living with Aphasia (ALA) and its Mandarin adaptation, the ALA-C, in Singaporeans with chronic aphasia. Both the ALA and ALA-C demonstrated good reliability and validity. Part Three, Chapter Six describes the development of Access2Aphasia™, an iPad-based aphasia assessment application that enables the use of supported conversation techniques. Chapter Seven investigates the reliability of telehealth aphasia assessment using Access2Aphasia™. Online aphasia assessment was found to be comparable to face-to-face assessment. Part Four concludes with a summary of the main contributions of this thesis to aphasia assessment and management in Singapore, its limitations and suggestions for future research

The Impact of dysarthria on everyday communication following traumatic brain injury

Primary objective: To compare the everyday communication of individuals with mild and moderate dysarthria and concomitant cognitive-communication impairments following traumatic brain injury (TBI) Methods and procedures: Five participants with mild dysarthria and five with moderate dysarthria following TBI were recorded during telephone service enquiries with bus timetable call centre operators. Transcripts were analysed using exchange structure analysis derived from systemic functional linguistics. Listener comfort ratings were collected using a novel equal appearing interval scale to measure how comfortable people would feel interacting with the participants. Main outcomes and results: Participants with moderate dysarthria were not necessarily penalised for having poorer intelligibility during bus timetable service encounters. While participants with moderate dysarthria were given poorer listener comfort ratings, this did not affect the way information was exchanged with bus timetable call centre operators. These findings were attributed to the powerful interactional role of TBI participants as customers, the amount of disability awareness training and experience held by call centre operators and the highly structured nature of bus timetable service enquiries. Listener comfort ratings could be predicted with moderate accuracy from intelligibility scores. Conclusions: Service encounters where individuals with TBI are placed in a powerful interactional role of customer may be functional generalization tasks. Training and education of service providers may also impact on the communicative effectiveness of individuals with TBI

Validation of the Stroke and Aphasia Quality of Life Scale in a Multicultural Population

10.3109/09638288.2016.1138551Disability and Rehabilitation38262584-259

Normative Study of a Multilingual Aphasia Screening Test in Singapore

10.1080/02687038.2018.1485866Aphasiology32S176-7

Multilingual Aphasia Speech Analysis with Machine Learning

Aphasia is an acquired language disorder that occurs after brain injury such as stroke, head trauma or tumor. People with aphasia (PWA) may have trouble speaking or understanding speech. If diagnosed early, aphasia is often treatable, and the communication can be improved with speech therapy. Early detection and evaluation of aphasia is crucial for the treatment and recovery. This paper reports a preliminary study of multilingual aphasia speech evaluation. In this study, the characteristics of speech from PWA and healthy controls are compared from both acoustic and linguistic perspectives. Multiple acoustic features are extracted from aphasic and normal speech to build a language independent aphasic speech detection model. The model achieved good aphasic speech detection performance on both English and Mandarin test sets.</p

Beyond the statistics: a research agenda in aphasia awareness

Background: An important goal of people living with aphasia, aphasia organizations and professionals who work with aphasia is increased awareness of aphasia by the public. However, surveys of the public awareness of aphasia around the world and over time suggest that public knowledge of aphasia is poor. Aims: The aim of this article is to examine the literature on aphasia awareness and aphasia awareness campaigns, and to propose a strategic research agenda to move awareness building forward. Main Contribution: Aphasia awareness campaigns appear to have had minimal impact on knowledge of aphasia by the general public. Potential problems with aphasia awareness building were identified including a lack of a unified and compelling message across awareness campaigns, lack of coordination across organizations and campaigns, tendency to target audiences already familiar with aphasia, failure to base campaigns on theory and research from disciplines such as marketing, health promotion and communication research, failure to involve people with aphasia, their families and health-care professionals in the co-design of campaigns and no evidence that the impact of campaigns has been evaluated. Conclusions: A strategic research agenda is needed in order to increase the effectiveness, co-design, and co-evaluation of aphasia awareness campaigns worldwide. The authors propose an international effort and comprehensive research agenda to address aphasia awareness