Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

OBJECTIVE: To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. DESIGN: Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. SETTING: Web-based survey. PARTICIPANTS: Respondents (N=170) from 29 countries. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Consensual validity (percent agreement and Kendall tau), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). RESULTS: The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (\u3e70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. CONCLUSIONS: This initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia

Claves estéticas de la primera recepción de la teoría wagneriana en Madrid

En la década de 1860, la crítica musical española planteó una oposición total entre dos sistemas considerados excluyentes: la ópera italiana y el drama musical wagneriano. El debate discutió sobre la relación que debía existir entre la música y el texto en el género de la ópera, es decir, cuál de las dos disciplinas debía prevalecer en la composición. La ópera italiana dio una preeminencia total a la música, reflejando una «concepción idealista». En el lado opuesto estaba el punto de vista de Wagner, quien dio al texto una posición de superioridad, pues creía que la música debía someterse al poema para lograr un espectáculo creíble, «realista», enlazando así con las teorías de Gluck. Esto significaba que la música debía secundar al texto para reforzar su verosimilitud dramática. Sin embargo, en la década de 1870 se produjo un cambio debido a la influencia de una filosofía importada a España, el Krausismo, cuyo nombre proviene del alemán Karl Christian Friedrich Krause. El entorno del krausismo, que ambicionaba la consecución de una ópera española, abordó el problema desde la perspectiva de armonización de contrarios, buscando resolver la oposición entre tradición y modernidad, nación y universalidad. En cuanto a esta última cualidad, se pretendía, asimismo, armonizar las diferentes escuelas de la ópera, considerando a Richard Wagner como el representante alemán más genuino y vanguardista y, por lo tanto, tener en cuenta para crear un género nacional.In the 1860s, Spanish music criticism propounded an opposition between two repertories, considered to be mutually exclusive: Italian opera and Wagnerian music drama. The debate surrounding these two repertories raised the issue of what relationship there should be between music and text in opera, centring on the question of which of the two disciplines should prevail in composition. Italian opera gave total prevalence to music over text, thus reflecting an «idealist conception» of art. Wagner’s point of view, conversely, put the text in a position of superiority: Wagner he believed that music should always be subjected to the requirements of the text to achieve a credible, «realistic» production. Wagner linked his ideas with Gluck’s notion that music must support the text in order to reinforce its dramatic authenticity. However, in the 1870s a change emanated from the influence of a philosophical current imported to Spain: Krausism (from the thinking of German Karl Christian Friedrich Krause). The Krausist followers, who strived for the establishment of a Spanish opera, addressed the issue from the perspective of the harmonisation of opposites, seeking to resolve the opposition between tradition and modernity, nationhood and universality. Concerning the latter, they attempted to reconcile the different operatic schools. They used Richard Wagner as an example, as they considered him to be the most genuine and avant-garde German representative of opera composition at the time, and the figure most likely to be taken into account in the creation of a national genre.Keywords: Richard Wagner (Reception, Controversial, Spain); Bel canto; Aesthetic; Spanish opera; Krausism; François-Joseph Fétis; Manuel de la Revilla.In the 1860s, Spanish music criticism propounded an opposition between two repertories, considered to be mutually exclusive: Italian opera and Wagnerian music drama. The debate surrounding these two repertories raised the issue of what relationship there should be between music and text in opera, centring on the question of which of the two disciplines should prevail in composition. Italian opera gave total prevalence to music over text, thus reflecting an «idealist conception» of art. Wagner’s point of view, conversely, put the text in a position of superiority: Wagner he believed that music should always be subjected to the requirements of the text to achieve a credible, «realistic» production. Wagner linked his ideas with Gluck’s notion that music must support the text in order to reinforce its dramatic authenticity. However, in the 1870s a change emanated from the influence of a philosophical current imported to Spain: Krausism (from the thinking of German Karl Christian Friedrich Krause). The Krausist followers, who strived for the establishment of a Spanish opera, addressed the issue from the perspective of the harmonisation of opposites, seeking to resolve the opposition between tradition and modernity, nationhood and universality. Concerning the latter, they attempted to reconcile the different operatic schools. They used Richard Wagner as an example, as they considered him to be the most genuine and avant-garde German representative of opera composition at the time, and the figure most likely to be taken into account in the creation of a national genre