ClearSpeechTogether: a Rater Blinded, Single, Controlled Feasibility Study of Speech Intervention for People with Progressive Ataxia

BACKGROUND: Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach. A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias. METHOD: This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation. RESULTS: Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing. DISCUSSION: ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia

Подземный сток в таёжной зоне Западной Сибири: многолетние изменения и их причины

Проведён расчёт среднемесячных и среднегодовых значений подземного стока в таёжной зоне Западной Сибири, выполнен статистический анализ полученных данных и материалов наблюдений за уровнями подземных вод верхней гидродинамической зоны на участках вне явного антропогенного влияния. Установлено, что в регионе в последние десятилетия происходило статистически значимое увеличение подземной составляющей речного стока и уровней подземных вод. Увеличение подземного стока удовлетворительно объясняется смещением сроков установления снегового покрова и снеготаяния, снижением испарения с поверхности водосборов при уменьшении температур воздуха в летний период и увеличением температуры в остальные месяцы года даже при отсутствии изменений годового атмосферного увлажнения. Calculation of monthly average and mid-annual values of a ground flow in a taiga zone of Western Siberia is carried out. The statistical analysis of the received data and materials of supervision over levels of ground waters of the top hydrodynamical zone on sites outside of obvious anthropogenous influence is executed. In region last decades there was statistically significant increase in a underground component of a river drain and levels of ground waters. The increase in a ground flow well speaks displacement of terms of an establishment of a snow cover and snow melting, decrease in evaporation from a surface of river basins at reduction of temperatures of air during the summer period and increase in temperature in other months of year even at absence of changes of annual atmospheric humidifying