Strategies to ensure motor learning during the treatment of vocal problems in neurodegenerative diseases

Los déficits del sistema sensoriomotor tienen un efecto dramático sobre la calidad de vida de las personas con enfermedades neurodegenerativas, especialmente la afectación de los nervios craneales responsables de la deglución, fonoarticulación, expresión facial y voz. Actualmente existe evidencia científica de que al entrenar sistemáticamente los grupos musculares encargados de los movimientos fonorrespiratorios, puede mejorarse o lentificarse el avance de la enfermedad y sus efectos sobre el deterioro sensoriomotor. Sin embargo aún no se ha avanzado lo suficiente en el diseño de estrategias específicas para propiciar la generalización de los resultados terapéuticos, esto es, para favorecer la transferencia de las mejorías desde la clínica a la vida cotidiana del enfermo neurodegenerativo. En este estudio se exponen los principios básicos del aprendizaje motor, sus fases y pautas de administración, centrándose en la aplicación de estos aspectos al tratamiento de personas con problemas de voz de origen neurodegenerativo. En una segunda parte se hace una revisión de la literatura sobre los factores que potencian la efectividad del método LSVT®. Se analiza cómo dicho modelo terapéutico aplica las teorías del aprendizaje motor al tratamiento de los problemas fonatorios de las personas que padecen Parkinson, proporcionando una generalización de las mejorías motoras y una repercusión de dichos beneficios a nivel de la lesión neurológica, la función vocal, la inteligibilidad del habla y la deglución, con resultados terapéuticos que han demostrado mantenerse a corto, medio y largo plazo por encima del nivel previo al tratamiento

Frecuencia de factores de riesgo y de la respuesta al tratamiento de constipación funcional en pacientes mayores de 4 años atendidos en consultorios de gastroenterología pediátrica de la ciudad de Chiclayo durante enero - junio del año 2016

Objetivos: estimar la frecuencia de los factores de riesgo y de la respuesta al tratamiento en pacientes mayores de 4 años atendidos en el consultorio de gastroenterología pediátrica. Material y métodos: se realizó un estudio observacional, descriptivo y prospectivo utilizando los datos de los pacientes con diagnóstico de constipación funcional, definido por los criterios de Roma III, en el Hospital Regional Lambayeque y una clínica privada de enero a junio del 2016. Se utilizó una ficha de recolección de datos y se realizó el análisis estadístico descriptivo. Resultados: el 90,8% de los pacientes no tuvo un horario defecatorio definido. La respuesta al tratamiento se dio en el 100,0% de los pacientes pero fue mayor a las 2 semanas (80,0%). Conclusiones: la ausencia de un horario defecatorio definido y el consumo inadecuado de agua fueron los factores de riesgo más frecuentes en nuestro medio. La respuesta al tratamiento fue completa en todos los pacientes y fue mayor en las primeras 2 semanas

LSVT LOUD and LSVT BIG: Behavioral Treatment Programs for Speech and Body Movement in Parkinson Disease

Recent advances in neuroscience have suggested that exercise-based behavioral treatments may improve function and possibly slow progression of motor symptoms in individuals with Parkinson disease (PD). The LSVT (Lee Silverman Voice Treatment) Programs for individuals with PD have been developed and researched over the past 20 years beginning with a focus on the speech motor system (LSVT LOUD) and more recently have been extended to address limb motor systems (LSVT BIG). The unique aspects of the LSVT Programs include the combination of (a) an exclusive target on increasing amplitude (loudness in the speech motor system; bigger movements in the limb motor system), (b) a focus on sensory recalibration to help patients recognize that movements with increased amplitude are within normal limits, even if they feel “too loud” or “too big,” and (c) training self-cueing and attention to action to facilitate long-term maintenance of treatment outcomes. In addition, the intensive mode of delivery is consistent with principles that drive activity-dependent neuroplasticity and motor learning. The purpose of this paper is to provide an integrative discussion of the LSVT Programs including the rationale for their fundamentals, a summary of efficacy data, and a discussion of limitations and future directions for research

Objective automatic assessment of rehabilitative speech treatment in Parkinson's disease

Vocal performance degradation is a common symptom for the vast majority of Parkinson's disease (PD) subjects, who typically follow personalized one-to-one periodic rehabilitation meetings with speech experts over a long-term period. Recently, a novel computer program called Lee Silverman voice treatment (LSVT) Companion was developed to allow PD subjects to independently progress through a rehabilitative treatment session. This study is part of the assessment of the LSVT Companion, aiming to investigate the potential of using sustained vowel phonations towards objectively and automatically replicating the speech experts' assessments of PD subjects' voices as “acceptable” (a clinician would allow persisting during in-person rehabilitation treatment) or “unacceptable” (a clinician would not allow persisting during in-person rehabilitation treatment). We characterize each of the 156 sustained vowel /a/ phonations with 309 dysphonia measures, select a parsimonious subset using a robust feature selection algorithm, and automatically distinguish the two cohorts (acceptable versus unacceptable) with about 90% overall accuracy. Moreover, we illustrate the potential of the proposed methodology as a probabilistic decision support tool to speech experts to assess a phonation as “acceptable” or “unacceptable.” We envisage the findings of this study being a first step towards improving the effectiveness of an automated rehabilitative speech assessment tool

Fertilization and Improvement of Native Subirrigated Meadows in Nebraska

It is the purpose of this circular to summarize the 1948-51 results of fertilizer applications upon subirrigated native meadows. It is upon these lands that the cattleman depends to a large extent for winter feed

A Qualitative Exploration of Former College Student-Athletes’ Wellness

College student-athletes (SAs) may experience difficulties while transitioning from college, which could reduce their overall wellness. However, it is essential to understand positive transition experiences and outcomes, as this can guide future research and intervention efforts. The purpose of this study was to explore the factors that led to higher levels of wellness in former SAs. Semi-structured interviews guided by the Indivisible Self Model were completed with former SAs (n = 12). Overall, participants displayed high levels of wellness - most prominently in terms of work and exercise. Many SAs perceived their current wellness was equal, if not better compared to when they were SAs. These results illustrate examples of successful transitions of former SAs, which can guide future research and interventions

Factors associated with reporting of sexual assault among college and non-college women

Purpose The purpose of this paper is to examine factors impacting college and non-college women reporting sexual assault to police. The goal is to increase knowledge regarding differences in the rates of reporting and reasons for reporting across these two groups. Design/methodology/approach Participants were drawn from a national telephone survey of US women and a sample of US college women. Bivariate and multivariate analyses were conducted to determine factors influencing the reporting of sexual assault to police. Findings Non-college women were more likely than college women to report to police. Women who perceived their victimization as rape were much more likely to report to the police and women who had contact with a helping agency were also much more likely to report their assault. Contacting a helping agency is more relevant to non-college women’s reporting to police, while considering the assault a rape is more important for college women. Practical implications The results suggest that significant work is needed to encourage women in college to view sexual assaults as worthy of reporting. Boosting victim awareness and access to services is paramount. Providing education and empowerment to student victims to inform their perceptions about the definition of rape is vital, as women perceiving sexual assault as rape are more likely to report the incident. Originality/value The research significantly adds to the literature indicating differences in rates of reporting and the factors that impact reporting uniquely for college vs non-college women

A Wellness Approach to Investigating Student Veterans’ Career Goals

A qualitative methodology was utilized to assess the wellness factors student Veterans (N = 10) perceived as influential to their decision to separate from the military and choice of intended career path. Participants included prior enlisted student Veterans pursuing undergraduate degrees at a mid-sized Midwestern university. Interview transcripts were coded according to the Indivisible Self Model of Wellness (IS-Wel; Myers & Sweeney, 2004) and analyzed phenomenologically. Participants referenced Control and Self-Worth as motivators for separation from military service; Work and Thinking were the main themes regarding choice of future profession. Additional themes emerged in reference to how Veterans’ priorities changed during their time in service. The IS-Wel serves as an innovative approach for facilitating student Veteran career development