An international perspective. A survey of clinician views and practices from 16 countries

Objective: To gain an insight into speech and language therapists’ perspectives and practices on quality of life in aphasia. Participants and Methods: The International Association of Logopedics and Phoniatrics Aphasia Committee developed a survey questionnaire, which was delivered on-line, anonymously, through SurveyMonkey (November 2012 – April 2013) to clinicians working with people with aphasia in 16 countries across the world. Results: A large number of speech and language therapists responded to the survey, with 19/21 questions answered by 385 – 579 participants. Clinicians were well informed on what constitutes quality of life and viewed it as a complex construct influenced by health, participation, in/dependence, communication, personal factors, and environmental factors. In their clinical practice, they considered quality of life as important, used informal approaches to explore it and aimed to address quality of life goals; yet the majority did not evaluate quality of life in a systematic way. Conclusion: There is a need for training on quality of life to facilitate speech and language therapists to incorporate quality of life outcome measures in their interventions. There is also a need for further research on what interventions improve quality of life in aphasia

Health-related quality of life in people with aphasia: Implications for fluency disorders quality of life research

Abstract It is increasingly important that clinicians address the health-related quality of life (HRQOL) of adults with communication disorders in clinical practice. The overall aim of this paper is to draw conclusion about the suitability of the Short Form 36 Health Survey for the communication disorders of aphasia and stuttering. This study reports on the impact of post-stroke aphasia on 30 Australian older adults’ HRQOL. It also comments on the capacity of the SF-36 to measure HRQOL in this population, specifically whether it is sensitive to the three known determinants of post-stroke HRQOL – emotional, physical and social functioning. Comparisons with other data are made to assist interpretation of the SF-36 subscale scores: with 75 older adults with no history of neurological conditions; and with data from the 1995 National Health Survey data. The main findings are: (1) adults with post-stroke aphasia have similar HRQOL to their peers on six subscales, but significantly lower Role emotional and Mental health HRQOL; (2) a substantial number of aphasic adults reported depressive mood; and (3) aphasic adults with depressive mood have significantly worse HRQOL on six subscales than aphasic adults without depressive mood, but similar Role emotional and Body pain HRQOL. In conclusion, stroke and aphasia have minimal impact on older adults’ HRQOL as measured by the SF-36, which conflicts with an established evidence base of the negative consequences of aphasia on life. Thus, the SF-36 is not advisable for use with aphasic adults. Implications of these findings for aphasia and stuttering are discussed. Educational objectives: The reader will be able to: (a) describe the impact of aphasia and depressive mood on quality of life; (b) compare the impact of aphasia on the quality of life of adults to adults who do not have aphasia; (c) describe the similarities and differences between quality of life of adults with aphasia and adults who stutter; and (d) describe the strengths and limitations of the SF-36 as a measure of quality of life in adults who stutter versus adults with aphasia

Cardiovascular Remodeling Experienced by Real-World, Unsupervised, Young Novice Marathon Runners.

Aims: Marathon running is a popular ambition in modern societies inclusive of non-athletes. Previous studies have highlighted concerning transient myocardial dysfunction and biomarker release immediately after the race. Whether this method of increasing physical activity is beneficial or harmful remains a matter of debate. We examine in detail the real-world cardiovascular remodeling response following competition in a first marathon. Methods: Sixty-eight novice marathon runners (36 men and 32 women) aged 30 ± 3 years were investigated 6 months before and 2 weeks after the 2016 London Marathon race in a prospective observational study. Evaluation included electrocardiography, cardiopulmonary exercise testing, echocardiography, and cardiovascular magnetic resonance imaging. Results: After 17 weeks unsupervised marathon training, runners revealed a symmetrical, eccentric remodeling response with 3-5% increases in left and right ventricular cavity sizes, respectively. Blood pressure (BP) fell by 4/2 mmHg (P < 0.01) with reduction in arterial stiffness, despite only 11% demonstrating a clinically meaningful improvement in peak oxygen consumption with an overall non-significant 0.4 ml/min/kg increase in peak oxygen consumption (P = 0.14). Conclusion: In the absence of supervised training, exercise-induced cardiovascular remodeling in real-world novice marathon runners is more modest than previously described and occurs even without improvement in cardiorespiratory fitness. The responses are similar in men and women, who experience a beneficial BP reduction and no evidence of myocardial fibrosis or persistent edema, when achieving average finishing times

The effect of lifestyle intervention in obesity on the soluble form of activated leukocyte cell adhesion molecule

Background: The aim of this study was to investigate the effect of a lifestyle intervention in obesity on the soluble form of the activated leukocyte cell adhesion molecule (sALCAM) and its association with metabolic parameters. Methods: Twenty-nine obese subjects selected from the OPTIFAST®52 program. This program consisted into 2 crucial phases: an initial 12-week active weight reduction phase, followed by a 40-week weight maintenance phase. At baseline, after 12 weeks and at the end of the program, fasting glucose and insulin, total cholesterol, LDL-C, HDL-C, triglycerides, adiponectin, leptin, high sensitivity CRP, sALCAM, homeostasis model assessment-estimated insulin resistance (HOMA-IR) and leptin-to-adiponectin-ratio were determined. Oral glucose tolerance test (OGTT) was performed when indicated. Results: At baseline, the serum concentration of sALCAM was increased and correlated positively with HOMA-IR and negatively with age. At the end of the program, sALCAM concentrations decreased significantly. Multivariate analysis showed that sALCAM significantly correlated with age, glucose concentration after 2 h OGTT and the HOMA-IR. A higher decrease of HOMA-IR during the study was observed in subjects with higher concentration of sALCAM at baseline. Conclusions: sALCAM might be a novel biomarker in obesity that correlates and predicts insulin sensitivity improvement and that can be affected by lifestyle intervention

Gender Differences in Ventricular Remodeling and Function in College Athletes, Insights from Lean Body Mass Scaling and Deformation Imaging

status: publishe