Speech motor control in fluent and dysfluent speech production of an individual with apraxia of speech and Broca’s aphasia

Apraxia of speech (AOS) is typically described as a motor-speech disorder with clinically well-defined symptoms, but without a clear understanding of the underlying problems in motor control. A number of studies have compared the speech of subjects with AOS to the fluent speech of controls, but only a few have included speech movement data and if so, this was primarily restricted to the study of single articulators. If AOS reflects a basic neuromotor dysfunction, this should somehow be evident in the production of both dysfluent and perceptually fluent speech. The current study compared motor control strategies for the production of perceptually fluent speech between a young woman with apraxia of speech (AOS) and Broca’s aphasia and a group of age-matched control speakers using concepts and tools from articulation-based theories. In addition, to examine the potential role of specific movement variables on gestural coordination, a second part of this study involved a comparison of fluent and dysfluent speech samples from the speaker with AOS. Movement data from the lips, jaw and tongue were acquired using the AG-100 EMMA system during the reiterated production of multisyllabic nonwords. The findings indicated that although in general kinematic parameters of fluent speech were similar in the subject with AOS and Broca’s aphasia to those of the age-matched controls, speech task-related differences were observed in upper lip movements and lip coordination. The comparison between fluent and dysfluent speech characteristics suggested that fluent speech was achieved through the use of specific motor control strategies, highlighting the potential association between the stability of coordinative patterns and movement range, as described in Coordination Dynamics theory.

A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review

Background:It has been stated that mandibular overdentures are more satisfactory than conventional dentures, but problems relating to the use of retrospective ratings, lack of control group and sequential provision of treatment may compromise the findings.Objective:To establish a comparison between treatment with conventional complete dentures and implant-retained overdentures in elderly patients by conducting a literature review.Materials and methods:A search of English language peer-review literature was completed using Medline up to 2008 focusing on evidence-based research. Randomised clinical trials (RCTs) and longitudinal prospective studies were favoured in the review, using a general hierarchical classification. Articles that did not focus exclusively on the comparison of patient satisfaction between complete dentures and overdentures were excluded from further evaluation. The last search was conducted in February 2008. Key terms included quality of life, patient satisfaction, edentulism, complete denture and overdenture.Results:Among the 90 articles found in the initial search, 27 met the inclusion criteria. This included 18 RCTs and eight prospective and one cohort study. Most of the articles stated superiority of the mandibular implant-retained overdenture therapy over the conventional complete denture regarding patient satisfaction and quality of life.Conclusion:Even with implant treatment presenting higher patient satisfaction and improvement of quality of life, it was not possible to establish a direct comparison between the studies due to differences in adopted methodologies.

Patients' Expectations of and Satisfaction with Implant-Supported Fixed Partial Dentures and Single Crowns

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Patients' expectation and satisfaction with removable dental prosthesis therapy and correlation with patients' evaluation of the dentists

Objective. Considering that patients' satisfaction is one of the most important goals in conducting removable dental prosthesis (RDP) therapy and the fact that there are many factors which influence this parameter, the present study aims to evaluate the expectation before and satisfaction after therapy with RDP in patients who seek such therapy. As a secondary objective, other variables that may be associated with patient satisfaction are also evaluated, such as gender, age, Kennedy's classification of the arch supporting the RDP, the number of RDP adjustments after delivery and patients' evaluation of the dentists' conduct. Materials and methods. A sample of 44 patients who received RDP therapy were assigned visual analog scale scores for their expectation before and satisfaction after therapy regarding chewing, aesthetics, comfort and phonetics. They also completed a questionnaire concerning the dentists' conduct. Results. There was no statistically significant difference among scores concerning different genders, age, number of post-delivery settings and arch involved in the RDP. Regarding patients' evaluation of the dentists' conduct, there was a predominance of positive evaluations, but only different answers to the statement (i.e. 'The dentist I saw thoroughly explained the recommended treatment before it commenced') present statistically significant different scores for chewing (p = 0.040) and phonetics (p = 0.046). Conclusions. The average visual analog scale scores were high for both expectation prior to treatment and satisfaction after treatment; however, the scores for expectations were higher than those for satisfaction. © 2013 Informa Healthcare.

Comparison of maximal lactate steady state with V2, V4, individual anaerobic threshold and lactate minimum speed in horses

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Adaptation and validation of the Patient Expectations and Satisfaction with Prenatal Care instrument among Brazilian pregnant women

Objective: to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbach’s alpha) for distinct groups and dimensions. Method: 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbach’s alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instrument’s adapted version is valid in the studied group. Results: there is strong evidence for the validity and reliability of the instrument’s adaptation. Conclusion: the instrument needs to be tested in groups of pregnant women with different social characteristics.

Caregivers' Social Capital and Satisfaction with their Children's Service Providers

The authors examine children's access to and caregiver's satisfaction with organizations that provide leisure time activities for children on Saturdays. The authors argue that access and satisfaction are a function of familie's financial, cultural and social capital. Using data on 1,036 households in the Phoenix metropolitan area in 2003-04, the authors found that families' financial and cultural capital affected whether or not children participate din activities organized by organizations, but family ties to the organization directly (e.g., either worked there, volunteered, donated) resulted in caregivers being more satisfied with the services. The authors also found that the benefits of network closure (caregivers knowing the parents of other children on site) were greater the riskier the activities of the child (e.g., sports or cheerleading). Contrary to the authors expectations, having family or friends in the area did not affect caregiver's satisfaction with the child's provider.

The Social Desintegration of an Ethnical German Group from Romanian Village Community Comparative with a Romanian Group and Hungarian Group from some Village Their Integration into the German Society

Zarna is witness to the disappearance of the Swabian community in Santana, a process which seems to date back to before the major changes in Central and Eastern Europe. His project showed how a strong German ethnic community, formed more than 250 years ago, has virtually disappeared from the village of Santana (Romania). Zarna presents the causes leading to the loss of their ethnic identity, of their culture, traditions and of the collective reproduction of their ethnicity, although the last Swabians remaining in the village have preserved their individual identity and not let themselves be assimilated. The policy of the former communist regime is not sufficient to explain the decline of the German ethnic group, nor is the present international context with its varying effects on the form and reproduction of their ethnic identity. Zarna has analysed the origins of the Swabian community, its development, historical changes (both desired and imposed) and the disappearance of elements that determined their German culture and their pride in being German. The Germans have demobilised more rapidly than other ethnic groups in Romania, partly because of Germany's pro-emigration policy over the last two decades. Many of the emigrants were however, poorly prepared for emigration and have not been able to recreate the prosperous financial situation which they left. The prevalent feeling among those interviewed was disappointment and this increases with age and education.

[Parent satisfaction with a child and family-centered treatment program for primary headache in childhood and adolescence]

Patient satisfaction represents a significant outcome criterion in the context of systemic psychotherapeutic therapy research. This study investigated parent satisfaction with a psychosocial treatment program (comprising three components: child group therapy, parents' evenings, systemic family sessions) for pediatric primary headache (diagnosed according to IHS criteria). 10 weeks after the end of the treatment program, the parents were sent a questionnaire containing open questions and ten-point numerical rating scales. The sample comprised n=48 families. The return rate was 89%. The qualitative content analysis showed a hierarchical category system consisting of 3 major categories, 7 main groups and 69 sub-categories. The parents stated that they were satisfied with (1.) the effects of the treatment program, (2.) the specific treatment techniques and the medical and psychosocial headache-related information provided, and (3.) the therapeutic relationship. The mean satisfaction for all three therapy components on the ten-point numerical rating scale was 8.1 with a standard deviation of 2.0 (child headache group: 8.5; parents' evenings: 8.2; family sessions: 7.5). The results are discussed with reference to methodological aspects: avoidance of ceiling effects and social desirability in measuring customer satisfaction, order effects of items, weighting of the significance of satisfaction levels as an outcome criterion.

Predictors of satisfaction with treatment decision, decision-making preferences, and main treatment goals in patients with advanced cancer

Purpose This study investigated satisfaction with treatment decision (SWTD), decision-making preferences (DMP), and main treatment goals, as well as evaluated factors that predict SWTD, in patients receiving palliative cancer treatment at a Swiss oncology network. Patients and methods Patients receiving a new line of palliative treatment completed a questionnaire 4–6 weeks after the treatment decision. Patient questionnaires were used to collect data on sociodemographics, SWTD (primary outcome measure), main treatment goal, DMP, health locus of control (HLoC), and several quality of life (QoL) domains. Predictors of SWTD (6 = worst; 30 = best) were evaluated by uni- and multivariate regression models. Results Of 480 participating patients in eight hospitals and two private practices, 445 completed all questions regarding the primary outcome measure. Forty-five percent of patients preferred shared, while 44 % preferred doctor-directed, decision-making. Median duration of consultation was 30 (range: 10–200) minutes. Overall, 73 % of patients reported high SWTD (≥24 points). In the univariate analyses, global and physical QoL, performance status, treatment goal, HLoC, prognosis, and duration of consultation were significant predictors of SWTD. In the multivariate analysis, the only significant predictor of SWTD was duration of consultation (p = 0.01). Most patients indicated hope for improvement (46 %), followed by hope for longer life (26 %) and better quality of life (23 %), as their main treatment goal. Conclusion Our results indicate that high SWTD can be achieved in most patients with a 30-min consultation. Determining the patient’s main treatment goal and DMP adds important information that should be considered before discussing a new line of palliative treatment.