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- The agreement between a transducer and a microphone in the analysis of a synthesized vowel—Using a laboratory model as a preliminary experimentPublication . Pestana, Pedro; Byrne, Allison; Alegria, Rita; Araújo, André; Melo, Celso; Brasil, Christina César Praça; Manso, Maria Conceição; Guerreiro Martins Araújo, Pedro AndréThe objective of this study was to assess the agreement between the acoustic parameters of synthesized vowels, as measured by a piezoelectric transducer and a microphone. The central hypothesis posited that there would be a substantial degree of concordance between the acoustic parameters obtained by these two methods. A laboratory experiment was conducted using synthesized vowels. Acoustic parameters were recorded simultaneously using a microphone and a piezoelectric transducer. Vowels were synthesized using Madde software, with variations in fundamental frequency (fo) and amplitude level. Acoustic signals were captured by a Shure MX153 T microphone and a Shadow SH712 piezoelectric transducer. Signals were recorded using a Behringer FCA1616 audio interface and analyzed using Sopran and VOXplot software. Bland–Altman plots were used for statistical comparison of acoustic parameters. The degree of agreement between the microphone and the transducer varied according to acoustic parameters. Excellent agreement was observed for jitter, mean fo, fo standard deviation, and fo range. Good agreement was found for tilt, equivalent continuous sound level, harmonics-to-noise ratio from Dejonckere, high frequency noise, minimum fo, and maximum fo. Moderate agreement was observed for slope, amplitude difference H1–H2, shimmer, harmonics-to-noise ratio, smoothed cepstral peak prominence, and period standard deviation. While there was moderate to high agreement between the two methods for several acoustic parameters, discrepancies were noted. The microphone exhibited a tendency to record slightly higher values for the majority of the parameters; however, the transducer did demonstrate heightened sensitivity for certain parameters. The findings indicate that neither method can be universally interchanged with the other, and the selection of a method should be contingent on the particular requirements of the analysis.
- Avaliação da participação das famílias no apoio prestado pelas equipas de intervenção precocePublication . Pinto, Marta; Serrano, Ana MariaOs estudos nacionais e internacionais respeitantes à participação das famílias nos serviços de intervenção precoce conduziram a autora à investigação desta temática na realidade portuguesa. Desta forma, foi desenvolvido um projeto de investigação onde se pretende compreender a participação das famílias nos apoios prestados pelo Sistema Nacional de Intervenção Precoce na Infância (SNIPI), bem como os facilitadores e as barreiras a essa participação, de forma a ajudar os profissionais a identificar as técnicas e as estratégias que mantêm os pais participantes ativos nos apoios prestados pelas Equipas Locais de Intervenção. Neste âmbito, a autora tem estado a desenvolver um estudo qualitativo, em que pretende entrevistar profissionais de intervenção precoce, a exercerem funções em Equipas Locais de Intervenção e familiares de crianças entre os zero e os seis anos de idade, com necessidades especiais, cumprindo os critérios de elegibilidade para integrarem estas equipas e desta forma, identificar como é que as famílias participam em todos os momentos da intervenção, de acordo com o que são as Práticas Centradas na Família. Os guiões de entrevista que serão utilizados para entrevistar quer os profissionais, quer as famílias de crianças entre os zero e os seis anos de idade têm sido desenvolvidos pela autora, de acordo com a recolha bibliográfica efetuada e com a sua prática profissional em intervenção precoce, ao longo dos últimos anos. Paralelamente, a autora utilizará uma checklist, para preenchimento pelos familiares das crianças apoiadas nas Equipas Locais de Intervenção. A checklist selecionada surgiu da recolha bibliográfica efetuada acerca dos instrumentos de avaliação disponíveis sobre o tema. Esta checklist será traduzida e adaptada, com a devida autorização do autor, de acordo com a realidade portuguesa. Neste artigo, a autora pretende descrever os procedimentos e os resultados das sucessivas fases de construção e adaptação dos instrumentos que lhe permitirão a fiabilidade e validade dos resultados finais nesta investigação.
- Características espectrais típicas do canto folclórico do Alto MinhoPublication . Araújo, AndréNa região do Alto Minho, no norte de Portugal, o canto folclórico é maioritariamente praticado em grupos, por cantoras amadoras, as cantadeiras, sendo a sua aprendizagem realizada por tradição oral. A sua voz é reconhecida pelas suas características agudas, fortes e “estridentes”, determinantes para a identidade regional do grupo. O presente estudo pretendeu: (i) descrever propriedades acústicas deste estilo de canto; e (ii) identificar quais destes parâmetros poderão ser indicadores do grau de representatividade da voz destas cantadeiras. 10 cantadeiras solistas do distrito de Viana do Castelo foram gravadas interpretando uma canção de repertório do Alto Minho. Posteriormente, o grau de tipicidade das suas características vocais foi avaliado através de um teste de perceção auditiva, por 72 elementos de vários grupos folclóricos. Após a análise de diversas medidas acústicas e fisiológicas, foi determinada a relação estatística das mesmas com o grau de tipicidade das cantadeiras. Concluiu-se que as cantadeiras com “vozes mais típicas” da região possuem: (i) elevados níveis de intensidade; (ii) elevada pressão subglótica; (iii) quociente de contacto das pregas vocais mais elevado; e (iv) predominância de parciais harmónicos elevados no espectro médio de longo termo.
- Caregiver perception of quality of life in neurological patients with DysphagiaPublication . Casanova, Maria Jorge; Carvalho, Isabel Silva; Freitas, Susana Vaz; Martins, Adriana; Magalhães, António; Meireles, Luís; Vaz Freitas, SusanaPatients with neurological conditions often present with oropharyngeal dysphagia, which impacts their quality of life. Many of these patients require assistance from a caregiver for their complex health needs. The goal of this study was to evaluate patient-caregiver agreement in the perception of the physical, functional, and emotional burden of dysphagia in the patient. Fifty-two adult patients with oropharyngeal dysphagia of neurological etiology and respective caregivers responded to the European Portuguese version of the Dysphagia Handicap Index (EP-DHI) questionnaire independently. Caregivers were asked to respond based on what they thought would be the answer given by the patient. The study found statistically significant differences in responses between patient and caregiver in the functional (14.7 ± 10.4 vs. 12.7 ± 9.2, P=.03) and emotional (12.0 ± 9.4 vs. 10.4 ± 8.9, P=.02) subscores of the EP-DHI. Although no statistically significant differences in total score and physical score between patient and caregiver were found, spouses as caregivers tended to undervalue the emotional subscale (9.4 ±7.3 for patients and 7.7 ± 6.2 for caregivers, P=.01), and children underrated the functional subscale (16.9 ± 11.4 by patients and 13.2 ± 10.0 bycaregivers, P=.02). Caregivers are a reliable proxy in evaluating the general and physical impacts of dysphagia on quality of life in patients with neuro-logical conditions. However, they undervalue the functional and emotional burdens.
- Characterization of the families participation in the local intervention teamsPublication . Pinto, Marta Joana de Sousa; Serrano, Ana MariaNational and international studies about the participation of families in early intervention services have led to a research project that intends to understand the participation of families in the support provided by the Local Intervention Teams, the National System of Early Intervention in Childhood (SNIPI). Family members of children between the ages of 0 and 6 were interviewed, fulflling the eligibility criteria to integrate these teams, with the aim to identify what families understand by active participation and how these families participate at all times in the intervention, in line with Family-Centered Practices, as well as to identify facilitators and barriers to active family involvement, to help practitioners identify techniques and strategies that keep parental participants active in the support provided by the Local Intervention Teams. An interview and a questionnaire, the Enabling Practices Scale, were used for data collection. Te interview script was developed by the author, according to the bibliographic collection previously done and with her professional practice in early intervention over the last years. Also, the author used the Enabling Practices Scale which was to be completed by family members at the end of their interview. Te selected instrument came from the collection and bibliographic analysis of the available evaluation tools on the subject. Data collection took place between March and December 2016 and a total of twenty relatives were contacted in the North, Center, Lisbon, Alentejo and Algarve regions. : Te results show attitudes (perception) of the participation of the families, about the support provided to them by the Local Early Intervention Teams. In this article, we intend to present the results obtained with the interviews conducted and with the completion of the Enabling Practices Scale by family members, characterizing the perception of the participation of the families, about the support provided to them by the Local Early Intervention Teams.
- Communicating simply, but not too simply: Reporting of participants and speech and language interventions for aphasia after strokePublication . Brady, Marian C.; Patrício, BrígidaSpeech and language pathology (SLP) for aphasia is a complex intervention delivered to a heterogeneous population within diverse settings. Simplistic descriptions of participants and interventions in research hinder replication, interpretation of results, guideline and research developments through secondary data analyses. This study aimed to describe the availability of participant and intervention descriptors in existing aphasia research datasets. We systematically identified aphasia research datasets containing 10 participants with information on time since stroke and language ability. We extracted participant and SLP intervention descriptions and considered the availability of data compared to historical and current reporting standards. We developed an extension to the Template for Intervention Description and Replication checklist to support meaningful classification and synthesis of the SLP interventions to sup port secondary data analysis. Of 11, 314 identified records we screened 1131 full texts and received 75 dataset contributions. We extracted data from 99 additional public domain datasets. Participant age (97.1%) and sex (90.8%) were commonly available. Prior stroke (25.8%), living context (12.1%) and socio-economic status (2.3%) were rarely available. Therapy impairment target, frequency and duration were most commonly available but predominately described at group level. Home practice (46.3%) and tailoring (functional relevance 46.3%) were inconsistently available. Gaps in the availability of participant and intervention details were significant, hampering clinical implementation of evidence into practice and development of our field of research. Improvements in the quality and consistency of participant and intervention data reported in aphasia research are required to maximise clinical implementation, replication in research and the generation of insights from secondary data analysis. Systematic review registration: PROSPERO CRD42018110947.
- Connecting Families and Schools of Students with Deafness: Describing the ICT and Internet use in EducationPublication . Capitão, Susana; Almeida, Ana Margarida Pisco; Vieira, Rui MarquesThe use of ICT, namely of internet-based solutions, on de education of students with deafness promotes their access to a wide variety of information and experiences, by decreasing the communication barriers implied in those special needs individuals. In this study was used a self-administered questionnaire, with closed-set questions, validated through the contribution of a team of experts and a prior pilot study. Then, the families and professionals that take part of the educational community of these students were asked to share their knowledge about their ideas concerning ICT and internet roles in the education of students with deafness. Results show that these subjects have access and frequently use a wide range of technologies and web services, being more frequently used the ones concerned with online search, productivity tools and e-mail. The need for more training in this area is referred by most of the subjects. Although acknowledging the positive influence that the internet can have in both the academic achievement and future career of the students with deafness, the subjects also express that these individuals are also in need of more training to make a critical use of the internet.
- Cross‑cultural adaptation and validation of the european portuguese Dysphagia handicap indexPublication . Silva‑Carvalho, Isabel ; Martins, Adriana ; Casanova, Maria Jorge ; Freitas, Susana Vaz; Meireles, LuísThe Dysphagia Handicap Index (DHI) is a valid Health-related Quality of Life (HRQoL) 25-item questionnaire assessing the physical, functional, and emotional aspects of patients with oropharyngeal dysphagia (OD), of heterogeneous etiologies. The purpose of this study is to translate and validate the European Portuguese-DHI (EP-DHI). This is a prospective study that was carried out at Centro Hospitalar Universitário do Porto (CHUPorto). The generated EP-DHI was administered to 132 patients with OD and 112 healthy control subjects. 132 patients undergoing fiberoptic endoscopic examination of swallowing (FEES). 15 patients were contacted by phone, 2 or 3 weeks later after the first interview to repeat the questionnaire. The validity of concurrent criteria was evaluated by comparing the results of the EP-DHI score with the score attributed to the pathological findings found in FEES and, consequently, Functional Oral Intake Scale (FOIS). The internal consistency of EP-DHI was successful: Cronbach’s alpha coefficient for total EP-DHI was 0.874. The test–retest reliability for the total and the three EP-DHI subscales obtained a Pearson's correlation coefficient ranged from 0.990 to 0.712. This study demonstrates that EP-DHI is a valid tool for self-assessment of the handicapping effect of dysphagia on physical, functional, and emotional aspects of patient’s quality of life, among an European Portuguese sample.
- Dosage, intensity and frequency of language therapy for aphasia: An individual participant data network meta-analysisPublication . Brady, Marian C.; Patrício, BrígidaOptimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia. Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. Outcome measurement scores were standardized. A statistical inferencing, one-stage, random effects, network meta-analysis approach filtered individual participant data into an optimal model examining SLT regimen for overall language, auditory comprehension, naming, and functional communication pre-post intervention gains, adjusting for a priori–defined covariates (age, sex, time poststroke, and baseline aphasia severity), reporting estimates of mean change scores (95% CI). Data from 959 individual participant data (25 trials) were included. Greatest gains in overall language and comprehension were associated with >20 to 50 hours SLT dosage (18.37 [10.58–26.16] Western Aphasia Battery–Aphasia Quotient; 5.23 [1.51–8.95] Aachen Aphasia Test–Token Test). Greatest clinical overall language, functional communication, and comprehension gains were associated with 2 to 4 and 9+ SLT hours/week. Greatest clinical gains were associated with frequent SLT for overall language, functional communication (3–5+ days/week), and comprehension (4–5 days/week). Evidence of comprehension gains was absent for SLT ≤20 hours, <3 hours/week, and ≤3 days/week. Mixed receptive-expressive therapy, functionally tailored, with prescribed home practice was associated with the greatest overall gains. Relative variance was <30%. Risk of trial bias was low to moderate; low for meta-biases. Greatest language recovery was associated with frequent, functionally tailored, receptive-expressive SLT, with prescribed home practice at a greater intensity and duration than reports of usual clinical services internationally. These exploratory findings suggest critical therapeutic ranges, informing hypothesis-testing trials and tailoring of clinical services.
- Down syndrome: otolaryngological effects of rapid maxillary expansionPublication . Moura, C. Pinto de; Andrade, D.; Cunha, L. M.; Tavares, M. J.; Gonçalves, Maria João; Vaz, P.; Barros, H.; Pueschel, S. M.; Clemente, M. PaisPhenotypical Down syndrome includes pharyngeal and maxillary hypoplasia and, frequently, constricted maxillary arch with nasal obstruction. This clinical trial assessed the effects of rapid maxillary expansion on ENT disorders in 24 children with Down syndrome randomly allocated to receive either rapid maxillary expansion or not. Each group received ENT and speech therapy assessments before expansion and after the device had been removed. In the rapid maxillary expansion group, the yearly ENT infection rate was reduced when assessed after device removal (p < 0.01). The parents of rapid maxillary expansion children reported a reduction in respiratory obstruction symptoms. Audiological assessment revealed improvements in the rapid maxillary expansion group (p < 0.01). Cephalometry showed increased maxillary width in the rapid maxillary expansion group. Rapid maxillary expansion resulted in a reduction in hearing loss, yearly rate of ENT infections and parentally assessed symptoms of upper airway obstruction, compared with no treatment. These findings are probably related to expanded oronasal space, due to rapid maxillary expansion.
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