| 1. |
- Stiernman, Mia, et al.
(författare)
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Comparison of corresponding scores From the cleft hearing appearance and speech questionnaire (CHASQ) and CLEFT-Q in Swedish patients with cleft lip and/or palate
- 2020
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to compare corresponding scores between 2 existing cleft-specific patient-reported outcome measures (PROMs)-Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q. The second aim of the study was to investigate patient opinion on the 2 PROMs.DESIGN: Cross-sectional questionnaire study.SETTING: Participants were recruited from a University Hospital. They answered CHASQ and CLEFT-Q either in the hospital or at home.PARTICIPANTS: Thirty-three participants with cleft lip and/or palate, aged 10 to 19 years.MAIN OUTCOME MEASURE: CHASQ and CLEFT-Q.RESULTS: The CHASQ scores and the corresponding CLEFT-Q scores on appearance correlated significantly. Corresponding scores regarding speech did not correlate significantly. A majority, 15 (58%) participants, answered that they liked CLEFT-Q more than CHASQ, 18 participants (69%) thought CHASQ was easier to complete, and 19 (76%) thought CLEFT-Q would better inform health care professionals.CONCLUSION: Both instruments showed strengths and limitations. Clinicians will have to consider each instrument's respective qualities when choosing to implement either PROM.
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| 2. |
- Karjalainen, Suvi, et al.
(författare)
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Implementation and evaluation of a teacher intervention program on classroom communication
- 2020
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Ingår i: Logopedics, Phoniatrics, Vocology. - : Taylor & Francis Group. - 1401-5439 .- 1651-2022. ; 45:3, s. 110-122
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Tidskriftsartikel (refereegranskat)abstract
- Background: Media frequently report on overall work-place challenges in Swedish schools, including teachers’ working conditions, their well-being, and students’ declining results. Language is the key to success in every school subject. Therefore, optimal language learning environments are important. Poor sound environments affect teachers’ vocal health, their general well-being, and students’ performance. To provide better conditions for teachers and students, it is necessary to combine optimized room acoustics with other preventive measures such as vocal training and evidence-based tools to improve classroom communication. Teachers play a key role in the classroom and need knowledge and skills in communicative strategies to ensure first-class communication. The purpose of this study is to explore the effects of an intervention program for primary-school teachers comprising strategies for enhanced language learning and interactions in the classroom, with focus on teachers’ verbal and body communication (voice, gaze, and gesture).Methods: Teachers (n = 25) from seven schools teaching in school year 3–6 participated. Assessments were made pre/post intervention and at 5-weeks and 3-months follow-up. The assessments included teachers’ self-assessments (questionnaires) of vocal health, self-efficacy, stress, burnout, and psychosocial work-environment.Results: The main results were significant decrease in voice problems at the 3-months follow-up and significant decrease of both stress and degree of burnout at 5-weeks follow-up. Self-efficacy score had increased significantly at 5-week follow-up.Conclusion: It can be concluded that the intervention program improves teachers’ self-reported vocal health, decreases their perception of stress, and degree of burnout whilst increasing their sense of self-efficacy in classroom management.
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| 3. |
- Alsved, Malin, et al.
(författare)
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Exhaled respiratory particles during singing and talking
- 2020
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Ingår i: Aerosol Science and Technology. - : Informa UK Limited. - 1521-7388 .- 0278-6826. ; 54:11, s. 245-1248
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Tidskriftsartikel (refereegranskat)abstract
- Choir singing has been suspended in many countriesduring the Covid-19 pandemic due to incidental reportsof disease transmission. The mode of transmission has been attributed to exhaled droplets, but with the exception of a study on tuberculosis from1968, there is presently almost no scientific evidence ofincreased particle emissions from singing. A substantial number of studies have,however, investigated aerosols emitted from breathing,talking, coughing and sneezing. It has also been shown that justnormal breathing over time can generate more viablevirus aerosol than coughing, since the latter is a less fre-quent activity.Compared to talking, singing often involves continu-ous voicing, higher sound pressure, higher frequencies,deeper breaths, higher peak airflows and more articu-lated consonants. All these factors are likely to increaseexhaled emissions.The aim of this study was to investigate aerosol anddroplet emissions during singing, as compared to talking and breathing. We also examined the presence of SARS-CoV-2 in the air from breathing, talking and singing,and the efficacy of face masks to reduce emissions. In this study we defined aerosol particles as having a drysize in the range 0.5–10mm. Although debatable from anaerosol physics point of view, a cutoff diameter between5 and 10mm is normally used in medicine for classifica-tion of aerosol versus droplet route of transmission. Droplets are here defined as exhaled particles, frommicron size with no upper size limit, and measured dir-ectly at the mouth before complete evaporation, thuspartly in liquid phase.
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| 4. |
- Adnan, Ali, et al.
(författare)
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Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population
- 2020
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Ingår i: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 42:5, s. 860-872
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Tidskriftsartikel (refereegranskat)abstract
- Background The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors' HRQOL was also compared to reference scores from the population. Methods In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results HRQOL was associated with gender, with males scoring better than females on a few scales. Patients' HRQOL was more associated with treatment than tumor stage. Patients' HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.
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| 5. |
- Karlsson, Fredrik, Docent, 1975-, et al.
(författare)
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Assessment of speech impairment in patients with Parkinson's disease from acoustic quantifications of oral diadochokinetic sequences
- 2020
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Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 147:2, s. 839-851
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Tidskriftsartikel (refereegranskat)abstract
- This investigation aimed at determining whether an acoustic quantification of the oral diadochokinetic (DDK) task may be used to predict the perceived level of speech impairment when speakers with Parkinson's disease (PD) are reading a standard passage. DDK sequences with repeated [pa], [ta], and [ka] syllables were collected from 108 recordings (68 unique speakers with PD), along with recordings of the speakers reading a standardized text. The passage readings were assessed in five dimensions individually by four speech-language pathologists in a blinded and randomized procedure. The 46 acoustic DDK measures were merged with the perceptual ratings of read speech in the same recording session. Ordinal regression models were trained repeatedly on 80% of ratings and acoustic DDK predictors per dimension in 10-folds, and evaluated in testing data. The models developed from [ka] sequences achieved the best performance overall in predicting the clinicians' ratings of passage readings. The developed [pa] and [ta] models showed a much lower performance across all dimensions. The addition of samples with severe impairments and further automation of the procedure is required for the models to be used for screening purposes by non-expert clinical staff.
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| 6. |
- Klintö, Kristina, et al.
(författare)
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Coverage, reporting degree and design of the Swedish quality registry for patients born with cleft lip and/or palate
- 2020
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Ingår i: BMC Health Services Research. - : BMJ Publishing Group Ltd. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of the Swedish cleft lip and palate (CLP) registry is to promote quality control, research and improvement of treatment, by comparison of the long-term results of surgery, orthodontics and speech from all six Swedish CLP centres. The purpose of the study was to investigate the coverage and reporting degree of the Swedish CLP registry, and to describe the design of the registry and discuss questions of reliability and validity of the data included.Methods: All six Swedish CLP centres participate in the registry. All children in Sweden with cleft lip and/or cleft palate, born from 2009 onwards, are included in the registry. Baseline data such as cleft type (ICD-10 diagnosis), heredity, birth weight and additional deformities and/or syndromes, as well as pre-surgical treatment, are recorded at first visit. Data on surgical treatment are recorded continuously. Treatment outcome regarding dentofacial development and speech are recorded at follow-ups at 5, 10, 16 and 19 years of age. Data on dentofacial development are also recorded 1 year after orthognathic surgery. In addition, data on babbling and speech are recorded at 18 months of age. Coverage degree and reporting degree of surgery was assessed by comparison with registrations in the Swedish Central patient registry. Reporting degree of orthodontic and speech registrations at 5 years of age was assessed by comparison with registrations at baseline.Results: The average coverage degree for children born 2009 to 2018 was 95.1%. For cleft-related surgeries, the average reporting degree was 92.4%. Average reporting degree of orthodontic registrations and speech registrations at age 5 years was 92 and 97.5% respectively.Conclusion: In order to achieve valid and reliable data in a healthcare quality registry, the degree of coverage and reporting needs to be high, the variables included should be limited and checked for reliability, and the professionals must calibrate themselves regularly. The Swedish CLP registry fulfils these requirements.
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| 7. |
- Bengtsson, Caroline, et al.
(författare)
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Sinonasal outcome test-22 and peak nasal inspiratory flow : valuable tools in obstructive sleep apnoea
- 2020
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 58:4, s. 341-348
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sinonasal complaints contribute to low adherence to continuous positive airway pressure (CPAP) treatment. We aimed to investigate sinonasal health in obstructive sleep apnoea (OSA) patients, using the sinonasal outcome test-22 (SNOT-22), and to analyse whether SNOT-22 is affected by CPAP adherence. We also aimed to investigate whether peak nasal inspiratory flow (PNIF) was able to predict adherence to CPAP. Methods:The study population comprised 197 OSA patients (60 females) initiating CPAP treatment The SNOT-22, PNIF and the Epworth Sleepiness Scale were assessed at baseline and follow-up. One-night polygraphy, the Hospital Anxiety and Depression Scale, peak expiratory flow and health-related issues were assessed at baseline. At follow-up, the patients were categorised into adherent (>4 hours/night) and non-adherent (<4 hours/night) to CPAP treatment. Results: The average time for following up CPAP treatment was (mean +/- SD) 24.0 +/- 23.9 days and it did not differ significantly between the groups.The SNOT-22 score was elevated among all OSA patients, 36.1 +/- 19.4.There was a larger improvement in the SNOT-22 score at follow-up among adherent CPAP users compared with non-adherent users (-10.4 +/- 13.9 vs. -3.2 +/- 15.4). A PNIF value of < 100 litres/min increased the risk of non-adherence to CPAP with an adjusted odds ratio (OR) of 2.40 ((95% CI 1.16-5.00)). Conclusions: The SNOT-22 was elevated in patients with OSA, indicating a considerable sinonasal disease burden.The SNOT-22 improved with good CPAP adherence. A low PNIF value was able to predict poor CPAP adherence. Both the SNOT-22 and PNIF can be valuable tools in the evaluation of OSA patients and in the management of CPAP treatment.
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| 8. |
- Lundström, Filip, et al.
(författare)
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Practice, complications and outcome in Swedish tonsil surgery 2009-2018. An observational longitudinal national cohort study
- 2020
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 140:7, s. 589-596
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Tidskriftsartikel (refereegranskat)abstract
- Background: To assure a high quality in tonsil surgery, it is necessary to monitor trends in clinical practice, complications and outcome. Aims/objectives: To describe rates and trends regarding indications, methods, techniques, complications, and outcome of tonsil surgery. Material and method: 98 979 surgeries from the National Tonsil Surgery Register 2009-2018. Groups were categorised by indication and method. Results: The proportion of patients undergoing tonsillotomy with adenoidectomy due to obstruction-snoring (mean age 5.3 y.) increased from 2009-2018. Hot tonsillectomy, but not tonsillotomy, techniques were related to a higher risk for postoperative bleeding. The use of cold techniques increased for all types of surgeries. The rates of patients reporting contact due to postoperative pain were associated with indication and method, with the lowest rate reported for tonsillotomy (4.5% in 2018) and the highest for tonsillectomy (34.5% in 2009). The rate of patients reporting that their symptoms were gone 6 months after surgery decreased. Conclusions and significance: All hot tonsillectomy techniques should be avoided as they are related to a higher risk for postoperative bleeding. The high rate of postoperative contacts due to pain after tonsillectomy indicates a need for improvement in pain management. The declining rates of symptom relief must be investigated further.
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| 9. |
- Taubner, Helena, 1977-, et al.
(författare)
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Still the same?–Self-identity dilemmas when living with post-stroke aphasia in a digitalised society
- 2020
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Ingår i: Aphasiology. - Abingdon : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:3
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Tidskriftsartikel (refereegranskat)abstract
- © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Self-identity construction through “stories of self” is highly relevant for people with aphasia, not only because the onset entails a “biographical disruption” but also since their ability to keep their “stories of self” going is reduced. Three dilemmas (constancy/change, sameness/difference and agency/dependency) are known to be central to identity. In a digitalised society like Sweden, self-identity construction, including the navigation of these dilemmas, takes place both online and offline. Nevertheless, research combining aphasia, identity and online issues is scarce. Aim: This qualitative study aims, in terms identity dilemmas, to investigate self-identity construction in working-age persons living with post-stroke aphasia in a digitalised society (i.e. Sweden). Are the dilemmas relevant to the participants, and if so, how do they navigate them online and offline? Methods and Procedures: Nine individuals (three men and six women, aged 24–54 at onset) with mild or moderate post-stroke aphasia participated. The data comprises nine individual audio-recorded interviews and 1,581 screenshots from online observations. Qualitative analyses were performed (vertically and horizontally), combining inductive and deductive approaches. Outcomes and Results: All three dilemmas are relevant to the participants. They construct their self-identity as both the same as they were pre-stroke and changed. They are both the same and different in relation to other stroke survivors (with or without aphasia), i.e. both “disabled” and “normal”. They display both dependency and agency. Thus, they navigate the dilemmas by constantly negotiating what to include in their stories of self. In addition, telling one story of self offline does not imply telling the same story online. Conclusion: The dilemmas are intertwined and highly relevant to the participants. Offline and online settings evoke different ways for them to navigate the dilemmas. Increased awareness of the possible struggle with self-identity dilemmas in people with aphasia, and the possible difference between their online and offline self-identities, should be of value to family members, clinicians and researchers. Further research based on a larger sample is suggested.
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| 10. |
- Håkansson, Bo, 1953, et al.
(författare)
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The mechanical impedance of the human skull via direct bone conduction implants
- 2020
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Ingår i: Medical Devices: Evidence and Research. - 1179-1470. ; 13, s. 293-313
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The mechanical skull impedance is used in the design of direct bone drive hearing systems. This impedance is also important for the design of skull simulators used in manufacturing, service, and fitting procedures of such devices. Patients and Methods: The skull impedance was measured in 45 patients (25 female and 20 male) who were using percutaneous bone conduction implants (Ponto system or Baha system). Patients were recruited as a consecutive prospective case series and having an average age of 55.4 years (range 18–80 years). Seven patients were treated in Gothenburg, Sweden, and 38 patients in Edmonton, Canada. An impedance head (B&K 8001), driven by an excitation transducer with emphasized low-frequency response, was used to measure the mechanical point impedance with a swept sine from 100 to 10k Hz. Results and Discussion: The skull impedance was found to have an anti-resonance of approximately 150 Hz, with a median maximum magnitude of 4500 mechanical ohms. Below this anti-resonance, the mechanical impedance was mainly mass-controlled corresponding to an effective skull mass of 2.5 kg at 100 Hz with substantial damping from neck and shoulder. Above the anti-resonance and up to 4 kHz, the impedance was stiffness-controlled, with a total compliance of approximately 450n m/N with a small amount of damping. At frequencies above 4 kHz, the skull impedance becomes gradually mass-controlled originating from the mass of the osseointegrated implant and adjacent bone. No significant differences related to gender or skull abnormalities were seen, just a slight dependence on age and major ear surgeries. The variability of the mechanical impedance among patients was not found to have any clinical importance. Conclusion: The mechanical skull impedance of percutaneous implants was found to confirm previous studies and can be used for optimizing the design and test procedures of direct bone drive hearing implants. © 2020 Håkansson et al.
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