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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
111

Variability in ultrasound measurement of hyoid displacement and submental muscle size within and across sessions using two methods of data acquisition in healthy participants

Winkelman, Corina Juliet January 2011 (has links)
Objective: Ultrasound is used increasingly in swallowing research because it can be a non-invasive, repeatable and cost effective measure of swallowing dynamics and rehabilitative effects. However unstable head position and transducer movement while imaging may result in measurement error that is substantive enough to bias research results. This study investigated the variation in measures of hyoid displacement and submental muscle size within and across three sessions using two methods of acquisition. Methods: Twenty-four healthy participants over the age of 50 attended three sessions. In each session, five dynamic video clips of hyoid movement and five static images of submental muscles were imaged in 2D ultrasound using two acquisition methods. One method involved manual hand-held stabilisation of the transducer and the other method involved a custom-designed stand for stabilisation of the transducer and participant. Hyoid displacement was measured as a percent change between measures made at rest and at maximal excursion. Additionally, cross sectional area (CSA) measurements were made of the paired geniohyoid and the left and right anterior belly of digastric (ABD) muscles at rest. Results: Out of 720 possible measures of hyoid displacement, 675 measures were analysed. There were no significant order effects of session or trial with changes that were <1% and no greater 4.5% for session and no greater than 1.5% for trial from estimated baseline measures. There was a significant effect of method (p<.01), with a systematic decrease in stand measures that were <9.5% and no greater than 16% from estimated baseline measures. Variance was larger across sessions than within sessions. The stand condition was more variable than the hand-held condition for measures of hyoid displacement. Out of a total of 2160 possible measures of submental muscle size, 555 measures of geniohyoid and 1408 measures of ABD muscles were analysed. There were no significant order effects of session, trial or method in geniohyoid muscle measures. The estimated order effects of session were <3% and no greater than 13%, and trials were <0.4% and no greater than 0.7% from estimated baseline measures. There were no significant order effects of session and method in ABD muscle measures with order effects of session that were <2% and no greater than 5.5%. There were significant effects of trial (p<.01) in both ABD muscles with a small systematic increase that was <0.5% and no greater than 0.8%. Variance was larger across sessions than within sessions in all measures of submental muscle size. The stand condition was less variable than the hand-held condition for all measures of submental muscle size. Conclusion: The results from this study provide guidance to researchers who intend to use repeated measures from ultrasound imaging as an outcome measure in swallowing research. The large variability within and across participants in measures of hyoid displacement and geniohyoid muscle size may require further investigation. When the variations described in this current study are considered in the measures of the ABD muscle size then it can be a valuable measure of rehabilitative techniques.
112

Magnetresonanztomographische und manometrische Untersuchungen zur Verlagerung oropharyngealer Strukturen während des Saugschluckvorgangs / Displacement of oropharyngeal structures during suction-swallowing cycles

Glombek, Johannes 07 October 2014 (has links)
No description available.
113

Die Konfrontationsbehandlung einer Spezifischen Phobie vor dem Verschlucken / Exposure in the Treatment of Specific Phobia of Swallowing

Becker, Eni S., Schneider, Silvia 11 February 2014 (has links) (PDF)
Die Spezifischen Phobien stellen die häufigste Gruppe der Angststörungen dar. Die Angst vor dem Verschlucken bzw. dem Ersticken wurde jedoch nur sehr selten beschrieben. Bei der Behandlung der Spezifischen Phobien wird fast immer eine Konfrontation in vivo eingesetzt. Die Angst vor dem Verschlucken scheint aber eine der Spezifischen Phobien zu sein, bei der eine Konfrontation schwierig ist. Die hier vorgestellte Fallgeschichte schildert eine mögliche Vorgehensweise, die Ängste vor dem Verschlucken mit einer Reizkonfrontation in vivo zu behandeln. Dabei werden die verschiedenen Schwierigkeiten, die aufgetreten sind, und ihre Lösungen geschildert. Die Therapie wurde erfolgreich abgeschlossen, und auch die Ergebnisse der Nachuntersuchungen zeigten eine stabile Verbesserung. / Specific phobias are the most common anxiety disorders. However, the fear of swallowing the wrong way and choking has rarely been described. Specific phobias are usually treated using exposure therapy. The excessive fear of swallowing the wrong way does not seem to be very well suited for an exposure in vivo. In this case study, a patient afflicted with the fear of swallowing and choking was treated with flooding. The various difficulties encountered during treatment and their remedies will be described. The therapy was successful. The patient showed stable and lasting improvements at posttreatment and at one-year follow-up. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
114

Estudo cinesiográfico da deglutição em indivíduos com dentição natural e com próteses totais

Sadalla, Karina Buainain de Freitas [UNESP] 03 December 2004 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:28:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2004-12-03Bitstream added on 2014-06-13T18:58:06Z : No. of bitstreams: 1 sadalla_kbf_me_arafo.pdf: 1077060 bytes, checksum: 3d0a4821550fb94ec4ed8a5977f30eaf (MD5) / O ato de deglutir tem sido empregado, clinicamente, durante a reabilitação protética, principalmente na etapa de determinação e registro das relações intermaxilares por se considerar que a deglutição de saliva levaria a mandíbula a uma posição que coincidiria com a relação central (RC) e com a dimensão vertical de oclusão (DVO) do paciente. O objetivo deste trabalho foi analisar quantitativamente, em indivíduos dentados e portadores de próteses totais bimaxilares, três medidas associadas à posição mandibular durante a deglutição de água:1) separação intermaxilar no eixo vertical; 2) desvio ântero-posterior; 3) desvio lateral. Dois grupos foram formados: GI - composto por 40 indivíduos (22 homens e 18 mulheres) dentados naturais com média de idade de 45,27 anos; e GII - composto por 40 indivíduos (29 homens e 11 mulheres) desdentados totais bimaxilares, portadores de próteses totais, com idade média de 63,92 anos. A análise foi realizada empregando-se um sistema eletrônico K6 I Diagnostic System (Myotronics Research, Inc., Seattle, WA, EUA) acoplado a um sistema operacional (Microsoft Windows 4.1) que fornece registros tridimensionais dos movimentos e posições mandibulares. Os indivíduos foram avaliados pela deglutição de um volume reduzido de água (20 mL), e a posição de maior fechamento durante a deglutição foi registrada em três eixos (vertical, lateral e ântero-posterior). Esse registro foi executado três vezes, e o valor médio foi utilizado para este estudo. Com base nos resultados obtidos, foi possível concluir que, durante a deglutição: 1) a separação intermaxilar vertical e os desvios horizontais foram semelhantes em ambos os grupos; 2) em média, houve separação intermaxilar significativa no sentido vertical; 3) nos eixos ântero-posterior e lateral, os resultados demonstraram um desvio moderado em relação à MI. / The act of swallowing has been used as a clinical method in prosthodontics, specially for determining and recording jaw relationship, considering that swallowing saliva guides the mandible to a position coincident with centric relation (CR) and vertical dimension of occlusion (VDO). The aim of this study was to evaluate, quantitatively, in dentate subjects and complete dentures wearers, three measurements associated to mandibular position during water swallowing: 1) intermaxillary distance on vertical axis; 2) anteroposterior deviation; and 3) lateral deviation. Two groups were selected: GI - composed by 40 subjects with complete dentition (22 males and 18 females - mean age 45,27 years); e GII - composed by 40 bimaxillary edentate subjects, complete denture weares (29 males and 11 females - mean age 63,92 years). A kinesiograph instrument (K6 I Diagnostic System(Myotronics Research, Inc., Seattle, WA, EUA) connected to a computer operational system (Microsoft Windows 4.1) was used for analysis, providing tridimensional records of mandibular movement and position. Each subject was tested during swallow of a small amount of water (29 mL), and the closest mandibular opening was recorded on vertical, lateral and anteroposterior axis. Three records were taken for each measurement and a mean value were obtained, these mean value was considered for this study. It was conclude that, during deglutition: 1) intermaxillary distance on vertical axis and horizontal deviation were similar for both groups; 2) there was a significant intermaxillary distance, on vertical axis; 3) for anteroposterior and lateral axis, results showed moderate deviation in relation to MI.
115

Comparação entre as avaliações clínica e videofluoroscópica da deglutição em crianças portadoras de laringomalacia ou de glossoptose

Gasparin, Marisa January 2015 (has links)
OBJETIVO: verificar a acurácia de um protocolo de avaliação clínica da deglutição em uma amostra de crianças com diagnóstico de laringomalacia ou de glossoptose, bem como descrever a prevalência de disfagia em cada uma dessas doenças e a resposta da dinâmica da deglutição às intervenções fonoterapêuticas de redução de fluxo e de modificação de consistência dos líquidos. DELINEAMENTO: estudo transversal. MATERIAIS E MÉTODOS: foram avaliadas crianças com idade entre um mês e 11 anos de vida, acompanhadas pelo Serviço de Otorrinolaringologia do Hospital de Clínicas de Porto Alegre, Brasil. Realizou-se a avaliação clínica da deglutição por uma fonoaudióloga e, após, a videofluoroscopia, seguindo-se a mesma rotina e padronização da avaliação clínica, porém por outra fonoaudióloga, cegada para o resultado da avaliação clínica, e por um médico radiologista. Os protocolos utilizados foram baseados nos instrumentos propostos por DeMatteo et al. (2005), sendo testadas as consistências líquida rala e líquida engrossada na viscosidade néctar. RESULTADOS: a amostra do estudo foi composta por 29 pacientes, sendo 10 portadores de laringomalacia e 19 de glossoptose. A sensibilidade da avaliação clínica não ultrapassou 50% em nenhuma das observações, mas a especificidade alcançou valor de 100% quando avaliada a consistência líquida engrossada. A prevalência de disfagia foi de 100% e o espessamento dos líquidos reduziu significativamente as aspirações traqueais. CONCLUSÕES: a disfagia foi altamente prevalente em crianças com laringomalacia ou glossoptose. A avaliação clínica mostrou-se pouco sensível na identificação de penetração laríngea e de aspiração traqueal. No entanto, sua elevada especificidade sugere repensar a indicação da videofluoroscopia nos casos em que tais eventos são identificados através da avaliação clínica. / OBJECTIVE: to investigate the accuracy of a swallowing clinical evaluation protocolin a sample of children with laryngomalacia or glossoptosis and describe the prevalence of dysphagia in each disease and the swallow response to speech and language therapy interventions with thickened liquids and reduced flow. STUDY DESIGN: cross-sectional study. MATERIALS AND METHODS: children aged one month to 11 years followed at the Otolaryngology Division of Hospital de Clínicas de Porto Alegre, Brazil, were evaluated. A clinical evaluation was performed by a speech pathologist. Subsequently, videofluoroscopy was performed, following the same steps as in the clinical evaluation, by a different speech therapist who was blinded to clinical data, and by a radiologist. The protocols used were based on those proposed by DeMatteo et al., (2005). The consistencies tested were thin liquid and thickened liquid (nectar-thick). RESULTS: the study sample consisted of 29 patients, 10 patients with laryngomalacia and 19 patients with glossoptosis. The sensitivity of clinical evaluation did not exceed 50% in any of the evaluations, but specificity reached 100% in some cases. The prevalence of dysphagia was 100%, and the use of thickened liquids significantly reduced tracheal aspiration. CONCLUSIONS: dysphagia was highly prevalent in children with laryngomalacia or glossoptosis. The sensitivity of clinical evaluation to detect laryngeal penetration and tracheal aspiration was low. However, its high specificity suggests that referral for videofluoroscopic swallow study in cases in which these events are detected during clinical evaluation should be reconsidered.
116

Correlação entre alterações cognitivas e alteração de deglutição nos indivíduos portadores da doença de Parkinson

Rodrigues, Diogo Mello January 2015 (has links)
Base teórica: Os principais sintomas motores da doença de Parkinson, rigidez, bradicinesia e tremor com a progressão da doença, frequentemente são acompanhados por alteração da deglutição que compromete consideravelmente a alimentação dos indivíduos com a doença. A alteração de deglutição está presente na fase oral, faríngea e esofágica e traz consequências para o individuo com doença de Parkinson, como desnutrição, risco de aspiração pulmonar e pneumonia. Apesar da doença de Parkinson (DP) ser primariamente considerada um distúrbio do movimento, algumas características não-motoras são típicas da doença, como alterações cognitivas, distúrbios do sono e distúrbios sensoriais. Objetivo: Estudar a correlação entre as alterações cognitivas e as alterações de deglutição dos indivíduos com DP. Métodos: Trata-se de estudo do tipo transversal e descritivo. O estudo conta com dois grupos: grupo controle, formado por indivíduos saudáveis, (n=47) e grupo de estudo formado por indivíduos com DP (n=47). Para avaliação cognitiva, foi utilizada uma bateria de testes cognitivos, onde foram avaliadas funções como atenção, memória, planejamento, funções executivas, entre outras. Para avaliação de deglutição, foi utilizada avaliação clínica, com base em protocolo, sendo possível avaliar estruturas e a função da deglutição, a fim de classificar o grau de alteração. Resultados: Dos pacientes com DP, 56 % eram do sexo masculino com média de idade de 62,0 (±11,0), escolaridade de 7,0 (±4,0), tempo de diagnóstico de 10,0 (±5,0), Hoehn e Yahr 2 (55%) e Hoehn e Yahr 3 (45%). Para o grupo controle, 56% do sexo masculino com média de idade de 64,0 (±7,0) e escolaridade de 9,0 (±4,0). Na avaliação miofuncional da deglutição entre grupo de estudo e grupo controle, foram observadas diferenças significativas como: face assimétrica p=(0,00), bochechas assimétricas p=(0,00), hipotonia do lado esquerdo p=(0,00), alteração do mentual (p=0,00), hipotonia de língua p=(0,00), tosse p=0,03), engasgos (p=0,00), projeção de língua (p=0,00), projeção de cabeça p=(0,00), resíduos alimentares (p=0,00), contração o periorbicular (p=0,00), deglutição normal (p=0,00), disfagia leve (p=0,04), disfagia leve a moderada (p=0,02). Na comparação do desempenho cognitivo entre os grupos, observou-se significância estatística nos testes de fluência verbal categórico (p=0,00), Rey Verbal A (p=0,00), Rey verbal I (p=0,00), Rey Verbal R (p=0,00). Para a associação entre cognição e deglutição em indivíduos com doença de Parkinson, observou-se o resultado significativo entre Rey Verbal I e deglutição normal (p= 0,02). Conclusão: Os pacientes com DP possuem maiores alterações cognitivas e de deglutição comparados ao grupo controle e o estudo apontou a influência da memória imediata de curto prazo na deglutição, tendo participação importante no processo de deglutição. Também foi possível observar a correlação da idade, H&Y e tempo de evolução da doença na deglutição. / Background: The primary motor symptoms of Parkinson's disease rigidity, bradykinesia and tremor with the progression of the disease are often accompanied by swallowing disorders which greatly compromises the power of individuals with the disease. Swallowing change is present in the oral, pharyngeal and esophageal and has consequences for the individual with Parkinson's disease, such as malnutrition, pulmonary aspiration and pneumonia. Although Parkinson's disease (PD) is primarily regarded as a disorder of movement, some non-motor characteristics are typical of the disease, and cognitive changes, sleep disorders and sensory disturbances. Objective: To study the correlation between cognitive impairment and swallowing disorders among individuals with PD. Objective: To study the correlation between cognitive impairment and swallowing disorders among individuals with PD. Methods: This is a study of cross-sectional and descriptive. The study has two groups: control group, consisting of healthy subjects (n= 47) and study group of individuals diagnosed with Parkinson's disease (n= 47). For cognitive evaluation, we used a battery of cognitive tests, which were evaluated functions such as attention, memory, planning, executive functions, among others. For evaluation of swallowing, clinical evaluation was used, based on protocol so it can evaluate structures and the function of swallowing in order to classify the degree of change. Results: Of PD patients, 56% were male with a mean age of 62.0 (±11.0), educational level of 7.0 (±4.0), diagnosis time of 10.0 (±5.0), Hoehn and Yahr 2 (55%) and Hoehn and Yahr 3 (45%). For the control group, 56% were male with a mean age of 64.0 (±7.0) and schooling of 9.0 (±4.0). In myofunctional evaluation of swallowing between study and control groups was observed significant differences as asymmetric face (p=0.00), asymmetrical cheeks (p=0.00), hypotonia the left (p=0.00), alteration of the mental (p=0.00), speaking hypotonia (p=0.00), cough (p=0.03), choking (p=0.00), tongue projection (p=0.00), head projection (p=0.00), food waste (p=0.00), the contraction periorbicular (p=0.00), normal swallowing (p=0.00), light dysphagia (p=0.04), mild to moderate dysphagia (p=0.02). In comparing cognitive performance between the groups there was statistical significance in categorical verbal fluency tests (p=0.00), Rey Verbal A (p=0.00), verbal Rey I (p=0.00), Rey verbal R (p=0.00). For the association between cognition and swallowing in people with Parkinson's disease was observed between the mean result Rey Verbal I and normal swallowing (p =0.02). The study also showed the influence of gender, age, disease stage and time of diagnosis in cognitive performance and swallowing. Conclusion: PD patients have higher cognitive and swallowing changes compared to the control group and the study pointed out the influence of short-term immediate memory in swallowing, with important participation in the swallowing process. It was also possible to observe the correlation of age, H & Y and duration of the disease in swallowing.
117

Reabilitação da deglutição: tempo e fatores prognósticos em pacientes disfágicos hospitalizados / Swallowing rehabilitation:duration and prognostic factors in dysphagic hospitalized patients

Menezes, Fernanda Teixeira [UNIFESP] 24 February 2010 (has links) (PDF)
Made available in DSpace on 2015-07-22T20:50:42Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24 / Objetivo: Analisar o número médio de sessões de fonoterapia necessárias para a liberação de ao menos uma consistência alimentar por via oral e fatores que interferem no número de sessões para reabilitação da deglutição. Método: Estudo observacional, analítico e retrospectivo com 260 pacientes disfágicos, de diversos diagnósticos, neurológicos e não neurológicos, internados no Hospital São Paulo (UNIFESP), com idade entre 02 e 105 anos, avaliados e tratados pelo Serviço Integrado de Fonoaudiologia, no período de agosto/2007 a agosto/2009. Resultados: O número médio de sessões de fonoterapia necessárias para a liberação da dieta por via oral na amostra estudada foi de 4,13 sessões. Os fatores que apresentaram significantemente mais sessões para a liberação da dieta oral foram: sexo masculino, tempo de internação hospitalar, tempo para solicitar a avaliação fonoaudiológica, tempo de via alternativa de alimentação, broncopneumonia, sepse, tempo de intubação orotraqueal, reintubação, tempo de traqueostomia, tempo de ventilação mecânica, tempo de nebulização, alteração na deglutição de saliva, alteração vocal, redução da elevação laríngea e penetração supraglótica. A análise de regressão evidenciou que a associação dos seguintes fatores implicou em maior número sessões de fonoterapia para liberação da dieta via oral: alteração na deglutição de saliva associada à alteração vocal, alteração na deglutição de saliva associada à redução da elevação laríngea e alteração na deglutição de saliva associada ao tempo para a avaliação fonoaudiológica inicial. Conclusões: O número médio de sessões para liberação da dieta por via oral foi de 4,13 sessões, o que corresponde a aproximadamente cinco dias. Foram identificados 15 fatores que ocasionaram o atraso para liberação da dieta por via oral. No entanto, a reabilitação da deglutição foi significativa na maioria dos pacientes disfágicos... / Purpose: To analyze the average number of swallowing rehabilitation sessions necessary for the release of oral intake, at least one consistency, and the factors that influenced the number of swallowing rehabilitation sessions. Methods: An observational, analytical and retrospective study of 260 dysphagic patients with different diagnosis, neurological or not, at the São Paulo Hospital (UNIFESP), ages between 02 and 105 years, evaluated and treated by Speech and Language Integrated Service among August / 2007 and August/2009. Results: The average number of swallowing sessions necessary for the release of oral intake was 4.13 sessions. The factors that contributed to a significantly higher number of rehabilitation sessions were male gender, duration of hospital stay, time to request initial bedside swallowing evaluation; time of tube feeding, pneumonia, sepsis, duration of intubation, reintubation, duration of tracheotomy, duration of mechanical ventilation, duration of nebulization, swallowing saliva impairment, voice impairment, reduction of laryngeal elevation and supraglottic penetration. Regression analysis showed that the combination of the following factors interfered in the number of swallowing rehabilitation sessions: swallowing saliva impairment associated with voice impairment, swallowing saliva impairment associated with reduced laryngeal elevation and swallowing saliva impairment associated with time to request initial bedside swallowing evaluation. Conclusions: The average number of sessions to release oral intake was 4.13, which corresponds to about 5 days. Were identified 15 factors that caused the delay to release the oral intake. However, the rehabilitation of swallowing showed significant improvement in these patients. / TEDE / BV UNIFESP: Teses e dissertações
118

Influência das etapas clínicas da prótese total sobre a separação maxilomandibular durante a pronúncia do som /s/ e a deglutição

Souza, Raphael Freitas de [UNESP] 20 September 2005 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:35:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2005-09-20Bitstream added on 2014-06-13T19:24:07Z : No. of bitstreams: 1 souza_rf_dr_arafo.pdf: 1225654 bytes, checksum: 8d5a88f0decec73c57f8d049e313dc17 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A pronúncia de sons sibilantes e a deglutição têm sido amplamente indicadas para a tomada da dimensão vertical para próteses totais. Foi objetivo deste estudo avaliar as mudanças no espaço de pronúncia do som /s/ e as distâncias interoclusais de repouso e de deglutição, em diversos momentos clínicos, durante e após o tratamento com próteses totais. Um total de 12 indivíduos edentados (5 homens) participaram deste estudo, e 7 medidas foram feitas: 1) Bases de prova, após determinação das relação intermaxilares; 2) Bases de prova, após provas funcionais; 3) Instalação; 4) uma semana; 5) 2 semanas; 6) um mês; 7) 3 meses após instalação. Um cinesiógrafo (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) mensurou os espaços interoclusais em sentido vertical e ântero-posterior. Não houve diferença significante entre as sete etapas para o espaço de pronúncia do /s/ ântero-posterior, distância interoclusal de repouso e de deglutição. A presença dos roletes de oclusão pode influenciar a posição mandibular durante o som /s/, e a montagem dos dentes modifica o espaço de pronúncia do /s/. No entanto, as posições de repouso e de deglutição mantêm-se estáveis durante a confecção das próteses totais e uso a curto prazo. / Sibilant sounds and swallowing have been widely used for vertical dimension assessment in complete denture wearers. Thus, the aim of this study was to investigate the changes in speaking space of /s/ sound, interocclusal distance of rest and during swallowing, during and after treatment with complete denture. A total of 12 edentulous subjects (5 men) participated in this study and 7 measures were carried out: A) Record bases following intermaxillary relation record; B) Trial dentures; C) Insertion; D) 1 week-; E) 2 weeks-; F) 1 month); G) 3 months after insertion. A jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) measured the interocclusal space vertically and anteroposteriorly. There was no significant difference between the 7 stages for anteroposterior speaking space of /s/ sound, interocclusal distance and IDS. The presence of occlusion rims can influence mandibular position during /s/ sound. The set up of artificial teeth changes the speaking space of /s/ sound. However, rest position and swallowing were not affected, neither during denture construction or short-term use.
119

Management of Feeding and Swallowing Disorders in Malawi

January 2018 (has links)
abstract: ABSTRACT Malawi, as a low and middle income country (LMIC), with one of the lowest per capita gross domestic products, faces challenges in the provision of healthcare to its citizens. According to the Centers for Disease Control (CDC), leading causes of death include but are not limited to, lower respiratory disease, stroke, cancer, neonatal disorders, and nutritional deficiencies. Feeding and swallowing disorders can present as a symptom to any of these medical diagnoses. Currently, there are no known studies focusing on the service provision for feeding and swallowing disorders in Malawi. This pilot study was designed to provide a baseline on how feeding and swallowing disorders are currently being provided for in an emerging country like Malawi. Malawian healthcare professionals who see patients with feeding and swallowing disorders completed a survey and interview pertaining to their personal demographics, caseload, opinions, experiences, and treatment recommendations regarding the management of swallowing disorders (dysphagia). Results indicate a wide range of occupations (Otolaryngoloists, Rehabilitation Technicians, Audiology Technicians, and Nurses) are involved in feeding and swallowing care. Participants expressed a high obligation to provide services for feeding and swallowing disorders, as well as a high concern for their patients. Generally, participants expressed high confidence in their treatment abilities, which did not correspond to knowledge of treatment recommendations that meet U.S. standards of care. Specifically, there was no variation in treatment recommendations across severities and a general lack of resources and tools for assessing and treating dysphagia. Treatment recommendations tended to align with resources currently available in Malawi. Implications for the utilization of NGOs (non-governmental organizations) and the education of healthcare providers on feeding and swallowing disorders in the social and cultural contexts of this country are discussed. / Dissertation/Thesis / Masters Thesis Communication Disorders 2018
120

Influência das etapas clínicas da prótese total sobre a separação maxilomandibular durante a pronúncia do som /s/ e a deglutição /

Souza, Raphael Freitas de. January 2005 (has links)
Orientador: Marco Antonio Compagnoni / Banca: João Neudenir Arioli Filho / Banca: Ana Lucia Machado / Banca: Renata Cunha Matheus Rodrigues Garcia / Banca: Cláudio Rodrigues Leles / Resumo: A pronúncia de sons sibilantes e a deglutição têm sido amplamente indicadas para a tomada da dimensão vertical para próteses totais. Foi objetivo deste estudo avaliar as mudanças no espaço de pronúncia do som /s/ e as distâncias interoclusais de repouso e de deglutição, em diversos momentos clínicos, durante e após o tratamento com próteses totais. Um total de 12 indivíduos edentados (5 homens) participaram deste estudo, e 7 medidas foram feitas: 1) Bases de prova, após determinação das relação intermaxilares; 2) Bases de prova, após provas funcionais; 3) Instalação; 4) uma semana; 5) 2 semanas; 6) um mês; 7) 3 meses após instalação. Um cinesiógrafo (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) mensurou os espaços interoclusais em sentido vertical e ântero-posterior. Não houve diferença significante entre as sete etapas para o espaço de pronúncia do /s/ ântero-posterior, distância interoclusal de repouso e de deglutição. A presença dos roletes de oclusão pode influenciar a posição mandibular durante o som /s/, e a montagem dos dentes modifica o espaço de pronúncia do /s/. No entanto, as posições de repouso e de deglutição mantêm-se estáveis durante a confecção das próteses totais e uso a curto prazo. / Abstract: Sibilant sounds and swallowing have been widely used for vertical dimension assessment in complete denture wearers. Thus, the aim of this study was to investigate the changes in speaking space of /s/ sound, interocclusal distance of rest and during swallowing, during and after treatment with complete denture. A total of 12 edentulous subjects (5 men) participated in this study and 7 measures were carried out: A) Record bases following intermaxillary relation record; B) Trial dentures; C) Insertion; D) 1 week-; E) 2 weeks-; F) 1 month); G) 3 months after insertion. A jaw-tracking device (K6-I Diagnostic System, Myotronics Research Inc., Seattle, WA, EUA) measured the interocclusal space vertically and anteroposteriorly. There was no significant difference between the 7 stages for anteroposterior speaking space of /s/ sound, interocclusal distance and IDS. The presence of occlusion rims can influence mandibular position during /s/ sound. The set up of artificial teeth changes the speaking space of /s/ sound. However, rest position and swallowing were not affected, neither during denture construction or short-term use. / Doutor

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