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Between 4-16% of adults in the United States have experienced difficulty swallowing at some point during their lives. Difficulty swallowing, or clinically referred to as dysphagia, poses increased concern when drinking beverages. While no treatment is currently available, it is often recommended that liquids be thickened to improve the safety of swallowing and prevent liquids from being aspirated in the lungs. However, thickened liquids are poorly accepted by individuals with dysphagia. Taste and flavor suppression has been shown in various thickened liquid matrices, but the mechanisms for understanding these changes in perception are quite complex. Additionally, literature focused on dysphagic patients’ experiences with different types of beverages and clinicians’ experiences with thickening beverages is minimal. The study had two main goals: 1) explore how sensory properties including texture, taste, and flavor affect acceptance of specific thickened liquids and 2) determine challenges clinicians experience with thickening different beverages. This was achieved through a quantitative and qualitative online survey administered to clinicians (n=83; 96% speech-language pathologist) in the United States who work with dysphagia patients. Free-response questions related to thickening issues highlighted challenges with carbonation, temperature, and dairy products. Coffee, water, soda, milk, and oral nutritional supplements were the most complained about thickened beverages, respectively. Disliking of texture was a common complaint for each beverage likely due to the dissimilarity to the unthickened version and challenges associated with thickening. Off-flavors were reported for each beverage and were the most present in water. Additionally, clinicians noted the thickened version of the beverage typically has less flavor. To increase the acceptance of thickened liquids, clinicians believe the texture and flavor need significant improvements. Interdisciplinary work in the field of food science is needed to create a smoother consistency, more stable thickness across time and temperature, and improved flavor/taste to develop more enjoyable beverages for dysphagic patients.

Need of nutritional intervention in patients after stroke Summary Aims: To identify how many patients after acute stroke have accurate oral intake of energy and proteins and how is this condition changed after one month of hospitalization. To evaluate the association between dysphagia and food intake. Methods: The evaluation was conducted by observations of food intake, eaten food records, calculating of energy and nutrients intake and comparing to needed energy (by Harris-Benedicts equation) and proteins. GUSS screening tool was used to evaluation of swallowing, ADL test for self-sufficiency assessment. Data included antropometrical indicators (weight, height, arm circumference) and nutritional screenings in Thomayer hospital in Prague. Results: Of the 35 patients, 54 % had adequate oral intake of energy and 23 % adequate intake of proteins in the first week after stroke. Adequate oral intake of energy was indicated in 66 % of patients and adequate intake of proteins in 11 % after one month of hospitalization. There were no significant improvements of oral energy intake (p=0,2891, α=0,05) or protein intake (p=0,1336, α=0,05) after one month of hospitalization. 84,4 % of patients suffered from dysphagia in first week after stroke and 60,6 % after one month of hospitalization. Correlation between inadequate...

The primary objective of the current study was to attempt to establish whether there is a need for a dysphagia training programme for nurses and speech-language therapists working with acute tracheostomised patients in critical care units in South Africa. The research design that was adopted for this project was within a mixed methods approach framework. An exploratory descriptive survey design using semi-structured face-to-face interviews was used. The final sample consisted of interviews with 20 speech-language therapists from eight different hospitals with critical care facilities and 12 nurses from four different hospitals with such facilities. Data from the close ended questions were analysed using descriptive statistics, while remaining data from open ended questions were thematically analysed and the constant comparison method was applied. The data demonstrated that all speech-language therapists and 10 out of the 12 nurses were in agreement that there was a need for a dysphagia training programme for nurses in critical care for tracheostomised patients presenting with dysphagia. An important and unexpected result of this study was that speech-language therapists themselves required additional training in this area. The data demonstrated that the majority of speech-language therapists and nurses were of the view that they had received minimal theoretical and practical hours on tracheostomy screening, assessment and management at an undergraduate level. Overall, the results of the current study suggested varied practices in the screening, assessment and management of tracheostomy and dysphagia, particularly with regard to blue dye testing, suctioning protocols and cuff inflation and deflation protocols. The research significance and implications of the study included the need to improve undergraduate training for speech-language therapists and nurses in the area of dysphagia and tracheostomy, to alert professional training bodies regarding institution of additional licensing and qualifications for speech-language therapists and nurses in the area of dysphagia and tracheostomy, and to thereby improve the situation of clinicians practising in dysphagia and tracheostomy management through the development of guidelines, protocols and position papers. An important implication of this research is that it established the need for a dysphagia training programme for both speech-language therapists and nurses in critical care in dysphagia and tracheostomy, and thereby monitoring the efficacy of this programme and measuring/monitoring the outcomes of multidisciplinary teamwork in the assessment and management of dysphagia and tracheostomy in critical care.