Oral-diadochokinesis between Parkinson's disease and neurotypical elderly among Malaysian-Malay speakers.

BACKGROUND: Parkinson's disease (PD) has an impact on speech production, manifesting in various ways including alterations in voice quality, challenges in articulating sounds and a decrease in speech rate. Numerous investigations have been conducted to ascertain the oral-diadochokinesis (O-DDK) rate in individuals with PD. However, the existing literature lacks exploration of such O-DDK rates in Malaysia and does not provide consistent evidence regarding the advantage of real-word repetition. AIMS: To explore the effect of gender, stimuli type and PD status and their interactions on the O-DDK rates among Malaysian-Malay speakers. METHODS & PROCEDURES: O-DDK performance of 62 participants (29 individuals with PD and 33 healthy elderly) using a non-word ('pataka'), a Malay real-word ('patahkan') and an English real-word ('buttercake') was audio recorded. The number of syllables produced in 8 s was counted. A hierarchical linear modelling was performed to investigate the effects of stimuli type (non-word, Malay real-word, English real-word), PD status (yes, no), gender (male, female) and their interactions on the O-DDK rate. The model accounted for participants' age as well as the nesting of repeated measurements within participants, thereby providing unbiased estimates of the effects. OUTCOMES & RESULTS: The stimuli effect was significant (p < 0.0001). Malay real-word showed the lowest O-DDK rate (5.03 ± 0.11 syllables/s), followed by English real-word (5.25 ± 0.11 syllables/s) and non-word (5.42 ± 0.11 syllables/s). Individuals with PD showed a significantly lower O-DDK rate compared to healthy elderly (4.73 ± 0.15 syllables/s vs. 5.74 ± 0.14 syllables/s, adjusted p < 0.001). A subsequent analysis indicated that the O-DDK rate declined in a quadratic pattern. However, neither gender nor age effects were observed. Additionally, no significant two-way interactions were found between stimuli type, PD status and gender (all p > 0.05). Therefore, the choice of stimuli type has no or only limited effect considering the use of O-DDK tests in clinical practice for diagnostic purposes. CONCLUSIONS & IMPLICATIONS: The observed slowness in O-DDK among individuals with PD can be attributed to the impact of the movement disorder, specifically bradykinesia, on the physiological aspects of speech production. Speech-language pathologists can gain insights into the impact of PD on speech production and tailor appropriate intervention strategies to address the specific needs of individuals with PD according to disease stages. WHAT THIS PAPER ADDS: What is already known on this subject The observed slowness in O-DDK rates among individuals with PD may stem from the movement disorder's effects on the physiological aspects of speech production, particularly bradykinesia. However, there is a lack of consistent evidence regarding the influence of real-word repetition and how O-DDK rates vary across different PD stages. What this study adds to existing knowledge The O-DDK rates decline in a quadratic pattern as the PD progresses. The research provides insights into the advantage of real-word repetition in assessing O-DDK rates, with Malay real-word showing the lowest O-DDK rate, followed by English real-word and non-word. What are the potential or actual clinical implications of this work? Speech-language pathologists can better understand the evolving nature of speech motor impairments as PD progresses. This insight enables them to design targeted intervention strategies that are sensitive to the specific needs and challenges associated with each PD stage. This finding can guide clinicians in selecting appropriate assessment tools for evaluating speech motor function in PD patients.

Awareness and Knowledge of Stuttering Among Malaysian School-Aged Children: An Exploratory Study.

INTRODUCTION: Knowledge and awareness of stuttering are closely associated with attitudes toward stuttering. Few studies have been conducted on the knowledge and awareness of school-aged children, and none have been conducted in Malaysia. This study aimed to: (a) determine knowledge and awareness of stuttering among Malaysian school-aged children, and (b) determine whether there are differences between age group, gender and PWS exposure groups. METHODS: A cross-sectional study was conducted among 192 Malay school-aged children (mean age = 9.47, SD = 1.781) recruited via email and social media platforms. They completed a Malay version of the questionnaire devised by van Borsel et al. (1999) on various aspects of stuttering, including prevalence, onset, gender distribution, occurrence in different cultures, cause, treatment, intelligence, and heredity of stuttering. The chi-square test of independence was performed to compare the distributions of survey responses by age group, gender and PWS exposure group. RESULTS: Around half of the school-age children had met a person who stutters, but certain aspects of their knowledge were limited. Knowledge also differed according to age and gender. Girls were more knowledgeable about stuttering than boys. Regarding stuttering treatment, younger children had more positive attitudes than older children. Participants who did not know a PWS were more likely to consult their family doctor rather than a speech-language pathologist in relation to stuttering. CONCLUSIONS: Knowledge and awareness of stuttering among Malaysian school-aged children were limited. Findings of this study could be used to develop a stuttering awareness program specific to children to increase their knowledge and awareness about stuttering.

Attitudes of Malaysian Speech-Language Pathologists and Speech-Language Pathology Students Toward Stuttering.

INTRODUCTION: Attitudes of speech-language pathologists (SLPs) toward stuttering play an important role in managing stuttering cases. Yet, such studies had not been studied in Malaysia, a country that is still developing the profession of speech-language pathology. This study aimed to explore the attitudes of Malaysian SLPs and speech-language pathology students toward stuttering. METHODS: A total of 50 SLPs and 67 speech-language pathology students completed the Clinician Attitudes Towards Stuttering (CATS) inventory. There were eight domains of attitudes toward stuttering: (a) etiology, (b) early intervention, (c) therapeutic efficacy, (d) personalities of PWS, (e) clinician expertise and roles, (f) teacher/counsellor roles and client/public reactions, (g) therapy strategies, and (h) parent attitudes. Descriptive data were presented and Multivariate Analysis of Variance was conducted to examine the effects of clinical certification on the eight domains of attitudes toward stuttering. RESULTS: Participants who possessed a clinical certification were more accepting toward the personalities of people who stutter (PWS) and therapy strategies. On the other hand, participants without a clinical certification were more accepting toward clinician expertise and roles. CONCLUSIONS: Current curriculum and professional training should be re-evaluated to remediate less accepting stereotypes held by SLPs and students toward PWS and to enhance essential skills such as counselling.

Acute effect of Melon Manis Terengganu peel powder on glycemic response, perceived satiety, and food intake: a randomized, placebo-controlled crossover trial in adults at risk of type 2 diabetes.

BACKGROUND: Melon Manis Terengganu (MMT) peel has a high dietary fiber content, but there is no data examining its health benefits in adults at risk of type 2 diabetes. The objective of the study was to evaluate whether consumption of MMT peel powder improves glycemic response, satiety, and food intake in adults at risk of type 2 diabetes. METHODS: An open-label, randomized, placebo-controlled, crossover design trial was conducted among adults (n = 30, ages 18-59 y) at risk of type 2 diabetes. They consumed Formulation 3 (formulated MMT peel powder) [A] and control (glucose) [B] with study breakfast based on randomly assigned treatment sequences (AB, BA) established by Research Randomizer ( www.randomizer.org ). Capillary blood glucose and perceived satiety were determined at baseline (0 min), 30, 60, 90 and 120 min, followed by a post-intervention food intake measurement. RESULTS: The repeated measures analysis of variance (ANOVA) revealed significant time (F = 84.37, p <  0.001, ηp2 = 0.744), condition (F = 22.89, p <  0.001, ηp2 = 0.441), and time*condition effects (F = 24.40, p <  0.001, ηp2 = 0.457) in blood glucose levels. Respondents (n = 30) who consumed Formulation 3 also had a significantly lower blood glucose 2-hour incremental area under the curve (iAUC) of 134.65 ± 44.51 mmol/L*min and maximum concentration (CMax) of 7.20 (7.10, 8.20) mmol/L with relative reduction of 26.8 and 13.3% respectively, when compared with control (p <  0.001). Besides, significantly greater perceived satiety, lower energy and fat intake as well as higher dietary fiber intake were also observed in the intervention group compared with the placebo group (p <  0.05). There were no marked side effects associated with the ingestion of the test products. CONCLUSIONS: Short-term consumption of formulated MMT peel powder may improve glycemic response, increase perceived satiety and reduce food intake in adults at risk of type 2 diabetes with the potential to be utilized as a functional beverage. Medium-to long-term clinical trial is warranted to determine whether taking this formulated MMT peel powder on a daily basis has an influence on health outcomes. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05298111. Registered 28/03/2022.