Identifying Predictors of Levator Veli Palatini Muscle Contraction During Speech Using Dynamic Magnetic Resonance Imaging.

Purpose The purpose of this study was to identify predictors of levator veli palatini (LVP) muscle shortening and maximum contraction velocity in adults with normal anatomy. Method Twenty-two Caucasian English-speaking adults with normal speech and resonance were recruited. Participants included 11 men and 11 women (M = 22.8 years, SD = 4.1) with normal anatomy. Static magnetic resonance images were obtained using a three-dimensional static imaging protocol. Midsagittal and oblique coronal planes were established for visualization of the velum and LVP muscle at rest. Dynamic magnetic resonance images were obtained in the oblique coronal plane during production of "ansa." Amira 6.0.1 Visualization and Volume Modeling Software and MATLAB were used to analyze images and calculate LVP shortening and maximum contraction velocity. Results Significant predictors (p < .05) of maximum LVP shortening during velopharyngeal closure included mean extravelar length, LVP origin-to-origin distance, velar thickness, pharyngeal depth, and velopharyngeal ratio. Significant predictors (p < .05) of maximum contraction velocity during velopharyngeal closure included mean extravelar length, intravelar length, LVP origin-to-origin distance, and velar thickness. Conclusions This study identified six velopharyngeal variables that predict LVP muscle function during real-time speech. These predictors should be considered among children and individuals with repaired cleft palate in future studies.

Transitions related to infection with human immunodeficiency virus (HIV).

Discovery of one's human immunodeficiency virus (HIV) infection, or receiving a diagnosis of acquired immune deficiency syndrome (AIDS), sets in motion a variety of transitions for individuals. Transitions may be characterized by changes in identity or role, changes in physical capacity and functioning, changes in outlook, changes in relationships, changes in routine, etc. Workplaces also face transitions to deal with increasing numbers of workers who are infected with HIV. A model for vocational rehabilitation counselors to assist individuals living with HIV infection in adjusting to their transitions is presented, and resources for providing informational support of individuals and organizations are described.