Understanding differences in practices and preferences during videofluoroscopic swallow studies: A survey of radiologists and speech language pathologists in the United States.

PURPOSE: The purpose of this study was to (a) examine the interprofessional relationship between radiologists and speech-language pathologists (SLPs), and (b) explore viewpoints and practice patterns of each profession regarding a videofluoroscopic swallow study (VFSS). METHODS: This IRB approved study utilized an online survey developed by the authors to gather information from radiologists and SLPs who currently perform videofluoroscopic swallow studies (VFSS) for the evaluation of swallow function. Surveys were primarily distributed through the American Speech-Language-Hearing Association's (ASHA) Special Interest Group 13 (Swallowing and Swallowing Disorders) forum, through LinkedIn and email networking among professional radiology-focused businesses and organizations (Bracco Diagnostics, Inc., Society of Abdominal Radiology), and via social media (e.g. Facebook). The survey consisted of 7 demographic questions and 15 practice-related items, using a modified Likert scale and multiple-choice items to assess agreement with statements regarding VFSS procedures and opinions on professional roles. RESULTS: Radiologists and SLPs differed significantly (p < 0.05) in practices regarding nearly all items surveyed, including preferences on: esophageal sweep, anteroposterior view, fluoroscopy time limitation, termination following an aspiration event, frame rate, as well as in defining the primary role of the SLP, the primary purpose of a VFSS, the most valuable piece of information obtained from a VFSS, and training requirements. Radiologists and SLPs agreed that a standardized protocol should exist for VFSS. CONCLUSIONS: Radiologists and SLPs differ in their practice patterns and opinions on the roles of team members in the performance of VFSS. However, both radiologists and SLPs agree that a standardized protocol for VFSS should exist.

Functional Swallow-Related Outcomes Following Transoral Robotic Surgery for Base of Tongue Carcinoma.

In an era where the incidence of oropharyngeal cancer is growing steadily, there have been few studies exploring functional outcomes for individuals whose definitive cancer management approach includes transoral robotic surgical (TORS) resection. This study was designed to examine swallow-related outcomes in individuals newly diagnosed with base of tongue cancer whose treatment plan included surgical resection via TORS. The aims of this study were to determine whether TORS resection for early stage BOT SCCA affected: (a) lingual strength, (b) swallow safety and efficiency, (c) oral intake, and (d) swallowing-related quality of life. Nine individuals meeting the inclusion criteria were recruited to participate from March 2017 to April 2018. Each participant was evaluated at four distinct time points: (a) preoperatively, (b) 1 week postoperatively, (c) 1 month postoperatively, and (d) 3 months postoperatively. The following data were collected at each time point: (a) maximum isometric lingual pressure, (b) Penetration-Aspiration Scale score, (c) Yale Pharyngeal Residue Severity Rating Scale scores, (d) Functional Oral Intake Scale score, and (e) EAT-10 score. Data analysis revealed that a significant decline in maximum isometric lingual pressure, EAT-10 scores, and Functional Oral Intake Scale scores occurred between preoperative baseline measurements and 1 week post surgery. All participants in the study demonstrated a return to levels at or near their baseline level of function for maximum isometric lingual pressure, EAT-10 score, and Functional Oral Intake Scale score by 1 or 3 months post surgery. There were no significant changes in swallow safety or efficiency observed at any time point during the study.

STEM Lab on a Kitchen Table: An Investigation of Remote Student-Driven Problem-Based Research.

In 2020, the COVID-19 pandemic affected formal and informal education programs in the USA. The pandemic had a devastating impact on programs that required a dedicated physical space and in-person laboratory research. The distinguishing feature of New Hampshire Academy of Science (NHAS) programs is the participation of secondary school students in STEM research projects that emulate university-level research. Moving to a remote format presented various challenges. In this case study, we describe and discuss our experiences transforming a summer STEM research program for secondary school students from on-site and in-person to a remote platform, providing details of the planning phase, the logistics of maintaining the quality of the students' research, and the results of internal and external evaluations. Of the 33 students who participated, 32 completed all central elements of the program, and 25 went further and submitted summary papers and presented their research at the remote annual meeting of the American Association for the Advancement of Science. External evaluation found that students saw their work as similar to that of professional scientists, and perceived themselves to have gained proficiency in the use of scientific techniques and instrumentation. Students expressed they missed elements of in-person lab work including social interactions.

Safety and efficacy of functional laryngectomy for end-stage dysphagia.

OBJECTIVES/HYPOTHESIS: To evaluate functional outcomes and complication rate after total laryngectomy (TL) for dysfunctional larynx with end-stage dysphagia. STUDY DESIGN: Retrospective chart review. METHODS: Chart review was performed on all patients who underwent TL from January 2008 to July 2016 at a single tertiary academic medical center. Patients who underwent TL for dysfunctional larynx without preoperative evidence of malignancy were included. Main outcome measures were post-TL functional swallowing and speech outcomes, and complication rate. RESULTS: The study included 19 patients from a cohort of 278 consecutive patients. All patients were previously treated with radiotherapy (RT), whereas 13/19 (68%) previously received chemoradiotherapy. The median time from RT to TL was 10.98 years (range, 0.67-23.94 years). Aspiration was evident preoperatively in 17/19 (89%) patients, with 11 experiencing recurrent aspiration pneumonia. Seventeen of 19 (89%) patients were nil per os (NPO) requiring enteral nutrition. Six of 19 (32%) patients had surgical complications, including three (16%) pharyngocutaneous fistulas. At 3-month and 1-year postoperative follow-up, there was significant improvement in mean Functional Oral Intake Scale (FOIS) score and aspiration, recurrent pneumonia, enteral nutrition, and NPO status rates (P < .05). At 1-year follow-up, no patients were NPO, and only one patient required gastrostomy tube supplementation. Mean FOIS score increased from 1.3 to 6.1 (P = .001). Eight of 13 patients (62%) were actively using a tracheoesophageal prosthesis at 1-year follow-up. CONCLUSIONS: Laryngectomy for dysfunctional larynx eliminates the morbidity of aspiration while improving diet and reducing gastrostomy tube dependence with an acceptable complication rate. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:597-602, 2018.

Comparing the influence of directly vs. indirectly encountered post-event misinformation on eyewitness remembering.

Some research has found a stronger influence of directly (face-to-face; co-witness; 'social') vs. indirectly (through written reports, 'non-social') encountered post-event misinformation on eyewitness memory reports, whereas other research finds no (big) difference. We argue and demonstrate that a crucial but so far neglected variable underlying this difference is memory for the misleading information itself. In a study with N=120 participants who encountered misinformation directly or indirectly, we found misinformation retention (as assessed in a separate test) to be positively associated with a broad range of misinformation effects. Influence type (direct vs. indirect), however, did not moderate the misinformation effect in terms of memory for original details, and misinformation endorsement was even weaker in the direct influence condition. In our view, these findings reflect differential conversion of retained misinformation into test performance. Other than this, influence type had essentially no effects on remembering; nor did an additional post-warning manipulation.

False memory ≠ false memory: DRM errors are unrelated to the misinformation effect.

The DRM method has proved to be a popular and powerful, if controversial, way to study 'false memories'. One reason for the controversy is that the extent to which the DRM effect generalises to other kinds of memory error has been neither satisfactorily established nor subject to much empirical attention. In the present paper we contribute data to this ongoing debate. One hundred and twenty participants took part in a standard misinformation effect experiment, in which they watched some CCTV footage, were exposed to misleading post-event information about events depicted in the footage, and then completed free recall and recognition tests. Participants also completed a DRM test as an ostensibly unrelated filler task. Despite obtaining robust misinformation and DRM effects, there were no correlations between a broad range of misinformation and DRM effect measures (mean r  = -.01). This was not due to reliability issues with our measures or a lack of power. Thus DRM 'false memories' and misinformation effect 'false memories' do not appear to be equivalent.