Regardless of the underlying neuromotor impairment, an almost universal consequence of dysarthria is a reduction in speech intelligibility. The purpose of this article is to examine critically and to discuss issues related directly to speech intelligibility in speakers with dysarthria. Reduced speech intelligibility resulting from dysarthria is examined using the World Health Organization's International Classification of Functioning, Disability and Health (ICF) conceptual framework. We propose that the ICF conceptual framework facilitates an awareness of the multidimensional nature of disablement. Furthermore, the ICF facilitates a broad understanding of the complex nature of dysarthria, ranging from the neuroanatomical and physiological substrates contributing to reduced speech intelligibility, to the effects of this type of communication disorder on an individual's functioning in society and beyond. Finally, a case example is presented that describes how the ICF can be applied to an individual with dysarthria and reduced speech intelligibility.

Food molds change the appearance of pureed items to resemble typically prepared food. The present study examined the perceptions of 12 adults with normal swallowing and two adults with impaired swallowing for typical pureed versus molded pureed fruits (peach and pear). Results are presented for ratings of overall liking, taste, texture, appearance, and ease of chewing and swallowing. The present findings indicated that the pureed food molds did not positively influence attribute ratings. For both groups of adults, the typical method of pureed food presentation was rated higher or very similar to the molded pureed fruit. Results are discussed in terms of scaling methods, criteria applied for ratings, and implication of altering the viscosity of pureed foods.

ObjectiveThe aim of this study was to evaluate the comparative effectiveness of an online, interdisciplinary, interactive course designed to increase the ability to accurately interpret the fiberoptic endoscopic exam of the swallow (FEES) procedure to traditional, face-to-face (F2F) lectures for both graduate medical education (GME) and graduate speech language pathology (GSLP) programs.DesignThis was a prospective, quantitative, nonrandomized study. Participants were medical residents in physical medicine and rehabilitation from two affiliated programs and graduate students in speech language pathology from two instructional cohorts at a single institution. Group 1, traditional group (n=51), participated in F2F lectures using an audience response system, whereas Group 2, online group (n=57), participated in an online, interactive course. The main outcome measure was pre- and post-course FEES knowledge test scores.ResultsFor Group 1, the mean pre-course score was 26.94 (SD=3.24) and the post-course score was 34.96 (SD=2.51). Differences between pre- and post-course scores for Group 1 were significant (t=−16.38, P≤0.0001). For Group 2, the mean pre-course score was 27.05 (SD=2.74) and the post-course score was 34.05 (SD=2.84). Differences between pre- and post-course scores for Group 2 were significant (t=−13.5, P≤0.0001). The mean knowledge change score for Group 1 and Group 2 was 8.01 (SD=3.50) and 7.04 (SD=3.91), respectively (nonsignificant, t=1.372, P=0.173), suggesting groups made similar gains.ConclusionIncorporating technology into GME and GSLP programs yielded comparable gains to traditional lectures. Findings support the use of online education as a viable alternative to the traditional F2F classroom format for the instruction of the cognitive component of the FEES procedure.

Salivary secretions play a critical role in maintaining oral health via innate host defense mechanisms and secretion of secretory IgA. One of the antimicrobial peptides, LL-37 is the only cathelicidin protein so far identified in human beings. Cathelicidins are a family of peptides thought to provide an innate defensive barrier against a variety of potential microbial pathogens. The purpose of this study was to examine the expression of cathelicidin in human salivary glands and to investigate up-regulation of cathelicidin in inflammatory conditions.Methods: Reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemical staining were performed on 20 salivary gland tissues, 10 from normal and 10 from chronic sialadenitis.Results: Cathelicidin mRNA transcripts were detected in the normal salivary gland and chronic sialadenitis. The level of cathelicidin mRNA in chronic sialadenitis was significantly increased compared with that in the normal salivary gland. cathelicidin protein was expressed in the glandular epithelium of the normal salivary gland and chronic sialadenitis. Conclusion:The results indicate that cathelicidin might play an important role in the innate host defense of human salivary glands.Significance: In the present study, we showed the localizing expression of the human cathelicidin in salivary glands and up-regulation in the inflammatory conditions. This finding suggested the physiologic importance of cathelicidin in the defense of retrograde infection. Other functions for this broadly expressed peptide and possible expression of cathelicidin in saliva need to be evaluated.

This article addresses adult learning theory, social cognitive theory, and level of expertise and its effect upon professional growth and development. Training and education strategies to enhance skill acquisition and development related to dysphagia evaluation and treatment are discussed. In most areas of life, and especially in clinical circles, it is common to defer to the “experts”. Looking for external, third-party validation from the “experts” can be a comfortable solution to a difficult question or challenging issue. But who are these “experts”? More to the point, what specific characteristics makes a clinician a dysphagia expert and what is the pathway to attaining this level of expertise?