Of the three subtypes of attention outlined by the attentional subsystems model, alerting (vigilance or arousal needed for task completion) and executive control (the ability to inhibit distracting information while completing a goal) are susceptible to age-related decline, while orienting remains relatively stable. Yet, few studies have investigated strategies that may acutely maintain or promote attention in typically aging older adults. Music listening may be one potential strategy for attentional maintenance as past research shows that listening to happy music characterized by a fast tempo and major mode increases cognitive task performance, likely by increasing cognitive arousal. The present study sought to investigate whether listening to happy music (fast tempo, major mode) impacts alerting, orienting, and executive control attention in 57 middle and older-aged adults (M = 61.09 years, SD = 7.16). Participants completed the Attention Network Test (ANT) before and after listening to music rated as happy or sad (slow tempo, minor mode), or no music (i.e., silence) for 10 min. Our results demonstrate that happy music increased alerting attention, particularly when relevant and irrelevant information conflicted within a trial. Contrary to what was predicted, sad music modulated executive control performance. Overall, our findings indicate that music written in the major mode with a fast tempo (happy) and minor mode with a slow tempo (sad) modulate different aspects of attention in the short-term.

In the current study, an interactive approach is used to explore possible contributors to the misattributions listeners make about female talker expression of confidence. To do this, the expression and identification of confidence was evaluated through the evaluation of talker- (e.g., talker knowledge and affective acoustic modulation) and listener-specific factors (e.g., interaction between talker acoustic cues and listener knowledge). Talker and listener contexts were manipulated by implementing a social constraint for talkers and withholding information from listeners. Results indicated that listeners were sensitive to acoustic information produced by the female talkers in this study. However, when world knowledge and acoustics competed, judgments of talker confidence by listeners were less accurate. In fact, acoustic cues to female talker confidence were more accurately used by listeners as a cue to perceived confidence when relevant world knowledge was missing. By targeting speech dynamics between female talkers and both female and male listeners, the current study provides a better understanding of how confidence is realized acoustically and, perhaps more importantly, how those cues may be interpreted/misinterpreted by listeners.

Purpose: Two disparate models drive American speech-language pathologists' views of evidence-based practice (EBP): the American Speech-Language-Hearing Association's (2004a, 2004b) and Dollaghan's (2007). These models discuss evidence derived from clinical practice but differ in the terms used, the definitions, and discussions of its role. These concepts, which we unify as clinical evidence , are an important part of EBP but lack consistent terminology and clear definitions in the literature. Our objective was to identify how clinical evidence is described in the field. Method: We conducted a scoping review to identify terms ascribed to clinical evidence and their descriptions. We searched the peer-reviewed, accessible, speech-language pathology intervention literature from 2005 to 2020. We extracted the terms and descriptions, from which three types of clinical evidence arose. We then used an open-coding framework to categorize positive and negative descriptions of clinical expertise and summarize the role of clinical evidence in decision making. Results: Seventy-eight articles included a description of clinical evidence. Across publications, a single term was used to describe disparate concepts, and the same concept was given different terms, yet the concepts that authors described clustered into three categories: clinical opinion, clinical expertise, and practice-based evidence, with each described as distinct from research evidence, and separate from the process of clinical decision making. Clinical opinion and clinical expertise were intrinsic to the clinician. Clinical opinion was insufficient and biased, whereas clinical expertise was a positive multidimensional construct. Practice-based evidence was extrinsic to the clinician—the local clinical data that clinicians generated. Good clinical decisions integrated multiple sources of evidence. Conclusions: These results outline a shared language for SLPs to discuss their clinical evidence with researchers, families, allied professionals, and each other. Clarification of the terminology, associated definitions, and the contributions of clinical evidence to good clinical decision-making informs EBP models in speech-language pathology. Supplemental Material: https://doi.org/10.23641/asha.21498546

Background This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. Methods This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score‐matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score‐matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. Results A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score‐matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). Conclusion There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast‐induced nephropathy should not be used as a reason to avoid contrast‐enhanced CT.

The peri-operative use of angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers is thought to be associated with an increased risk of postoperative acute kidney injury. To reduce this risk, these agents are commonly withheld during the peri-operative period. This study aimed to investigate if withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers peri-operatively reduces the risk of acute kidney injury following major non-cardiac surgery. Patients undergoing elective major surgery on the gastrointestinal tract and/or the liver were eligible for inclusion in this prospective study. The primary outcome was the development of acute kidney injury within seven days of operation. Adjusted multi-level models were used to account for centre-level effects and propensity score matching was used to reduce the effects of selection bias between treatment groups. A total of 949 patients were included from 160 centres across the UK and Republic of Ireland. From this population, 573 (60.4%) patients had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers withheld during the peri-operative period. One hundred and seventy-five (18.4%) patients developed acute kidney injury; there was no difference in the incidence of acute kidney injury between patients who had their angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers continued or withheld (107 (18.7%) vs. 68 (18.1%), respectively; p = 0.914). Following propensity matching, withholding angiotensin-converting enzyme inhibitors or angiotensin-2 receptor blockers did not demonstrate a protective effect against the development of postoperative acute kidney injury (OR (95%CI) 0.89 (0.58-1.34); p = 0.567).