Douglas F. Parham

Hydration in older adults: The contribution of bioelectrical impedance analysis

Abstract The sensory and gastrointestinal changes that occur with ageing affect older adults’ food and liquid intake. Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in older adults with dysphagia. The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care. This pilot study investigated the contribution of bioelectrical impedance analysis to measure hydration in 19 older women in residential care: 13 who viewed themselves as healthy and six with dysphagia. Mann-Whitney U analyses documented no significant between-group differences for Total Body Water (TBW), Fat Free Mass (FFM), Fat Mass (FM), and percentage Body Fat (%BF). However, when compared to previously published data for age-matched women, the TBW and FFM values of the two participant groups were notably less, and FM and %BF values were notably greater than expected. If results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.

Autism Spectrum Disorder Early Screening Practices A Survey of Physicians

The American Academy of Pediatrics (AAP) released a policy statement in 2007 urging physicians to screen for autism spectrum disorder (ASD) at 18 and 24 months. This study sought to identify the screening practices of pediatricians and family physicians (FPs) in following the AAP guidelines for ASD. A survey was mailed to 1,500 pediatricians and FPs in Kansas, Oklahoma, and Iowa. A total of 481 participants (32%) returned surveys. Results revealed 66 (17%) of the respondents routinely screened for ASD according to AAP guidelines and 162 (41%) respondents screened for ASD but did not follow the guidelines. Pediatricians were more likely to screen for ASD than were FPs. Respondents’ pre-professional education in ASD was significantly associated with their tendency to routinely screen and be confident identifying warning signs of ASD. When physicians administer ASD-specific screenings and identify early signs, they can put children and families on the right path for receiving desperately needed services.

Automatic cycle identification in tidal breathing signals

In this paper, we introduce a novel cycle identification algorithm using MATLAB programming to automatically identify cycles in tidal breathing signals. The algorithm was designed in four steps using filtering, derivation, and other signal processing techniques. To verify the accuracy of the proposed algorithm, its results were compared with those of cycles identified manually by a human coder. Simulations results showed that despite the complexity of respiratory signals, the proposed algorithm could identify cycles more accurately than the human coder. This algorithm could serve as an important first step toward timely identification and coding for more complex respiratory signals, such as those underlying speech productions.

Cycle detection in speech breathing signals

As with any physiological process, breathing behaviors can be represented by time-varying signals. Speech breathing, or breathing behavior that supports speech production, is one particular type of breathing that can be difficult and time-consuming to analyze visually. In this paper, we introduce a novel cycle identification algorithm using MATLAB programming that automatically identifies breath cycles in speech breathing signals. The results of simulations have shown that the proposed algorithm can identify breath cycles correctly and efficiently despite the complexity of speech breathing signals. The use of this algorithm can help researchers and clinicians more easily identify and analyze cycles associated with speech breathing.

Overcoming Barriers to Investigating Mother–Infant Interactions in the First Two Hours of Life

As a result of the unexpected delays experienced in a study designed to investigate mother–infant interactions and infant cry patterns in the first 2 hours following delivery, the study was assessed to identify the barriers that the investigators had encountered in its planning and conduct. These barriers can be categorized as issues with (1) institutional review board approval, (2) participant recruitment and retention, (3) requirements for study personnel, (4) instrumentation, (5) potential observer and participant bias, and (6) budgeting. Each barrier is detailed, along with suggested solutions. It is hoped that that these experiences will be of value to other researchers, particularly those working in non–research-intensive institutions, as they gather data to contribute to the understanding of mother–infant interactions in the immediate postpartum period.

Utterance Duration as It Relates to Communicative Variables in Infant Vocal Development.

Purpose We aimed to provide novel information on utterance duration as it relates to vocal type, facial affect, gaze direction, and age in the prelinguistic/early linguistic infant. Method Infant utterances were analyzed from longitudinal recordings of 15 infants at 8, 10, 12, 14, and 16 months of age. Utterance durations were measured and coded for vocal type (i.e., squeal, growl, raspberry, vowel, cry, laugh), facial affect (i.e., positive, negative, neutral), and gaze direction (i.e., to person, to mirror, or not directed). Results Of the 18,236 utterances analyzed, durations were typically shortest at 14 months of age and longest at 16 months of age. Statistically significant changes were observed in utterance durations across age for all variables of interest. Conclusion Despite variation in duration of infant utterances, developmental patterns were observed. For these infants, utterance durations appear to become more consolidated later in development, after the 1st year of life. Indeed, 12 months is often noted as the typical age of onset for 1st words and might possibly be a point in time when utterance durations begin to show patterns across communicative variables.

Students’ self-perceptions of interprofessional education following participation on a diagnostic team for autism spectrum disorder

ABSTRACT Interprofessional education is essential for producing future allied-health and education professionals. Unfortunately, opportunities for students to get authentic interprofessional field-based experiences are lacking. This pilot study explored students’ self-perceptions towards interprofessional education (IPE) following participation on an interprofessional diagnostic team designed to rule in or out the diagnosis of autism spectrum disorder (ASD). Thirty-nine students from seven professions responded to a survey before and after completing this interprofessional education experience. The results indicated that the students’ self-perceptions remained consistent during the experience. They reflected positive self-perceptions in the areas of collaboration, professional identity, and the desire to work with others, all in the context of an ASD-focused team. The findings suggest that students entering the IPE experience with positive expectations remained positive during the experience. This pilot study provides support for the benefits of providing students with the opportunity to engage in authentic collaborative practice when working with children with ASD.

DtP score method for assessing dual-task performance using stability and cognition measures

BACKGROUND: Poor lower limb stability during dynamic movement is thought to increase the risk of musculoskeletal injury. Biomechanically, stability is determined by a number of factors including the external load and contributions from passive and active tissues. One approach for studying lower limb stability is the single leg squat (SLS) test, which requires coordinated lower limb movement across a range of joint motions under external load. Although clinicians typically assess SLS quality from a single point of view (i.e. frontal plane), a 3D investigation of SLS kinematics would help to determine factors that differentiate clinician-defined “good” from “poor” quality performance. PURPOSE: To determine the kinematic parameters that characterise a good or a poor SLS performance in young adults. METHODS: 22 healthy young adults (13 male, 9 female; age: 23.8 ±3.1 years; height: 1.73 ±0.07 m; mass: 69.4 ±12.7 kg) free from musculoskeletal impairment were recruited. Video footage was collected in the frontal plane as participants performed three SLSs on each leg. SLS quality was assessed by a panel of physiotherapists using a ten-point ordinal scale. Performances were subsequently divided into tertiles corresponding to poor, intermediate and good SLS technique. 3D trajectories of 28 reflective markers attached to the pelvis, and lower limbs were simultaneously recorded at 200 Hz using a 10-camera, motion capture system (Vicon Motion Systems, Oxford, UK). Pelvis, hip and knee angles were calculated using a validated lower limb biomechanical model that incorporated functional identification of hip and knee joint centres. RESULTS: Mean rating of SLS quality as assessed by the panel of physiotherapists was 6.3±1.9 (range: 2.4 - 9.1). 3D analysis of SLS performance revealed that poor squatters had increased hip adduction (22.4 ±6.1 vs 14.7 ±4.7 deg, p<0.01), reduced knee flexion (73.1 ±8.7 vs 90.1 ±12.1 deg, p<0.01) and increased medal-lateral displacement of the knee joint centre (53.7 ±16.8 vs 38.4 ±14.3 mm, p=0.02) compared to good squatters. CONCLUSION: In healthy young adults a poor SLS is characterised by inadequate knee flexion and excessive frontal plane motion at the knee and hip. It is recommended that clinicians standardise knee flexion angle when using the SLS test as it might confound the perception of SLS quality.Purpose: To evaluate changes in performance and cardiac autonomic control (i.e. heart rate [HR] variability [HRV]) in elite soccer players during their pre-season training regime. Methods: Eight Spanish Premier League soccer players were examined at the first (week 1) and the last week (week 8) of the pre-season period (July-September). Nocturnal HR recordings on 4 days per week were averaged to evaluate the weekly HRV. Players also completed the Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) for the assessment of specific fitness. Results: During the pre-season period, there was no significant change (4.5 ± 23.9%) in Yo-Yo IR1 performance (2,475 ± 421 vs. 2,600 ± 786 m, p=0.55), while there was a significant decrement (6.3 ± 4.3%) in maximal HR (HRmax) recorded during the test (191 ± 7 vs. 179 ± 8 bpm, p = 0.004). Over the 8-week pre-season, significant increases in the standard deviation of the long-term continuous HRV (SD2) (174 ± 56 vs. 212 ± 53 ms, p = 0.017), and in the standard deviation of all HR intervals (SDNN) (135 ± 50 vs. 163 ± 41 ms, p = 0.023) were noted. No significant correlations were identified between Yo-Yo IR1 and HRV measures at week 1. In contrast, Yo-Yo IR1 performance was significantly correlated with SDNN (r =0.89, p=0.007) and SD2 (0.92, p=0.003) at week 8. Greater values in HRV at week 1 were substantially associated with lower HRV changes at the end of pre-season (r values ranged from -0.79 to -0.98, p< 0.05). Furthermore, HRV changes were significantly correlated with decreases in HRmax during the pre-season (r values from 0.83 to 0.94, p<0.05). Conclusions: The current results confirm that despite minimal changes in specific fitness (i.e. Yo-Yo IR1), pre-season training significantly improved various HRV indices in elite soccer players with greater changes evident for those with lower initial HRV levels. Nocturnal HRV may provide an important monitoring tool for identification of cardiovascular function changes in top-class soccer players during pre-season regimes.

Sensitivity of spectral moments to Swedish dental versus American English alveolar word‐initial /t/ bursts

Previous investigations comparing Swedish dental versus American English alveolar /t/ production found many acoustic differences in both adults and 30‐month‐old children [C. Stoel‐Gammon, K. Williams, and E. H. Buder, ‘‘Cross‐language differences in phonological acquisition: Swedish and American /t/,’’ Phonetica 51, 146–158 (1994)]. The primary differences in the word initial consonants included the second spectral moment (‘‘spectral SD’’), VOT, and burst intensity. However, subsequent studies demonstrated that spectral SD and other moments measures were sensitive to recording environment and correlated with other production characteristics. Moreover, measurements of spectral SD differed across these languages in other stop bursts such as /p/ and /k/. These observations raised questions regarding the true sensitivity of this measure in place of articulation for /t/. To examine these questions, the current work examines stop burst characteristics of two adult male native speakers of Swedish and American En...