Speech training aids for hearing-impaired individuals: I. Overview and aims

Prelingual profound deafness typically results in aberrant or unintelligible speech production. For approximately 70 years, researchers and engineers have attempted, with little success, to provide electronic aids for speech training. Recent computer and signal processing technology has provided the impetus for several groups to implement new speech training aids. Following a review of deaf speech characteristics, several current computer-based aids are described. Included among those reviewed are two interrelated speech training aids which resulted from collaboration among the authors.     

Speech training aids for hearing-impaired individuals: II. Configuration of the Johns Hopkins aids

Two interrelated personal computer (PC) based speech training aids have been developed: one for use in a school or clinic, the Speech Training Station (STS); and the other for the deaf child's home, the Speech Practice Station (SPS). The STS monitors speech production by microphone, electroglottograph, and pneumotachograph. The SPS system uses only the microphone input. Both systems utilize commercially available board-level hardware and a custom analog preprocessor board for the analysis of the acoustic and/or physiologic inputs. The school system has been used by speech therapists for diagnosis, training by game playing, and specification of exercises for the SPS. The home system provides directed speech practice between therapy sessions.     

Challenges for care homes: education and training of healthcare assistants

The spotlight is increasingly on all care homes, including those catering specifically for older people, to deliver on quality targets in an attempt to drive up the standards of care provision. These targets include the education, training and supervision of care staff. Representing a major component of the care staff workforce in care homes are healthcare assistants and they play a key role in care provision and will continue so to do. However, pivotal to their effective role performance is preparation and support - the provision of which has been patchy to date. For care homes that provide nursing care the challenges of delivering on these targets by 2005 are significant, particularly as the majority of these homes are run as private enterprises and in the absence of any form of central funding. This article examines key issues to education and training provision. A strategic nationwide approach to education and training for healthcare assistants in care homes is recommended, coupled with robust evaluation of outcomes. Such initiatives will need to be supported by significant financial investment if the Government's targets are to be achieved.     

Metabolic training: new paradigms of exercise training for metabolic diseases with exercise calorimetry targeting individuals.

For patients with metabolic diseases, as with other diseases, exercise training is a fully recognized therapy. Such training helps obese patients stabilize weight after slimming. For patients with type 2 diabetics, it is both a prevention and a glucose-lowering treatment and reduces health care costs. We propose a targeted training for individuals at the level of maximal lipid oxidation (LIPOXmax) with a protocol of exercise calorimetry (four 6-min workloads) based on Brooks and Mercier's crossover concept. Calorimetric interpretation of gas exchange at the fifth and sixth minutes of each stage shows a bell-shaped curve for lipid oxidation that peaks at LIPOXmax, a point that varies considerably among individuals. As well, glucose oxidation is a linear function of power (carbohydrate cost of the watt). Such a calculation predicts fairly actual lipid oxidation over 45 min at the same level. Other protocols, with 3-min workloads used in sports medicine, are not reliable for patients with metabolic diseases. For obese adults and teenagers, as well as those with type 2 diabetes, 2 months' training at the LIPOXmax (three sessions at 45 min per week) results in a net loss of fat mass, with preserved fat-free mass, and increased ability to oxidize lipids. At the end of this period, training can be "re-targeted" to be more effective and, possibly, associated with other strategies with stronger exercise intensities. Therefore, metabolic training is a viable option for patients with metabolic diseases, but the full concept is still evolving. However, the major challenge remains to transform inactive individuals into active ones.     

Patient records in nursing homes. Effects of training on content and comprehensiveness

The purpose of this study was to describe the effects on the contents and comprehensiveness of the nursing-care documentation in the patient records at nursing homes following an educational intervention. A review was made of records (n = 120) from nursing homes in six Swedish municipalities, allocated to a study group and a reference group. All the nursing home nurses in three municipalities received education concerning the nursing process and how to document according to the VIPS model. A retrospective audit of all nursing notes in the records from the nursing homes was made before and after the intervention. Improvements were found in the contents of the records in the study group. The number of notes on nursing history more than doubled. The occurrence of the recording of nursing diagnoses, goals and discharge notes increased. No corresponding changes were observed in the reference group. In the study group, an increase in the number of acceptable notes with contents on nursing history, status, nursing diagnosis, planned and implemented interventions, and nursing discharge notes was found. This increase was significant. The comprehensiveness in the documentation of single nursing problems was only slightly improved in the study group. No record met the requirements of the national regulations on nursing documentation or followed the nursing process thoroughly.     

Radial counter-immunoelectrophoresis in the determination of specific anti-hydatidosis antibodies. Preliminary observations

Radial counter-immunoelectrophoresis was evaluated with sera from surgically-confirmed hydatidosis cases, patients with other parasitic diseases and healthy controls. Radial counter-immunoelectrophoresis was a sensitive as classic counter-immunoelectrophoresis based on the same positivity criterion and was equally specific for the immunodiagnosis of human hydatidosis. The procedure appears to be simple and rapid (the immunoprecipitation step requires just 5 minutes) and merits consideration.     

Without prejudice: results and realisation of a training needs audit in nursing homes

An analysis of training needs among registered nurses and carers in nursing homes will be used to form education action plans that will foster a learning culture and, ultimately, improve patient care     

A new ultrasonic probe for endosonographic imaging of the upper GI-tract. Preliminary observations

A new ultrasonic probe (7.5 MHz, diameter 3.7 mm) was used in vitro in 3 gastric resection specimens and in vivo in 12 patients in an attempt to visualize normal and pathological wall structure of the esophagus, stomach and duodenum via the working channel of a gastroscope, and of the biliary tract via the percutaneous approach. In 5 of these patients conventional endosonography was performed. The probe visualizes the normal layer structure and pathological lesions of the upper GI-tract wall, since it can be accurately positioned at the structure of interest under visual control; water is instilled into the hollow organs to improve transmission of the ultrasound beam. Intra- and transmural changes such as blood vessels in the wall of the esophagus and stomach in portal hypertension, or gastric and esophageal tumors were demonstrated. The important advantage of the probe is that it can be used in stenosed or narrowed hollow organs, where conventional endosonography fails. However, the depth of penetration of the ultrasonic beam (10-15 mm) and circumferential imaging of the gastric wall are still inferior to those of conventional endoscopic ultrasound. As the focus distance of the ultrasound probe to the biliary ducts is too small, visualization of the biliary system is incomplete. Technical improvements could make this new probe an irreplacable diagnostic tool in the future.     

Brakes and levers to implement an animal-assisted intervention in nursing homes: Preliminary study

BackgroundIncreasing numbers of scientific studies have dealt with the benefits of animal assisted intervention programs (AAI). Although many positive effects have been identified, there are still few AAI programs in nursing homes. To date, no study has investigated special the difficulties in implementing such a program.The aim of this study was to explore the representations of this type of program among caregivers.MethodsThis qualitative study was conducted between January and June 2019. Psychologists conducted 11 interviews with people working in nursing homes. The sample was based on different professions and on the fact that participants had already been involved in an IAA program.ResultsThe results were organized according to two main themes: brakes and levers. The results show that the brakes were raised quickly before the implementation of the project, but once the project had been implemented, the perceived beneficial effects multiplied and all those interviewed mentioned the benefits of animals. More than half of the caregivers interviewed mentioned animals as a lever, facilitating contact with elderly people suffering from dementia. Setting up a project upstream enhanced the success of this type of program.ConclusionThe benefits perceived by the people interviewed are consistent with the scientific literature. The obstacles mentioned for implementing this type of program can be reduced by a rigorous and well-thought-out project.