Dysphagia management: Does structured training improve the validity and reliability of cervical auscultation?

: Cervical auscultation (CA) uses a stethoscope or microphone to complement the clinical swallow examination by interpreting swallowing sounds and swallow-respiratory coordination. This study investigated the effects of structured CA training on CA-rating agreement with Flexible Endoscopic Evaluation of Swallowing (FEES) and CA rater reliability.: Thirty-nine speech-language pathologists participated in a structured CA training course at Gothenburg University.

A spoonful of sugar helps the medicine go down? A review of strategies for making pills easier to swallow.

Solid oral dosage forms such as tablets and capsules are generally the preferred method of drug delivery due to their convenience, cost, and acceptability. However, for many people, it can be a challenge to swallow solid oral medications, even those with healthy swallowing function. This review describes current strategies available to facilitate medication administration to otherwise healthy people with pill-swallowing difficulties.

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale.

Objective: To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient.

Design: Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel.

Nurses' experiences of medication administration to people with swallowing difficulties in aged care facilities: a systematic review protocol.

The objective of this review is to identify the experiences of nurses in administering oral medications to residents of aged care facilities with swallowing difficulties.More specifically, the review question is:What problems do nurses experience when administering oral medicines to people with swallowing difficulties living in aged care facilities?

Development of International Terminology and Definitions for Texture-Modified Foods and Thickened Fluids Used in Dysphagia Management: The IDDSI Framework.

Dysphagia is estimated to affect ~8% of the world's population (~590 million people). Texture-modified foods and thickened drinks are commonly used to reduce the risks of choking and aspiration. The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded with the goal of developing globally standardized terminology and definitions for texture-modified foods and liquids applicable to individuals with dysphagia of all ages, in all care settings, and all cultures.

Oral medication delivery in impaired swallowing: thickening liquid medications for safe swallowing alters dissolution characteristics.

Acetaminophen (paracetamol) is available in a wide range of oral formulations designed to meet the needs of the population across the age-spectrum, but for people with impaired swallowing, i.e. dysphagia, both solid and liquid medications can be difficult to swallow without modification.

Erratum to: The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review.

Erratum to: Dysphagia DOI 10.1007/s00455-014-9578-x. In the original version of this article, Fig.

The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review.

Texture modification has become one of the most common forms of intervention for dysphagia, and is widely considered important for promoting safe and efficient swallowing. However, to date, there is no single convention with respect to the terminology used to describe levels of liquid thickening or food texture modification for clinical use. As a first step toward building a common taxonomy, a systematic review was undertaken to identify empirical evidence describing the impact of liquid consistency and food texture on swallowing behavior.

Crushed tablets: does the administration of food vehicles and thickened fluids to aid medication swallowing alter drug release?

Purpose: To evaluate the influence of co-administered vehicles on in vitro dissolution in simulated gastric fluid of crushed immediate release tablets as an indicator for potential drug bioavailability compromise.

Methods: Release and dissolution of crushed amlodipine, atenolol, carbamazepine and warfarin tablets were tested with six foods and drinks that are frequently used in the clinical setting as mixers for crushed medications (water, orange juice, honey, yoghurt, strawberry jam and water thickened with Easythick powder) in comparison to whole tablets. Five commercial thickening agents (Easythick Advanced, Janbak F, Karicare, Nutilis, Viscaid) at three thickness levels were tested for their effect on the dissolution of crushed atenolol tablets.

Implications of changing the amount of thickener in thickened infant formula for infants with dysphagia.

When a dysphagic infant is prescribed thickened infant formula (TIF) as a treatment method, some clinicians determine their own addition rates of thickener to meet the specific needs of the infant rather than relying on the directions on the tin. In this study the rheological behaviour of a TIF at different addition levels of thickener was measured to determine whether there was a difference in full rheological response and in viscosity. In addition, the time taken for the TIF to reach a near-stable viscosity was also measured.

Physiological factors related to aspiration risk: a systematic review.

Penetration-aspiration is considered the most serious component of oropharyngeal dysphagia. Clinicians regularly evaluate the pathophysiology of swallowing and postulate reasons or mechanisms behind penetration-aspiration. In this article we share the results of a two-stage literature review designed to elucidate the association between abnormalities in physiological measures of swallowing function and the occurrence of penetration-aspiration.

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative.

Conservative estimates suggest that dysphagia (difficulty swallowing) affects approximately 8 % of the world's population. Dysphagia is associated with malnutrition, dehydration, chest infection and potentially death. While promising treatments are being developed to improve function, the modification of food texture and liquid thickness has become a cornerstone of dysphagia management.

Thickening agents used for dysphagia management: effect on bioavailability of water, medication and feelings of satiety.

Dysphagia is the medical term for difficulty swallowing. Thickened liquids are often used in the management of dysphagia to improve bolus control and to help prevent aspiration. A range of starches and gums has historically been used to thicken liquids.

Definition, prevalence and burden of oropharyngeal dysphagia: a serious problem among older adults worldwide and the impact on prognosis and hospital resources.

Oropharyngeal dysphagia describes difficulty with eating and drinking. This benign statement does not reflect the personal, social, and economic costs of the condition. Dysphagia has an insidious nature in that it cannot be 'seen' like a hemiplegia or a broken limb.

Evaluation of the uptake of the Australian standardized terminology and definitions for texture modified foods and fluids.

This paper discusses the uptake of standardized terminology and definitions for texture modified foods and fluids. The Australian dietetic and speech-language pathology associations endorsed national standards in 2007. This project sought to determine the barriers and enablers for use of the national standards in clinical practice.

Triaging dysphagia: nurse screening for dysphagia in an acute hospital.

Aims And Objectives: To (1) develop a dysphagia screening tool to triage all patients at risk of aspiration/dysphagia on admission to acute hospital wards, (2) evaluate tool reliability, (3) evaluate nursing compliance and (4) develop a robust dysphagia training programme.

Background: Failure to diagnose dysphagia has significant medical and economic costs. Dysphagia screening reduces pneumonia threefold.

Acoustic signature of the normal swallow: characterization by age, gender, and bolus volume.

Despite growing clinical use, cervical auscultation suffers from a lack of research-based data. One of the strongest criticisms of cervical auscultation is that there has been little research to demonstrate how dysphagic swallowing sounds are different from normal swallowing sounds. In order to answer this question, however, one first needs to document the acoustic characteristics of "normal," nondysphagic swallowing sounds.

Detection of swallowing sounds: methodology revisited.

Cervical auscultation is in the process of gaining clinical credibility. In order for it to be accepted by the clinical community, the procedure and equipment used must first be standardized. Takahashi et al.