Challenges to quality in contemporary, hybrid general practice a multi-site longitudinal case study.

Background: Since 2022, general practice has shifted from responding to the acute challenges of COVID-19 to restoring full services using a hybrid of remote, digital, and in-person care.

Aim: To examine how quality domains are addressed in contemporary UK general practice.

Design And Setting: Multi-site, mostly qualitative longitudinal case study, placed in UK national policy context.

The impact of social media influencers on health outcomes: Systematic review.

A fast emerging area of public health interest is the potential role of social media influencers in spreading health information and affecting health behaviour. The aim of this research was to systematically synthesise evidence on the impact of social media influencers on health outcomes. A systematic search of six databases (Medline, Embase, PsycINFO, CINAHL, Science Citation Index and Sociology Collection) was conducted in October 2021, with an update search in January 2023.

Using Virtual Reality to Bring Restorative Environments to Employees: An Online Pilot Study.

Employees face many demands throughout the workday. Participating in activities can help employees recover from the pressures of work, and physical activity and time spent in nature are among the most beneficial. Simulations of nature offer some of the benefits of actual contact with nature and can address some of the barriers to exercising outdoors that some employees may face.

Amateur choir singers - Does good vocal health matter?

Background: Many amateur singers enjoy singing in choirs. They are likely to lack the training and expertise of professional singers and this may have an impact on their vocal health.

Aims: To assess the experiences of amateur singers, their use of warm-up and cool-down sessions, their vocal health, their sources of help and advice and their reactions to receiving a diagnosis and treatment.

Measuring outcomes of a peer-led social communication skills intervention for adults with acquired brain injury: A pilot investigation.

Reduced social competence following severe acquired brain injury (ABI) is well-documented. This pilot study investigated a peer-led group intervention based on the claim that peer models may be a more effective mechanism for behaviour change than clinician-led approaches. Twelve participants with severe ABI were recruited from a post-acute neurorehabilitation setting and randomly assigned to either a peer-led intervention or a staff-led activity group (usual care) (Clinicaltrials.

Deficient Resident Memory T Cell and CD8 T Cell Response to Commensals in Inflammatory Bowel Disease.

Background And Aims: The intestinal microbiota is closely associated with resident memory lymphocytes in mucosal tissue. We sought to understand how acquired cellular and humoral immunity to the microbiota differ in health versus inflammatory bowel disease [IBD].

Methods: Resident memory T cells [Trm] in colonic biopsies and local antibody responses to intraepithelial microbes were analysed.

Effectiveness of vocabulary intervention for older children with (developmental) language disorder.

Background: Children with developmental language disorder (DLD) frequently have difficulties with word learning and understanding vocabulary. For these children, this can significantly impact on social interactions, daily activities and academic progress. Although there is literature providing a rationale for targeting word learning in such children, there is little evidence for the effectiveness of specific interventions in this area for children with identified DLD.

The Neutrophil-to-Lymphocyte Ratio as a Marker of Lymph Node Status in Patients with Rectal Cancer.

Aim: The aim of the study was to investigate the role of the neutrophil-to-lymphocyte ratio (NLR) as a prognostic marker of rectal cancers.

Methods: We undertook a retrospective review of patients with rectal cancer. Pre-treatment NLR was assessed for association and predictive values against clinicopathological staging and post-treatment outcomes.

Inequalities in the provision of paediatric speech and language therapy services across London boroughs.

Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest.

Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs.

Methods & Procedures: Information on the employment of paediatric speech and language therapists was obtained from London boroughs by freedom-of-information requests.

TOT phenomena: Gesture production in younger and older adults.

This study explored age-related changes in gesture to better understand the relationship between gesture and word retrieval from memory. The frequency of gestures during tip-of-the-tongue (TOT) states highlights this relationship. There is a lack of evidence describing the form and content of iconic gestures arising spontaneously in such TOT states and a parallel gap addressing age-related variations.

The working practices and clinical experiences of paediatric speech and language therapists: a national UK survey.

Background: The majority of speech and language therapists (SLTs) work with children who have speech, language and communication needs. There is limited information about their working practices and clinical experience and their views of how changes to healthcare may impact upon their practice.

Aims: To investigate the working practices and professional experiences of paediatric SLTs working in the UK through an online survey.

Enhancing communication through gesture and naming therapy.

Purpose: In this study, the authors investigated whether gesture, naming, and strategic treatment improved the communication skills of 14 people with severe aphasia.

Method: All participants received 15 hr of gesture and naming treatment (reported in a companion article [Marshall et al., 2012]).

Does mode of administration affect health-related quality-of-life outcomes after stroke?

Telephone interviews and postal surveys may be a resource-efficient way of assessing health-related quality-of-life post-stroke, if they produce data equivalent to face-to-face interviews. This study explored whether telephone interviews and postal surveys of the Stroke and Aphasia Quality of Life Scale (SAQOL-39g) yielded similar results to face-to-face interviews. Participants included people with aphasia and comprised two groups: group one (n =22) were 3-6 months post-stroke; group two (n =26) were ≥1 year post-stroke.

Gesture and naming therapy for people with severe aphasia: a group study.

Purpose: In this study, the authors (a) investigated whether a group of people with severe aphasia could learn a vocabulary of pantomime gestures through therapy and (b) compared their learning of gestures with their learning of words. The authors also examined whether gesture therapy cued word production and whether naming therapy cued gestures.

Method: Fourteen people with severe aphasia received 15 hr of gesture and naming treatments.

Feeding difficulties in children with cerebral palsy: low-cost caregiver training in Dhaka, Bangladesh.

Background: The majority of children with cerebral palsy have feeding difficulties, which, if not managed, result in stressful mealtimes, chronic malnutrition, respiratory disease, reduced quality of life for caregiver and child, and early death. In well-resourced countries, high- and low-cost medical interventions, ranging from gastrostomy tube feeding to caregiver training, are available. In resource-poor countries such as Bangladesh, the former is not viable and the latter is both scarce and its effectiveness not properly evaluated.

Speech perception in noise by monolingual, bilingual and trilingual listeners.

Background: There is strong evidence that bilinguals have a deficit in speech perception for their second language compared with monolingual speakers under unfavourable listening conditions (e.g., noise or reverberation), despite performing similarly to monolingual speakers under quiet conditions.

Therapy for naming difficulties in bilingual aphasia: which language benefits?

Background: The majority of the world's population is bilingual. Yet, therapy studies involving bilingual people with aphasia are rare and have produced conflicting results. One recent study suggested that therapy can assist word retrieval in bilingual aphasia, with effects generalizing to related words in the untreated language.

Self-perception of speech changes in patients with Parkinson's disease following deep brain stimulation of the subthalamic nucleus.

Deep brain stimulation of the subthalamic nucleus (STN-DBS) improves the motor difficulties experienced by patients with Parkinson's disease (PD); however, the effects on speech are variable. In this study, patients rated their current post-surgery speech difficulties using the Voice Handicap Index (VHI) and used the same measure to retrospectively rate their pre-surgery speech. Scores pre- and post-surgery were also available on the UPDRS-III, and the patients' intelligibility was assessed by an independent listener.

Treating children with phonological problems: does an eclectic approach to therapy work?

Background: A survey of clinicians made by Joffe and Pring in 2008 revealed that different approaches exist between researchers and clinicians in the treatment of children with phonological problems. Researchers have examined specific approaches to treatment often giving substantial amounts of therapy and have obtained encouraging results; clinicians, with less time available, often use an eclectic approach mixing different treatment methods. The reasons for this difference are discussed.

Delivering the Lee Silverman Voice Treatment (LSVT) by web camera: a feasibility study.

Background: Speech disorders are a feature of Parkinson's disease, typically worsening as the disease progresses. The Lee Silverman Voice Treatment (LSVT) was developed to address these difficulties. It targets vocal loudness as a means of increasing vocal effort and improving coordination across the subsystems of speech.

Children with phonological problems: a survey of clinical practice.

Background: Children with phonological problems are a significant proportion of many therapists' caseloads. However, little is known about current clinical practice with these children or whether research on the effects of therapy have influenced this practice.

Aims: To investigate the methods of assessment and remediation used by therapists working in the UK.

Quality of life in multiple sclerosis: should clinicians trust proxy ratings?

Purpose: Measures of quality of life (QoL) are increasingly used to monitor psychological and social well being of clients with chronic illnesses. They are particularly useful in cases where an illness results in multiple disabilities. Where clients have difficulty completing the measure, others who know them may act as proxies.

Teaching productive sign modifications to children with intellectual disabilities.

Research suggests that few children who are reliant on manual sign for expressive communication progress beyond a basic level of sign combinations. However, they may be capable of expressing complex meanings by changing the form of their signs. This study investigated whether children with intellectual disabilities could be taught productive use of modified signs.

The cognitive competence of speakers with acquired dysarthria: judgements by doctors and speech and language therapists.

Background: Studies have shown that listeners make negative attributions towards people with communication impairments. This appears to be the case for health care professionals as well as non-professional listeners.

Aims: This study extends this line of research to speakers with acquired dysarthria.