Purpose: The aim of the study was to provide an updated systematic review of randomized controlled trials that studied the effectiveness of pharmacological and nonpharmacological interventions to prevent aspiration pneumonia in older adults at risk for aspiration. Method: The search was conducted in MEDLINE (PubMed), Scopus, and Web of Science databases and the Cochrane Central Register of Controlled Trials, using a protocol registered on PROSPERO (CRD42019139973). Randomized controlled trials of interventions to reduce the incidence of aspiration pneumonia in individuals older than 65 years at risk for aspiration, published between January 2002 and July 2019 and written in English, were included. Two reviewers independently evaluated the methodological quality of studies using the revised Cochrane risk-of-bias tool. Results: Thirteen out of 703 articles identified met the eligibility criteria and were included. Six studies focused on pharmacological interventions, three studies focused on dietary interventions and compensatory strategies, one study focused on oral care, two studies focused on multidisciplinary interventions, and one study assessed a screening method. Four studies showed positive and statistically significant effect in reducing aspiration pneumonia but were considered to have unclear or high risk of bias. Three studies showed promising results on the preventive effect of pharmacological interventions. Conclusions: The most recent evidence on the prevention of aspiration pneumonia in older adults revealed modest to poor methodological quality. Given the burden of aspiration pneumonia on patients and on the health care systems, the development of larger well-designed trials on this topic is of undoubted importance.

Background: Addressing the long-term consequences of stroke is a top 10 research priority, and understanding the views of different stakeholders is essential in designing appropriate patient-centred multidisciplinary rehabilitation. Aims: This study reports on the perspectives of 38 individuals who live with or work with aphasia: people with aphasia (PWA), family members (FM) and friends, and speech and language therapists (SLTs), about its consequences in the daily lives of PWA. Method & Resources: In total, 14 PWA, 14 FM and 10 SLTs participated in the study. All participants were interviewed about the consequences of stroke and aphasia. Small focus groups were used with some participants. In-depth semi-structured interviews were used with other participants. Interviews were carried out in groups or individually in order to accommodate severe aphasic impairments or respondents with fewer years of education. Interviews were video or audio-recorded. Verbal and non-verbal communication was transcribed and analysed qualitatively using content analysis. Data was coded and mapped onto the ICF framework. Outcomes & Results: All three groups reported consequences in Body Functions and Body Structures, primarily in Mental Functions (Specific Mental Functions and Global Mental Functions) and Neuromusculoskeletal and Movement-Related Functions. Within Specific Mental Functions, PWA emphasised Expression of Oral Language, whereas FM and SLTs emphasised Emotional Functions. Within Global Mental Functions, PWA and FM emphasised Energy and Drive Functions, whereas SLTs emphasised Temperament and Personality Functions. Some consequences were shared between PWA and SLTs (Sensory Functions and Pain, and Functions of the Digestive, Metabolic and Endocrine Systems), whilst others were specific to SLTs alone (Voice and Speech Functions, and Cardiovascular, Haematological, Immunological and Respiratory Systems). All three groups reported consequences in Activities and Participation in Major Life Areas; Community, Social and Civic Life; Interpersonal Interactions and Relationships; Communication; and Mobility. Some consequences were shared by PWA and FM (Domestic Life), and others by FM and SLT (Self Care). Consequences in General Tasks and Demands were only described by SLTs and in Learning and Applying Knowledge by PWA. Both PWA and FM reported a general Loss of Autonomy. Conclusions: PWA, FM and SLTs reported a considerable range of stroke and aphasia consequences in the daily life of those who live with it. They were concerned to different degrees with language, physical and emotional changes, and impact on communication, mobility, self-care, relationships, leisure and work. Professionals’ practices in Portugal need to be changed in order to consider these findings.

Background and objectives: More and more children with severe-to-profound hearing loss are receiving cochlear implants (CIs) at an early age to improve their hearing and listening abilities, speech recognition, speech intelligibility, and other aspects of spoken language development. Despite this, the rehabilitation outcomes can be very heterogeneous in this population, not only because of issues related to surgery and fitting or the specific characteristics of the child with his/her additional disabilities but also because of huge differences in the quality of the support and rehabilitation offered by the therapist and the family. These quality standards for the rehabilitation of young deaf children receiving CIs are developed within the European KA202 Erasmus+ project “VOICE”—vocational education and training for speech and language therapists and parents for the rehabilitation of children with CIs, Ref. No.: 2020-1-RO01-KA202-080059. Material and methods: To develop these quality standards, we used the input from the face-to-face interviews of 11 local rehabilitation experts in CIs from the four partner countries of the project and the outcomes of the bibliographic analysis of 848 publications retrieved from six databases: Pub Med, Psych Info, CINAHL, Scopus, Eric, and Cochrane. Based on all this information, we created a first set of 32 quality standards over four domains: general, fitting, rehabilitation, and for professionals. Further on, the Delphi method was used by 18 international rehabilitation experts to discuss and agree on these standards. Results: The results from the literature analysis and the interviews show us that more than 90% of the consulted international experts agreed on 29 quality standards. They focus on different aspects of rehabilitation: the multidisciplinary team, their expertise and knowledge, important rehabilitation topics to focus on, and programming issues related to rehabilitation. Conclusions: These quality standards aim to optimize the activity of speech rehabilitation specialists so that they reach the optimal level of expertise. Also presented is the necessary equipment for the IC team to carry out the rehabilitation sessions in good conditions. This set of quality standards can be useful to ensure the appropriate postoperative care of these children. As a result, the rehabilitation process will be more relaxed, and therapists will have the opportunity to focus more on the specific needs of each child, with the provision of quality services, which will result in better results. This theme is particularly complex and dependent on multifactorial aspects of medicine, education, speech therapy, social work, and psychology that are very intricate and interdependent.

The objective of this study is to investigate the presence of sarcopenia and the risk of oropharyngeal dysphagia (OD) in a geriatric population and to analyze the relationship between the factors associated with sarcopenic dysphagia. The cross-sectional study was carried out in two nursing homes. The presence of OD was screened using the gugging swallowing screen, and sarcopenia was assessed according to the European working group on sarcopenia in older people criteria. The sample (N=36; 23 women, 13 men) presents a mean age of 88.0±5.6, with 55.6% being at risk of OD, 52.8% with sarcopenia, and 36.1% with probable sarcopenic dysphagia. The score of the simple questionnaire to rapidly diagnose sarcopenia (SARC-F)≥4 was a significant predictor (odds ratio=9.0; confidence interval 95%=1.285-63.025) for the risk of having sarcopenic dysphagia. It was observed that sarcopenia was associated with higher odds of being at risk of OD. Also, an increase in age, poorly fitting prostheses, a higher level of dependence during activities of daily living, and a risk of malnutrition or malnourishment raised the potential of having probable sarcopenic dysphagia. We suggest including a speech and language therapist in the multidisciplinary geriatric teams to improve the prevention of sarcopenic dysphagia and to avoid its consequences.