ABSTRACT
Emphysematous cystitis (EC) is a potentially life-threatening urinary tract infection (UTI) characterized by the presence of gas within the bladder wall and lumen. The extension of gas beyond the bladder wall is rare and indicative of severe disease. We present a case of septic shock secondary to EC with the extension of air through the paraspinal and psoas muscles and into the epidural space of the lumbar spinal canal. This finding of intraspinal air is a rare radiographic phenomenon known as pneumorrhachis (PR).
ABSTRACT
We are in a climate and ecological emergency, where climate change and direct anthropogenic interference with the biosphere are risking abrupt and/or irreversible changes that threaten our life-support systems. Efforts are underway to increase the resilience of some ecosystems that are under threat, yet collective awareness and action are modest at best. Here, we highlight the potential for a biosphere resilience sensing system to make it easier to see where things are going wrong, and to see whether deliberate efforts to make things better are working. We focus on global resilience sensing of the terrestrial biosphere at high spatial and temporal resolution through satellite remote sensing, utilizing the generic mathematical behaviour of complex systems-loss of resilience corresponds to slower recovery from perturbations, gain of resilience equates to faster recovery. We consider what subset of biosphere resilience remote sensing can monitor, critically reviewing existing studies. Then we present illustrative, global results for vegetation resilience and trends in resilience over the last 20 years, from both satellite data and model simulations. We close by discussing how resilience sensing nested across global, biome-ecoregion, and local ecosystem scales could aid management and governance at these different scales, and identify priorities for further work. This article is part of the theme issue 'Ecological complexity and the biosphere: the next 30 years'.
Subject(s)
Climate Change , EcosystemABSTRACT
Purpose The ability of 5- and 6-year-old male children (23 participants) between the chronological ages of 5;0 and 6;11 (years;months) with childhood apraxia of speech (CAS; n = 9) and with typical development (TD; n = 14) to detect differences in vowel duration of syllable pairs is explored. We asked whether the children with CAS show different patterns of performance on the vowel duration difference experimental task than those of their similarly aged peers with TD. Method A male adult audio-recorded the syllable /bÉ/. The /É/ was digitally lengthened and shortened, while maintaining uniform fundamental frequency and amplitude of the vowel and duration of the consonant /b/ at 42 ms. Vowel lengths increased in 40-ms increments, ranging from 208 to 488 ms. Eight pairs of syllables, 1 with equal length and 7 with differing vowel lengths, were randomly presented to the children 10 times in blocks of 16 pairs via a computer application. Results Numerous complementary analyses indicated patterns of performance differed for children with CAS compared to the children with TD. The children with CAS were notably less accurate in their duration discrimination and evidenced greater variability in their performances across duration difference conditions than their peers with TD, signifying they were generally challenged to discriminate the vowel duration differences. Conclusion These results suggest that CAS, which is more generally considered a motor speech disorder, may have a perceptual component of CAS related to vowel duration discrimination. Further research directions and clinical implications are discussed. Supplemental Material https://doi.org/10.23641/asha.8411876.
Subject(s)
Apraxias/physiopathology , Speech Discrimination Tests/methods , Speech Disorders/physiopathology , Speech Perception/physiology , Case-Control Studies , Child , Child, Preschool , Humans , MaleABSTRACT
This article describes a procedure to aid in the clinical appraisal of child speech. The approach, based on the work by Dinnsen, Chin, Elbert, and Powell (1990; Some constraints on functionally disordered phonologies: Phonetic inventories and phonotactics. Journal of Speech and Hearing Research, 33, 28-37), uses a railway idiom to track gains in the complexity of speech sound production. A clinical case study is reviewed to illustrate application of the procedure. The procedure is intended to facilitate application of an evidence-based procedure to the clinical management of developmental speech sound disorders.
Subject(s)
Articulation Disorders/diagnosis , Articulation Disorders/physiopathology , Phonetics , Speech Production Measurement/methods , Speech-Language Pathology/methods , Aphasia, Broca/diagnosis , Aphasia, Broca/physiopathology , Child Language , Child, Preschool , Evidence-Based Practice/methods , Geography , Humans , Language , Male , WalesABSTRACT
Generalization refers to the extension of learned behaviours to novel conditions, and it is one of the criteria by which the effectiveness and efficiency of a remediation programme may be judged. This article extracts principles of generalization from the treatment literature, and provides examples of how this information may be used to help guide treatment decisions. Included is a discussion of client, clinician, and treatment variables that may contribute to the generalization process.
Subject(s)
Articulation Disorders/therapy , Generalization, Psychological , Phonetics , Speech Therapy/methods , Child , Child Language , Child, Preschool , Female , Humans , Male , Models, PsychologicalABSTRACT
PURPOSE: The use of nonspeech oral motor treatments (NSOMTs) in the management of pediatric speech sound production disorders is controversial. This article serves as a prologue to a clinical forum that examines this topic in depth. METHOD: Theoretical, historical, and ethical issues are reviewed to create a series of clinical questions that should be considered before one incorporates new methods into clinical practice. CONCLUSION: Speech production disorders are complex and multifaceted. Speech-language pathologists are encouraged to advocate on behalf of clients by adopting the highest standards of clinical practice and by evaluating treatment options in a systematic, critical, and ethical manner.
Subject(s)
Dysarthria/rehabilitation , Language Development Disorders/rehabilitation , Myofunctional Therapy/methods , Phonation , Phonetics , Speech Therapy/methods , Child , Dysarthria/diagnosis , Dysarthria/etiology , Ethics, Professional , Humans , Language Development Disorders/diagnosis , Language Development Disorders/psychology , Risk Factors , Speech Therapy/ethics , Treatment OutcomeABSTRACT
PURPOSE: This article functions as an epilogue to the clinical forum examining the use of nonspeech oral motor treatments (NSOMTs) to remediate speech sound disorders in children. METHOD: Conclusions to eight clinical questions are formed based on the findings that were reported in the clinical forum. Theoretical and clinical challenges are also identified. CONCLUSION: NSOMTs have serious theoretical and empirical shortcomings. At present, there is insufficient evidence to support the routine clinical application of these procedures to remediate developmental speech sound disorders.
Subject(s)
Dysarthria/rehabilitation , Myofunctional Therapy , Child , Humans , Treatment OutcomeABSTRACT
The emergence of clinical phonetics and linguistics as an area of scientific inquiry gives rise to the need for guidelines that define ethical and responsible conduct. The diverse membership of the International Clinical Phonetics and Linguistics Association (ICPLA) and the readership of this journal are uniquely suited to consider ethical issues from diverse perspectives. Accordingly, this paper introduces a multi-tiered six-factor model for ethical practices to stimulate discussion of ethical issues.
Subject(s)
Ethics, Professional , Phonetics , Humans , Interprofessional Relations/ethics , Linguistics/ethics , Professional-Patient RelationsABSTRACT
The third edition of the Boston Diagnostic Aphasia Examination (Goodglass, Kaplan, and Barresi) introduced standardized procedures for coding discourse samples elicited using the well known Cookie Theft illustration. To evaluate the reliability of this discourse coding procedure, a transcribed sample was coded by 14 novice examiners using the Goodglass et al. coding criteria. Percentage of agreement scores between novice and expert coders were poor (with an average of <50% agreement). This paper describes factors that may have contributed to the poor interjudge agreement, and one approach to improving agreement is described.
Subject(s)
Aphasia/diagnosis , Neuropsychological Tests , Speech , Adult , Female , Humans , Male , Reproducibility of Results , Speech Production Measurement , Verbal BehaviorABSTRACT
Oral reading passages are often used to elicit speech samples from clinical populations. Few objective guidelines exist, however, to guide one's selection from among the many existing passages. Therefore, this study was undertaken to describe phonetic, lexical, and structural characteristics of 15 oral reading passages. The passages differed markedly in the demands that they placed upon the speaker (i.e., length and complexity), as well as the adequacy of the phonetic sample.
Subject(s)
Phonetics , Reading , Humans , Speech Disorders/diagnosis , Speech Production Measurement , Verbal BehaviorABSTRACT
This paper discusses the contributions of informatics technology to the field of clinical linguistics and phonetics. The electronic publication of research reports and books has facilitated both the dissemination and the retrieval of scientific information. Electronic archives of speech and language corpora, too, stimulate research efforts. Although technology provides many opportunities, there remain significant challenges. Establishment and maintenance of scientific archives is largely dependent upon volunteer efforts, and there are few standards to ensure long-term access. Coordinated efforts and peer review are necessary to ensure utility and quality.
