BEYOND THE ISOLATED SWALLOW: DYSPHAGIA IN THE CONTEXT OF PERFORMANCE DURING A MEAL
Bibliographic record
Abstract
Dysphagia (difficulty in swallowing) makes the socially and culturally important meal situation problematic in elderly people, and may lead to decreased health, well-being and quality of life. Since eating, drinking and swallowing are complex and integrated neuromuscular processes, it is proposed that assessment of dysphagia should be based on a multi-stage process of ingestion: pre-oral (anticipatory), oral, pharyngeal, and esophageal. However, there is limited literature regarding the influences of the individual ingestion stages on the swallowing safety in dysphagic elders during a meal. As a part of a comprehensive needs assessment for developing and enhance dysphagia rehabilitation, this study aimed to provide insights into which specific ingestive skill impairments influences unsafe swallowing in elderly (65+) people with dysphagia. A cross-sectional study with 328 Danish elderly people (mean age: 77.7 ± 11.6 years) referred to occupational therapy for swallowing evaluation was carried out, and data on mealtime performance was collected using the McGill Ingestive Skills Assessment. Multiple logistic regression models showed that unsafe swallowing during a meal was significantly associated with: 1) inability to maintain a seating position, 2) inability to self-feed, impaired judgment and energy and 3) reduced labial seal, inability to bite and chew food items, piecemeal deglutition, inability to coordinate respiratory pattern during ingestion and inability to clear the airway in case of aspiration. Since impairments in all stages of ingestion tend to occur concurrently in elders with dysphagia, the goal of rehabilitation should not only address the swallowing impairment, but also eating as an activity of daily living.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".