Abstract: Posturography allows evaluating the integration of the three sensory systems involved in postural and balance control: vestibular, visual and somatosensory (Ronda, Galvan, Monerris & Ballester, 2002). The present research seeks to describe and analyze the results of posturography in children between six and eleven years old with hearing loss who have not compensated their hearing age with respect to their chronological age. Two groups were evaluated: the control group made up of 32 children with normal peripheral hearing sensitivity and the study group, made up of 16 children with hearing loss, who use hearing amplification and attend the CINDA Foundation for auditory therapy to close the GAP between the chronological age and the hearing age. In the audiological evaluation, anamnesis, review of clinical history, tonal audiometry was applied to verify peripheral hearing sensitivity and posturography, with a NeuroCom brand equipment, performing the following tests: Modified-balance sensory integration (CTSIB), limits stability (LOS) and weight distribution (WHT). In the results, statistically significant differences were found between the two study groups for the three tests in different variables. In conclusion, it was possible to determine that there are statistically significant differences between the control group and the study group. The occupational therapy intervention positively influenced the results in posturography, especially in the 10 to 11-year-old group. Successive differences were observed in the three age groups, indicating a neuromaturation component.

Abstract: espanolLa nocion de carne, perteneciente a la ultima etapa del pensamiento de Merleau-Ponty, ocupa un lugar determinante en las investigaciones especializadas sobre el autor. Sin embargo, en escasas publicaciones se destaca la inmensa influencia de esta ultima en el pensamiento actual, especialmente en las corrientes posthumanistas y materialistas de la contemporaneidad filosofica. Nos proponemos, en las paginas que siguen, analizar dicha categoria desde el punto de vista de una filosofia de la relacion, interpretandola desde la figura de la medialidad o emparentandola a una nocion de medio. Para esto, en la primera parte, se dilucidara la nocion merleau-pontiana de medio en Fenomenologia de la percepcion y la postulacion de la experiencia como punto de partida. En la segunda, se explicitaran las multiples dimensiones en las cuales se despliega la nocion de carne en la filosofia tardia del autor. Una vez abordados los aspectos epistemologico, fenomenologico y ontologico de la ontologia de la carne se analizara su potencial filosofico proyectando los tratamientos a la problematica de la naturaleza, cuestion que consideramos de vital importancia para las reflexiones filosoficas actuales. English“Chiasm, Flesh and Nature. Merleau-Ponty and the Problem of Mediality”. The notion of flesh, belonging to the last stage of Merleau-Ponty’s thought, occupies a decisive place in specialized research on the author. However, few publications highlight the immense influence of the latter in current thought, especially in the post-humanist and materialist currents of contemporary philosophy. We propose, in the pages that follow, to analyze this category from the point of view of a philosophy of relationship, interpreting it from the figure of mediality or relating them to a notion of medium. For this, in the first part, we will elucidate the notion of medium used in Phenomenology of Perception and the postulation of experience as a starting point. In the second part, we will specify the multiple dimensions in which the notion of flesh unfolds in the late philosophy of the author. Once the epistemological, phenomenological and ontological aspects of the ontology of the flesh have been addressed, its philosophical potential will be analyzed, projecting the treatments for the problems of nature, an issue that we consider of vital importance for current philosophical reflections.

Abstract: In the clinical care, the speech language pathologist has evaluative resources to describe the sequential biomechanics of swallowing; one of the resources used is Cervical Auscultation (CA). Taking into account the description of the importance of the timely and effective intervention of the swallowing processes in children with cerebral palsy, it is considered necessary to solve: what is the spectrographic profile that records the pharyngeal phase of swallowing in the pediatric patient with cerebral palsyl?. The Systematic review based of a PRISMA methodology, specifically in the use of cervical auscultation as a reference for the clinical evaluation of swallowing and dysphagia in diagnosed pediatric subjects. with Cerebral Palsy. Of the180 articles found in the cientific databases, taking 6 articles out of the total according to the eligibility criteria, establishing a 3.34% of inclusion. In the absence of instrumental swallowing evaluation processes, CA provides the accessibility of the procedure as a benefit, in addition to temporality characteristics in the sequence of swallowing sounds, without any type of adverse factor for its performance. The CA is an important resource in clinical evaluation, it establishes a first step in the physiological analysis of swallowing with the physiological aspects of the pharyngeal phase. This puts auscultation in a privileged position, but it must be standardized by cientifics and theorists on the subject.

Abstract: espanolEste articulo busca presentar el legado teorico-politico de Rousseau a traves de la interpretacion de su Discurso sobre los origenes y fundamentos de la desigualdad entre los hombres y el Contrato social, entendidos como una unidad argumentativa y metodologica en la obra del ginebrino. Para esto se expondran en un primer momento las consideraciones normativas y antropologicas que marcan el problema politico de Rousseau. A partir de alli se presentaran las ideas principales de su nocion de democracia, para finalmente concluir que el legado democratico de Rousseau resulta particularmente util como elemento critico en el contexto de la hegemonia de las democracias representativas liberales actuales. English“Rousseau’s Philosophical-political Program: the Theoretical Link between the Discourse on the Origins and Foundations of the Inequality Among Mankind and the Social Contract”. This paper presents Rousseau’s political and theoretical legacy through the interpretation of his Discourse on the Origins and Foundations of the Inequality Among Mankind and the Social Contract, understanding both as a sole argumentative and methodological unit in his work. In order to achieve this objective, the paper explores first the normative and anthropological considerations that mark the problem of Rousseau’s political theory. From there, the main ideas of his notion of democracy will be presented. Finally, the paper concludes that Rousseau’s democratic legacy is particularly useful as a form of critique in the hegemonic context of the current liberal and representa-tive democracies.

Abstract: The International Dysphagia Diet Standardisation Initiative (IDDSI) allows, amongst other things, to classify liquid viscosity in different levels. Although it is normally used as a treatment strategy for dysphagia, it may also be used in the execution of different assessment methods to establish how difficult it is for a patient to manage a particular viscosity. Nonetheless, IDDSI doesn´t determine specific amount of thickener required to obtain each viscosity level, also the initiative recommends establishing adaptations according to fixed conditions of application (e.g. type of thickener or foods offered in an institution). This study developed a proposal to prepare viscosities through experimental tests, specifying milliliters of water and grams of thickener for each viscosity. Therefore, measures of water and thickener to obtain viscosity levels 0-4 are defined and verified through flow test. The presented findings take into account influential variables like geographic location, temperature and altitude. It is hoped that this proposal impacts swallowing assessment practices in Colombian clinical area, so that evaluation could be more accurate and effective. Finally, it is appropriate to determine specific measures of thickener to achieve all viscosity levels in liquids other than water. It is also necessary, to replicate this proposal with other thickeners more easily available to clients as well as consideration of other factors like palatability.

Abstract: The aging process, as in the whole organism, generates a series of changes in the stomatognathic structures, and these morphological changes, characteristic in the swallowing mechanism in healthy elderly subjects, characterize Presbyophagia. An interesting discussion is generated around presbyophagia and the parameters of safety, effectiveness, competence and comfort, given that neurological-structural changes are frequent in the elderly, which carry various consequences, from mild to severe degrees, that impact in a differentiated way in the indicators that are usually described in the clinic. However, the conceptualization used is not clear when making a distinction between a transitional state or a state of affection. For this reason, it is analyzed whether there are key factors that allow elucidating the contemporary conception to create a unified language in favor of directing speech therapy actions towards the areas of health promotion of the swallowing function and prevention of dysphagia in this population.

Abstract: This article arises from the need to generate reflection spaces of the (SLP) speech and language pathology´s role in pediatric feeding disorders. It should be taken into account that feeding is a natural process that transcends culture. In the pediatric field, consultations for difficulties of this nature are frequent increasingly. SLP assess and rehab feeding and swallowing disorders in all range age. Particularly in babies and young children, these problems may be due to multiple conditions that alter or hinder swallowing safety and efficacy; as well as comfort during feeding. Throughout the manuscript, an attempt is made to review central themes closely related to this topic, which has multiple edges, and as a final part of the discussion, the complexity posed by the challenges of nutrition is addressed with special emphasis on the need for interdisciplinary work. Therefore, the final goal is to make the role of the SLP in pediatric feeding disorders known to the scientific community.

Abstract: The purpose of this study was to describe the use of tracheostomy speaking valves by Colombian speech-language pathologists as part of the management of tracheostomised patients. To do that, a digital form was distributed to speech-language pathologists graduated in Colombia. Questions were grouped in five categories and were analyzed descriptively to observe response patterns. Several generalized linear models were adjusted to determine the influence of variables like city, professional experience, postgraduate studies, population and setting of attention and presence of tracheostomy teams in the adaptation of speaking valves. Open questions were analyzed regarding categories of analysis identified in participants’ responses. The form was filled out by 27 speech-language pathologists from different cities, with a variety of postgraduate studies. Above all, participants look after adults with tracheostomy in the context of intensive care. 66.66% of participants declared having adapted at least a valve and only 33.33% of these professionals claimed that administrative issues to order the device were straightforward. None of the predictive variables were significant to explain the adaptation of speaking valves (p>0.05). The present study suggests that Colombian speech-language pathologists are aware of speaking valves and their benefits. Furthermore, it states that studied variables don’t have a significant effect in adaptation of the device. Lastly, it confirms that administrative issues regarding medical orders and authorizations may have a negative role to gain access to the valves.

Abstract: The present review was proposed in order to compile the existing evidence on the rehabilitative approach in older adults with neurodegenerative diseases, since these treatments directly influence the health of patients. The search methods were implemented under an ordered systematic review process under the Preferred Reporting Items for Systematic Reviews, PRISMA model, in which information is collected chronologically on the scientific evidence of a particular topic. Descriptors such as: Adult, Neurodegenerative, Dysphagia; Rehabilitation. Twenty-one articles were included in the systematic review, including studies and reviews on the treatments used in neurodegenerative diseases. In the findings it is evident inter-transdisciplinary intervention, modification of the environment, use of drugs as a means to mitigate mainly motor symptoms, surgical procedures; in addition, swallowing, compensatory, rehabilitative maneuvers, among others. Some alternatives require the participation of the speech pathologist because in most people suffering from neurodegenerative diseases the oral and / or pharyngeal phase of swallowing is affected, triggering dysphagia in different degrees of severity and directly compromising food intake. due to the risk of aspiration, pneumonia and / or death and, in turn, the quality of life, This systematic review allows us to identify the need to make more proposals for therapeutic options, studies that show their efficacy and that above all generate significant changes in those who suffer described diseases.

Abstract: Dysphagia is known as the difficulty or disability when it comes to eating food, which is analyzed from different points since it can be generated by anatomical factors, be they birth or acquired, psychological or functional causes. The professional work in dysphagia allows classifying the severity of dysphagia, but not the qualification of the risk of the different functional errors during ingestion. For this reason, this paper proposes to classify the level of risk due to functional swallowing errors. The research was proposed from a prospective nature with a validity relationship, through the Delphi method, through which a list of functional swallowing errors was postulated to be validated by 6 expert judges in the area. A proposal was made in a matrix, which evaluated the different functional errors divided into the swallowing phases and the risk levels to affect dysphagia, according to the items of sufficiency, relevance, coherence and clarity. A list of 38 validated errors was obtained, which are based on risk, since when they materialize, they promote a greater probability of penetration / aspiration of food into the airway in the glutory sequence. The consensus on the classification of these errors according to risk will be a useful tool for professionals in the area. A list of risks due to functional swallowing errors is concluded through Fisher's least significant difference (LSD) for means, in descending order according to the severity of the risk represented by the error in intake.

Abstract: Respiration comprises a series of complex mechanisms, ranging from gas exchange with the outside to the use of oxygen (O2) by the cell and the elimination of carbon dioxide (CO2). These mechanisms require the coordination of different organs and systems, not only the respiratory system, which is closely related to sucking and swallowing in the newborn, becoming a determining factor when feeding or not feeding a newborn via oral, especially if he is born preterm or has some respiratory difficulty. The objective of this review is to determine the most important criteria for the initiation of nutritive sucking in neonates with respiratory difficulties, for which the scientific evidence in this regard is searched in different databases such as PubMed, Scopus and Cochrane from 2000 onwards, where 70 articles are chosen, of which, after applying some selection criteria, 14 of them are considered the most appropriate for the development of the subject. It was concluded that, among the most important criteria to initiate nutritional suction in patients with respiratory difficulties, are the measurement of peripheral oxygen saturation (SpO2), an adequate coordination of the SRD triad, the absence of alarm signs such as coughing, nasal regurgitation and intercostal pulling and definitely a nutritious sucking through breastfeeding, thanks to its multiple benefits including the reduction of the risk of desaturation.

Abstract: The purpose of the work is the interpretation of the social interaction with the elements of the nature of the object [physical and social] through the life stories at the levels of semantic and pragmatic language of the eighth grade students of a school of Antofagasta in phonoaudiological perspective. Aligned transversally to the international 2030 agenda of the Sustainable Development Goal N ° 4 [target 4.7] they are aimed at guaranteeing safe and inclusive learning contexts. The research is biographical narrative [narrative]; qualitative approach; study of a school case and content analysis of the data collection instrument. Transcript of the corpus of the semi-structured interview, in addition to the written account of eight [8] eighth grade students aged between 13 and 14 from a school in the city of Antofagasta, Chile. The results give the meaning of the nature of the physical and social object in view of the need for a period of communicative immersion in school in effective interaction. The importance of speech and language support for communicatively fostering social support networks for a linguistic immersion that allows anticipation regarding the pragmatics to be placed in context in relation to behavior and at the semantic level mediate with the new concepts used in the establishment.

Abstract: Emergency rooms are spaces with coordinate protocols and sequential diagnostic and therapeutic actions. Emergency rehabilitation professionals contribute to decision-making on hospitalization or egress behaviors, home plans, diagnostic aids, and referral to specialists. The purpose of this literature analysis was to identify international evidence, about the phono-audiologist in the emergency room and his professional actions with patients, family members and health teams. Materials and methods. Evidence was reviewed from the Ebsco, PubMed, Scielo, Elsevier and Web of Science databases, from January 2015 to September 2020, with search terms: speech language pathology, speech therapy, emergency room in Spanish and English. They selected documents informing about emergency room rehabilitation processes, including actions from speech therapy. Sand analyzed 51 documents according to inclusion criteria. The evidence shows the incursion of speech therapy work in a non-traditional context, motivated by the needs in clinical decision-making in interdisciplinary dialogue, mainly under conditions of dysphagia and swallowing disorders. Professional actions in this context include the promotion and prevention of emergency room admissions, up to critical, acute, and end-of-life care. This context represents professional challenges towards clinical judgment skills, professional scientific argumentation, use of detection tools and interdisciplinary work. that make the difference between aspects such as egress and hospitalization, a treatment or procedure and in some cases, between life and death.

Abstract: The objective is to present the methodology of our protocol of nasofibroscopic evaluation of swallowing in a cooperative manner and to disseminate among otorhinolaryngologists and phonoaudiologists that it is an agile, simple and easily feasible process to study, diagnose and plan the therapy of oropharyngeal dysphagia jointly in the multidisciplinary team. It was a cross-sectional descriptive pilot study where swallowing nasofibroscopy was applied by means of the functional evaluation protocol as a cooperative multidisciplinary method, taking a pilot sample of 29 adults, with an average age of 62.5 years. It was performed in patients without any alteration in the state of consciousness and presenting findings compatible with dysphagia in the context of neurological pathology, post intubation and some dysphonic patients. The protocol begins with anamnesis, physical and functional examination of the orofacial structures, and ends with clinical endoscopic examination of the structures involved in oropharyngeal dysphagia. After the application of the pilot test, the events during the swallowing process were observed. The frequent findings were: presence of residues in the vallecula and pharyngeal recesses after ingestion of pudding-like consistency, in addition to subsequent leakage of liquids in nectar-like consistency. It is concluded that nasofibroscopy of swallowing is a very versatile objective test, easy and safe to perform, that allows an adequate diagnosis of oropharyngeal dysphagia, which if applied in a cooperative manner between the speech therapist and the otolaryngologist can guide the rehabilitation work and the therapeutic behavior. Translated with www.DeepL.com/Translator (free version)