Julie Regan

Trinity College Dublin | TCD · Department of Clinical Speech and Language Studies

The following discussion on the physiology of the esophagus includes commentaries on the function of the muscularis mucosa and submucosa as a mechanical antireflux barrier in the esophagus; the different mechanisms of neurological control in the esophageal striated and smooth muscle; new insights from animal models into the neurotransmitters mediat...

Background: This paper aims to measure upper esophageal sphincter (UES) distensibility and extent and duration of UES opening during swallowing in healthy subjects using EndoFLIP(®). Methods: Fourteen healthy subjects (20-50 years) were recruited. An EndoFLIP(®) probe was passed trans-orally and the probe balloon was positioned across the UES. T...

Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is...

The incidence of dysphagia in the population with mental health disorders may be higher as a result of a number of factors including the nature of the psychiatric disorder, effects of psychiatric medications, co-occurring neurologic conditions, and institutionalization and behavioral changes associated with the mental illness. This study aimed to d...

Dysphagia affects up to 70% of older adults living in residential long-term care settings (RLTCS) and may lead to serious complications if not identified and adequately managed. However, there is a dearth of clinical guidelines tailored to older adults at risk of dysphagia in RLTCS. An online survey consisting of 40 questions was conducted to ident...

This is an editorial introducing the Framework for RigOr aNd Transparency In REseaRch on Swallowing (FRONTIERS) forum.

Objectives To evaluate participant-reported atypical dysphagia symptoms and their association with oxaliplatin treatment. Methods This observational study recruited 73 adults with solid tumours outside the head, neck or upper gastrointestinal tract. All had dysphagia, were in hospital or hospice and were treated by Medical Oncology, Radiation Onco...

Introduction Current clinical trials on swallowing disorders (dysphagia) in Parkinson’s disease (PD) apply a high variety of outcomes and different outcome measures making comparative effectiveness research challenging. Furthermore, views of patients and dysphagia clinicians when selecting trial outcomes have not been considered in the past, thus s...

Chronic oropharyngeal dysphagia (COD) and aspiration after esophageal cancer surgery may have clinical significance; however, it is a rarely studied topic. In a prospective cross-sectional observational study we comprehensively evaluated the nature, severity, and impact of COD, its predictors, and the impact of the surgical approach and site of ana...

Background Dysphagia is common in older adults with neurological and/or neurodegenerative conditions requiring early identification to avoid serious complications, including malnutrition, dehydration and aspiration pneumonia. The aim of this study was to describe dysphagia identification practices in Residential Long-Term Care Settings (RLTCS) in t...

This systematic review examined (i) prevalence, severity, and impact of persistent post-extubation laryngeal injury beyond hospital discharge and (ii) differences in persistent laryngeal injury between COVID-19 and non-COVID-19 populations. The review was completed following PRISMA-2020 guidelines. Four databases (PubMed, CINHAL complete, EMBASE, W...

Dysphagia can be a common secondary sequela of neurological and neurodegenerative disorders in older adults. Early screening, identification, and management of dysphagia is essential to avoid serious complications, including malnutrition, dehydration, aspiration pneumonia; and promote quality of life. Although individuals of all ages may experience...

BACKGROUND: One of the most prevalent types of atypical parkinsonian syndromes is progressive supranuclear palsy (PSP). PSP is associated with early onset of dysphagia which can result in malnutrition, dehydration, and aspiration pneumonia, affecting quality of life and increasing mortality rate. To date, research describing dysphagia in PSP and it...

Background Dysphagia is common in older adults living in Residential Long-Term Care (RLTC) settings, requiring timely diagnosis and appropriate management to avoid potential complications and improve quality of life. Current dysphagia prevalence rates, screening and management practices in RLTC settings in the Republic of Ireland are not known. Me...

Survivors of curative oesophageal resection for oesophageal cancer present with oropharyngeal and oesophageal dysphagia for many years following surgery. Few studies have explored the presentation of oropharyngeal dysphagia throughout survivorship or its impact on swallow-related quality of life (QoL). This prospective observational study investiga...

Introduction: Dysphagia is a common problem following oesophagectomy, and is associated with aspiration pneumonia, malnutrition, weight loss, prolonged enteral feeding tube dependence, in addition to an extended in-hospital stay and compromised quality of life (QOL). To date, the prevalence, nature and trajectory of post-oesophagectomy dysphagia h...

Context Dysphagia is common in cancer, but underlying pathophysiology and manifestations within patients are unknown. Objectives To examine dysphagia characteristics in those with solid malignancies outside the head, neck and upper gastrointestinal tract. Methods Seventy-three individuals with dysphagia (46 male, 27 female, aged 37-91) were recru...

BACKGROUND: Clinical practice guidelines (CPGs) can act as a bridge between clinical research and everyday practice. CPGs have been generated to inform Fiberoptic Endoscopic Evaluation of Swallowing (FEES), but their quality is unclear. OBJECTIVE: This study aims to systematically evaluate the quality of FEES CPGs to identify their suitability for...

Patient reported outcome measures (PROMs) are commonly used to evaluate the impact of a health condition on quality of life (QOL). This study aimed to identify the range of PROMs that are currently in common use in clinical trials in dysphagia following stroke and to qualitatively analyse these PROMs by mapping the content to both the International...

There has been a recent shift towards proactive dysphagia intervention in motor neurone disease (MND) to maintain physiological reserve. Pharyngeal high-resolution manometry (PHRM) can quantify swallowing pathophysiology to inform and evaluate proactive dysphagia intervention. This study aims to explore the current use of PHRM as a dysphagia evalua...

Background Dysphagia is prevalent in oesophageal cancer with significant clinical and psychosocial complications. The purpose of this study was i) to examine the impact of exercise-based dysphagia rehabilitation on clinical and quality of life outcomes in this population and ii) to identify key rehabilitation components that may inform future resea...

Introduction: This study aimed to summarise research findings on dysphagia prehabilitation initiated before chemoradiation therapy (C)RT in head and neck cancer (HNC) including its impact on three swallow-related outcomes at distinct time points. Methods: A comprehensive search was completed in PubMed, Embase, Web of Science and CINAHL. Inclusio...

Purpose: Evidence base to support the use of the effortful swallow in clinical populations with dysphagia is currently lacking. This study aims to quantify the effects of effortful swallowing on pharyngeal swallowing biomechanics in adults with dysphagia using pharyngeal high-resolution manometry (PHRM). Method: ManoScan HRM equipment with a 4.2 mm...

Objective: To investigate the presence, degree, predictors, and trajectory of dysphagia, dysphonia, and dysarthria among adults hospitalized with COVID-19 across the Republic of Ireland (ROI) during the first wave of the pandemic. Study design: Prospective observational cohort study. Methods: Adults with confirmed COVID-19 who were admitted in...

Objectives: This study aims to (i) investigate post-extubation dysphagia and dysphonia amongst adults intubated with SARS-COV-2 (COVID-19) and referred to speech and language therapy (SLT) in acute hospitals across the Republic of Ireland (ROI) between March and June 2020; (ii) identify variables predictive of post-extubation oral intake status an...

Background Speech and language therapists (SLTs) working with dysphagia have had to radically alter diagnostic and rehabilitation services during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, hereafter referred to as coronavirus disease (COVID-19). Given the aerosol-generating procedures inherent in swallow assessment a...

Background Dysphagia is a highly prevalent condition and affects a wide range of cohorts. A common compensatory strategy to manage dysphagia is diet modification. However, this technique is often associated with poor patient quality of life and adverse long-term effects. Carbonated liquids have shown promise as an alternative compensatory strategy...

This study aimed to (a) identify characteristics of dysphagia research receiving online attention; (b) determine associations between altmetric scores and traditional research metrics; (c) establish differences in altmetric scores between open access and closed access research and funded and non-funded research. Altmetric Explorer was searched on 7...

Objectives: This study aims to (i) investigate post-extubation dysphagia and dysphonia amongst adults intubated with SARS-COV-2 (COVID-19) and referred to speech and language therapy (SLT) in acute hospitals across the Republic of Ireland (ROI) between March and June 2020; (ii) identify variables predictive of post-extubation oral intake status and...

Background Older adults with dysphagia are at a higher risk of experiencing serious complications where dysphagia is not identified and adequately managed. Nursing personnel are critical for timely identification and management of dysphagia and prevention of these subsequent serious complications in residential care settings. Objectives To identif...

Purpose To develop a European White Paper document on oropharyngeal dysphagia (OD) in head and neck cancer (HNC). There are wide variations in the management of OD associated with HNC across Europe. Methods Experts in the management of specific aspects of OD in HNC across Europe were delegated by their professional medical and multidisciplinary so...

Evidence supporting sensory stimulation of swallowing is based mostly on videofluoroscopy and provides little insight into changes to swallowing physiology. In this study, the impact of sensory stimulation on pharyngo-esophageal swallowing biomechanics was investigated in adults with dysphagia using pharyngeal high-resolution manometry. Fifteen adu...

Background/aims: The Objective Structured Clinical Examination (OSCE) has an established history of assessing clinical competence for medical and allied healthcare professionals. No research has investigated the use of the OSCE within speech and language therapy undergraduate education. This study aimed to evaluate undergraduate speech and languag...

Purpose: The aim of this study was to investigate international oesophageal screening (OS) practices during videofluoroscopy (VFS) amongst speech-language pathologists (SLPs) and to establish SLP perspectives regarding OS during VFS. Method: A 25-item online survey was developed and disseminated internationally. Respondents were SLPs with dysphagia...

Introduction: Initial research has been conducted to determine the diagnostic accuracy of the pitch glide during the clinical swallow evaluation to identify aspiration in adults after stroke. Findings suggest that reduced pitch glide can predict aspiration in patients with dysphagia after stroke. This study aimed to identify the diagnostic accurac...

Context: Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract but also occurs in those with tumors outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in t...

The Dysphagia Outcome and Severity Scale (DOSS) is widely used to measure dysphagia severity based on videofluoroscopy (VFSS). This study investigated inter-rater reliability (IRR) of the DOSS. It also determined the effect of clinical experience, VFSS audio-recording and training on DOSS IRR. A quantitative prospective research design was used. Se...

Dysphagia is often associated with head and neck and upper gastrointestinal (GI) tract cancers. Evidence suggests that those with solid malignancies in other primary sites may also have swallowing difficulties. Timely and accurate identification of dysphagia is important given the impact it has on hydration, medical treatment, nutrition, prognosis,...

Adults with COPD frequently present with dysphagia, which often leads to clinical complications and hospital admissions. This study investigates the ability of the Eating Assessment Tool (EAT-10) to predict aspiration during objective dysphagia evaluation in adults with stable COPD. Thirty adults (20 male, 10 female; mean age = 69.07 ± 16.82) with...

Objective: Clinical guidelines place considerable emphasis on early swallow screening, as it has significant impact on patient outcomes. This study aims to examine perspectives and practices of speech and language therapists (SLTs) in the Republic of Ireland on swallow screening, exploring challenges in screening methods to improve practice and fa...

An oesophageal screen (OS) is recommended during videofluoroscopy (VFS) (Easterling, 2012). A validated OS protocol is the administration of 20mls liquid barium and a 13mm radio-opaque tablet while the patient stands with or without knees flexed. The bolus is tracked in an anterior-posterior (AP) view from the pharynx into the stomach (Allen et al,...

This study explores the contribution of Speech and Language Therapists (SLTs) to the assessment and management of patients presenting on videofluoroscopic swallow studies (VFSS) with a suspected pharyngo-oesophageal diverticulum. Records for all patients who attended for VFSS in an acute hospital over an eleven-year period were examined (N=1820). T...

This nonsystematic review aims to describe recent developments in the use of functional lumen imaging in the gastrointestinal tract stimulated by the introduction of the functional lumen imaging probe. When ingested food in liquid and solid form is transported along the gastrointestinal tract, sphincters provide an important role in the flow and co...

Objectives To evaluate safety of positioning and distending the Functional Lumen Imaging Probe (FLIP) in the pharyngo-oesophageal segment (POS) in adults with known POS dysfunction and to obtain preliminary measurements of POS distensibility and opening during swallowing in a clinical group.Methods Prospective case-series of ten adults post total l...

Background: Adequate upper oesophageal sphincter (UOS) opening is critical to safe and efficient swallowing due to the close proximity of the UOS to the airway entrance. Many people with neurological conditions, progressive and non-progressive, present with UOS dysfunction. The consequences for the person include difficulty swallowing food with su...

Introduction Standard upper endoscopy (SE) is an integral aspect of diagnostic and therapeutic gastroenterology. Patients frequently request conscious sedation as they perceive the procedure may cause pain or discomfort. Administration of sedation incurs additional costs and risks. Transnasal endoscopy (TNE) has the potential to overcome these issu...

Objective and reliable evaluation of upper esophageal sphincter (UES) opening during swallowing based on videofluoroscopy and pharyngeal manometry challenges dysphagia clinicians. The functional lumen imaging probe (FLIP) is a portable tool based on impedance planimetry originally designed to measure esophogastric junction compliance. It is hypothe...

The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation. To ascertain speech and language therapists' (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS evaluation. A surve...

Objectives: To examine a sample of adults with mental health disorders attending at an area psychiatric service, for the presence of impairments in language, communication and swallowing, using a test battery administered by speech and language therapists. Method: The study surveyed a randomly selected sample (n = 60) of patients from an acute psy...