News

Earlier this year, Beatrice Manduchi successfully completed her PhD under Dr. Martino’s supervision.

Dr. Manduchi has already published several papers highlighting her doctoral work, including:

1. Patient-reported outcome measures for dysphagia in head and neck cancer: a) systematic review, and b) multi-stakeholder Delphi study
2. Examining the acceptability of behavioural swallowing interventions for head and neck cancer patients during radiotherapy: a) patients’ experiences, and b) clinicians’ experiences

Recent PhD graduate, Victoria Sherman, has just published a paper in the Journal of the American Heart Association, investigating the benefit of dysphagia screening in the adult stroke population. Click here to read the article.

The Swallowing Lab was involved in providing simulated learning opportunities for Speech Language Pathology students at the University of Toronto during COVID. Click here for the full story.

Sherman, V, Martino, R. , Bhathal, I, Deverber, G, Dlanini, N, MacGregor, D, Pulcine, L, Beal, D, Thorpe, K, Moharir, M. Swallowing, oral motor, motor speech and language impairments following acute pediatric ischemic stroke. Stroke. 2021; 52: 1309–1318. Click here for article.

Greco, E, Ringash, K, Tomlinson, G, Huang, SH, O’Sullivan, B, Waldron, J, Martino, R. Presence and duration of feeding tube in a 5-year cohort of patients with head and neck cancer treated with curative intensity-modulated radiation therapy. Head and Neck 2021; 1-11. Click here to access article.

Swallowing Lab PhD students, Victoria Sherman and Beatrice Manduchi, were recently recognized with academic excellence awards by the University of Toronto.

Victoria was awarded the SickKids Clinician Scientist Program Training Award.

Beatrice was awarded the Mary H. Beatty Fellowship.

Congratulations to both!!!

Members of the Swallowing Lab share some useful insights into the unique challenges presented by COVID-19, specifically the shift from in-person to virtual care for their dysphagic patients.

The Dangers of Swallowing Disorders, which was recently featured in the Globe and Mail, showcases Dr. Rosemary’s Martino’s multi-site PRO-ACTIVE study. This study aims to determine what type of intervention – early or reactive – is most effective at treating swallowing problems among head and neck cancer patients undergoing radiation therapy.

Dr. Martino was one of 21 recipients of new and renewed Canada Research Chairs at the University of Toronto this year. Total estimated funding for the chairs is $19 million. Dr. Martino’s Canada Research Chair (Tier 2) in Swallowing Disorders was first awarded in 2013 and helps to fund her research program, which focuses on understanding swallowing impairment (dysphagia) and its impact on the patient. Her aim is to conduct research that will assist clinicians in providing the best possible care to their patients and that will ultimately help reduce the burden of dysphagia for patients, their caregivers and the community.

For full details about this year’s Canada Research Chair recipients from the University of Toronto, please click here.

Victoria Sherman, a third year doctoral student, recently published the first systematic review on dysphagia following stroke in children. This review highlighted that, although limited data is available, dysphagia commonly occurs after childhood stroke, with reported frequencies from 24.2% to 88.6%. There is very little known on dysphagia-related health outcomes and caregiver burden, and no standardized tool available to identify dysphagia early following stroke in children. This review was the first study from Victoria’s dissertation research, and she is excited to continue her studies on dysphagia in children after stroke.

Elissa Greco (PhD student) conducted a systematic review on dysphagia treatment for patients with head and neck cancer treated with radiotherapy. Through meta-analysis, she found that behavioural dysphagia intervention is beneficial to measures of swallow function and physiology, regardless of intervention start time. This study was the first to pool data from several randomized controlled trials and observational studies to determine the overall benefit from active dysphagia intervention. This study is now published in a high impact journal (International Journal of Radiation Oncology Biology Physics).

Victoria Sherman, in the second year of her doctoral program, received the prestigious multi-year SickKids Clinician Scientist Training Program (CSTP) award (2017-2021). This scholarship is awarded yearly to only a few select students whose proposed research is based at SickKids and is judged as scientifically meritorious. As a recipient of this award, Victoria will participate in monthly seminars, attend annual national meetings, and have opportunities to meet and collaborate with other Canadian paediatric clinician researchers from a variety professions.

In April, Dr. Rosemary Martino had the honour of being a judge in George Brown College’s “Top Chef Challenge: Dysphagia”. This annual event, which takes place at the waterfront campus, involves teams made up of Culinary Arts students and staff from Baycrest, who compete to prepare a meal that is suitable for individuals with swallowing difficulties. The meal also has to be nutritionally balanced, aesthetically pleasing, and most importantly delicious. For more information about this event, please follow this link.
(Photography by Alexa Fernando – www.ajfernando.com)

In recent months, the Swallowing Lab team has been busy building bridges to sustain and promote dysphagia research and patient care throughout the continent. To that end, the lab eagerly accepted the opportunity to present its work at the ninth international conference of the American Head and Neck Society (ANHS). Held over five days in mid-July, the annual conference was designed to enable multidisciplinary collaborations amongst member clinicians in the pursuit of new mechanisms for head and neck cancer identification, treatments, and measurement of outcomes and quality of care.

Dr. Rosemary Martino was invited to both moderate and present in the members’ education series on the innovative research of the Swallowing Lab. Spanning clinical Speech Language Pathology care and head and neck cancer treatment, Dr. Martino’s session brought the audience of Head and Neck clinicians and researchers up to date on promising new dysphagia interventions targeting patient swallowing related issues. Dr. Martino also discussed some of the lab’s most recent work which examined the relationship between measures of objective swallowing physiology and observer-rated toxicities, function and Quality of Life (QoL). The findings show that patient reported outcomes alone are not sufficiently accurate in detecting changes in swallow physiology. The study provided clear support for the idea that accurate and comprehensive assessments also require objective clinical testing completed by a skilled clinician. The lab envisions this fresh research will further contribute to the field by facilitating better understanding of patient perception of the severity of their issues in relation to clinical evaluations.

As the single largest organization in North America for the advancement of research and education in head and neck oncology, Dr. Martino was pleased to be able to present at the AHNS’s 2016 conference, and looks forward to future opportunities to share the Swallowing Lab’s trailblazing research.

Beyond the call, student researchers buttress local communities

While the work of the Swallowing Lab is focused on making inroads in dysphagia research and clinical practice, several members of the team also make time to prioritize giving back to their local communities.  In recent months, two research students working in the Swallowing Lab have been commended for their beyond the call, extra-curricular contributions to sustain and support fellow students and colleagues.

This year’s spring convocation saw 4^th year PhD student Stephanie Shaw recognized for her leadership within the University of Toronto with a Gordon Cressy Award.   Established in 1994 and named after the former vice-president of development and university relations, the Cressy Awards aim to identify and acknowledge students who have made outstanding extra-curricular contributions to the University of Toronto.   Stephanie was recognized for her work as co-chair of the International Students’ Caucus, a body that addresses the interests and concerns of the university’s international graduate student community.  Among other achievements, during her three years with the group Stephanie was able to realize a tenfold increase in international student participation.  Stephanie and her fellow 2016 Cressy Award recipients are in good company, joining a community of more than 3,400 graduates who have received the prize since it’s inauguration in 1994.

Not to be outdone, in May second-year PhD candidate Elissa Greco was presented with an Evelyn Hall Education Award.  Established in 1991 this award, marking the retirement of the former Chief Operating Officer of the Toronto Hospital, aims to encourage interdisciplinary collaboration among health care professionals within the University Health Network.   Nominated by her colleagues at the Toronto Western Hospital, Elissa received the award for her deliberate efforts to harmonize the clinical work of the SLP team at the Western Hospital, with the research activity of the Martino Swallowing Lab.

Congratulations Stephanie and Elissa!

The Swallowing Lab of Dr. Rosemary Martino — In the heat of the race to advance dysphagia research and treatment

This year’s Annual Meeting of the Dysphagia Research Society (DRS) took place February 25^th to 27^th in sunny Tucson, Arizona.  The DRS was established a quarter century ago to enhance and encourage interdisciplinary and innovative research pertinent to swallowing function and dysfunction.  The 2016 Annual Meeting brought together a wide range of clinicians, researchers, resident physicians, fellows, and students who take care of patients with swallowing disorders.

The Swallowing Lab was well-represented at this year’s event.  A team of three affiliated students and clinicians successfully presented posters on their academic research, while Dr. Martino’s pivotal work in Head and Neck Cancer swallowing disorder treatment was recognized by the society with an Oral Presentation Award.

As part of the Scientific Poster Exhibit, second-year PhD candidate Elissa Greco presented her systemic review of published literature evaluating the efficacy of exercise for head and neck cancer patients on swallow physiology, function, and quality of life.  Greco’s findings revealed that future randomized control trials are sorely needed in order to accurately identify those dysphagia interventions that most benefit this patient population.

From the perspective of improving care and screening of Parkinson’s patients, Speech Language Pathology (SLP) clinician Erin Yeates has been busy working on a review of published literature to identify any existing dysphagia screening tools for adults with Parkinson’s disease (PD).  Yeates has determined that there is a gap in assessment of this patient group, who may be not be aware of their swallowing difficulties. Her work establishes that more research is needed to develop a high precision screening tool, which is valid across the spectrum of PD severity.

Rounding out the poster presentations was the work of first-year PhD candidate Victoria Currie, whose research focused
on studying established clinical practice in early dysphagia identification of the acute stroke patient population. Currie’s work assessed and compared the accuracy of informal swallowing screening protocols to more formal protocol, such as the TOR-BSST© screening tool.  Her work underscored the greater accuracy of the formal screening protocol and need as part of routine post-stroke patient evaluation.

Finally, Dr. Rosemary Martino was honoured to be the 2016 co-recipient of the Head and Neck Cancer award. Funded by the Head and Neck Cancer Alliance (HNCA), this award is open at all disciplines presenting swallowing research in patients with head and neck cancer.  Dr. Martino received the award for the presentation she gave on her longitudinal study investigating changes in the swallow status of head and neck cancer patients treated with chemo-radiotherapy.

The Dysphagia Research Society recognized Dr. Martino’s presentation as fulfilling the mandate of the HNCA “… to advance prevention, detection, treatment and rehabilitation of oral, head and neck cancer through public awareness, research, advocacy and survivorship.”  As a result of this significant undertaking in longitudinal research, Dr. Martino has established that there is a need to offer this patient group effective therapy protocols tailored to the specific swallow impairments involving the throat and airway resultant from their cancer treatment.

With the hard work of the DRS Annual Meeting behind them, the team made sure to get out and enjoy a bit of what Arizona had to offer!

CONGRATULATIONS to Margit Labas-Weber and Nadia Pennella, two TOR-BSST© SLPs from North York General Hospital who, along with colleagues Tina Chopra and Bojay Hansen, won first place at the 2016 GTA Rehab Conference for their poster titled ‘Successful Interprofessional Knowledge Translation and Implementation for TOR-BSST (Toronto Bedside Swallowing Screening Test) Best Practices in Stroke Care’.

Last week we celebrated the completion of enrollment for our CIHR-funded study that aims to validate the TOR-BSST© in critically ill patients who have undergone prolonged intubation (> 24hrs). We thanked all the dedicated ICU screeners and clinical staff who helped us reach this important milestone.

The Swallowing Lab’s first doctoral graduate, Heather Flowers (PhD, 2014), is currently featured on the UofT Faculty of Medicine’s Graduate and Life Sciences Education website. See her full profile here.

We accept Ed Steger and NFOSD’s Thickened Liquid Challenge!

The Swallowing Lab was challenged by Ed Steger, President of the National Foundation of Swallowing Disorders:

Skoretz, SA, Yau, TM, Ivanov, J, Granton, JT, & Martino, R. Dysphagia and associated risk factors following extubation in cardiovascular surgical patients. Dysphagia. 2014. 29:647-54.

Flowers HL, Flamand-Roze C, Denier C, Roze E, Silver FL, Rochon E, Skoretz SA, Baumwol K, Burton L, Harris G, Langdon C, Shaw S, Martino R. English adaptation, international harmonization, and pretesting of the Language Screening Test (LAST). Aphasiology. 2015 Feb;29(2):214-236.

Shaw, SM, Flowers, H, O’Sullivan, B, Hope, A, Liu, LWC, & Martino, R. The effect of prophylactic percutaneous endoscopic gastrostomy (PEG) tube placement on swallowing and swallow-related outcomes in patients undergoing radiotherapy (with or without chemotherapy) for head and neck cancer. Dysphagia. In Press.

Excerpt from EDGE:

[Tiffany] Tram is a research coordinator for Martino’s current study on the medical outcomes of dysphagia that measures the complications caused by the condition. The study focuses on the effects of a swallowing disorder on nutrition, the lungs and on a patient’s mental health.

“The hard part of this research is that we have to make sure everything we find is translatable to all patients. That’s why it is important that I find a variety of patients with dysphagia. We want to collect unbiased facts, not generalities.”

The University of Toronto’s Research and Innovation Magazine, called EDGE, profiles of one of our research coordinators in their summer issue. Check out the complete article!

(Photo credit: Christopher Wahl for EDGE)