Exploring Communication Apprehension and its Relationship to Communication Attitude and Socio-Communicative Functioning in Children with Velopharyngeal Insufficiency

Myriad findings on children with velopharyngeal insufficiency (VPI) indicate the potential for this population of children to experience feelings of apprehension specific to communication and the potential for other psychological and social difficulties. The purpose of the present investigation was to explore the construct of communication apprehension (CA) and its potential relationship to social and communicative functioning in a diverse group of children with VPI. Potential linkages between CA and multiple socio-communicative constructs including attitude, speech satisfaction, speech and language skill, social competence, and speech severity were explored in a cohort of children with and without VPI, followed by an in-depth exploration of these interrelationships within the VPI group. Two groups of children between the ages of 7 and 14 years participated in this prospective comparative study; 20 children who presented with VPI and 20 typically developing children without VPI. Children completed a battery of questionnaires: The Measure of Elementary Communication Apprehension (Revised) (MECA-R), the Communication Attitude Test (CAT), and the Speech Satisfaction measure (SS). In addition, parents of study participants completed the Social Competence Scale (SC) of the Home and Communication Social Behavior Scales (HCSBS), and (for parents of children with VPI), the Children’s Communication Checklist-Second Edition (CCC-2). Finally, perceptual evaluations of the speech characteristics of children with VPI were also gathered. Children with VPI reported higher CA than did the typically developing children. Correlational analyses revealed expected relationships between CA and social and communicative functioning for the combined cohort of children, but not so for the VPI group alone. However, significant relationships between communication attitude and social-communicative constructs were identified for both the combined cohort data and the VPI group only data. Unexpectedly, results of the present study found that communication attitude, rather than CA, was more strongly related to the functional abilities examined for both the combined cohort of children and children with VPI alone. Results of the present study suggest the presence of great variability in the social and communicative functioning of children with VPI. As such, comprehensive, yet individualized clinical assessments of social and communicative profiles of children with VPI should be sought in this clinical population

AN EVALUATION OF COMMUNICATION APPREHENSION IN ADOLESCENTS WITH VELOPHARYNGEAL INSUFFICIENCY

The purpose of this study was to evaluate the communication apprehension (CA) of adolescents with velopharyngeal insufficiency (VPI). Phase one of the study involved completion of the MECA, a measure of CA, by 28 adolescents (14 from the VPI group and 14 from the control group) followed by voice recordings of speech phrases. Phase two of the study involved conducting a perceptual assessment of the speech samples provided by participants in phase one using the ACPA. Phase one and phase two of the study were conducted to answer two experimental questions: 1) Do adolescents with VPI experience higher levels of CA than adolescents who do not have a speech/voice disorder? 2) What is the relationship between MECA scores and perceptual assessment of voice quality scores? In addition, reliability of the MECA and the ACPA were also investigated. Results indicated good reliability of the MECA, and poor-to-good inter-rater and good-to-excellent intra-rater reliability of the ACPA. The VPI group reported statistically significant higher levels of CA than the control group. Finally, a statistically significant fair positive correlation was found between the MECA and the velopharyngeal function variable. Results of the study are discussed with special consideration given to the literature. Keywords: Communication Apprehension, MECA, ACPA, Velopharyngeal Insufficiency (VPI), Perceptual Assessment

The Impact of Maternal Diabetes on Fetal and Infant Outcomes: A Secondary Analysis of Peridata.net® from 2013 to 2017

ABSTRACT THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES: A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017 Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database. Methods: Women with diabetes were case matched to women without diabetes by pre-pregnancy BMI and race to mitigate obesity effects on outcomes in this secondary analysis of PeriData.Net®. Results (p\u3c0.05= *,p -\u3c0.01 = **, p\u3c0.001 = ***): Compared to Caucasian and Hispanic women with diabetes, African-American women with diabetes had less gestational/more preexisting diabetes (65.3%, CI 56.5-73.9% vs 86.8%, CI 83.7-89.9%***), more pre-pregnancy hypertension (15.7%, CI 9.0-22.3% vs. 7.2%, CI 4.9-9.6%**) and more prematurity (37.4%, CI 28.5-46.2% vs. 23.6%, CI 19.8-27.5%**), and more infant mortality (4.3%, CI 0.6-8.1% vs. 0.9%,CI 0.0-1.7%**). Women of all races with diabetes had higher C-section (44.8%, CI 41.1-48.6% vs. 30.6%, CI 28.1-33.1%***) and hypertension (22.4%, CI 19.2%-25.6% vs.13.8%, CI 11.9%-15.6%***), while diabetes exposed infants experienced more prematurity (25.3%, CI 22.0-28.6% vs. 12.9%, CI 11.1-14.7%,***), NICU admission (18.2%, CI 15.1-21.0% vs. 10.4%, CI 8.6-11.9%***), respiratory distress (9.5%, CI 7.2-11.6% vs. 4.7%, CI 3.5-5.8%,***), hypoglycemia (7.7%, CI 5.6-9.6% vs. 2.3%, CI 1.5-3.1%***), hyperbilirubinemia (8.6%, CI 6.5-10.8% vs. 3.9% CI 2.9-5.0%***), LGA (18.2%, CI 15.2-21.1% vs. 11.6%, CI 9.9-13.4%***) and risk of SGA (OR 1.51, CI 1.04-2.19*). Women with diabetes gained less weight and had heavier infants when adjusted for gestational age. Conclusions: Diabetes increased cesarean sections and hypertension prevalence for all women. Maternal diabetes increased LGA, SGA, prematurity, hypoglycemia, hyperbilirubinemia and respiratory distress which also increases risk for infant morbidity and mortality. A higher prevalence of preexisting diabetes and prematurity contributes to an increased risk of mortality for African-American infants

Zagospodarowanie czasu młodzieży w kontekście środowiska rodzinnego i szkolnego

Family and school are important spaces influencing the acquisition of competences in time management by students. Each of these spaces occupy a particular position in the process of youth development. The family teaches planning and time management. Teachers’ work should continue to foster skills in a secondary development context. The compatibility of these environments is a prerequisite for effective time budget planning by the young people. Considering the role of time in the life of an individual, the aim of the research was to know what is the time budget of students and how the space of the family and school environment is conducive to its development. In order to collect the empirical data, charts were used in which 97 tested pupils from secondary schools were asked to show the amount of time devoted during the day and week to various activities. Other aspects of time management by the young people as well as the participation of family and school as significant places in which young people reside were determined based on a questionnaire survey. The obtained results lead to the conclusion that staying at school and doing homework dominates, which can be explained by the fact that education is the basic form of youth activity. However, the time devoted to it significantly limits free time, which does not always allow for sufficient rest. It was noticed that the way of spending time with parents is passive, while teachers to a small extent compensate for unfavorable patterns of time management shaped in the family.Rodzina i szkoła są ważnymi przestrzeniami oddziaływającymi na nabywanie kompetencji w zakresie gospodarowania czasem przez uczniów. Każda z tych przestrzeni zajmuje określoną pozycję w procesie rozwoju młodzieży. Rodzina uczy planowania i gospodarowania czasem. Praca nauczycieli powinna kontynuować nabywanie przez uczniów umiejętności w sekundarnym kontekście rozwojowym. Kompatybilność tych środowisk jest warunkiem koniecznym do efektywnego planowania budżetu czasu przez młodzież. Rozpatrując rolę czasu w życiu jednostki, celem badań było poznanie, jaki jest budżet czasu uczniów oraz jak przestrzeń środowiska rodzinnego i szkolnego sprzyja jego zagospodarowaniu. W celu zgromadzenia danych empirycznych wykorzystano wykresy, na których 97 badanych uczniów szkół ponadpodstawowych miało ukazać ilość czasu przeznaczonego w ciągu doby i tygodnia na różne czynności. Inne aspekty zagospodarowania czasu przez młodzież, a także udział rodziny i szkoły jako znaczących miejsc, w których młodzież przebywa, określono na podstawie kwestionariusza ankiety. Uzyskane wyniki skłaniają do refleksji, że pobyt w szkole i odrabianie lekcji dominują, co można tłumaczyć tym, że edukacja jest podstawową formą aktywności młodzieży. Jednak czas poświęcony na nią znacząco ogranicza czas wolny, co nie zawsze pozwala na dostateczny odpoczynek. Dostrzeżono, że sposób spędzania czasu z rodzicami ma charakter bierny, natomiast nauczyciele w małym zakresie kompensują niekorzystne wzory gospodarowania czasem kształtowane w rodzinie

Career : employee or beneficiary? Implications of careers’ status on public finance : case of the European Union

PURPOSE: This paper aims to indicate the critical role as an important actor of public policy and the undervalued entity with an essential impact on public finance.DESIGN/METHODOLOGY/APPROACH: The article employs document analysis, desk research, statistical analysis of the caregiver's households' budgets from a nationwide questionnaire survey in 2015 and 2020.FINDINGS: The empirical results show that in countries with underdeveloped care infrastructure, the lack of caregivers' input can induce considerable increases in public burdens within the next 50 years. As the group of caregivers is not (economically) homogeneous, public actions should aim to prevent the impact of pandemic risk and provide caregivers with adequate income for the activities performed, treated, or as an employee or as an allowance.PRACTICAL IMPLICATIONS: The ongoing (although very late) process of reforms on long-term care within UE should be more evidence-based to avoid further income stratification between caregivers households and a rapid increase in public finance expenditure.ORIGINALITY/VALUE: The article presents the original concept of the classification of caregivers' income, changes taking place over the last five years in the forms of careers' income in the EU, and the selected results of the author's research on the budgets of caregivers' households in Poland in 2015 and 2020.The project is financed within the framework of the Minister of Science and Higher Education program under the name „Regional Excellence Initiative” in the years 2019 - 2022; project number 001/RID/2018/19; the amount of financing PLN 10,684,000.00. The usual disclaimer applies.peer-reviewe

Surgical interventions in velopharyngeal dysfunction: comparative perceptual speech and nasometric outcomes for three techniques

Background: The aim of this study was to evaluate speech outcomes following surgical intervention for velopharyngeal dysfunction (VPD). Perceptual speech outcome data were subsequently analyzed in conjunction with patient factors such as congenital abnormalities, presence of cleft lip and/or palate, and age of repair. We hope to aid in the eventual creation of treatment algorithms for VPD, allowing practitioners to tailor surgical technique selection to patient factors. Methods: A retrospective analysis was performed for all patients who underwent surgical correction of VPD at London Health Sciences Centre between the years 2005 and 2018. Two hundred and two consecutive VPD patients (median age 10.6 years) were followed for an average of 20.2 months after having undergone a superiorly based pharyngeal flap (121), Furlow palatoplasty (72), or sphincteroplasty (9). Speech outcomes were measured via the American Cleft Palate-Craniofacial Association (ACPA) perceptual speech assessment, and MacKay-Kummer Simplified Nasometric Assessment Procedures Revised (SNAP-R) was used to measure nasalence. Comparisons of mean preoperative and postoperative outcomes were made, as well as analyses regarding surgical procedure, syndrome, cleft status, and age. Results: Mean perceptual scores improved significantly postoperatively (p \u3c.0001), and successful perceptual resonance was identified in 86.1% patients (n = 174). Postoperative perceptual speech scores for three ACPA domains were superior with pharyngeal flap compared to both Furlow palatoplasty and sphincteroplasty ([hypernasality: p \u3c.001, p \u3c.02], [audible nasal emissions: p \u3c.002, p \u3c.05], [velopharyngeal function: p \u3c.001, p \u3c.05]). Success rate was higher in pharyngeal flap (94.2%) than in Furlow palatoplasty (75.0%, p \u3c.001) or sphincter pharyngoplasty (66.7%, p \u3c.001). No significant difference was identified in success rate based on syndrome or cleft status. Conclusion: Operative management of VPD is highly effective in improving perceptual speech outcomes. Given proper patient selection, all three procedures are viable treatment options for VPD. For those patients identified as appropriate to undergo a pharyngeal flap, robust improvements in speech outcomes were observed. Graphical abstract: [Figure not available: see fulltext.

Barriers and enablers to learning during team-based clinical simulations: reflective interviews with final year undergraduate nursing students

Background: Contemporary approaches to clinical simulation can enhance educational outcomes. However, simulation approaches do have limitations with possible compromises for learning and teaching. This paper aims to identify barriersand enablers to learning in simulated clinical settings.Methods: A generic qualitative design was applied. Semi-structured group video debriefing interviews were held with Australian final-year nursing students who completed three patient deterioration scenarios with a standardized patient.Audio-recorded interviews were transcribed and analysed to identify emergent themes.Results: Interviews with 15 teams of three students (n = 45) from three universities were analysed. Learning enablers were ‘Realism of the simulated environment’; ‘Practicing: we should do this at uni’; ‘Learning from reflection and expert feedback’, and ‘How to become competent: know the gaps’. Barriers to learning included ‘Increased stress from inexperience; ‘Expectations when pretending’ and ‘Lack of assistance’. Skills practice in team-based settings with applicable reflection and debriefing was regarded as beneficial. Simulated patients enhanced fidelity but were unable to replicate actual clinical signs. High stress levels were perceived as a barrier to learning.Conclusions: Applicably designed high fidelity simulations with video-based reflective review offer repeated rehearsal of clinical situations to enable learning. This educational strategy may reduce the time it takes undergraduate students toreach competency

Kształcenie nauczycieli w Uniwersytecie Marii Curie-Skłodowskiej w Lublinie

In the introduction, the article highlights the importance of professionalism and shows the complexity of the teacher’s work . It was emphasized that effective educational activities are possible due to their teachers’ qualifications and personality characteristics as well as their selfawareness. It was noted that the training of future teachers is the process of becoming a teacher who is not helpless in school reality and will be able to cope with educational and didactics problems.The article shows a way of introducing standards of education that prepare them for work as a teacher at the Maria Curie-Skłodowska University in Lublin at the undergraduate, graduate and postgraduate studies. It shows the main conceptual framework and the modifications made in the field of education, inspired by experience during their implementation and organizational premises.We wprowadzeniu do artykułu podkreślono znaczenie profesjonalizmu i ukazano złożony charakter pracy nauczyciela. Podkreślono, że efektywne działania edukacyjne są możliwe dzięki posiadanym przez nauczycieli kwalifikacjom i cechom osobowości oraz  ich świadomości samego siebie. Zwrócono uwagę, że przygotowanie przyszłych pedagogów do zawodu jest procesem stawania się nauczycielem, który nie będzie bezradny w rzeczywistości szkolnej i poradzi sobie z napotykanymi problemami wychowawczymi i dydaktycznymi.Przedstawiono sposób wprowadzania standardów kształcenia przygotowującego do wykonywania zawodu nauczyciela w Uniwersytecie Marii Curie-Skłodowskiej w Lublinie na studiach licencjackich, magisterskich i podyplomowych. Ukazano główne założenia koncepcyjne oraz dokonywane modyfikacje w zakresie kształcenia inspirowane doświadczeniami podczas ich wdrażania oraz przesłankami organizacyjnymi

Changes to the practice of pediatric otolaryngology as a consequence of the COVID-19 pandemic

Background: The COVID-19 pandemic has shifted medical practice globally. The objective of this study was to examine the changes to the practice of pediatric otolaryngology internationally due to the COVID-19 pandemic and examine potential contributors. Method: An online survey was designed to assess practice demographics, patterns of COVID-19 related restrictions in communities, and changes to practice and referrals. This was disseminated via an international Covid-19 WhatsApp™ group of pediatric otolaryngologists. Results: There were 45 respondents of 177 group members (25.4%) from 15 countries. The mean estimated time spent under strictest lockdown measures was 16.2 (±10.7) weeks (range: 1–45 weeks). Operating room time was reduced for 82.9%, with an average reported reduction of 41.5%. Almost all (\u3e75%) of respondents reported reduced referrals for five common conditions: otitis media with effusion (average reported decrease – 56.1%); acute otitis media (average decrease 62.8%); acute mastoiditis (average decrease 66.6%); recurrent pharyngotonsillitis (average decrease 51.0%); and peritonsillar abscess (average decrease 52.1%). COVID-19 cases per million population significantly influenced the acuity of referrals received (p \u3c.05). No conditions were reported as increased in frequency and the acuity of most conditions was reported as unchanged by the majority of respondents. Conclusion: The measures taken to reduce the spread of COVID-19 have resulted in many changes to pediatric otolaryngology practice and the referral patterns of common conditions. Some of these changes may have enduring sequelae

On the relationship between microstructure, mechanical properties and hydrogen embrittlement of pipe steels

The medium carbon casing pipe steels for oil and gas wells with fine grain bainitic microstructure and with coarse microstructure of ferrite-pearlite were tested. The steel with higher strength and with more dispersed microstructure was less susceptible to hydrogen embrittlement than the another one. The finite element method of load simulation of the specimens with crack was used for assessment of the embrittlement of the studied steel