The Efficacy of Telepractice in the Assessment and Treatment of Speech Disorders: A Systematic Review

Purpose: Children and adults with speech disorders face numerous barriers in accessing traditional face-to-face services with a speech-language pathologist. Telepractice may be a feasible solution. The aim of this systematic review was to investigate the efficacy of telepractice in the assessment and treatment of speech disorders in children and adults. Methods: Research articles were ascertained from Ovid MEDLINE, PsychInfo, and CINAHL using an established and consistent search strategy that utilized both medical subject headings and subject terms related to telepractice. The predetermined inclusion criteria included diagnosis of a speech disorder, participants across the lifespan, direct comparison of both delivery methods (i.e., telepractice to face-to-face), and objective outcome measures. Articles were excluded due to lack of speech disorder diagnosis, use of purely subjective outcome measures, and lack of direct comparison of delivery methods. Quality assessment was established by the authors using the criteria in the Assessing the Quality and Applicability of Systematic Reviews and a rating scale (i.e., \u27poor,\u27 \u27fair,\u27 \u27good,\u27 \u27strong\u27). Results: Electronic searches of the databases resulted in the acquisition of 16 full-text research studies, which were used in this systematic review. The quality of the studies ranged from \u27poor\u27 to \u27strong\u27 with a majority of the articles rated as \u27good.\u27 The studies explored telepractice efficacy in speech sound disorders, fluency disorders, dysarthria, apraxia, and voice disorders. Conclusions: Generally, the quality of intervention delivered via telepractice is comparable to traditional face-to-face therapy. Additional research involving diverse populations with varied levels of severity in natural environments is required to confirm the efficacy of the delivery method. It is imperative the use of telepractice is considered by each clinician on a per case basis.https://scholarworks.uvm.edu/csdms/1007/thumbnail.jp

Enhanced catalytic activity of Ni on η-Al2O3 and ZSM-5 on addition of ceria zirconia for the partial oxidation of methane

peer-reviewedNickel supported on η-Al2O3 and ZSM-5(80) catalysts with and without the addition of ceria-zirconia, were prepared by co-precipitation and wet impregnation methods and used for the low temperature catalytic partial oxidation of methane (CPOM). The catalysts were tested under reaction temperatures of between 400 and 700 °C with a WHSV of 63,000 mL g−1 h−1. The activity of the catalyst was found to be dependent on the support and preparation method. The optimum catalyst composition of those tested was 10% Ni on 25%CeO2-ZrO2/ZSM-5(80), prepared by co-precipitation, where the reaction reached equilibrium conversion at 400 °C (T50% < 400 °C), which is one of the lowest temperatures reported to date. Further increases in temperature led to improved selectivity to CO reaching 60% at 600 °C. Although the observed kinetics were found to be controlled by strong adsorption of CO at lower temperature, this was an equilibrium limitation with longer time on stream experiments showing no decrease in the catalyst activity over 25 h at 400 °CACCEPTEDpeer-reviewe

Impact of Ionic Liquids on Silver Thermoplastic Composite Membrane Polyurethane for Propane/Propylene Separation

This work describes newly synthesized composite polymeric membranes and their utilization in propane/propylene separation in a gas mixture. The nonporous composite polymers were successfully synthesized by using thermoplastic polyurethane (TPU) and several silver salts/silver salts with ionic liquids (ILs). Our studies showed that silver bis(trifluoromethanesulfonyl)imide (Ag[Tf2N]) containing membranes outperformed other silver salt containing membranes in terms of selectivity. In addition, to this finding, ILs, as additives for the membranes, enhanced the selectivity by facilitating improved coordination of the olefin with the silver ions in the dense composite polymers.Scopu

Multiple faces elicit augmented neural activity

How do our brains respond when we are being watched by a group of people? Despite the large volume of literature devoted to face processing, this question has received very little attention. Here we measured the effects on the face-sensitive N170 and other ERPs to viewing displays of one, two and three faces in two experiments. In Experiment 1, overall image brightness and contrast were adjusted to be constant, whereas in Experiment 2 local contrast and brightness of individual faces were not manipulated. A robust positive-negative-positive (P100-N170-P250) ERP complex and an additional late positive ERP, the P400, were elicited to all stimulus types. As the number of faces in the display increased, N170 amplitude increased for both stimulus sets, and latency increased in Experiment 2. P100 latency and P250 amplitude were affected by changes in overall brightness and contrast, but not by the number of faces in the display per se. In Experiment 1 when overall brightness and contrast were adjusted to be constant, later ERP (P250 and P400) latencies showed differences as a function of hemisphere. Hence, our data indicate that N170 increases its magnitude when multiple faces are seen, apparently impervious to basic low-level stimulus features including stimulus size. Outstanding questions remain regarding category-sensitive neural activity that is elicited to viewing multiple items of stimulus categories other than faces

Tuftsin Combines With Remyelinating Therapy and Improves Outcomes in Models of CNS Demyelinating Disease

Though promoting remyelination in multiple sclerosis (MS) has emerged as a promising therapeutic strategy, it does not address inflammatory signals that continue to induce neuronal damage and inhibit effectiveness of repair mechanisms. Our lab has previously characterized the immunomodulatory tetrapeptide, tuftsin, which induces an anti-inflammatory shift in microglia and macrophages. This targeted anti-inflammatory agent improves physical deficits in experimental autoimmune encephalomyelitis (EAE), an animal model of MS. Here, we sought to determine whether tuftsin is also effective in combination with benztropine, an FDA-approved drug that stimulates remyelination, in both EAE and in the cuprizone model of demyelination. We show that combining these two agents to promote anti-inflammatory and remyelinating mechanisms alleviates symptoms in EAE and lessens pathological hallmarks in both MS models. Importantly, tuftsin is required to transform the inflammatory CNS environment normally present in EAE/MS into one of an anti-inflammatory nature, and benztropine is required in the cuprizone model to improve remyelination. Our data further support tuftsin's beneficial immunomodulatory activity in the context of EAE, and show that when studying remyelination in the absence of an autoimmune insult, tuftsin still activated microglia toward an anti-inflammatory fate, but benztropine was necessary for significant repair of the damaged myelin. Overall, tuftsin effectively combined with benztropine to significantly improve MS-like pathologies in both models

Looking inside the black box : a theory-based process evaluation alongside a randomised controlled trial of printed educational materials (the Ontario printed educational message, OPEM) to improve referral and prescribing practices in primary care in Ontario, Canada

Background: Randomised controlled trials of implementation strategies tell us whether (or not) an intervention results in changes in professional behaviour but little about the causal mechanisms that produce any change. Theory-based process evaluations collect data on theoretical constructs alongside randomised trials to explore possible causal mechanisms and effect modifiers. This is similar to measuring intermediate endpoints in clinical trials to further understand the biological basis of any observed effects (for example, measuring lipid profiles alongside trials of lipid lowering drugs where the primary endpoint could be reduction in vascular related deaths). This study protocol describes a theory-based process evaluation alongside the Ontario Printed Educational Message (OPEM) trial. We hypothesize that the OPEM interventions are most likely to operate through changes in physicians' behavioural intentions due to improved attitudes or subjective norms with little or no change in perceived behavioural control. We will test this hypothesis using a well-validated social cognition model, the theory of planned behaviour (TPB) that incorporates these constructs. Methods/design: We will develop theory-based surveys using standard methods based upon the TPB for the second and third replications, and survey a subsample of Ontario family physicians from each arm of the trial two months before and six months after the dissemination of the index edition of informed, the evidence based newsletter used for the interventions. In the third replication, our study will converge with the "TRY-ME" protocol (a second study conducted alongside the OPEM trial), in which the content of educational messages was constructed using both standard methods and methods informed by psychological theory. We will modify Dillman's total design method to maximise response rates. Preliminary analyses will initially assess the internal reliability of the measures and use regression to explore the relationships between predictor and dependent variable (intention to advise diabetic patients to have annual retinopathy screening and to prescribe thiazide diuretics for first line treatment of uncomplicated hypertension). We will then compare groups using methods appropriate for comparing independent samples to determine whether there have been changes in the predicted constructs (attitudes, subjective norms, or intentions) across the study groups as hypothesised, and will assess the convergence between the process evaluation results and the main trial results.The OPEM trial and OPEM process evaluation are funded by the Canadian Institute of Health Research (CIHR). The OPEM process evaluation study was developed as part of the CIHR funded interdisciplinary capacity enhancement team KT-ICEBeRG. Gaston Godin, Jeremy Grimshaw and France Légaré hold Canada Research Chairs. Louise Lemyre holds an R.S. McLaughlin Research Chair

TRE-FX:Delivering a federated network of trusted research environments to enable safe data analytics

Trusted Research Environments (TREs) are secure locations in which data are placed for researchers to analyse. TREs host administrative data, hospital data or any other data that needs to remain securely isolated, but it is hard for a researcher to perform an analysis across multiple TREs, requesting and gathering the outputs from each one. This is a common problem in the UK's devolved healthcare system of geographical and governance boundaries. There are different ways of implementing TREs and the analysis tools that use them. A solution must be straightforward for existing, independent systems to adopt, must cope with the variety of system implementations, and must work within the "Five Safes" framework that enables data services to provide safe research access to data. TRE-FX assembled leading infrastructure researchers, analysis tool makers, TRE providers and public engagement specialists to streamline the exchange of data requests and results. The "Five Safes RO-Crate" standard packages up (Crates) the Objects needed for Research requests and results with the information needed for the tools and TRE providers to ensure that the crates are reviewed and processed according to Five Safes principles. TRE-FX showed how this works using software components and an end-to-end demonstrator implemented by a TRE in Wales. Two other TREs, in Scotland and England, are preparing to follow suit. Two analysis tool providers (Bitfount and DataSHIELD) modified their systems to use the RO-Crates. The next step is practical implementation as part of the HDR UK programme. Two large European projects will develop the approach further. TRE-FX shows that it is possible to streamline how analysis tools access multiple TREs while enabling the TREs to ensure that the access is safe. The approach scales as more TREs are added and can be adopted by established systems. Researchers will then be able to perform an analysis across multiple TREs much more easily, widening the scope of their research and making more effective use of the UK's data. If we had had this for COVID-19 data analysis, it would have super-charged researchers to be able to quickly answer pressing questions across the UK. This work was funded by UK Research &amp; Innovation [Grant Number MC_PC_23007] as part of Phase 1 of the DARE UK (Data and Analytics Research Environments UK) programme, delivered in partnership with Health Data Research UK (HDR UK) and Administrative Data Research UK (ADR UK)

Using Esterase Selectivity to Determine the in Vivo Duration of Systemic Availability and Abolish Systemic Side Effects of Topical β-Blockers

© 2020 American Chemical Society. For disorders of the skin, eyes, ears, and respiratory tract, topical drugs, delivered directly to the target organ, are a therapeutic option. Compared with systemic oral therapy, the benefits of topical treatments include a faster onset of action, circumventing the liver first pass drug metabolism, and reducing systemic side effects. Nevertheless, some systemic absorption still occurs for many topical agents resulting in systemic side effects. One way to prevent these would be to develop drugs that are instantly degraded upon entry into the bloodstream by serum esterases. Because topical β-blockers are used in glaucoma and infantile hemeangioma and cause systemic side effects, the β-adrenoceptor system was used to test this hypothesis. Purified liver esterase reduced the apparent affinity of esmolol, an ester-containing β-blocker used in clinical emergencies, for the human β-adrenoceptors in a concentration and time-dependent manner. However, purified serum esterase had no effect on esmolol. Novel ester-containing β-blockers were synthesized and several were sensitive to both liver and serum esterases. Despite good in vitro affinity, one such compound, methyl 2-(3-chloro-4-(3-((2-(3-(3-chlorophenyl)ureido)ethyl)amino)-2-hydroxypropoxy)phenyl)acetate, had no effect on heart rate when injected intravenously into rats, even at 10 times the equipotent dose of esmolol and betaxolol that caused short and sustained reductions in heart rate, respectively. Thus, ester-based drugs, sensitive to serum esterases, offer a mechanism for developing topical agents that are truly devoid of systemic side effects. Furthermore, differential susceptibility to liver and serum esterases degradation may also allow the duration of systemic availability for other drugs to be fine-tuned

The multi-layered nature of the internet-based democratization of brand management

The evolution of the internet, including developments such as Web 2.0, has led to new relationship realities between organizations and their stakeholders. One manifestation of these complex new realities has been the emergence of an internet-based democratization of brand management. Research about this phenomenon has so far mainly focused on investigating just one or more individual themes and thereby disregarded the inherent multi-layered nature of the internet-based democratization of brand management as a holistic, socio-technological phenomenon. The aim of this paper is to address this limitation through an investigation of the various socio-technological democratization developments of the phenomenon. To achieve this aim, a balanced and stakeholder-oriented perspective on brand management has been adopted to conduct an integrative literature review. The review reveals three key developments, which together form the essential parts of the phenomenon: (I) the democratization of internet technology, (II) the democratization of information, and (III) the democratization of social capital. The insights gained help to clarify the basic structures of the multi-layered phenomenon. The findings contribute also to the substantiation of a call for a new brand management paradigm: one that takes not only company-initiated but also stakeholder-initiated brand management activities into accoun