Early Experiences of Parents of Children who are Deaf or Hard of Hearing: Navigating through Identification, Intervention, and Beyond

Guidelines created by the Joint Committee on Infant Hearing ([JCIH], 2019) were designed to aid in the early identification of infant hearing loss. Despite these guidelines, a quarter of children who fail their initial screening are lost to the follow-up process and many more do not receive care in line with the 1-3-6 guidelines (Centers for Disease Control and Prevention [CDC], 2018; JCIH, 2019). To acquire more information about the experiences of families and identify specific barriers to timely diagnosis and intervention, interviews were conducted with 13 parents of children who are deaf or hard of hearing whose children were enrolled in a larger longitudinal study. These interviews revealed common themes regarding delayed identification, frustrations about timely intervention, and confusion when choosing communication modalities. Common themes amongst families who felt well-supported were also identified

Are Audience Response Systems Worth the Cost? Comparing Question-Driven Teaching Strategies for Emergency Medical Technician Education

Purpose: As Emergency Medical Technician educators develop curricula to meet new national educational standards, effective teaching strategies validated for course content and unique student demographics are warranted. Three methods for answering multiple choice questions presented during lectures were compared: a) Audience Response System (ARS, clickers), b) hand-raising-with-eyes-closed (no-cost option), and c) passive response (no-cost option). The purpose was to determine if using the ARS resulted in improved exam scores. Method: 113 Emergency Medical Technician (EMT) students participated in this cross-over, block randomized, controlled trial, which was incorporated into their Cardiac Emergencies and Pulmonary Emergencies course lectures. Students took pretests, immediate post-tests, and delayed post-tests composed of multiple choice questions that targeted either lower or higher order thinking. Results: For both lectures, there were significant improvements on all immediate post-test scores compared to all pretest scores (p Conclusions: In this cohort, incorporation of no-cost question-driven teaching strategies into lectures was as effective as an ARS at encouraging significant, immediate and sustained improvements in answering multiple choice questions

The Comparative Efficiency of Speech Sound Interventions That Differ by Delivery Modality: Flashcards Versus Tablet

Although speech-language pathologists increasingly make use of tablets in clinical practice, little research to date has evaluated the effectiveness or efficiency of tablet use for targeting speech sound goals. The three-fold purpose of this study was to compare (a) the effectiveness and (b) the efficiency of speech sound intervention using tablets versus flashcards, as well as (c) child motivation in speech sound intervention when using tablets versus flashcards. Four kindergarten students with at least two similar speech sound errors participated in this adapted alternating treatments single subject design study that explored the functional relation between speech sound intervention that differed by modality of delivery (tablet versus flashcards) and increased speech sound skill in elementary school children with speech sound errors. Flashcards and tablets were both effective speech sound intervention modalities; however, for three of four participants, flashcards were more efficient than tablets. Motivation ratings did not differ across modalities

Recurrent eczema herpeticum – a retrospective European multicenter study evaluating the clinical characteristics of eczema herpeticum cases in atopic dermatitis patients

Background Eczema herpeticum (EH ) is a disseminated viral infection of eczematous skin disease with the herpes simplex virus. Knowledge on clinical characteristics, risk factors and recurrent disease is limited. Our aim was to better define clinical characteristics and risk factors for EH and especially for recurrent EH . Methods A retrospective analysis of EH cases assessed the history, clinical signs, prior treatment and laboratory results using a predefined questionnaire. Results A total of 224 EH cases from eight European centres were included. Extrinsic AD was identified as risk factor for EH , and only one patient suffered from intrinsic AD . Early onset of AD was identified as risk factor for recurrent EH . Pretreatment with topical steroids, systemic steroids, topical calcineurin inhibitors or plain emollients reflected standard therapy. Many patients showed AD lesions without EH , but skin without AD lesions was never affected by herpetic lesions. Conclusion Patients with clinically active, extrinsic AD are at risk of EH . Recurrent EH is associated with confounders of severe atopic distortion and requires active AD lesions for clinical manifestation. Recurrent eczema herpeticum mainly affects patients with early onset of AD

The Relation Between Linguistic Awareness Skills and Spelling in Adults: A Comparison Among Scoring Procedures

Purpose: Spelling is a skill that relies on an individual’s linguistic awareness, the ability to overtly manipulate language. The ability to accurately spell is important for academic and career success into adulthood. The spelling skills of adults have received some attention in the literature, but there is limited information regarding which approach for analyzing adults’ spelling is optimal for guiding instruction or intervention for those who struggle. Thus, we aimed to examine the concurrent validity of four different scoring methods for measuring adults’ spellings (a dichotomous scoring method and three continuous methods) and to determine whether adults’ linguistic awareness skills differentially predict spelling outcomes based on the scoring method employed. Method: Sixty undergraduate college students who were determined to be average readers as measured by a word reading and contextual word reading task, were administered a spelling task as well as morphological, orthographic, phonemic, and syntactic awareness tasks. Results: All four scoring methods were highly correlated suggesting high concurrent validity among the measures. Two linguistic awareness skills, morphological awareness and syntactic awareness, predicted spelling performance on both the dichotomous and continuous scoring methods. Contrastively, phonemic awareness and orthographic awareness predicted spelling performance only when spelling was scored using a continuous measure error analysis. Conclusions: The results of this study confirm that multiple linguistic awareness skills are important for spelling in adults who are average readers. The results also highlight the need for using continuous measures of spelling when planning intervention or instruction, particularly in the areas of orthographic and phonemic awareness

Difficult to control atopic dermatitis

Difficult to control atopic dermatitis (AD) presents a therapeutic challenge and often requires combinations of topical and systemic treatment. Anti-inflammatory treatment of severe AD most commonly includes topical glucocorticosteroids and topical calcineurin antagonists used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, the topical calcineurin inhibitors tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection contribute to disease exacerbation and thus justify additional antimicrobial/antiseptic treatment. Systemic antihistamines (H1) may relieve pruritus but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength. "Eczema school" educational programs have been proven to be helpful

Complement C5a regulates IL-17 by affecting the crosstalk between DC and ΓΔ T cells in CLP-induced sepsis

Complement 5a (C5a) and Interleukin-17 (IL-17) are two important inflammatory mediators in sepsis. Here we studied the mechanisms underlying regulation of IL-17 by anaphylatoxin C5a. We found that C5a blockade increased the survival rate of mice following cecal ligation and puncture (CLP)-induced sepsis and decreased IL-17 expression in vivo . IL-17 was secreted mainly by ΓΔ T cells in this model. Importantly, our data suggest that C5a participates in the regulation of IL-17 secretion by ΓΔ T cells. Dendritic cells (DC) were found to act as a “bridge” between C5a and ΓΔ T cells in a mechanism involving IL-6 and transforming growth factor Β (TGF-Β). These results imply that C5a affects the crosstalk between DC and ΓΔ T cells during sepsis development, and this may result in a large production of inflammatory mediators such as IL-17.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71378/1/1079_ftp.pd

When Children Teach a Robot to Write: An Autonomous Teachable Humanoid Which Uses Simulated Handwriting

This article presents a novel robotic partner which children can teach handwriting. The system relies on the learning by teaching paradigm to build an interaction, so as to stimulate meta-cognition, empathy and increased self-esteem in the child user. We hypothesise that use of a humanoid robot in such a system could not just engage an unmotivated student, but could also present the opportunity for children to experience physically-induced benefits encountered during human-led handwriting interventions, such as motor mimicry. By leveraging simulated handwriting on a synchronised tablet display, a nao humanoid robot with limited fine motor capabilities has been configured as a suitably embodied handwriting partner. Statistical shape models derived from principal component analysis of a dataset of adult-written letter trajectories allow the robot to draw purposefully deformed letters. By incorporating feedback from user demonstrations, the system is then able to learn the optimal parameters for the appropriate shape models. Preliminary in situ studies have been conducted with primary school classes to obtain insight into children’s use of the novel system. Children aged 6-8 successfully engaged with the robot and improved its writing to a level which they were satisfied with. The validation of the interaction represents a significant step towards an innovative use for robotics which addresses a widespread and socially meaningful challenge in education

The patient-reported disease burden in adults with atopic dermatitis : a cross-sectional study in Europe and Canada

Cross-sectional data on patient burden in adults with atopic dermatitis () from real-world clinical practice are limited. This study compared patient-reported burden associated with adult across severity levels from clinical practices in Canada and Europe. This study included adults (18-65 years) diagnosed with by dermatologists, general practitioners or allergists. Participants categorized as mild (n = 547; 37.3%), moderate (n = 520; 35.4%) or severe (n = 400; 27.3%) based on Investigator's Global Assessment completed a questionnaire that included pruritus and pain numerical rating scales, Patient-Oriented-Scoring of Atopic Dermatitis (PO-SCORAD) itch and sleep visual analogue scales, Dermatology Life Quality Index (), and the Hospital Anxiety and Depression Scale (HADS). Participants were also stratified by inadequate efficacy/intolerance/contraindication to cyclosporine [Cyclo; n = 62 (4 mild, 18 moderate, 40 severe)] and any systemic immunomodulatory agent [; n = 104 (13 mild, 31 moderate, 60 severe)] and compared with the severe group excluding participants identified as Cyclo/. Age was similar across severity groups; the proportion of women was higher in the mild group relative to severe (61.2% vs. 50.5%; P < 0.001). Compared with moderate and mild, participants with severe had more comorbidities, higher itch and pain severity, worse sleep and higher levels of anxiety and depression (all P < 0.001). Mean ± score among participants with severe (16.2 ± 6.9) showed a large effect on quality of life that was higher than those with moderate (10.2 ± 6.3) and mild (5.5 ± 4.9) (both P < 0.001). The burden among Cyclo and subgroups was generally similar to that of participants with severe . Adults with reported a substantial burden across multiple domains that was significantly higher in those with severe disease. The burden among participants in the Cyclo/ subgroups was similar to those with severe