Demand for Domestic Marine and Coastal Tourism

Domestic marine and costal tourism has increased in importance over the last number of years due to the impacts of international travel, environmental concerns, associated health benefits and COVID-19 related travel restrictions. Consequently, this paper conceptualizes domestic marine and coastal tourism within an economic framework. Two logit models examine the factors that influence participation in the coastal day trips and overnight stays markets, respectively. Two truncated travel cost models are employed to explore trip duration, one analyzing the number of day trips taken and the other examining the number of nights spent in marine and coastal areas. Although a range of variables predict participation, no one variable had a significant and consistent affect in every model. A division in access to domestic marine and coastal tourism is also observed based on variation in household income. The results also indicate a vibrant day trip market and large consumer surpluses. The decision to use logit participation models and travel cost models applied to day trips and overnight stays is a direct result of the audiences this paper aims to inform. Firstly, by presenting the decision making process for domestic marine and coastal tourism in this depth, evidence based decision makers can gather a better understanding of how domestic tourist decided to participate in marine and coastal tourism, who the larger beneficiary are of the different types of marine and coastal tourism and how policy focused solely on overnight stays can adversely affect particular segment of society, often those less well off financially. Secondly, the academic literature has presented a dearth of information comparing day trip participation to overnight stays in marine and coastal tourism, as such, this paper provides a valuable source of information.

Parental and Practitioner Views of Telepractice for Pediatric Auditory Verbal Habilitation at a Time of Global Pandemic

Purpose: The aim of this study was to explore parents' and therapists' views of the benefits and challenges of telepractice for early intervention for children who are deaf or hard of hearing during the COVID-19 pandemic. Method: Surveys probed the views of (a) parents and (b) Listening and Spoken Language Specialist (LSLS) Certified Auditory Verbal Therapists (AVTs) in using telepractice to deliver auditory verbal (AV) sessions. The survey for parents covered technology, coaching, communication, learnings for the parent, learnings for the child, and parental preference. The survey for the therapists examined therapy style, technology, relationships with families, and coaching style. Using a convenience sample of 65 families and nine LSLS Certified AVTs, data were collected using Google Forms. Results: A response rate of 42% was achieved for the parents' survey. Families were overwhelmingly confident in the subjective effectiveness of AV sessions delivered by telepractice with modal ratings of 8 and 9 on a 10-point rating scale for telepractice sessions and in-person sessions, respectively. On average, however, parents rated in-person sessions at a significantly higher level. Eighty-five percent opted to continue with either AV delivered solely via telepractice or a blend of telepractice and in-person sessions. Changes in therapists' style included (a) increased interactions with the parent rather than the child and (b) an improvement in coaching techniques. Eight of nine therapists (89%) felt that sessions delivered via telepractice were equally effective as or more effective than in-person sessions. Discussion: The necessary transfer of all AV sessions to telepractice from inperson sessions during the global pandemic of COVID-19 was enacted successfully for the majority of families. Both parents and therapists described benefits and challenges of telepractice for AV intervention. Going forward, the high proportion of families requested either a blended service delivery of telepractice and in-person sessions or therapy via telepractice alone, demonstrating the families' satisfaction with this approach.

International Telepractice for Therapy and Training: Auditory Verbal UK's Perspective

Purpose: The aim of this clinical focus article is to discuss Auditory Verbal UK's (AVUK) training program for prospective listening and spoken language specialist certified auditory verbal (AV) therapists delivered globally via telepractice. Since 2015, AVUK has delivered training via telepractice to 18 countries. Consideration is given to the barriers and challenges of training across geographical and cultural boundaries, including access to technology, cultural and linguistic difference of families and trainees, and the differing global states of audiological practice for early intervention. Some possible solutions are offered. Although there have been calls for international consensus on early intervention, the reality of provision across Europe differs especially in the wake of COVID-19. From a global perspective, audiology and early intervention services differ considerably. Some countries are not up-to-date with the latest hearing technology and do not have access to tuning for cochlear implants or the technology required for families to attend therapy via telepractice. Conclusions: With appropriate technology, telepractice is a viable means of providing training in AV therapy. It builds communities across geographical areas, breaking down boundaries and facilitating global collaboration. Although considerable differences remain in both service provision and access to services across different countries, the passion of trainees worldwide and the good will of the AV community in supporting our colleagues give reason for optimism going forward.

Mesenchymal stromal cell-derived extracellular vesicles reduce lung inflammation and damage in nonclinical acute lung injury: Implications for COVID-19.

Mesenchymal stem cell derived extracellular vesicles (MSC-EVs) are bioactive particles that evoke beneficial responses in recipient cells. We identified a role for MSC-EV in immune modulation and cellular salvage in a model of SARS-CoV-2 induced acute lung injury (ALI) using pulmonary epithelial cells and exposure to cytokines or the SARS-CoV-2 receptor binding domain (RBD). Whereas RBD or cytokine exposure caused a pro-inflammatory cellular environment and injurious signaling, impairing alveolar-capillary barrier function, and inducing cell death, MSC-EVs reduced inflammation and reestablished target cell health. Importantly, MSC-EV treatment increased active ACE2 surface protein compared to RBD injury, identifying a previously unknown role for MSC-EV treatment in COVID-19 signaling and pathogenesis. The beneficial effect of MSC-EV treatment was confirmed in an LPS-induced rat model of ALI wherein MSC-EVs reduced pro-inflammatory cytokine secretion and respiratory dysfunction associated with disease. MSC-EV administration was dose-responsive, demonstrating a large effective dose range for clinical translation. These data provide direct evidence of an MSC-EV-mediated improvement in ALI and contribute new insights into the therapeutic potential of MSC-EVs in COVID-19 or similar pathologies of respiratory distress.