A Viewpoint on Accent Services: Framing and Terminology Matter.

PURPOSE: The purpose of this article is to offer a contemporary viewpoint on accent services and contend that an equity-minded reframing of accent services in speech-language pathology is long overdue. Such reframing should address directly the use of nonpejorative terminology and the need for nurturing global linguistic diversity and practitioner diversity in speech-language pathology. The authors offer their perspective on affirmative and least-biased accent services, an in-depth scoping review of the literature on accent modification, and discuss using terms that communicate unconditional respect for speaker identity and an understanding of the impact of accent services on accented speakers. CONCLUSIONS: Given ongoing discussions about the urgent need to diversify the profession of speech-language pathology, critical attention is needed toward existing biases toward accented speakers and how such biases manifest in the way that accent services are provided as well as in how clinicians conceptualize their role in working with accented speakers. The authors conclude with discussing alternate terms and offer recommendations for accent services provided by speech-language pathologists.

Potential of aerosolized rifampicin lipospheres for modulation of pulmonary pharmacokinetics and bio-distribution.

The aim of the present study was to establish the potential of rifampicin loaded phospholipid lipospheres carrier for pulmonary application. Lipospheres were prepared with rifampicin and phospholipid in the ratio of 1:1 using spray drying method. Further, lipospheres were evaluated for flow properties and surface area measurement. The formulated lipospheres were evaluated in vitro for aerodynamic characterization and in vivo for lung pharmacokinetics and biodistribution studies in Sprague Dawley rats. Powder flow properties finding suggested the free flowing nature of the lipospheres. In-vitro aerosol performance study indicated more than 80±5% of the emitted dose (ED) and 77.61±3% fine particles fraction (FPF). Mass median aerodynamic diameter (MMAD) and geometric standard deviation (GSD) were found to be 2.72±0.13 µm and 3.28±0.12, respectively. In-vitro aerosol performance study revealed the higher deposition at 3, 4 and 5 stages which simulates the trachea-primary bronchus, secondary and terminal bronchus of the human lung, respectively. The drug concentration from nebulized lipospheres in the non-targeted tissues was lesser than from rifampicin-aqueous solution. The pulmonary pharmacokinetic study demonstrated improved bioavailability, longer residence of drug in the lung and targeting factor of 8.03 for lipospheres as compared to rifampicin-aqueous solution. Thus, the results of the study demonstrated the potential of rifampicin lipospheres formulation would be of use as an alternative to existing oral therapy.

Merits of HPLC-based method over spectrophotometric method for assessing the kinetics and inhibition of mammalian adenosine deaminase.

Measurement of adenosine deaminase (ADA) activity using spectrophotometric method presents problem, regarding the quantitative estimation of the substrate degradation and product formation, due to the closely apposed lambda(max) of the substrates, product and the inhibitor. The feasibility of applying reverse-phase HPLC technique, for studying adenosine deaminase-catalyzed reaction product and inhibition study was examined. We have drawn a comparison between the HPLC-based method over the corresponding spectrophotometric method. A gradient elution pattern was used to separate substrate (adenosine and deoxyadenosine), product (inosine and deoxyinosine) and standard adenosine deaminase inhibitor (erythro-9-(3-nonyl-p-aminobenzyl)-adenine) in the HPLC method. The product formation was quantitated by monitoring the absorbance at 260 nm with the progress of time. The limit of detection as well as the limit of quantification of the respective enzymatic product were found to be in nano molar (nM) range in the HPLC method. This study was also extended to monitor adenosine deaminase activity in different cancer cells of hematological origin. The HPLC-based method is found to be suitable for the quantitative estimation of adenosine deaminase-catalyzed reaction product and for studying inhibition mechanism of different inhibitors. The HPLC-based method has specific advantages over the spectrophotometric method. Moreover, the concentration of different nucleotides in cell lysate and body fluid can be measured using this HPLC method.

Seasonality of month of birth among African American children with diabetes mellitus in the city of Chicago.

AIM: To study the seasonality of month of birth among African American children with insulin-treated diabetes mellitus (DM) in the city of Chicago, in order to determine whether perinatal exposures play a significant role in diabetes risk among children of non-European origin. METHOD: The Chicago Childhood Diabetes Registry ascertains new cases of insulin-treated DM among minority children < 18 years of age; these cases were compared with birth certificate data for the general African American population in Chicago. The chi2 test and Poisson regression were used to compare the pattern of month of birth of children with DM (n = 604) to that of the general population (n = 758,658) over the same period of years (1968-1995). RESULTS: In a month-by-month comparison, there were significantly fewer children who later developed DM born during October (chi2 = 6.74, df = 1). This seasonal pattern was stronger among males (n = 284) than females (n = 320), and among those who apparently developed type 2 DM (n = 155) compared to those who developed type 1 DM (n = 449). Children who were diagnosed between 15 and 17 years of age (n = 131) demonstrated significant seasonality (chi2 = 27.6, df = 11) compared to the general population. CONCLUSIONS: The apparent protective effect of October birth, and the significant overall seasonality among those diagnosed at ages 15-17 years, suggest the possibility that seasonal environmental factors at conception, during pregnancy or in the neonatal period may affect DM risk in adolescence. The greater impact of month of birth in adolescent type 2 DM patients is surprising and seems to indicate a role for mechanisms other than the immunological ones previously suggested.

Microbiology of severe aspiration pneumonia in institutionalized elderly.

We sought to investigate prospectively the microbial etiology and prognostic indicators of 95 institutionalized elders with severe aspiration pneumonia, and to investigate its relation to oral hygiene in using quantitative bronchial sampling. Data collection included demographic information, Activity of Daily Living, Plaque Index, antimicrobial therapy, and outcome. Out of the 67 pathogens identified, Gram-negative enteric bacilli were the predominant organisms isolated (49%), followed by anaerobic bacteria (16%), and Staphylococcus aureus (12%). The most commonly encountered anaerobes were Prevotella and Fusobacterium species. Aerobic Gram-negative bacilli were recovered in conjunction with 55% of anaerobic isolates. The Plaque Index did not differ significantly between the aerobic (2.2 +/- 0.4) and the anaerobic group (2.3 +/- 0.3). Functional status was the only determinant of the presence of anaerobic bacteria. Although seven cases with anaerobic isolates received initially inadequate antimicrobial therapy, six had effective clinical response. The crude mortality was 33% for the aerobic and 36% for the anaerobic group (p = 0.9). Stepwise multivariate analysis identified hypoalbuminemia (p < 0.001) and the burden of comorbid diseases (p < 0.001) as independent risk factors of poor outcome. In view of the rising resistance to antimicrobial agents, the importance of adding anaerobic coverage for aspiration pneumonia in institutionalized elders needs to be reexamined.