Readability of Individuals With Disabilities Education Act Part B Procedural Safeguards Notices Written in Spanish.

PURPOSE: The purpose of this study was to analyze the readability of the Individuals with Disabilities Education Act (IDEA) Part B procedural safeguard notices written in Spanish, as distributed by each of the 50 states in the United States and the District of Columbia. Results were compared with the 6th-8th grade document readability guideline recommended by experts in health communication. METHOD: A commercially available readability software program was used to assess document readability using three readability indices: the Gilliam-Peña-Mountain Graph, SOL, and the Fry Readability Adaptation for Spanish Evaluation. RESULTS: All procedural safeguard notices were written at a reading grade level greater than established guidelines. This finding agrees with research that has examined the readability of English-language versions of IDEA Part B procedural safeguard notices. CONCLUSIONS: Literacy-related skills and demands may influence the ability of the parent to advocate on behalf of his or her child with a disability within the school setting. Educators and specialists should be sensitive to parent reading preferences and proficiency when reviewing IDEA procedural safeguards notices. Authors of procedural safeguard notices should account for the native language and culture of the intended reader as revisions to, and translations are made of, IDEA procedural safeguards notices.

Readability of Cochlear Implant Brochures: A Potential Factor in Parent Decision Making.

PURPOSE: The purpose of this study was to examine the ease of reading cochlear implant (CI) brochures provided to parents and caregivers who are making informed decisions about the management of their child's hearing loss. METHOD: CI brochures from three Food and Drug Administration-approved CI manufacturers were examined: Advanced Bionics, Cochlear Americas, and MED-EL. Reading grade levels and ease of reading were analyzed using a commercially available computer software program, applying six readability formulas commonly used to examine hearing-related patient education materials (PEMs). RESULTS: The readability of the CI brochures exceeds the fifth- to sixth-grade reading-level guidelines. The CI brochures may be difficult for the average English-speaking adult to read with ease and requires at least a 10th-grade comparable reading level. CONCLUSIONS: Despite health literacy initiatives, audiology-focused PEMs continue to be created without full consideration of the burden for the reader. Authors of PEMs should consider the average reading level of the reader as a variable potentially influencing the decision-making process. Likewise, clinicians should consider the average reading level needed to understand PEMs when presenting information and resources to parents and caregivers for informed and shared decision making.

Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation.

OBJECTIVE: To evaluate the association between race/ethnicity and insurance status on the access to early cochlear implantation. STUDY DESIGN: Population-based retrospective analysis of pediatric cochlear implantation procedures. SETTING: State Ambulatory Surgery and Services Databases of Florida from 2005 to 2017. METHODS: All children aged 18 years or younger in the state of Florida undergoing cochlear implantation were identified. The outcome measures were access to early cochlear implantation (before 1 and 2 years of age). Descriptive and multivariate logistic regression analyses were conducted. RESULTS: Among 1511 pediatric cochlear implantation procedures with complete data, 65 (4.3%) procedures were performed by 1 year of age and 348 (23.0%) by 2 years of age. Black children (odds ratio [OR], 0.44; 95% CI, 0.28-0.70), Hispanic children (OR, 0.70; 95% CI, 0.52-0.94), and children with Medicaid (OR, 0.64; 95% CI, 0.48-0.84) were significantly less likely to be implanted before 2 years of age. Even when insured by private insurance, black and Hispanic children were still less likely to be implanted before 2 years of age compared to white children with private insurance. Greater racial and insurance disparities existed in access to cochlear implantation before 1 year of age compared to implantation before 2 years of age. CONCLUSION: Racial/ethnic and insurance disparities in pediatric cochlear implantation can be observed at the population level. To address these racial and insurance inequalities, a multidisciplinary care team is needed and priorities should be given to research endeavors and policy interventions that target these disparities.

Intensive treatment of speech disorders in robin sequence: a case report.

PURPOSE: To describe the speech of a patient with Pierre Robin Sequence (PRS) and severe speech disorders before and after participating in an Intensive Speech Therapy Program (ISTP). METHODS: The ISTP consisted of two daily sessions of therapy over a 36-week period, resulting in a total of 360 therapy sessions. The sessions included the phases of establishment, generalization, and maintenance. A combination of strategies, such as modified contrast therapy and speech sound perception training, were used to elicit adequate place of articulation. The ISTP addressed correction of place of production of oral consonants and maximization of movement of the pharyngeal walls with a speech bulb reduction program. Therapy targets were addressed at the phonetic level with a gradual increase in the complexity of the productions hierarchically (e.g., syllables, words, phrases, conversation) while simultaneously addressing the velopharyngeal hypodynamism with speech bulb reductions. RESULTS: Re-evaluation after the ISTP revealed normal speech resonance and articulation with the speech bulb. Nasoendoscopic assessment indicated consistent velopharyngeal closure for all oral sounds with the speech bulb in place. CONCLUSION: Intensive speech therapy, combined with the use of the speech bulb, yielded positive outcomes in the rehabilitation of a clinical case with severe speech disorders associated with velopharyngeal dysfunction in Pierre Robin Sequence.

Intensive treatment of speech disorders in robin sequence: a case report

ABSTRACT Purpose To describe the speech of a patient with Pierre Robin Sequence (PRS) and severe speech disorders before and after participating in an Intensive Speech Therapy Program (ISTP). Methods The ISTP consisted of two daily sessions of therapy over a 36-week period, resulting in a total of 360 therapy sessions. The sessions included the phases of establishment, generalization, and maintenance. A combination of strategies, such as modified contrast therapy and speech sound perception training, were used to elicit adequate place of articulation. The ISTP addressed correction of place of production of oral consonants and maximization of movement of the pharyngeal walls with a speech bulb reduction program. Therapy targets were addressed at the phonetic level with a gradual increase in the complexity of the productions hierarchically (e.g., syllables, words, phrases, conversation) while simultaneously addressing the velopharyngeal hypodynamism with speech bulb reductions. Results Re-evaluation after the ISTP revealed normal speech resonance and articulation with the speech bulb. Nasoendoscopic assessment indicated consistent velopharyngeal closure for all oral sounds with the speech bulb in place. Conclusion Intensive speech therapy, combined with the use of the speech bulb, yielded positive outcomes in the rehabilitation of a clinical case with severe speech disorders associated with velopharyngeal dysfunction in Pierre Robin Sequence.

Respuesta a la terapia antirretroviral altamente activa en pacientes de 50 años de edad o más viviendo con infección VIH/SIDA / Highly actve antirretroviral therapy responce in patients over 50 years old living with HIV/AIDS infection

Para el 2015 >50% de la población con infección por el virus de inmunodeficiencia humana será >50 años, proponiéndose diversos retos en su atención. En el presente estudio se planteó como objetivo evaluar la respuesta a la terapia antirretroviral altamente activa, características epidemiológicas y clínicas en pacientes con infección del virus de inmunodeficiencia humana/síndrome de inmunodeficiencia adquiridad >50 años. Se realizó estudio descriptivo, retrospectivo, observacional, no experimental, con diseño de casos y controles (pacientes >50 años, casos; y <50 años, controles), comparando sus evaluaciones basales, a los 6 y a los 12 meses, entre enero 2005 y junio 2009. Se incluyeron 311 pacientes, 99 casos (>50 años) y 121 controles (<50 años), representado el género femenino un tercio de la población. Más del 65% consultaron en etapas avanzadas de la enfermedad, 47% correspondieron con síndrome de inmunodeficiencia adquirida estadio C3. La medida del lapso entre diagnóstico e inicio de la terapia antirretroviral altamente activa fue >1 año, en los grupos. Los regímenes de terapia antirretroviral altamente activa más usados fueron AZT/3TC/EFV y AZT/3TC+LOP/RIT. No se encontraron diferencias significativas en la respuesta inmunológica ni virológica a la terapia antirretroviral altamente activa a los 6 y 12 meses entre los grupos; valores promedio de carga viral a los 6 meses: 58221,08 copias de ARN/mm³ (2,21 log) y 6081,92 copias de ARN/mm³ (2,28 log) para adultos mayores y jóvenes, respectivamente. En adultos mayores , el incremeto de valores promedio de linfocitos TCD4+pos-terapia antirretroviral altamente activa fue significativa (P<0,05) comparando niveles basales y a los 12 meses; en los jóvenes dicha significancia se alcanzó a los 6 meses. Más del 85% de los pacientes tuvieron carga viral indetectable por 12 meses. En los pacientes >50 años se observó buena respuesta inmunológica y virológica similar a los jóvenes, a los 6 y 12 meses de la terapia....

For the year 2015 >50% of the population living with the human immunodeficiency virus infection will be >50 years old, facing it diverse challenges in their attention. In the current study the objetive to assess the response to the highly active antiretroviral therapy (HAART), epidemiological and clinical characteristics in patients with human immnodeficiency virus infection/acquired immunodeficiency syndrome >50 years old, was proposed. A descriptive, retrospective, observational, non-experimental, cases and control desing study (patients >50 years old, cases; and <50 years old, controls), comparing their basal, at 6 months and t 12 months evalutions, between january 2005 and june 2009, was done. A total 311 patients, 99 cases (>50 years old) and 212 controls (<50 years old) were included. Females represented a third of the population. More than 65% of the patients consulted in advanced stages of diseases, 47% corresponded with acquired immnodeficiency syndrome stage C3. Mean time between diagnosis and beginning of highly active antiretroviral therapy was >1 year, in both groups. Most used highly active antiretroviral therapy schemes were AZT/3TC/EFV and AZT/3TC+LOP/RIT. No significant differences between immunological and virological responce to highly active antiretroviral therapy at 6 and 12 months between both groups were found; mean values of viral load at 6 months: 5,821.08 RNA copies/mm³ (2.21 log) and 6,081.92 RNA copies/mm³ (2.28 log) for mayor adults and young patients, respectively. In mayor adults, increase in mean values of TCD4 + lymphocyte counts post-highly active antiretroviral therapy were significant (P<0.05) when compared basal with 12 months moments. In young patients that significant change was reached at 6 months. More than 85% of the patients had undetectable viral at 12 months. In patients >50 years old a good immunological and virological responce was observed, being similar to that seen in young patients, at 6 and 12 months.....

Atención hospitalaria de la leishmaniosis tegumentaria americana en los miembros inferiores / Hospital care of American tegumentary leishmaniasis in the lower limbs

La leishmaniosis tegumentaria americana (LTA) como enfermedad endémica crónica continúa afectando a la población del medio rural venezolano, ocasionándole morbilidad y limitaciones laborales. Mediantes la descripción de casos clínicos se evaluaron 38 pacientes con LTA que recibieron atención hospitalaria por úlceras leishmánica en miembros inferiores. De los pacientes descriptos 63% eran niños, 84% procedía del Estado Miranda, 66% tenía una lesión ulcerosa única, 45% recibió cefadroxilo previo al tratamiento antiparasitario específico y el 24% había recibio inmunoterapia previa para la enfermedad. Treinta y siete pacientes (97%) recibieron antimoniato de meglumina en series terapéuticas de aiez días y uno anfoterecina B, por contraindicación cardiovascular para el uso del antimonial. Todos presentaron re-epitelización adecuada de sus lesiones, por lo que el antimoniato de meglumina demuestra una vez más su utilidad en la terapéutica de esta zoonosis parasitaria.

American tequmentary leishmaniasis (ATL) endemic chronic disease continues to affect the population of rural Venezuela, causing morbidity and labor constraints. By the description of clinical were evaluated 38 patients with ATL who received hospital care for leishmanial ulcers in lower limbs. Sixty-three percent of the patients were children, 84% came from Miranda state, 66% had a unique ulcerated lesion, 45% received cefadroxil prior to parasite specific treatment and 24% had received immunotherapy for the diseaes. Thirtyseven patients (97%) received meglumine antimoniate in series of ten days and one patient received anfotericine B, due to cardiovascular contraindication for the use of the antimonial. All ulcers healed. The antimoniate of meglumine demonstrates once again its usefulness in the treatment of this parasitic zoonosis.

The critical shortage of speech-language pathologists in the public school setting: features of the work environment that affect recruitment and retention.

PURPOSE: The primary focus of this study was to elicit the perspectives of speech-language pathologists (SLPs) regarding features of the work environment that contribute to and/or hinder recruitment and retention in the public school setting. METHOD: A questionnaire was distributed to SLPs employed in 10 school districts in Central Florida representing small, medium, and large school districts. The primary goal of the questionnaire was to elicit the perspectives of school-based SLPs regarding (a) factors in the work environment that contribute to retention, (b) factors in the work environment that hinder retention, and (c) issues that may contribute to the recruitment and retention of SLPs in the school setting. A total of 382 questionnaires was obtained, yielding a 64.5% response rate. RESULTS: The participants ranked working with children, school schedule, and educational setting as primary reasons for their satisfaction with working in the public school setting. The participants ranked workload, role ambiguity, salary, and caseload as primary reasons for their dissatisfaction with working in the public school setting. CONCLUSION: Themes emerged from the data that provide insight into several factors that serve as powerful influences in understanding issues of recruitment and retention of SLPs in the public school setting.

Meeting the Critical Shortage of Speech-Language Pathologists to Serve the Public Schools-Collaborative Rewards.

This article presents a collaborative approach to providing graduate education to speech-language pathologists who are employed in public school districts. A partnership called the Central Florida Speech-Language Consortium was established among the University of Central Florida, 10 Central Florida school districts, and community agencies to address the issue of the critical shortage of speech-language pathologists in the public schools. The consortium program provided bachelor-level speech-language pathologists in the public schools the opportunity to obtain a master's degree while they continued to work in the schools. Key innovations of the program included: (a) additional graduate slots for public school employees; (b) modifications in the location and time of university courses, as well as practica opportunities in the schools; and (c) the participation and support of public school administrators in facilitating supervision and practicum experiences for the consortium participants. The consortium program resulted in an increase in the number of master's level and culturally and linguistically diverse speech-language pathologists available for employment in the public schools of Central Florida. Recommendations for facilitating future endeavors are discussed.