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Purpose: Changes in quality of life (QoL) in persons with aphasia (PWA) has emerged as a key metric of aphasia treatment effectiveness. Several tools have been designed to measure aphasia related QoL and offer the appropriate compensation for communication issues that frequently exclude persons with aphasia (PWA) from participation of such studies. The purpose of this study was to measure post–aphasia treatment change in QoL and calculate the efficiency and cost of QoL change. Method: In this study, we measured change in aphasia-related QoL as a metric of post–aphasia treatment efficiency using the American Speech-Language-Hearing Association Quality of Communication Life Scale. We also calculated the associated cost of that change in relationship with the change of aphasia impairment using a sample of PWA who received community-based telerehabilitation. Cost of QoL improvement from the intervention was calculated accounting for differences in age, time post onset, aphasia severity, and aphasia type. Results: PWA that exhibited more severe aphasia impairment experienced larger QoL improvement than those at lower impairment levels. Similarly, the average cost of improvement in QoL was lower for those more severe aphasia. Conclusions: Changes in aphasia-related QoL captures the impact of communication disorders on QoL, and the cost associated with the change. Measurement of aphasia-related QoL will allow clinicians and researchers to measure aphasia treatment outcomes and the cost effectiveness of those treatments using a commonly reported patient outcome—QoL.

Purpose: The U.S. Food and Drug Administration (FDA) introduced the Reauthorization Act that included provisions for self-fitting hearing aids to be sold over the counter in 2017, and in August 2022, the FDA published the final regulatory guidelines for the safety and efficacy of the devices. The American Speech-Language-Hearing Association and other professional organizations provided feedback to proposed regulations before they were finalized. This article updates hearing health care and related professionals on the history and state of hearing aid delivery models and addresses considerations for clinicians, physicians, and consumers. Conclusions: Direct-to-consumer (DTC) hearing devices can vary largely in quality and performance capability. Some might meet the finalized FDA safety and performance criteria for over-the-counter hearing aids and be able to provide accurate amplification for mild-to-moderate hearing loss but most likely cannot meet the needs of more severe hearing losses, for which they are not approved. Other DTC devices may not meet the FDA criteria and may not provide accurate amplification for many degrees of hearing loss. It is important that these devices are correctly advertised and marketed to those with hearing loss no worse than mild to moderate. Consumers and health care providers also need to know how to identify quality devices that can meet patients' hearing needs. The DTC hearing devices may be difficult to program; thus, manufacturers should provide support for consumers to properly fit these devices. Lastly, hearing health care professionals should take the time to verify that any current and soon-to-come DTC hearing devices can be useful for a given patient population.

Purpose: Aphasia is a devastating communication disorder that negatively impacts an individual's ability to engage in society. Despite the frequent occurrence after stroke, little is known about the frequency that aphasia occurs worldwide. To date, reports of aphasia have primarily emerged from high-income countries. This review explores the frequency of aphasia worldwide. Method: An integrative review examined rates of aphasia from 2000 to 2021. We primarily identified stroke studies that reported the number or percentage of participants with aphasia. Secondly, we identified journals that frequently published studies of stroke that included individuals with aphasia. This was supplemented by a country + stroke + aphasia via Google and Google Scholar search to identify those studies primarily focused on stroke outcomes that potentially reported the percentage of individuals with aphasia. Results: Seventy-five articles from 43 different countries published between 2000 and 2021 reported presence of aphasia in 7%–77% of all individuals with stroke. Rates were similar between high- and middle-income countries; however, no studies were identified from low-income countries. Conclusions: Rates of reported aphasia are highly variable and likely reflect different diagnostic approaches and timing of identification of the condition. Understanding differences in the presence of aphasia among stroke survivors across countries is critical in the effort to advocate for the resources needed to improve long-term outcomes. Supplemental Material: https://doi.org/10.23641/asha.21183478

While research on suicidal behavior for people with disability (PWD) suggests they experience higher risk than people without disability, less is known about variations among individuals with different disability types. This nationally representative, cross-sectional study compared differences in suicide-related outcomes (ideation, planning, attempts) among PWD by functional disability type (hearing, vision, cognitive, mobility, complex activity) and number. Secondary analysis of adult PWD in the 2015-2019 National Survey on Drug Use and Health (unweighted N = 35,544; representing 47,723,378 PWD, weighted) was used to estimate relationships between suicide-related outcomes and disability type and number. Most respondents were female (55.9%), and 36.0% were aged ≥65 years. Adjusted odds ratios (AORs) from multivariable logistic regression indicated that suicidal ideation and suicide attempt, respectively, were significantly more likely among individuals with cognitive (AOR = 1.71, 95% CI = 1.24-2.35; AOR = 2.54, 95% CI = 1.31-4.91), complex activity (AOR = 1.96, 95% CI = 1.37-2.81; AOR = 2.67, 95% CI = 1.32-5.41), and ≥2 limitations (AOR = 2.02, 95% CI = 1.52-2.69; AOR = 3.46, 95% CI = 1.84-6.50) than hearing limitation. Also, relative to other disability types, suicide-related outcomes were significantly more likely among individuals with cognitive limitation and complex activity limitation (p 0.001). Additionally, suicide-related outcomes elevated in likelihood as the number of limitations increased, with the largest associations among those with ≥5 limitations for suicidal ideation (AOR = 2.31, 95% CI = 1.46-3.66), suicide planning (AOR = 3.34, 95% CI = 1.97-5.68), and suicide attempt (AOR = 6.37, 95% CI = 3.76-10.79). Subgroup analyses showed that presence of cognitive limitation and multiple limitations differentiated between suicidal ideators and suicide attempters. Further research is needed to identify causes of these risks and develop suicide prevention efforts for these particularly vulnerable groups.

Racial disparities have been reported in post-stroke conditions such as aphasia, yet findings have been inconsistent. Prior studies have generally included small numbers of people of color for comparisons of outcome. Consequently, it is unclear if the racial disparities that are consistently observed in stroke, the primary cause of aphasia, parallel disparities in aphasia outcomes.In this study we examined aphasia outcomes among Black and White persons with aphasia (PWA) based on data from the Moss Aphasia Psycholinguistics Project Database (MAPPD).In initial comparisons of the measures of aphasia impairment (Western Aphasia Battery-Revised Aphasia Quotient; WAB-R AQ), White PWA exhibited greater impairment than Black PWA. However, after adjusting for aphasia type, age, sex, estimates Blacks exhibited lower average WAB AQs.This study illustrates how more sophisticated statistical methods should be used to examine racial differences in aphasia and other communication outcomes particularly given differences commonly observed sociodemographic characteristics that are present in the primary cause of the disorders. Without careful analysis of data and consideration of its implications, researchers and clinicians will continue to ignore key differences in clinical populations that influence aphasia outcomes. More importantly, in order to grow knowledge in the field and a continue to improve clinical outcomes, the field must fully exploit tools of empirical analysis and focus their research on discovering, adapting and improving the lives of all individuals with aphasia.

Background: This study compares the cost of implementing a Medical Food Pantry (MFP) serving food insecure (FIS) patients to the predicted hospital utilization costs incurred in the absence of a MFP by FIS patients. Methods: This case-control study utilized propensity score matching was usedto match patients identified as FIS who received a voucher to a MFP to individuals in the Medical Expenditure Panel Survey (MEPS) to estimate healthcare utilization and costs. Participants were patients identified as food insecure during an in-patient stay who received a voucher for an emergency tailored food bag: carb controlled, sodium controlled, general healthful between June 2018-July 2019. Patients were grouped based on redemption status (redeemed a voucher (RV) =206, did not redeem (NRV) =336). Results: FIS patients who did not redeem a voucher had higher average cost per inpatient visit compared to those who redeemed their voucher (RV: $13,464.87 vs. NRV: $15,238.63). They also had higher aggregate annual expenditures (RV: $46,112.52 vs. NRV: $50,071.59). The total cost of the MFP was estimated to be $300 per patient voucher redeemed resulting in estimated savings cost saving of $1773.76 per inpatient visit or $3,959.07 per year in healthcare cost. Conclusions: While our previous work showed that a hospital-based MFP was associated with lower hospital readmissions, this research suggests that the cost of addressing nutritional risks through a hospital-based MFP is feasible and cost-effective.

Background The threat of a deadly pandemic, racial tension, recessionary economic circumstances, and educational disruption likely contributed to the heightened anxiety felt by many Americans in 2020. This study examines the differential anxiety experienced by Black, White, and Hispanic households with and without children during 2020. Method Data from the Census Bureau’s Household Pulse Survey detailing the frequency of anxiety among a nationally representative sample of adults from April 23 to December 21, 2020, was coupled with Centers for Disease Control and Prevention records of COVID-19 diagnoses and state-level police killings. Multinomial logistic regression assessed the relative contribution of COVID-19 deaths, police violence, unemployment, fear of unemployment, change in educational delivery, and geographic location to anxiety among racial/ethnic cohorts with and without children. Results Anxiety frequency increased over the sample for all groups. However, White anxiety was highly responsive to state-level COVID-19 fatalities, while Black anxiety was highly correlated with police violence. Households with children showed higher levels of anxiety during nontraditional educational delivery, whereas both households with and without children experienced high levels of fear regarding employment uncertainty and poverty. Conclusions Experiences in 2020 impacted all groups differently, but each showed a high frequency of anxiety.

This study was designed to estimate the economic burden of poststroke aphasia in the United States. The economic burden of aphasia was calculated based on three cost factors: medical and healthcare...

Verbal fluency tasks are a common part of neuropsychological batteries and are frequently used in clinical and research practices to support the diagnosis of neurological impairments. Semantic verbal fluency is most frequently examined using only the category of animals. Little is known about the differences other semantic categories may present on semantic verbal fluency performance. The purpose of this study was to establish preliminary categorical normative data across twelve categories comprising of different animate and inanimate categories using semantic verbal fluency in neurotypical Lebanese-speaking adults and to determine the impact of category affiliation (animacy) on semantic verbal fluency performance. The task was administered to seventy female and male adults aged between 19 and 79 years having different educational levels. Participants generated the greatest number of exemplars for the category of body parts. Participants then produced exemplars in the following decreasing order: animals, vegetables, fruits, clothes, kitchen utensils, naturals, electronics, furniture, means of transportation, tools, and accessories. The animate categories were associated with the greatest number of exemplars compared to the inanimate. Clustering strategy might have been reinforced by the shared properties of animates.

In addition to the threat of serious illness, COVID-19 and subsequent restrictions had devastating economic consequences for many US citizens. This study examines the evolution of food security over the first months of the COVID-19 pandemic testing whether the initial economic stimulus payment improved the nutritional well-being of vulnerable populations. We use data from phase 1 of the Census Bureau's Household Pulse Survey among a nationally representative sample of adults and the 2017-2018 Current Population Survey Food Security Supplement. Using an ordered logistic regression, we assess differences in the incidence and severity of food security across demographic, income, geographic, and employment status cohorts and assess the effects of the first economic stimulus payment. Our results show that marginalized groups faced greater food insecurity and had food-related outcomes worsen over time. Blacks, Hispanics, and individuals living in rural areas became less food secure as the pandemic progressed. However, receipt of a stimulus payment appears to have improved conditions. Rising food prices and persistent high unemployment have the potential to exacerbate food insecurity among marginalized and at-risk groups.

In recent years, stakeholders engaged in the study, treatment, and understanding of aphasia outcomes have emphasized the need for greater transparency regarding the economics of aphasia rehabilitation. Most notably, third-party payers and clinicians have a keen interest in understanding the resources used to treat aphasia, particularly the cost-effectiveness and value of aphasia treatments. In this article, we review the current literature related to the economic burden of aphasia and the cost and cost-effectiveness of aphasia treatments. To date, relatively few scholars have attempted to study the efficiency, scale, and scope related to the economics of aphasia and the cost-effectiveness of aphasia treatment. While studies of the cost-effectiveness of aphasia treatments have shown rehabilitative treatments conform to established quality and cost benchmarks, the continued progress and developments in the treatment of aphasia and measurement of clinical outcomes has left many areas unstudied. We highlight the need for greater emphasis on the cost-effectiveness of aphasia treatments in addition to the traditional focus on the efficacy of treatment outcomes.

Introduction: Health services research has demonstrated the association between patient satisfaction and treatment outcomes illustrating the importance of satisfaction in determining favorable treatment outcomes. Despite abundant evidence in the acute care setting, few researchers have explored these associations among patients receiving speech rehabilitation or therapeutic treatment particularly those receiving treatment through nontraditional delivery methods. Objective: To examine the satisfaction with a community-based telepractice approach for treating aphasia among stroke survivors who reside in rural areas and assess potential correlations between satisfaction and patient outcomes. Methods: In total, 22 adults with poststroke aphasia who resided in rural areas received comprehensive language-oriented treatment (LOT) for aphasia through community-based telepractice. Post-treatment satisfaction with the telepractice approach was assessed using the Client Satisfaction Questionnaire-8 (CSQ-8). Results: After 12 sessions of LOT, Western Aphasia Battery-revised (WAB-R) aphasia quotients (AQs) improved on average 4.64 U. Mean scores on the CSQ-8 averaged 31.0/32.0, indicating a high level of satisfaction with the telepractice approach. In addition, each 1 U of improvement in patient satisfaction was associated with a 1.75 U increase in the WAB-R AQ. Conclusions: Examination of post-treatment satisfaction indicated that satisfaction was highly predictive of effectiveness—a one-point increase in satisfaction was associated with a nearly two-point increase in WAB-R AQ. Results echo findings from acute care studies underscoring the importance of the patient experience in treatment efficacy.

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

Alternatives assessment and green chemistry share a common goal of supporting the transition to safer, more sustainable chemicals, materials, and products. Yet the two fields, and their respective scientific communities, are not well integrated. To better understand the nexus between alternatives assessment and green chemistry as complementary approaches to support the development and adoption of safer, more sustainable chemicals for specific functional uses, this article discusses the foundations of the two fields and examines two case examples in which companies have utilized the tools and approaches of both disciplines in developing safer chemical solutions. This research demonstrates the importance and utility of the overlapping skillsets and tools of the two disciplines and the potential benefit of educational opportunities and collaborative spaces in jointly strengthening both fields. Additionally, the literature and case examples identify a number of research and practice needs that would bolster the application of both alternatives assessment and green chemistry in supporting the transition to safer, more sustainable chemistry, including: clearer definitions and criteria of what is ‘safer’; improved approaches to evaluate potential unintended consequences of chemical applications; and more effective tools to evaluate toxicity, consider inherent exposure trade-offs, and combine multiple attributes to make an informed decision.

The 2010 report of the President's Cancer Panel concluded that the burden of cancer from chemical exposures is substantial, while the programs for testing and regulation of carcinogens remain inadequate. New research on the role of early life exposures and the ability of chemicals to act via multiple biological pathways, including immunosuppression, inflammation, and endocrine disruption as well as mutagenesis, further supports the potential for chemicals and chemical mixtures to influence disease. Epidemiologic observations, such as higher leukemia incidence in children living near roadways and industrial sources of air pollution, and new in vitro technologies that decode carcinogenesis at the molecular level, illustrate the diverse evidence that primary prevention of some cancers may be achieved by reducing harmful chemical exposures. The path forward requires cross-disciplinary approaches, increased environmental research investment, system-wide collaboration to develop safer economic alternatives, and community engagement to support evidence-informed action. Engagement by cancer researchers to integrate environmental risk factors into prevention initiatives holds tremendous promise for reducing the rates of disease. See all articles in this CEBP Focus section, “Environmental Carcinogenesis: Pathways to Prevention.”

Background Clinical provision of intensive behavioral therapy for obesity (IBTO) has been a reimbursable treatment for obesity since 2012. However, gaps remain in the literature regarding its impact on patient outcomes. Objectives The primary objective of this study was to examine the integration of registered dietitian nutritionist provided IBTO into a primary care setting and evaluate clinic outcomes for Medicare Part B beneficiaries. A secondary objective was to examine intensity of IBTO (quantity of IBTO visits) versus clinical outcomes and influence of socioeconomic factors. Methods A case–control retrospective chart review was conducted at a rural, Academic Family Medicine Clinic in Eastern North Carolina for patients seen between 1 January 2016 and 1 January 2019. In order to be included in the treatment group, patients had to be female, white or black race, have Medicare insurance and a body mass index ≥ 30 kg/m2. Results Mixed model analysis showed statistically significant improvements in clinical outcomes from IBTO treatment. Weight decreased by nearly 3 pounds, while body mass index was half a point lower. A1C was 0.1 units lower for IBTO patients, and they took prescription medication and average of 6 days less than the control group. Minorities and older respondents experienced smaller, all else constant, and annual fixed effects suggest that differentials widen over time. Conclusions Registered dietitian nutritionist (RDN) provision of IBTO has demonstrated benefit in improving clinical outcomes including weight, A1C, and reduced medication duration (use) as demonstrated by the IBTO treatment group versus control. IBTO intensity was not predictive of success, and its impact was reduced with older and African American patients. IBTO is beneficial and can be delivered within the primary care setting by a RDN.

A stroke is a life-altering event that occurs without warning. Strokes differ in severity with some being mild and others leaving survivors with permanent disabilities. While the physical and mental consequences of stroke can require extensive treatment and rehabilitation, the emotional ramifications are often ignored. In addition to outlining the prevalence and severity of depression among stroke survivors, this study examines the likelihood of mental health service utilization and barriers to care. Using data from the 2018 National Health Interview Survey, regression analysis evaluated the association between depression, depression frequency, and race/ethnicity controlling for income, insurance, and demographic characteristics among adult stroke survivors. Analyses also tested the likelihood of mental health services utilization and potential barriers to care among survivors who reported depression. Results indicated that Blacks and Hispanics stroke survivors were more likely to experience depression and experience depression more frequently than Whites. Minority groups were also less likely to utilize mental health services but did not cite lack of insurance or affordability as the reason for low utilization. This study found a higher prevalence and frequency of depression among Blacks and Hispanics and lower likelihood of receiving mental health services. Findings suggest lower mental health service utilization among depressed minority stroke survivors may be related to unobservable factors such as social stigma, lack of available care, inability to clearly identify depressive symptoms, and potentially greater resilience to overcome the negative impact of the condition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alternatives assessment is gaining traction as a systematic method to support the informed substitution of chemicals of concern. The 2nd International Symposium on Alternatives Assessment, on 1-2 November 2018, convened nearly 150 professionals from government agencies, industry, consultant firms, academia, and advocacy organizations to advance a greater understanding of the evolving methods, practices, and challenges in the use of alternatives assessment. This article reviews highlights and lessons from the symposium, including 1) notable advances in methods, 2) shared insights from practitioners on best practices as well as inherent tensions and challenges, and 3) research and practice needs in the field that can be addressed by organizations such as the newly launched Association for the Advancement of Alternatives Assessment. Being interdisciplinary in nature, the establishment of educational frameworks across disciplines and inclusion of diverse expertise in hazard and exposure assessments, life cycle impacts considerations, design principles, and economic and engineering evaluations will ensure continued growth of the field. Integr Environ Assess Manag 2019;00:1-8. © 2019 SETAC.

Purpose The purpose of this article is to explore how racism, privilege, power, and positionality negatively impact clinical research conducted in the discipline of communication sciences and disorders. Conclusions Evidence suggests solutions will not emerge from a minor revision or adjustment of current research approaches. Instead, to make deep and necessary changes, a complete restructuring of the research process is needed. This restructuring calls for a reconceptualization of how research questions and hypotheses are formed, how methods are selected, how data are analyzed and interpreted, and who is at the table throughout this process of knowledge generation. Such an overhaul of current research approaches will offer the field a solution-oriented roadmap for scientific investigation that facilitates greater equity in the research enterprise that translates into improved clinical outcomes for all clients served.

Background Although age specific stroke rates are higher in men, women have a higher lifetime risk and are more likely to die from a stroke. Despite this increased severity, most studies focus on male/female differences in stroke onset, patterns of care and stroke-related outcomes. Given that stroke presents differently in men and women, mixed sex studies fail to fully capture heterogeneity among women with stroke and the subsequent impact on their outcomes. This study examined the sociodemographic characteristics, factors related to stroke incidence and post-stroke functional status between young ( Methods Using 5 years of data from the National Health Interview Survey (NHIS), a nationally representative sample of US adults, cohorts of young and old women with stroke were identified. A set of demographic/lifestyle, health services utilization and health status characteristics were used evaluate within gender heterogeneity in three ways. First, disparities in population characteristics were assessed using Chi-Square and t tests. Second, young and old women with stroke were matched with women without stroke in their respective cohorts to determine differences in factors related to stroke incidence. Finally, the determinants of post-stroke functional limitation for the two cohorts were determined. Results Young women with stroke were more likely to be Black, smoke regularly and frequently consume alcohol than older women. Young women were also less likely to engage with their health provider regularly or receive preventative health screenings. Diabetes, high blood pressure, high cholesterol and high BMI were correlated with an increased relative likelihood of stroke among older women. In contrast, family size, smoking frequency, alcohol consumption and sleep were correlated with an increased prevalence of stroke among young women. Although factors correlated with stroke varied between young and old women, health status and receipt of healthcare were the most significant determinants of post-stroke functional status for both cohorts. Conclusions Health related characteristics were the primary correlates of stroke in older women, whereas post-stroke lifestyle and behaviors are the most significant correlates for younger stroke survivors. These findings suggest that while receipt of health services is essential for preventing stroke in both young and old women, providers should stress the importance of post-stoke lifestyle and behaviors to younger women at risk of stroke using approaches that may be different from older stroke women.

Background In addition to the threat of serious illness, COVID-19 brought abrupt changes in lifestyle resulting in widespread fear among many Americans. This study examines the evolution of anxiety over the first months of the COVID-19 pandemic, testing for differential experiences among vulnerable populations. Methods Phase 1 of the Census Bureau's Household Pulse Survey details the frequency of anxiety among a nationally representative sample of adults from April 23, 2020 through July 21, 2020. Negative binomial regression assessed differences in the frequency of anxiety among demographic, income, health and employment status cohorts. Propensity score matching to the 2019 National Health Interview Survey allowed previous anxiety and health status to be included in the model. Results Anxiety frequency for 944,719 individuals was observed over three months. Whites, blacks and Hispanics showed increasing frequency of anxiety over the time period, particularly blacks. Prior to COVID-19, 13% of respondents reported regular or semiregular anxiety, compared to 25–35% during the pandemic. Regression analysis suggests that frequent anxiety was highly and positively correlated with COVID-19 case fatality rate and higher levels of frequency were observed among those with poor health, incomes below $25,000, and without paid employment. Limitations Causal inference was not able to be investigated due to the cross-sectional study design. Conclusions While blacks showed lower levels of anxiety initially, the proportion of the population experiencing regular anxiety increased nearly 20% over the first months of the COVID-19 pandemic. This rapid increase in anxiety could be due to inequity in health and economic outcomes among blacks.

The determinants of health have received substantial attention in the medical literature as recent evidence has shown that they play in vital role in general health and health-related outcomes. Despite the advancing literature, the field of communication sciences and disorders (CSD) has been slow in the both the consideration of the determinants of health as well as the measurement of commonly known determinants believed to influence clinical outcomes. The goal of this chapter is to explore the determinants of health and potential relationship to the study of communication disorders and the outcomes being measured.

The existence of disparities in health has gained national attention. While disparities in communication disorders undoubtedly exist, little research has documented these disparities. Disparities may occur across categories such as race/ethnicity, age, sex/gender, geographic, and socioeconomic status. In order to heighten awareness of existing disparities in the field of communication sciences and disorders (CSD), this chapter focuses on designing and conducting research to identify and explain disparities among population subgroups. The chapter consists of seven sections: 1) Challenges in Defining Variables for Measuring Health Disparities, 2) Other Data Considerations, 3) Thinking Beyond the Traditionally Measured Sociodemographic Variables, 4) Causal Pathways Between Social Determinants and Health Outcomes, 5) Research Designs, 6) Research Frameworks, and 7) Theories of Contextual Factors. The goal of this chapter is to offer information that assist CSD researchers in systematically identifying, analyzing, and addressing health disparities in CSD.

Measures of satisfaction following treatment for aphasia have been limited. The challenge associated with reduced verbal output among many persons with aphasia (PWA) has reportedly been a key reason measures of treatment satisfaction have been limited. A novel approach to measure treatment satisfaction is the use of content analysis (CA), which uses the presence of certain words, themes, or concepts to explore outcomes such as treatment satisfaction particularly among individuals who generate limited output. CA utilizes responses and response patterns to assign meaning to client responses. The aim of this study was to use CA to measure posttreatment satisfaction with a telepractice approach for aphasia treatment. Seventeen PWA received 12 treatment sessions over a 6-week period. At the conclusion of the treatment, CA was utilized to explore patient satisfaction with this treatment approach. The participants reported an overall positive sentiment for the telepractice approach. Two primary topics emerged which were healthcare provider and healthcare delivery, where text analysis revealed discussion of these topics to be centered around being “helpful” and “being effective.” This study demonstrated that CA can be an effective approach for determining satisfaction with aphasia treatment particularly among PWA with limited verbal abilities.

Purpose The purpose of this study was to investigate the relationship between depressive symptoms and suicidal ideation and living with stuttering while accounting for time, sex, and health-related confounders. Method The data for this study come from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative survey study that has followed 13,564 respondents over the course of 14 years. Responses to the question “Do you have a problem with stuttering or stammering?” at two time points were used to establish stuttering and non-stuttering groups. Regression analysis, propensity score matching, and structural equation modeling were used. Results Compared to their fluent counterparts, males and females reported significantly elevated symptoms of depression. Although symptoms of depression among males who stutter were stable over time, depressive symptoms among females who stutter increased with age. Compared to males who do not stutter, males who stutter were significantly more likely to report feelings of suicidal ideation. There were no differences in suicidal ideation between females who do and do not stutter. Conclusions Speech-language pathologists should be aware of the associations between stuttering and depressive symptoms, as well as the increased risk for suicidal ideation among males who stutter. Clinicians should be knowledgeable about symptoms of depression and suicidal ideation and be familiar with processes to refer as needed.

Concerns have been raised regarding toxic chemicals found in tire crumb used as infill in artificial turf and other play surfaces. A hazard-based analysis was conducted, comparing tire crumb with other materials marketed as alternative infills. These include other synthetic polymers as well as plant- and mineral-based materials. The comparison focused on the presence, absence, number, and concentration of chemicals of concern. No infill material was clearly free of concerns, but several are likely to be somewhat safer than tire crumb. Some alternative materials contain some of the same chemicals of concern as those found in tire crumb; however, they may contain a smaller number of these chemicals, and the chemicals may be present in lower quantities. Communities making choices about playing surfaces are encouraged to examine the full range of options, including the option of organically managed natural grass.