The Effects of Altered Auditory Feedback (AAF) on Fluency in Adults Who Stutter: A Systematic Review

Background and Objectives: Stuttering affects 70 million people worldwide, which is about 1% of the population. Altered auditory feedback (AAF) is a process by which an individual’s auditory speech signal is electronically changed to temporarily increase the fluency of a person who stutters. For the purpose of this systematic review, AAF includes delayed auditory feedback (DAF) and frequency-altered feedback (FAF). This systematic review examines fluency enhancement in adults who stutter when using AAF devices. Methods: A review of the literature was searched using PubMed, Ovid MEDLINE, PsycINFO, and CINAHL databases with key search terms related to stuttering and AAF. Inclusion criteria included: 1) adults ages ≥ 18 years old who stutter, 2) comparison of altered auditory feedback forms and/or no altered auditory feedback forms in the treatment of stuttering, 3) inclusion of DAF or FAF, 4) outcomes related to aspects of stuttering or people who stutter (e.g., fluency level, speech naturalness, speech rate), and 5) experimental research. Studies were quality assessed and rated by the authors. Results: A total of 16 articles were included in this review. Articles were of ‘moderate’ quality. Conclusions: AAF devices are generally effective in reducing stuttering frequency, with most notable fluency enhancement occurring during oral reading. The degree of fluency enhancement between individuals who stutter is variable and is influenced by factors such as stuttering severity. While research generally supports the use of AAF devices in reducing stuttering frequency, there are inconsistent findings regarding speech naturalness. AAF is likely most effective when used in conjunction with traditional speech therapy. Further research is needed to better understand the relationship between AAF and stuttering, particularly regarding unstructured speaking tasks and speech naturalness.https://scholarworks.uvm.edu/csdms/1004/thumbnail.jp

Becoming Psychotherapists: Experiences of Novice Trainees in a Beginning Graduate Class

The authors investigated the experiences related to becoming psychotherapists for 5 counseling psychology doctoral trainees in their first prepracticum course. Qualitative analyses of weekly journals indicated that trainees discussed challenges related to becoming psychotherapists (e.g., being self-critical, having troubling reactions to clients, learning to use helping skills), gains made during the semester related to becoming psychotherapists (e.g., using helping skills more effectively, becoming less self-critical, being able to connect with clients), as well as experiences in supervision and activities that helped them cope with their anxieties. Results are discussed in 5 broad areas: feelings about self in role of psychotherapist, awareness of reactions to clients, learning and using helping skills, reactions to supervision, and experiences that fostered growth. Implications for training and research are provided

Naturopathic Physician Attitudes and Practices for Vaccination and Primary Care in the State of Vermont

Introduction: Recent increase in measles cases has sparked vaccination controversy. Naturopathic physicians (NDs) have been recognized as primary care providers by VT since 2012. It is not well understood how NDs address vaccination with patients. Our goal was to determine how Vermont NDs address vaccines and preventative care with their patients.https://scholarworks.uvm.edu/comphp_gallery/1234/thumbnail.jp

Novel Inducers of the Envelope Stress Response BaeSR in Salmonella Typhimurium: BaeR Is Critically Required for Tungstate Waste Disposal

The RpoE and CpxR regulated envelope stress responses are extremely important for SalmonellaTyphimurium to cause infection in a range of hosts. Until now the role for BaeSR in both the Salmonella Typhimurium response to stress and its contribution to infection have not been fully elucidated. Here we demonstrate stationary phase growth, iron and sodium tungstate as novel inducers of the BaeRregulon, with BaeR critically required for Salmonella resistance to sodium tungstate. We show that functional overlap between the resistance nodulation-cell division (RND) multidrug transporters, MdtA, AcrD and AcrB exists for the waste disposal of tungstate from the cell. We also point to a role for enterobactinsiderophores in the protection of enteric organisms from tungstate, akin to the scenario in nitrogen fixing bacteria. Surprisingly, BaeR is the first envelope stress response pathway investigated in S. Typhimurium that is not required for murine typhoid in either ityS or ityR mouse backgrounds. BaeR is therefore either required for survival in larger mammals such as pigs or calves, an avian host such as chickens, or survival out with the host altogether where Salmonella and related enterics must survive in soil and water

Stressful events in early childhood and developmental trajectories of bedwetting at school age

Objective To examine whether early stressful events are associated with developmental trajectories of bedwetting. Methods This is a prospective cohort study comprising 8,761 participants from the Avon Longitudinal Study of Parents and Children. Stressful events were measured using a maternal questionnaire completed at 3 time points before their child was 4 years old. The association between stressful events and trajectories of bedwetting from 4 to 9 years was examined using multinomial regression. Results The association with stressful events was strongest for the frequent persistent bedwetting trajectory (wetting at least twice a week up to age 9). A 1 standard deviation increase in the stressful events score was associated with a 29% (13–47%) increase in the odds of experiencing frequent persistent bedwetting compared with normal attainment of nighttime bladder control. Conclusions Clinicians and parents should be aware that continence is a developmental outcome that is associated with high levels of stress in the family