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RESULTS Participants with postexertional slowing (PES group, n = 33) had a longer duration of recovery (17 days versus 13.5 days, P = .033) than participants without PES (no-PES group, n = 66). At any clinic visit, PES was also associated with a relative risk of 2.36 (95% confidence interval = 1.55, 3.61; P less then .001) of not recovering within the following week. CONCLUSIONS The current study validates our prior work showing that acutely concussed adolescents who did not display the typical learning effect on the KD test after the BCTT took longer to recover from SRC than those who exhibited the typical learning effect.Purpose The purpose of this article is to examine the current state of counseling curriculum within the discipline. The last systematic survey of counseling curriculum within the disciplines of communication sciences and disorders was completed with data from 1983 (McCarthy et al., 1986). The Council on Academic Accreditation in Audiology and Speech-Language Pathology (2017) states that counseling should be included in accredited programs but does not specify to what extent. Currently, there are no standards to specify number of credits, need for a stand-alone course, or guidance regarding content delivered. Method The present investigation collected data on the status of counseling curricula in accredited communication sciences and disorders graduate programs. A Qualtrics survey was distributed to identify counseling curriculum practices across accredited programs. Quantitative data such as percentages and frequency counts were compiled to summarize program offerings. Qualitative analyses were used to charac 1983, as well as a disparity regarding how programs provide training in counseling. Furthermore, survey responses differed from curriculum listings on program websites. Information derived from this study may serve as a starting point for the development of flexible standards that provide direction for achieving consistent preparation of counseling skills. Supplemental Material https//doi.org/10.23641/asha.12149703.The pulmonary epithelial glycocalyx, an anionic cell-surface layer enriched in glycosaminoglycans such as heparan sulfate and chondroitin sulfate, contributes to the alveolar barrier. Direct injury to the pulmonary epithelium induces shedding of heparan sulfate into the airspace; the impact of this shedding on recovery after lung injury is unknown. Using mass spectrometry, we found that heparan sulfate was shed into the airspace for up to three weeks after intratracheal bleomycin-induced lung injury and coincided with induction of matrix metalloproteinases (including matrix metalloproteinase 2). Delayed inhibition of metalloproteinases, beginning seven days after bleomycin using the nonspecific MMP inhibitor doxycycline, attenuated heparan sulfate shedding and improved lung function, suggesting that heparan sulfate shedding may impair lung recovery. While we also observed an increase in airspace heparanase activity after bleomycin, pharmacologic and transgenic inhibition of heparanase in vivo failed to attenuate heparan sulfate shedding or protect against bleomycin-induced lung injury. However, experimental augmentation of airway heparanase activity significantly worsened post-bleomycin outcomes, confirming the importance of epithelial glycocalyx integrity to lung recovery. We hypothesized that matrix metalloproteinase-associated heparan sulfate shedding contributed to delayed lung recovery in part by the release of large, highly sulfated fragments that sequestered lung-reparative growth factors such as hepatocyte growth factor. In vitro, heparan sulfate bound hepatocyte growth factor and attenuated growth factor signaling, suggesting that heparan sulfate shed into the airspace after injury may directly impair lung repair. Accordingly, administering exogenous heparan sulfate to mice after bleomycin injury increased the likelihood of death with severe lung dysfunction. check details Taken together, our findings demonstrate that alveolar epithelial heparan sulfate shedding impedes lung recovery after bleomycin.Purpose Little is known about the professional knowledge, training, and attitudes of current and future speech-language pathologists (SLPs) toward serving people who are transgender. The purpose of this study was to understand the current climate of students and professionals in delivering voice and communications services to people who are transgender. An understanding of these areas is necessary to help practicing and aspiring SLPs work toward cultural competence in serving this population. Method A survey was completed by 386 speech-language pathology students and SLPs at three professional conferences. The survey assessed the professional and ethical knowledge, training experiences, and attitudes of the participants in relation to communication services for people who are transgender. Results In terms of professional knowledge, the majority of students and experienced SLP respondents agreed or strongly agreed (77.8%) that treating clients who are transgender was within the SLP scope of practice and was their ethical responsibility (82.2%). Regarding training, approximately 20% of survey respondents received training for working with people who are transgender, whereas approximately 8% of survey respondents reported having experience working with clients who are transgender. With respect to attitude, approximately 54% of survey respondents reported being comfortable treating clients who are transgender, and 37% of survey respondents reported they were likely to pursue training for treating clients who are transgender. Additional analyses were completed comparing students and experienced SLPs as well as the influence of geographic region. Discussion Students and SLPs were generally knowledgeable of professional guidelines and standards regarding serving people who are transgender. However, in this survey, very few clinicians indicated they had received training to serve this population. Recommendations to address this gap are discussed.RATIONALE Long-term antibiotic use for managing chronic respiratory disease is increasing however the role of the airway resistome and its relationship to host microbiomes remains unknown Objective To evaluate airway resistomes, and, relate them to host and environmental microbiomes using ultra-deep metagenomic shotgun sequencing Methods Airway specimens from n=85 individuals with and without chronic respiratory disease (severe asthma, COPD and bronchiectasis) were subjected to metagenomic sequencing to an average depth exceeding twenty million reads. Respiratory and device-associated microbiomes were evaluated based on taxonomical classification and functional annotation including the Comprehensive Antibiotic Resistance Database (CARD) to determine airway resistomes. Co-occurrence networks of gene-microbe association were constructed to determine potential microbial sources of the airway resistome. Paired patient-inhaler metagenomes were compared (n=31) to assess for the presence of airway-environment overlap in microbiomes and/or resistomes.