Over the past decades, professional medical authority has been transformed due to internal and external pressures, including weakened institutional support and patient-centered care. Today's patients are more likely to resist treatment recommendations. We examine how patient resistance to treatment recommendations indexes the strength of contemporary professional authority. Using conversation analytic methods, we analyze 39 video recordings of patient-clinician encounters involving pediatric epilepsy patients in which parents resist recommended treatments. We identify three distinct grounds for parental resistance to treatments preference-, fear-, and experience-based resistance. Clinicians meet these grounds with three corresponding persuasion strategies ranging from pressuring, to coaxing, to accommodating. Rather than giving parents what they want, physicians preserve their professional authority, adjusting responses based on whether the resistance threatens their prerogative to prescribe. While physicians are able to convert most resistance into acceptance, resistance has the potential to change the treatment recommendation and may lead to changed communication styles.Transmission of Pseudomonas aeruginosa along the food chain could cause gastrointestinal infections. To show this involvement, the prevalence, putative virulence genotype, and antibiotic resistance phenotype of P. aeruginosa isolates from stool of 1482 patients with community and hospital acquired diarrhea were compared with 87 isolates from the environmental samples. The results showed infection with P. aeruginosa in 3.4% of the cases, while 57.4% of vegetable samples were contaminated. Significantly higher frequency of lasB (98%), aprA (98%), exoY (98%), and exoS (90%), but lower rate of exoT (39.2%), was detected among the stool isolates. Multi-drug resistance (MDR) phenotype was detected in 25.5% and 4% of the stool and vegetable isolates, respectively. A higher rate of studied virulence genes was detected among the MDR strains vs non-MDR strains. These results indicate P. aeruginosa as a causative agent of diarrhea either among the hospitalized patients and those with community-acquired diarrhea.Purpose The purpose of this article was to examine the current state of counseling education and to present examples of strategies for teaching counseling based on the author's 40 years of university teaching. Conclusion Current research suggests that students and clinicians are not getting sufficient training in personal adjustment counseling. A recent unpublished survey suggests that only a few graduate programs require a counseling course for speech-language pathology students. Additional research suggests that, although audiology students do have access to counseling coursework, these courses focus primarily on informational/educational counseling strategies and not on teaching personal adjustment counseling strategies. The American Speech-Language-Hearing Association should review current standards for including counseling training in the curriculum, and graduate programs should review how they are teaching counseling and determine if their processes are effective.This study aimed to investigate the trends in childhood asthma hospitalization in regions with differing levels of air pollution in Taiwan, 2001-2012. Joinpoint regression was used to identify significant trend changes. The hospitalization rate varied according to gender, geographic region, and age. The incidence of childhood asthma hospitalization decreased from 127.99 to 76.67 (/100,000 population), with an average annual percentage change of around -4.1%; in the Yilan region, the average air pollution concentrations were 19.92 μg/m3, 39.47 μg/m3, 25.99 ppb, 2.19 ppb, and 11.23 ppb for PM2.5, PM10, O3, SO2, and NO2, respectively, which were lower than Taiwan's average values; however, the childhood asthma hospitalization rate was the highest (179.75/100,000 population). The national trend in childhood asthma hospitalization exhibited a significant decrease. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while less association was observed in the lower-level air pollution regions.Purpose The purpose of this study is to determine the sensitivities and specificities of different audiometric hearing screening criteria and single-item and multi-item hearing disability questionnaires among a group of Spanish-speaking adults in a rural community. Method Participants were 131 predominantly older (77% 65+ years) Hispanic/Latinx adults (98%). A structured Spanish-language interview and pure-tone threshold test data were analyzed for each participant. The sensitivities and specificities of three single questions and the Hearing Handicap Index for the Elderly-Screening (HHIE-S; Ventry & Weinstein, 1983) in Spanish, as well as three audiometric screening criteria, were evaluated in relation to the pure-tone threshold test for detecting hearing loss. Results Sensitivity and specificity of audiometric screening criteria varied, but the highest sensitivity was found for the criterion of > 25 dB HL at 1-4 kHz in either ear. The single self-perception question, "¿Cree usted que tiene pérdida de audición? (Do you think you have a hearing loss?)," was shown to be the most sensitive self-report screening compared to other single-item questions and the HHIE-S.  https://www.selleckchem.com/products/lys05.html  This single question was as sensitive as an audiometric screening to detect a moderate hearing loss (> 40 dB HL in either ear). Results from the Spanish HHIE-S indicated poor performance to detect hearing loss in this population, consistent with previous research. Conclusions Among older Spanish-speaking adults, self-reported hearing status had varying sensitivities depending on the question asked. However, of the tools evaluated, the self-perception question proved to be a more sensitive and specific tool than a multi-item screen. Objective audiometric testing (> 25 dB HL) resulted in the highest sensitivity to detect a mild hearing loss.The purpose of this review was to synthesise available knowledge on the main health effects associated with the use of probiotics, prebiotics and/or synbiotics in athletes and active individuals, including their effects on the immune system, oxidative stress, the gastrointestinal and respiratory symptoms, as well as other possible clinical outcomes. A systematic and comprehensive search in electronic databases, including Web of Science (WOS, Scielo), PubMed-MEDLINE, Biblioteca virtual de la Salud (LILACS, IBECS), EBSCO (Academic Search Complete CINAHL; SPORTDiscus) and Cochrane Library, focused on generic articles about probiotics, prebiotics and/or synbiotics and their functionality and effects on human health. The search process was completed using the keywords 'probiotics', 'prebiotics', 'synbiotics', 'athletes' and 'health'. The only exclusion criterion was experimental studies with animals. A total of 31 studies met the inclusion criteria and were included in the review. The vast majority were experimental studies about probiotics and health effects (n=28), while only a few demonstrated the results of consuming prebiotics and/or synbiotics (n=3) in athletes and active individuals.