The study investigated how pediatric speech-language pathologists (SLPs) applied telepractice to compensate for the loss of in-person services and the dynamics of telepractice use during the COVID-19 pandemic in a rural state. We conducted interviews with 10 SLPs and then a statewide survey in which 51 SLPs participated. The qualitative interviews revealed themes including changes in service environment due to the pandemic (e.g., transition to telepractice, losing clients), challenges in the transition to telepractice (e.g., limited training, difficulty engaging clients), worsening wellbeing of clinicians and clients, and SLPs’ perspectives and suggestions towards telepractice in the future. Survey results showed service disruptions and transition dynamics during the pandemic. SLPs’ weekly caseloads reduced from an average of 42.3 clients prior to the pandemic to 25.9 and 23.4 from March to May and from June to September 2020, respectively, and then recovered to 37.2 clients from October to December 2020. In contrast, the number of telepractice caseloads sharply increased from 0.2 clients per week prior to the pandemic to 14.8 from March to May 2020. The weekly telepractice caseloads then declined to 5.5 clients from June to September and 7.9 clients from October to December 2020. In the months right after the pandemic outbreak (i.e., March to May), client children struggled with treatment gains and behavioral wellbeing. However, their outcomes gradually improved by October to December and approached pre-pandemic levels. About one-third of the SLPs reported that they would be more likely or much more likely to use telepractice in the future regardless of the pandemic. However, only about a quarter perceived telepractice as comparable to in-person services. We concluded that the transition from in-person services to telepractice substantially mitigated service disruptions right after the pandemic outbreak and that telepractice’s substitute role evolved over time.

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Three patients with multiple facial neurofibromas were treated by dermabrasion with good cosmetic results. Wound healing was entirely normal and no complications were observed. There was no evidence of accelerated regrowth of tumors during follow-up.

Payday lenders provide high-cost short-term loans to those who have limited access to traditional financial institutions. Although an overwhelming majority of payday loan customers are repeat borrowers, studies examining the phenomenon of repeat borrowing is scant. Our study aimed to assess risk and protective factors among repeat payday loan borrowers. Using Bankruptcy filers' data obtained through the Public Access to Court Electronic Records database of the United States Bankruptcy Court of a Southern district, we conducted a multinomial logistic regression analysis to compare one-time and repeat borrowers with non-borrowers (N = 453). Findings revealed that medical debt and the number of children are associated with an increased risk of repeat borrowing. Homeownership is associated with a decreased risk of both one-time and repeat borrowing. In contrast, student loans are associated with an increased risk of one-time borrowing. Implications for social work practice, policy, research, and education to engage with financially vulnerable households, build assets and financial capability, and address risk and protective factors of alternative financial services such as repeat payday loan borrowing toward achieving socio-economic justice goals are discussed.

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