Substance abuse disorders (SUDs) create significant and pervasive health and economic burdens in the U.S. and the world. After primary treatment has ended, supportive social environments are critically important to prevent relapse and to sustain long-term sobriety. Although approaches to SUDs and treatment vary internationally, studies in the United States indicate that a major risk factor for SUD relapse are lack of social environments to support sustained remission from substance use after primary treatment has ended. Evidence suggests that abstinence is enhanced when individuals are embedded in drug-free settings that support abstinence. Longabaugh, Beattie, Noel, and Stout proposed a theory of social support that engages two processes general social support, which affectspsychological functioning, and abstinence-specific social support, which supports ongoing abstinence from substance use.Purpose The Voice Handicap Index (VHI) questionnaire assesses the impact of total laryngectomy on voice-related quality of life. This study evaluates the Mandarin VHI, including its internal consistency, test-retest reliability, content validity, and differences in scores for Mandarin alaryngeal patients with pneumatic artificial laryngeal (PA) and esophageal (ES) speech. Method Translation and validation of the VHI questionnaire was performed through the forward-backward translation technique. This study used a sample of 78 PA and 23 ES participants from Taiwan who completed the Mandarin VHI. Forty-two of the alaryngeal participants completed the Mandarin VHI twice over a period of 7-63 days. Results The measurement of the internal consistency of the Mandarin VHI showed a high Cronbach's alpha coefficient for the total score (.975) and the functional (.930), physical (.939), and emotional (.938) subscales. Based on the results of the intraclass correlation coefficients, good test-retest reliability for the total and domain scores was found (intraclass correlation coefficient = .827-.863). Conclusion The Mandarin VHI was validated as an instrument with proper internal consistency and reliability, which supports the Mandarin VHI as a valid instrument for the self-evaluation of handicaps related to voice problems in PA and ES speakers.Purpose People who stutter (PWS) have more unstable speech motor systems than people who are typically fluent (PWTF). Here, we used real-time magnetic resonance imaging (MRI) of the vocal tract to assess variability and duration of movements of different articulators in PWS and PWTF during fluent speech production. Method The vocal tracts of 28 adults with moderate to severe stuttering and 20 PWTF were scanned using MRI while repeating simple and complex pseudowords. Midsagittal images of the vocal tract from lips to larynx were reconstructed at 33.3 frames per second. For each participant, we measured the variability and duration of movements across multiple repetitions of the pseudowords in three selected articulators the lips, tongue body, and velum. Results PWS showed significantly greater speech movement variability than PWTF during fluent repetitions of pseudowords. The group difference was most evident for measurements of lip aperture using these stimuli, as reported previously, but here, we report that movements of the tongue body and velum were also affected during the same utterances. Variability was not affected by phonological complexity. Speech movement variability was unrelated to stuttering severity within the PWS group. PWS also showed longer speech movement durations relative to PWTF for fluent repetitions of multisyllabic pseudowords, and this group difference was even more evident as complexity increased. Conclusions Using real-time MRI of the vocal tract, we found that PWS produced more variable movements than PWTF even during fluent productions of simple pseudowords. PWS also took longer to produce multisyllabic words relative to PWTF, particularly when words were more complex. This indicates general, trait-level differences in the control of the articulators between PWS and PWTF. Supplemental Material https//doi.org/10.23641/asha.14782092. To examine the safety of high-level mobility (HLM) prescription in the early sub-acute phase of recovery following moderate-to-extremely severe traumatic brain injury (TBI) with specific focus on provocation of concussion-like symptoms. Systematic review. PROSPERO ID CRD42017069369. Extracted data included study design, brain injury severity, time to commence HLM, type of HLM, physiological and symptom monitoring, and rate of adverse events. Nineteen studies were included in the review. Selleck OD36 Fifteen studies included participants who commenced HLM within 6 weeks of injury, with the earliest time to commencement being 3 days. Overall, adverse events and symptom monitoring were poorly reported. A total of six adverse events were reported across three studies. One of the six adverse events was a concussion-like symptom. No falls were reported. No studies monitored concussion-like symptom provocation in direct relation to HLM. A safe timeframe for return to HLM after moderate-to-extremely severe TBI could note events and symptoms are poorly reported.Clinicians should continue to proceed with caution when assessing and prescribing high-level mobility for patients with moderate-to-extremely severe traumatic brain injury in the early sub-acute phase of recovery and monitor for risks such as falls and exacerbation of concussion-like symptoms.In many species, sexual dimorphism increases with body size when males are the larger sex but decreases when females are the larger sex, a macro-evolutionary pattern known as Rensch's rule (RR). Although empirical studies usually focus exclusively on body size, Rensch's original proposal included sexual differences in other traits, such as ornaments and weapons. Here, we used a clade of harvestmen to investigate whether two traits follow RR body size and length of the fourth pair of legs (legs IV), which are used as weapons in male-male fights. We found that males were slightly smaller than females and body size did not follow RR, whereas legs IV were much longer in males and followed RR. We propose that sexual selection might be stronger on legs IV length than on body size in males, and we discuss the potential role of condition dependence in the emergence of RR.