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Articles 301 - 330 of 1423
Full-Text Articles in Speech and Hearing Science
Intervention Approaches For Childhood Apraxia Of Speech: An Overview Of Prevailing Treatment Methods, Toni Lewis
Intervention Approaches For Childhood Apraxia Of Speech: An Overview Of Prevailing Treatment Methods, Toni Lewis
University Honors Theses
This paper aims to describe the theory and methods of select intervention approaches for childhood apraxia of speech so readers may better understand current treatment techniques. Covered in this paper are Rapid Syllable Transitions (ReST), Dynamic Temporal and Tactile Cueing (DTTC), Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT), as well as supplemental techniques such as augmentative and alternative communication (AAC) and ultrasound biofeedback. Also covered briefly are instances of CAS treatment in languages other than English.
A Diagnostic Pocket Guide For Audiologists: Outer, Middle, And Inner Ear Disorders And Chronic Diseases, Ashley Andino
A Diagnostic Pocket Guide For Audiologists: Outer, Middle, And Inner Ear Disorders And Chronic Diseases, Ashley Andino
Dissertations, Theses, and Capstone Projects
Given the Scope of Practice for Audiologists as outlined by the American Speech-Language-Hearing Association (ASHA), the diverse occupational settings audiologists belong to, and the varied multidisciplinary collaboration necessary, audiologists are tasked with needing, at minimum, a baseline understanding of a wide range of disorders. This includes not only otological diseases, but multisystem disorders that affect the auditory system. While an abundance of diagnostic audiological information on various disorders and their impacts are available, there exists a gap in the availability of condensed and accessible diagnostic information for everyday use. The goal of the resulting diagnostic pocket guide is to provide …
Augmentative And Alternative Communication Use, Service Delivery Experiences, And Communicative Participation For People With Amyotrophic Lateral Sclerosis, Betts Peters
Dissertations and Theses
People with amyotrophic lateral sclerosis (ALS) often experience changes to their speech, and may use augmentative and alternative communication (AAC) devices and techniques to maintain the ability to communicate. The use of AAC may facilitate the participation of people with ALS in various life situations involving communication. There is limited data in the literature about the AAC approaches currently used by people with ALS, the professional services they receive to support communication, or the effects of AAC on their communicative participation. This dissertation involved a nationwide online survey of people with ALS, and comprises three papers intended to add to …
Audiologists' Perspectives On Noise Induced Hearing Loss, Rachael L. Cleary
Audiologists' Perspectives On Noise Induced Hearing Loss, Rachael L. Cleary
Dissertations, Theses, and Capstone Projects
Excessive noise has long been established in the literature as a prevalent workplace hazard. The high prevalence of occupational noise-induced hearing loss (NIHL) has led to high economic costs and has produced many physical and mental health effects on workers exposed to occupational noise. Standards set by OSHA are implemented in the workplace in order to protect employees. Despite these regulations set by OSHA, millions of workers in the United States are still exposed to excessive occupational noise, with limited use of hearing protection. The high prevalence of occupational NIHL and low use of hearing protective devices (HPDs) brings into …
Effects Of Animal-Assisted Therapy On Communication, Agitation And General Health In Individuals With Dementia Living In Long-Term Care Facilities And The Secondary Effects On Their Caregivers., Jenilee K. Woltman
Communication Disorders Theses, Dissertations, and Student Creative Activity
The use of animals for therapeutic purposes has existed for centuries. However, it was not until recently that people realized the human-animal interaction has potential effects on our overall health. Human-animal interaction positively impacts humans' social, emotional, and cognitive functions (Woods et al., 2005). This research encompasses two studies. Both studies examined the therapeutic effects of an animal-assisted therapy (AAT) dog presence on communication abilities and agitation of individuals with mild to severe dementia residing in a long-term care facility. Study 1 examined agitated behaviors, communications, and social interactions of older adults with dementia living in a long-term care facility …
Dynamic Measures Of Referential Communication Reveal Hidden Pragmatic Strengths For Adolescents With Autism Spectrum Disorder, Mariana Schreuders
Dynamic Measures Of Referential Communication Reveal Hidden Pragmatic Strengths For Adolescents With Autism Spectrum Disorder, Mariana Schreuders
Senior Honors Projects, 2020-current
The ability to communicate effectively and efficiently while maintaining mutual understanding is a fundamental aspect of human-to-human interaction. Studies have shown that individuals with autism spectrum disorder (ASD) face challenges in areas of social communication skills, such as aspects of referential communication; or the ability to refer to things in such a way that a listener will know what the speaker is describing. The current study used data from a preexisting Barrier study to compare the referential communication abilities of school-aged children with ASD to those of neurotypical children (NT). Referential communication was observed during a barrier task, where participants …
Pre-Pulse Inhibition In Mutated Mice: Studying Compromised Microglial Cells To Discover New Genetic Connections To Autism, Bailey R. Kramarik
Pre-Pulse Inhibition In Mutated Mice: Studying Compromised Microglial Cells To Discover New Genetic Connections To Autism, Bailey R. Kramarik
Senior Honors Projects, 2020-current
Microglial cells “play a pivotal role in refining neural networks during early critical periods” (Gabriele & Gray, 2020, p. 1). A disturbance in the functioning of these microglial cells contribute to specific characteristics of some neurodevelopmental disorders- including autism spectrum disorder. In this study, we used a mouse model to study disruptions in cell activity, as understanding the biological and genetic background of autism spectrum disorder could help us provide better treatment and therapy options to those diagnosed.
The mutated mice in this experiment have microglial cells with “compromised fractalkine signaling” (Gabriele & Gray, 2020, p. 4-5). We studied multimodal …
The Relationship Between Quality Of Life Outcomes And Social Hearing For Cochlear Implant Recipients Using The Nciq And Pipsl, Bonnie A. Purtill
The Relationship Between Quality Of Life Outcomes And Social Hearing For Cochlear Implant Recipients Using The Nciq And Pipsl, Bonnie A. Purtill
Dissertations, 2020-current
Unmanaged hearing loss can have profound cognitive, social, and emotional impacts on a person’s life. Cochlear implants improve functional skills such as auditory detection and speech discrimination, and have also been shown to improve quality of life. Health related quality of life (HRQoL) measures are a great tool to assess mental, physical, and social changes after cochlear implantation. While previous research has established improvement in HRQoL after cochlear implantation, there remains a lack of research evaluating long-term effects of cochlear implants for post-lingually and bilaterally deafened adults. Using a disease specific HRQoL questionnaire—Nijmegen Cochlear Implant Questionnaire (NCIQ) and a social …
Temporal Modulation Transfer Functions Of Amplitude-Modulated Cervical Vestibular Evoked Myogenic Potentials In Young Adults, Kerri Lawlor
Temporal Modulation Transfer Functions Of Amplitude-Modulated Cervical Vestibular Evoked Myogenic Potentials In Young Adults, Kerri Lawlor
Dissertations, 2020-current
Cervical vestibular evoked myogenic potentials (cVEMPs) are widely used to evaluate saccular function in clinical and research applications. Typically, transient tonebursts are used to elicit cVEMPs. In this study, we used bone-conducted amplitude-modulated (AM) tones to elicit AMcVEMPs. This new approach allows the examination of phase-locked vestibular responses across a range of modulation frequencies. Currently, cVEMP temporal modulation transfer functions (TMTFs) are not well defined. The purposes of the present study were 1) to characterize the AMcVEMP TMTF in young, healthy individuals, 2) to compare AMcVEMP TMTFs across different analysis approaches, and 3) to determine the upper frequency limit of …
Association Between Craniofacial Anomalies And Newborn Hearing Screening Fail Rate, Kaitlyn Sheapp, Ruth S. Marin, Larry Medwetsky
Association Between Craniofacial Anomalies And Newborn Hearing Screening Fail Rate, Kaitlyn Sheapp, Ruth S. Marin, Larry Medwetsky
Journal of Early Hearing Detection and Intervention
Purpose: Increased knowledge of the prevalence of various craniofacial anomalies and their associated risks for hearing loss can help guide 1) development of evidence-based practice regarding detection and documentation of risk factors at birth and 2) health care professionals to make appropriate recommendations for follow-up testing and monitoring.
Method: Records were reviewed for 39,813 infants born at Adventist HealthCare Shady Grove Medical Center and White Oak Medical Center between January 1, 2014 and December 31, 2019 to determine the association between the presence of craniofacial anomalies and newborn hearing screening fail rates, as well as the prevalence of confirmed hearing …
Resilience Training And Quality Of Life In Stuttering Therapy: A Systematic Review, Ashley Koehler
Resilience Training And Quality Of Life In Stuttering Therapy: A Systematic Review, Ashley Koehler
Honors Theses
Abstract
This study investigated correlations between resilience and quality of life relative to stuttering therapy. A systematic review and meta-analysis of articles published with focuses on stuttering, resilience training, and quality of life was conducted. Electronic databases, PubMed, and Google Scholar, were used to gain results of relevant published articles. Both search engines in this review produced relevant articles. Google Scholar produced more articles that met all 3 inclusion criteria, while PubMed produced more results that met at least 1 or 2 inclusion criteria. From both databases, numerous articles included the need for a multidimensional therapy emphasizing personal resilience. However, …
The Efficacy Of The Student Communication Repair Inventory And Practical Training Program On Adolescent’S Self-Advocacy Skills In Communication Breakdowns, Karlye Tolbird
Honors Theses
Purpose
Hearing loss can affect several aspects of an adolescent’s life, particularly their self-advocacy skills and ability to communicate their needs in the classroom. Literature shows that adolescents between the ages of 12 and 18 years have a prevalence of hearing loss between 14.9 percent and 19.5 percent (Shargorodsky et al., 2010). Therefore, early identification and intervention of hearing loss are necessary to reduce the adverse effects on the development of cognition, verbal communication skills, and self-advocacy skills (Michael & Zidan, 2018). This research study aimed to determine if the implementation of the SCRIPT program changes the communication repair behavior …
Patients’ Perspective Of Patient-Centered Approach Vs. Biomedical Approach, Lakynn Hillhouse
Patients’ Perspective Of Patient-Centered Approach Vs. Biomedical Approach, Lakynn Hillhouse
Honors Theses
Evidence-based practice in audiology may consist of a patient-centered approach or a biomedical approach when offering individuals the results of hearing evaluations. Boisvert et al. (2017) and the Institute for Defense Analysis confirmed that audiologists preferred to select one approach. The question was if an audiology patient is presented with two options of explaining the hearing health issues, which model/approach will be his or her preference?
Participants may have had unconscious biases related to race or gender that could have unknowingly impacted their perception of the videos. The results of this research will facilitate clinical understanding of individual preferences regarding …
How Are The Features Of Infant Directed Speech Related To Cradling Bias?, Tiffany S. Jacob
How Are The Features Of Infant Directed Speech Related To Cradling Bias?, Tiffany S. Jacob
Honors Capstones
The current study explored whether the cradling bias observed in mothers of very young infants is related to acoustic features of infant directed speech. Six mothers were asked to set their 4-month-old infants down and pick them up to determine which side mothers used to cradle their infants. Mothers were placed in two groups: left-sided cradling bias and right-sided cradling bias. The mothers were then recorded as they talked to their infants while they shared books and simple toys designed to elicit the vowels /i/, /a/, and /u/. Vowel fundamental frequency (/i, a, u/) and word length (i.e., “sheep, shop, …
Investigation Of The Externship Selection Process Across Asha-Accredited Speech Language Pathology Programs, Teale Niles, Lindsey Schwab, Brandon Eddy
Investigation Of The Externship Selection Process Across Asha-Accredited Speech Language Pathology Programs, Teale Niles, Lindsey Schwab, Brandon Eddy
Student Research Symposium
Graduate students in speech-language pathology (SLP) must complete 400 clinical clock hours during graduate training, the majority of which frequently come from off-campus externship experiences. Graduate students are matched to externship sites by their program. No studies to date have systematically documented how graduate programs in speech-language pathology select students for externship experiences nor the constraints involved in the externship process (e.g., academic schedule). The goal of this study is to survey ASHA accredited SLP programs to describe the current procedures being used to place students at externship sites and the roles and perspectives of the externship coordinators. Externship coordinators …
Implicit Learning In Preschoolers With Developmental Language Disorder, Crystal L. Cairns, Sam Ward, Emma Duran, Molly Franz, Carolyn Quam
Implicit Learning In Preschoolers With Developmental Language Disorder, Crystal L. Cairns, Sam Ward, Emma Duran, Molly Franz, Carolyn Quam
Student Research Symposium
We compared implicit learning in preschoolers with and without developmental language disorder (DLD), to test the procedural deficit hypothesis (PDH), which proposes that implicit learning is the core impairment in DLD. During the first experiment we tested 26 preschoolers with typical language development (TLD) and 26 preschoolers with DLD. Eligibility was determined through standardized assessment. We predicted children with DLD would show impairments in a test of implicit learning.
Using computer-based tasks, participants received training on sound discrimination in two dimensions: duration and pitch.They were tested on their ability to accurately categorize these two dimensions by mapping sounds to meaning. …
Augmentative And Alternative Communication Course Design And Features: An Analysis Of Course Syllabi And Calendars, Celine Goodbody, Hosanna Broderick, Brandon Eddy
Augmentative And Alternative Communication Course Design And Features: An Analysis Of Course Syllabi And Calendars, Celine Goodbody, Hosanna Broderick, Brandon Eddy
Student Research Symposium
Augmentative and alternative communication (AAC) is an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension (ASHA, n.d.). A survey study by Johnson and Prebor (2019) found 86% of graduate speech-language pathology (SLP) programs offered an AAC course, though half (49%) suggested their students were underprepared to provide AAC services. High-quality graduate training, including AAC coursework, has been suggested as a solution to prepare clinicians to provide AAC services. Recently, Sauerwein and Burris (2021) surveyed AAC course instructors at accredited SLP graduate programs to analyze AAC course design features. Sixty-four (24.2%) programs responded to …
Factors Impacting Heritage Language Maintenance In Children, Helena Sai
Factors Impacting Heritage Language Maintenance In Children, Helena Sai
Student Research Symposium
This review article aims to examine families’ beliefs and strategies regarding heritage language maintenance in the US. Language status, caregiver beliefs, and community factors are explored in relation to language maintenance across generations. The broader context in which parents make decisions about family language policies were investigated through the following research questions:
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What is the nature of the relationship between a heritage language’s language status in society and language maintenance across generations?
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How do parents’ beliefs about the impact of heritage language on academic, social, and career success influence their decision to pass this language to their children?
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To what …
Perspectives Of Special Educators And Paraprofessionals On Person-Centered Planning Tools For People Who Use Aac, Samantha K. Stidham, Brandon Eddy, Andryce Andres
Perspectives Of Special Educators And Paraprofessionals On Person-Centered Planning Tools For People Who Use Aac, Samantha K. Stidham, Brandon Eddy, Andryce Andres
Student Research Symposium
Person-centered planning (PCP) is an intervention approach for people experiencing disability. This often results in a document outlining the individual’s preferences in their care, life goals, and transitions. Some people with disabilities communicate using augmentative and alternative communication (AAC), which supplements or compensates for impairments in speech and language production often involving the use of external communication tools. Current PCP tools may not fulfill the needs of people who use AAC (PWUAAC) due to limited focus on supporting communication. No PCP tools yet exist specifically designed for PWUAAC. The purpose of this study was to inform the design of a …
Developing Therapeutic Alliance Through Improvisation: A State-Of-The-Art Review For The Speech-Language Pathologist, Ryan Depauw
Developing Therapeutic Alliance Through Improvisation: A State-Of-The-Art Review For The Speech-Language Pathologist, Ryan Depauw
Student Research Symposium
Background: With the needs of patients in modern healthcare becoming increasingly complex, providers may benefit from using adaptive skills to develop therapeutic alliance in patient-centered care. This review examined the potential application and benefit of theatrical improvisational skills in healthcare generally and in the allied health profession of speech-language pathology specifically.
Methods: A literature search was completed across 6 databases. Search terms included “clinical improvisation,” “medical improvisation,” and “applied improvisation.” Searches were limited to journal articles published in English from November 2011 through November 2021. Articles included for full review were of original research and focused on applied …
Qualitative Research Approaches: Descriptive Phenomenology In The Healthcare Field, Emily Goble, Karyssa Stonick, Alison Wong, Deanna Britton
Qualitative Research Approaches: Descriptive Phenomenology In The Healthcare Field, Emily Goble, Karyssa Stonick, Alison Wong, Deanna Britton
Student Research Symposium
Qualitative research analyzes psychosocial aspects of the world in an effort to synthesize and understand lived experiences. It is a powerful tool for collecting rich data to explore and build theory in new areas of research with limited existing theory. This oral presentation will share an overview of commonly used qualitative research approaches and their applications with a focus on descriptive phenomenology for patient-centered healthcare research. Developed as part of a student-led research team looking into experiences of dysphagia among individuals with Ehlers-Danlos syndrome, this project will justify why we selected a descriptive phenomenological approach for this project, provide a …
Patterns Of And Experiences With Dysphagia In People With Hypermobile Ehlers Danlos Syndrome (Heds) With Or Without Dysautonomia, Karyssa A. Stonick, Deanna Britton Dr., Emily Goble, Alison Wong, Alena Guggenheim Dr., Donna Graville
Patterns Of And Experiences With Dysphagia In People With Hypermobile Ehlers Danlos Syndrome (Heds) With Or Without Dysautonomia, Karyssa A. Stonick, Deanna Britton Dr., Emily Goble, Alison Wong, Alena Guggenheim Dr., Donna Graville
Student Research Symposium
Ehlers Danlos Syndromes (EDS) are collagen-based hereditary connective tissue disorders characterized by decreased tissue integrity. Historically, the musculoskeletal and dermatological manifestations have been emphasized. However, EDS is associated with symptoms and conditions affecting nearly all body systems, including swallowing (dysphagia). A Cohort Discovery analysis at Oregon Health & Science University (OHSU) revealed that 14.9% ± 0.3% of patients with an ICD-10 diagnosis of EDS also have an ICD-10 diagnosis of dysphagia in their medical record. Despite only one article in the current literature, the prevalence of dysphagia in EDS is not insignificant and warrants further investigation. Our long-term hypothesis is …
Respiratory Function In Transgender And Gender Diverse Individuals On Testosterone Therapy: A Comparative Study, Jillian River R. Browy, Alicia Heitzman, Deanna Britton, Jeff Conn, Karen Drake, Aaron Ziegler
Respiratory Function In Transgender And Gender Diverse Individuals On Testosterone Therapy: A Comparative Study, Jillian River R. Browy, Alicia Heitzman, Deanna Britton, Jeff Conn, Karen Drake, Aaron Ziegler
Student Research Symposium
Introduction: The primary goal of this pilot study was to examine the impact of testosterone therapy, as part of medical treatment to align gender identity, on measures of respiration and voice.
Methods: Participants consisted of a group of transgender and gender-diverse individuals, assigned female at birth, who had been taking testosterone for at least one year and a control group of age- and race-matched peers, also assigned female at birth, who had never taken testosterone. Data were collected on the primary outcomes of respiratory volume and strength, reflected by measures of forced vital capacity (FVC), maximum inspiratory pressure (MIP), and …
The Index Of Phonetic Complexity: At-A-Glance Scoring System, Terminology, Instructions, & Data Forms, Kathy J. Jakielski
The Index Of Phonetic Complexity: At-A-Glance Scoring System, Terminology, Instructions, & Data Forms, Kathy J. Jakielski
Building Speech and Quantifying Complexity
This document is the Index of Phonetic Complexity, the at-a-glance scoring system, terminology, instructions, & data forms to accompany Building Speech & Quantifying Complexity. To see the entire series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …
Building Speech Pattern 1: Picture Stimuli, Kathy J. Jakielski
Building Speech Pattern 1: Picture Stimuli, Kathy J. Jakielski
Building Speech and Quantifying Complexity
Building Speech Pattern 1: Picture Stimuli is part 1 of 8 in the picture stimuli to accompany the Building Speech & Quantifying Complexity documents. To see the full series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …
Building Speech Pattern 2: Picture Stimuli, Kathy J. Jakielski
Building Speech Pattern 2: Picture Stimuli, Kathy J. Jakielski
Building Speech and Quantifying Complexity
Building Speech Pattern 2: Picture Stimuli is part 2 of 8 in the picture stimuli to accompany the Building Speech & Quantifying Complexity documents. To see the full series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …
Building Speech Pattern 6: Picture Stimuli, Kathy J. Jakielski
Building Speech Pattern 6: Picture Stimuli, Kathy J. Jakielski
Building Speech and Quantifying Complexity
Building Speech Pattern 6: Picture Stimuli is part 6 of 8 in the picture stimuli to accompany the Building Speech & Quantifying Complexity documents. To see the full series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …
Building Speech And Quantifying Complexity: The Manual, Kathy J. Jakielski
Building Speech And Quantifying Complexity: The Manual, Kathy J. Jakielski
Building Speech and Quantifying Complexity
This document is the manual to accompany Building Speech & Quantifying Complexity. The full series can be viewed here: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, at one point in time or over time.
The Building Speech …
Building Speech Pattern 4: Picture Stimuli, Kathy J. Jakielski
Building Speech Pattern 4: Picture Stimuli, Kathy J. Jakielski
Building Speech and Quantifying Complexity
Building Speech Pattern 4: Picture Stimuli is part 4 of 8 in the picture stimuli to accompany the Building Speech & Quantifying Complexity documents. To see the full series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …
Building Speech Pattern 5: Picture Stimuli, Kathy J. Jakielski
Building Speech Pattern 5: Picture Stimuli, Kathy J. Jakielski
Building Speech and Quantifying Complexity
Building Speech Pattern 5: Picture Stimuli is part 5 of 8 in the picture stimuli to accompany the Building Speech & Quantifying Complexity documents. To see the full series, visit: https://digitalcommons.augustana.edu/cgi/siteview.cgi/csdbuildingspeech
Building Speech & Quantifying Complexity is a dual approach to treating and evaluating articulatory complexity in child speech. It has two components: Building Speech and Quantifying Complexity. These two components can be used independently or together. When used together, the speech-language pathologist has a method for selecting goals and targets of varying levels of articulatory difficulty, plus a means for measuring changes in a child’s words, targeted and produced, …