224 research outputs found

    Doctor of Philosophy

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    dissertationThis publication examines the impact of integrating mental health into primary health care. Mental Health Integration (MHI) in Intermountain Healthcare (IH) has changed the culture of primary health care by standardizing a team-based care process that includes mental health as a normal part of the routine medical encounter. MHI sees mental illness through a new lens integrating mind and body and introduces a team approach that values both the patient and staff experiences. This multisite comparative study using qualitative techniques reports on health outcomes associated with MHI for patients and staff. Fifty-nine patients and 50 staff were interviewed to evaluate the impact of MHI on care for depression. Patients receiving MHI reported an improved relationship with caregivers (p <.001) and improved overall functioning in their lives. Patients valued responsive shared decision processes with team care givers (p <.0001) and coordinated follow-up plans (p <.05). Patients receiving care for depression via MHI were more likely to participate in treatment decisions, self-management, follow up care (p <.01) and lifestyle change (p <. 05) and desire to share lessons learned with others suffering from depression. Staff working in MHI clinics were more comfortable addressing mental health (p <.01) and had more time to spend with patients due to team support (p <.05). They defined MHI as an organized usual team process that empowered them to provide better care to patients (p < .001). As clinics became more committed to MHI staff viewed mental health as a normalized part of their practice (p <.01). Staff reported that the quality of the care provided had improved as a result of MHI (p <.01). Mental health problems rank second in chronic disease today. Normalizing mental health as an organized team process within the context of primary care offers promising results for improving outcomes and lowering costs. Using the patients' perceptions of the quality of care and its impact is timely focus for realigning health reform efforts towards patient-centered care

    Maximizing Audibility and Speech Recognition with Non-Linear Frequency Compression by Estimating Audible Bandwidth

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    Objective—Nonlinear frequency compression attempts to restore high-frequency audibility by lowering high-frequency input signals. Methods of determining the optimal parameters that maximize speech understanding have not been evaluated. The effect of maximizing the audible bandwidth on speech recognition for a group of listeners with normal hearing is described. Design—Nonword recognition was measured with twenty normal-hearing adults. Three audiograms with different high-frequency thresholds were used to create conditions with varying high-frequency audibility. Bandwidth was manipulated using three conditions for each audiogram: conventional processing, the manufacturer’s default compression parameters, and compression parameters that optimized bandwidth. Results—Nonlinear frequency compression optimized to provide the widest audible bandwidth improved nonword recognition compared to both conventional processing and the default parameters. Conclusion—These results showed that using the widest audible bandwidth maximized speech identification when using nonlinear frequency compression. Future studies should apply these methods to listeners with hearing loss to demonstrate efficacy in clinical populations

    The influence of audibility on speech recognition with nonlinear frequency compression for children and adults with hearing loss

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    Objective—The primary goal of nonlinear frequency compression (NFC) and other frequency lowering strategies is to increase the audibility of high-frequency sounds that are not otherwise audible with conventional hearing-aid processing due to the degree of hearing loss, limited hearing aid bandwidth or a combination of both factors. The aim of the current study was to compare estimates of speech audibility processed by NFC to improvements in speech recognition for a group of children and adults with high-frequency hearing loss. Design—Monosyllabic word recognition was measured in noise for twenty-four adults and twelve children with mild to severe sensorineural hearing loss. Stimuli were amplified based on each listener’s audiogram with conventional processing (CP) with amplitude compression or with NFC and presented under headphones using a software-based hearing aid simulator. A modification of the speech intelligibility index (SII) was used to estimate audibility of information in frequency-lowered bands. The mean improvement in SII was compared to the mean improvement in speech recognition. Results—All but two listeners experienced improvements in speech recognition with NFC compared to CP, consistent with the small increase in audibility that was estimated using the modification of the SII. Children and adults had similar improvements in speech recognition with NFC. Conclusion—Word recognition with NFC was higher than CP for children and adults with mild to severe hearing loss. The average improvement in speech recognition with NFC (7%) was consistent with the modified SII, which indicated that listeners experienced an increase in audibility with NFC compared to CP. Further studies are necessary to determine if changes in audibility with NFC are related to speech recognition with NFC for listeners with greater degrees of hearing loss, with a greater variety of compression settings, and using auditory training

    A Rapid Scoping Review on Academic Integrity and Algorithmic Writing Technologies

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    This presentation provides insight into the development and findings of a rapid scoping review centred on the intersections of academic integrity and artificial intelligence, with particular attention to algorithmic writing technologies (e.g., ChatGPT) involving faculty, students, teaching assistants, academic student support staff, and educational developers in higher education contexts. This rapid scoping review was developed by a transdisciplinary team including Communication studies, Education, Engineering, and English, and followed Joanna Brigg Institute’s (JBI) updated manual for scoping reviews and the Preferred Reporting Items for Systematic reviews Meta-Analysis (PRISMA) reporting standards. JBI provides a high-quality, trusted framework for conducting these kinds of studies. This inquiry’s study design includes qualitative, quantitative, mixed methods, theoretical and opinion studies; additionally, this inquiry did not restrict studies by geographic location and focused on sources written in English. This review’s studies involved faculty, students, teaching assistants, academic support staff, and educational developers in higher education. It also included studies about artificial intelligence in the context of academic integrity, focusing on artificial intelligence tools that assist text generation and writing developed in Tertiary type A and B postsecondary education. Studies excluded from this review were related to primary and secondary education contexts, did not address the ethical implications of artificial intelligence, and focused on text plagiarism software. The protocol of this rapid review was published in the Canadian Perspectives on Academic Integrity Journal. Its implementation helped this team identify various ethical implications signalled by scholars between 2007 and 2022. Considering the expansive emergence of these technologies and the multiple positionings derived from these new and unprecedented encounters with such technology, we believe that the implications identified in this rapid scoping review are particularly relevant to inform academic staff, administration, students, and academic integrity researchers’ ethical decision-making and practices when teaching, learning, designing, and implementing assessments, and doing research. The findings of this rapid scoping review encompass nuanced perspectives concerning the ethical and unethical uses of these emerging technologies and insights into equity, diversity, and inclusion issues
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