Reimagining the Discourse: Media Representation of Women in Boston Public Schools\u27 Superintendency, 1991 - 2016

This study examines the relationship among public discourse, power and leadership for women superintendents in Boston Public Schools. For this qualitative study, I use a feminist poststructural discourse analysis (FPDA) to examine newspaper articles from The Boston Globe from 1991 to 2016. Through a FPDA, I illuminate the ways in which women superintendents have been discursively produced amidst neoliberal educational reform movements. In this study, I focus on how the superintendent’s role was conceptualized as a male endeavor in The Boston Globe, and the implications of this for current educational leaders. Two major discursive stages frame the study’s time period: Superintendent as Political Strategist Focused on Excellence and Superintendent as Collaborator (Brunner, Grogan, & Bjork, 2002). In the first discursive stage, superintendents focused navigating complex city politics and politicians invested in the quality of educational programs. During the second discursive stage, superintendents had to work with rather than over others. Superintendents in larger urban communities needed to collaborate and engage communities of color. This study examines four superintendents: Lois Harrison Jones (1991-1995), Thomas Payzant (1995-2006), Carol Johnson (2007-2013), and Tommy Chang (2015-present). The findings fall into three categories: (1) superintendent as a capable leader; (2) superintendent as a politician or educator; and (3) superintendent as a community ally. For each category, gendered and racialized discourses play a key role in the superintendent’s positioning. This study suggests that the discursive stages are insufficient in the depiction of a superintendent in local media. Intersections of race and gender, situated in the discursive stage’s context, provide a more nuanced analysis. By understanding this intersection, superintendents can identify how these discourses impact their subject positions and use this understanding in their practice. Lastly, the analysis shows a need for a new discursive stage focused on the prominence of neoliberalism in educational reforms in order to fully address educational leadership in the twenty-first century

Effects of simultaneous speech and sign on infants’ attention to spoken language

Objectives: To examine the hypothesis that infants receiving a degraded auditory signal have more difficulty segmenting words from fluent speech if familiarized with the words presented in both speech and sign compared to familiarization with the words presented in speech only. Study Design: Experiment utilizing an infant-controlled visual preference procedure. Methods: Twenty 8.5-month-old normal-hearing infants completed testing. Infants were familiarized with repetitions of words in either the speech + sign (n = 10) or the speech only (n = 10) condition. Results: Infants were then presented with four six-sentence passages using an infant-controlled visual preference procedure. Every sentence in two of the passages contained the words presented in the familiarization phase, whereas none of the sentences in the other two passages contained familiar words.Infants exposed to the speech + sign condition looked at familiar word passages for 15.3 seconds and at nonfamiliar word passages for 15.6 seconds, t (9) = -0.130, p = .45. Infants exposed to the speech only condition looked at familiar word passages for 20.9 seconds and to nonfamiliar word passages for 15.9 seconds. This difference was statistically significant, t (9) = 2.076, p = .03. Conclusions: Infants\u27 ability to segment words from degraded speech is negatively affected when these words are initially presented in simultaneous speech and sign. The current study suggests that a decreased ability to segment words from fluent speech may contribute towards the poorer performance of pediatric cochlear implant recipients in total communication settings on a wide range of spoken language outcome measures

Feasibility of personalised remote long-term follow-up of people with cochlear implants: a randomised controlled trial

Introduction: substantial resources are required to provide lifelong post-operative care to people with cochlear implants. Most patients visit the clinic annually. We introduced a person-centred remote follow-up pathway, giving patients telemedicine tools to use at home so they would only visit the centre when intervention was required. Objectives: to assess the feasibility of comparing a remote care pathway to the standard pathway in adults using cochlear implants. Design: two-arm Randomised Controlled Trial. Randomisation used a minimisation approach, controlling for potential confounding factors. Participant blinding was not possible, but baseline measures occurred before allocation. Setting: University of Southampton Auditory Implant Service: provider of NHS care. Participants: 60 adults who had used cochlear implants for at least 6 months. Interventions: control group (n = 30) followed usual care pathway. Remote care group (n = 30) received care remotely for 6 months incorporating: •Home hearing in noise test •Online support tool •Self-adjustment of device (only 10 had compatible equipment) Main outcome measures: Primary: change in patient activation; measured using the Patient Activation Measure® Secondary: change in hearing and quality of life; qualitative feedback from patients and clinicians. Results: one participant in the remote care group dropped out. The remote care group showed a greater increase in patient activation than the control group. Changes in hearing differed between the groups. The remote care group improved on the Triple Digit Test hearing test; the control group perceived their hearing was worse on the Speech, Spatial and Qualities of Hearing questionnaire. Quality of life remained unchanged in both groups. Patients and clinicians were generally positive about remote care tools and wanted to continue. Conclusions: adults with cochlear implants were willing to be randomised and complied with the protocol. Personalised remote care for long-term follow-up is feasible and acceptable, leading to more empowered patients

Have cochlear implant, won’t have to travel: introducing telemedicine to people using cochlear implants

Purpose: This paper describes a planned project to design, implement, and evaluate remote care for adults using cochlear implants and compare their outcomes with those following the standard care pathway.Method: Sixty people with cochlear implants will be recruited and randomized to either the remote care group or a control group. The remote care group will use new tools for 6 months: remote and self-monitoring, self-adjustment of device, and a personalized online support tool. The main outcome measure is patient empowerment, with secondary outcomes of hearing and quality of life stability, patient and clinician preference, and use of clinic resources.Conclusion: The clinical trial ends in summer 2016. Remote care may offer a viable method of follow-up for some adults with cochlear implants

Evaluation of factors predicting tinnitus outcomes following cochlear implantation: Protocol for a prospective quasi-experimental study

Cochlear implantation is an effective intervention to restore useful aspects of hearing function in adults with severe-to-profound hearing loss. Tinnitus, the perception of sound in the absence of an external source, is common in people with severe-to-profound hearing loss. Existing evidence suggests cochlear implantation may be effective in reducing the negative impact of tinnitus in this population. However, this is contradicted by data suggesting that up to half of cochlear implant recipients experience tinnitus, and that some of these patients who did not have tinnitus before cochlear implantation experience it after surgery or cochlear implant activation. Most evidence on the effects of cochlear implantation on tinnitus comes from secondary data in cochlear implant studies primarily concerned with hearing-related outcomes. Hence, the quality of the evidence for effects on tinnitus is low and not suitable to inform clinical recommendations or decision-making. This study will systematically collect data on tinnitus and tinnitus-related outcomes from patients at multiple points during the cochlear implant pathway to characterise changes in tinnitus. This will improve our understanding of the effects of cochlear implantation for tinnitus in adults with severe to profound hearing loss and inform the design of clinical trials of cochlear implantation for tinnitus

Personalised long-term follow-up of cochlear implant patients using remote care, compared with those on the standard care pathway: study protocol for a feasibility randomised controlled trial

Introduction: Many resources are required to provide postoperative care to patients who receive a cochlear implant. The implant service commits to lifetime follow-up. The patient commits to regular adjustment and rehabilitation appointments in the first year and annual follow-up appointments thereafter. Offering remote follow-up may result in more stable hearing, reduced patient travel expense, time and disruption, more empowered patients, greater equality in service delivery and more freedom to optimise the allocation of clinic resources. Methods and analysis: This will be a two-arm feasibility randomised controlled trial (RCT) involving 60 adults using cochlear implants with at least 6 months device experience in a 6-month clinical trial of remote care. This project will design, implement and evaluate a person-centred long-term follow-up pathway for people using cochlear implants offering a triple approach of remote and self-monitoring, self-adjustment of device and a personalised online support tool for home speech recognition testing, information, self-rehabilitation, advice, equipment training and troubleshooting. The main outcome measure is patient activation. Secondary outcomes are stability and quality of hearing, stability of quality of life, clinic resources, patient and clinician experience, and any adverse events associated with remote care. We will examine the acceptability of remote care to service users and clinicians, the willingness of participants to be randomised, and attrition rates. We will estimate numbers required to plan a fully powered RCT. Ethics and dissemination: Ethical approval was received from North West—Greater Manchester South Research Ethics Committee (15/NW/0860) and the University of Southampton Research Governance Office (ERGO 15329). Results: Results will be disseminated in the clinical and scientific communities and also to the patient population via peer-reviewed research publications both online and in print, conference and meeting presentations, posters, newsletter articles, website reports and social media. Trial registration number: ISRCTN14644286; Pre-results

Telemedicine for Adults With Cochlear Implants in the United Kingdom (CHOICE): Protocol for a Prospective Interventional Multisite Study

Background: Cochlear implants provide hearing to approximately 750,000 people with deafness worldwide; these patients require lifelong follow-up. Care for adults with implants in the United Kingdom occurs at one of 19 centers, which may be far from the patients’ homes. In a previous randomized controlled trial, we successfully introduced person-centered care. We designed, implemented, and evaluated the following remote care pathway: a personalized web-based support tool, home hearing check, self–device adjustment, and upgrading of sound processors at home rather than in the clinic. The remote care group had a significant increase in empowerment after using the tools, and the patients and clinicians were keen to continue. We would now like to scale up these improvements as an option for >12,000 UK adults using implants; we are commissioning an independent evaluation of this intervention and rollout to establish if it achieves its aims of more empowered and confident patients; more accessible and equitable care; stable hearing; more efficient, person-centered, and scalable service; and more satisfied and engaged patients and clinicians. Objective: This study aims to evaluate the impact and rollout of a person-centered clinical care pathway via telemedicine for adults with cochlear implants in the United Kingdom, using both outcomes and process evaluation. Methods: This project will scale up and evaluate a person-centered long-term follow-up pathway for adults using cochlear implants through a personalized website, including a home hearing check, uploading photos of cochlear implant site, listening in noise and music practice, ordering of spares, questionnaires, and other resources. Both quantitative and qualitative analyses will be conducted, and they will be both an outcome and process evaluation. Results: As of July 2021, the trial is closed, and all data collection is complete. The evaluation report is expected to be published in December 2021, and the research data have not yet been analyzed. Conclusions: This project will present the results of the first scaling up of a remote care pathway for adults with cochlear implants in the United Kingdom. Trial Registration: International Standard Randomized Controlled Trial Number ISRCTN51668922; https://www.isrctn.com/ISRCTN51668922 International Registered Report Identifier (IRRID): DERR1-10.2196/2720