Hearing aid effectiveness after aural rehabilitation - individual versus group (HEARING) trial: RCT design and baseline characteristics

<p>Abstract</p> <p>Background</p> <p>Hearing impairment is the most common body system disability in veterans. In 2008, nearly 520,000 veterans had a disability for hearing loss through the Department of Veterans Affairs (VA). Changes in eligibility for hearing aid services, along with the aging population, contributed to a greater than 300% increase in the number of hearing aids dispensed from 1996 to 2006. In 2006, the VA committed to having no wait times for patient visits while providing quality clinically-appropriate care. One approach to achieving this goal is the use of group visits as an alternative to individual visits. We sought to determine: 1) if group hearing aid fitting and follow-up visits were at least as effective as individual visits, and 2) whether group visits lead to cost savings through the six month period after the hearing aid fitting. We describe the rationale, design, and characteristics of the baseline cohort of the first randomized clinical trial to study the impact of group versus individual hearing aid fitting and follow-up visits.</p> <p>Methods</p> <p>Participants were recruited from the VA Puget Sound Health Care System Audiology Clinic. Eligible patients had no previous hearing aid use and monaural or binaural air-conduction hearing aids were ordered at the evaluation visit. Participants were randomized to receive the hearing aid fitting and the hearing aid follow-up in an individual or group visit. The primary outcomes were hearing-related function, measured with the first module of the Effectiveness of Aural Rehabilitation (Inner EAR), and hearing aid adherence. We tracked the total cost of planned and unplanned audiology visits over the 6-month interval after the hearing aid fitting.</p> <p>Discussion</p> <p>A cohort of 659 participants was randomized to receive group or individual hearing aid fitting and follow-up visits. Baseline demographic and self-reported health status and hearing-related measures were evenly distributed across the treatment arms.</p> <p>Outcomes after the 6-month follow-up period are needed to determine if group visits were as least as good as those for individual visits and will be reported in subsequent publication.</p> <p>Trial Registration</p> <p>NCT00260663</p

Forgotten Sources of Capital for the Family-Owned Business

The recent scandals on Wall Street in the banking and savings and loan industries have created a financial crisis for many family businesses, particularly those in smaller towns and cities. The long-standing personal relationships with financial intermediaries have been altered by the loss of these financial organizations and by heightened government intervention and regulation. To manage the finances of a family business successfully, the owners must reassess forgotten sources of capital for their businesses. This article examines these sources of capital for family businesses in the United States.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

Friends Antiques Collection

Photograph of a street scene in Clinton, OK. Photo by D.D. Dillion, July 28, 1909

John Sipes Collection

Photograph of Cheyenne Indians smoking the pipe of peace at an "Old Blow Out." Photo by D.D. Dillion, Clinton, OK, c. 1910. Copy print by SMC Cartographic Section, Concho, OK, c. 1979

Oklahoma City, OK

Photograph of Wheeler Park in Oklahoma City, OK. Photo by DD Dillion, Oklahoma City, OK

Application of Probabilistic Neural Networks in Modelling Structural Deterioration of Stormwater Pipes

In Australia, when stormwater systems were first introduced over 100 years ago, they were constructed independently of the sewer systems, and they are normally the responsibility of the third level of government, i.e., local government or city councils. Because of the increasing age of these stormwater systems and their worsening performance, there are serious concerns in a significant number of city councils regarding their deterioration. A study has been conducted on the structural deterioration of concrete pipes that make up the bulk of the stormwater pipe systems in these councils. In an attempt to look for a reliable deterioration model, a probabilistic neural network (PNN) model was developed using the data set supplied from participating councils. The PNN model was validated with snapshot-based sample data, which makes up the data set. The predictive performance of the PNN model was compared with a traditional parametric model using discriminant analysis on the same data set. Structural deterioration was hypothesised to be influenced by a set of explanatory factors, including pipe design and construction factors&amp;mdash;such as pipe size, buried depth&amp;mdash;and site factors&amp;mdash; such as soil type, moisture index, tree root intrusion, etc. The results show that the PNN model has a better predictive power and uses significantly more input variables (i.e., explanatory factors) than the discriminant model. More importantly, the key factors for prediction in the PNN model are difficult to interpret, suggesting that besides prediction accuracy, model interpretation is an important issue for further investigation