Improving Instructional Practice Through Instructional Coaching

The purpose of this action research study was to determine how instructional coaching impacted implementation of shared reading strategies in kindergarten classrooms. This study included four teachers from one primary school in South Carolina. All of the teachers that participated in this study had more than two years of teaching experience. Data for this study was collected from surveys, classroom observations, lesson plans, and focus groups. Teachers, instructional coaches, and administrators at one elementary school are concerned with the students’ ability to comprehend materials that are being read to them, as well as reading materials that students are reading independently. Shared reading was identified, by the administrative team, as the intervention to put in place to try to improve reading comprehension. The teachers received sustained professional development from the instructional coach throughout the implementation of shared reading to improve teaching practice. The instructional coach collected teacher information weekly and observed classrooms bi-weekly. This information was used to guide bi-weekly focus groups. Teachers and the instructional coach used data and discussions to collaboratively plan for best instructional practices in regards to shared reading

Breaking Down Blackout: Building Understanding of Media Effects at OSU

In the days following Oct. 5, 2007, the staff of The Daily Barometer - the student newspaper at Oregon State University - was left scrambling for understanding. The paper published a image of a man wearing black face paint for an event called "Blackout Reser." That black face paint looked like Mistrel-era blackface to many on campus. University officials were calling for a teachable moment. A case study was conducted by surveying those involved in conversations following "Blackout Reser" to identify the training needs of the OSU Department of Student Media as well as examine the "Blackout Reser" incident in detail. Case studies of other universities examine incidents across the racial spectrum. The OSU Department of Student Media needs not one training solution but an ongoing and ever-present training in the areas of diversity, inclusion and systems of oppression. The Daily Barometer staff failed to act quickly because of a lack of understanding of both the history of media effects nationwide and media effects at Oregon State University

Electronic health records as a platform for audiological research: data validity, patient characteristics and hearing-aid use persistence among 731,213 US Veterans

Objectives: This article presents a summary of audiological, general health, and hearing aid (HA) outcome data in a large sample of U.S. Veterans receiving HAs. The current article also provides the foundation for a series of papers that will explore relationships between a wide range of factors and HA outcomes.Design: The patient sample is all (n = 731,213) patients for whom HAs were ordered between April 2012 and October 2014 through the U.S. Veterans Health Administration Remote Order Entry System. For these patients, Veterans Affairs electronic health records (EHRs) stored in various databases provided data on demographics, received diagnostic and procedure codes (2007 to 2017), audiometry, self-reported outcomes up to 6 months postfitting, and HA battery orders (to 2017). Data cleaning and preparation was carried out and is discussed with reference to insights that provide potential value to other researchers pursuing similar studies. HA battery order data over time was used to derive a measure of long-term HA use persistence. Descriptive statistics were used to characterize the sample, comparative analyses against other data supported basic validity assessment, and bivariate analyses probed novel associations between patient characteristics and HA use persistence at 2 years postfitting.Results: Following extensive cleaning and data preparation, the data show plausible characteristics on diverse metrics and exhibit adequate validity based on comparisons with other published data. Further, rates of HA use persistence are favorable when compared against therapy persistence data for other major chronic conditions. The data also show that the presence of certain comorbid conditions (Parkinson’s disease, diabetes, arthritis, and visual impairment) are associated with significantly lower HA use persistence, as are prior inpatient admissions (especially among new HA recipients), and that increasing levels of multimorbidity, in general, are associated with decreasing HA use persistence. This is all despite the fact that deriving relevant audiological care-process variables from the available records was not straightforward, especially concerning the definition of the date of HA fitting, and the use of battery ordering data to determine long-term HA use persistence.Conclusions: We have shown that utilizing EHRs in audiology has the potential to provide novel insights into clinical practice patterns, audiologic outcomes, and relations between factors pertaining to hearing and to other health conditions in clinical populations, despite the potential pitfalls regarding the lack of control over the variables available and limitations on how the data are entered. We thus conclude that research using EHRs has the potential to be an integral supplement to population-based and epidemiologic research in the field of audiology

Fitting a Hearing Aid on the Better Ear, Worse Ear, or Both: Associations of Hearing-aid Fitting Laterality with Outcomes in a Large Sample of US Veterans

Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better-ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting

A measure of long-term hearing-aid use persistence based on battery re-ordering data

Objective: We describe the construction of a hearing-aid long-term use persistence measure based on battery reorder data. The measure is derived from the notion that hearing-aid users keep using their devices for some time after placing a battery order. Design: A hearing-aid user is defined as persistent at time í µí± if they placed a battery order within a timespan í µí± preceding í µí±. We characterize and validate this measure using electronic health records from a large sample of US Veterans. Results: We describe how to choose parameters í µí± and í µí± for calculating persistence rates in the patient sample. For validation, the associations of persistence with (a) the duration over which users received outpatient hearing-aid care, (b) self-reported hearing-aid use shortly after fitting, (c) patient age and hearing loss are investigated. In all cases, plausible dependencies are observed. Conclusions: We conclude that our persistence measure is viable and hope this will motivate its use in similar studies

Dementia and hearing-aid use: a two-way street

ObjectivesHearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths.MethodsHealth records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n = 72,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5–5 years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n = 272,748) modelled the likelihood of being a persistent hearing-aid user at 3 years 2 months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors.ResultsThe adjusted OR for incident dementia was 0.73 (95% CI 0.66–0.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43–0.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia).ConclusionSubstantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status

Insights Into Conducting Audiological Research With Clinical Databases

The clinical data stored in electronic health records (EHRs) provide unique opportunities for audiological clinical research. In this viewpoint article, we share insights from our experience of working with a large clinical database of over 730,000 cases. Under a framework outlining the process from patient care to researcher data use, we describe issues that can arise in each step of this process, and how we overcame specific issues in our data set. Correct interpretation of findings depends on an understanding of the data source and structure, and efforts to establish confidence in the data through the processes are discussed under the framework. We conclude that EHRs have considerable utility in audiological research, though researchers must exhibit caution and consideration when working with EHRs

Fitting a hearing aid on the better ear, worse ear, or both: Associations of hearing-aid fitting laterality with outcomes in a large sample of US veterans

Longitudinal electronic health records from a large sample of new hearing-aid (HA) recipients in the US Veterans Affairs healthcare system were used to evaluate associations of fitting laterality with long-term HA use persistence as measured by battery order records, as well as with short-term HA use and satisfaction as assessed using the International Outcome Inventory for Hearing Aids (IOI-HA), completed within 180 days of HA fitting. The large size of our dataset allowed us to address two aspects of fitting laterality that have not received much attention, namely the degree of hearing asymmetry and the question of which ear to fit if fitting unilaterally. The key findings were that long-term HA use persistence was considerably lower for unilateral fittings for symmetric hearing loss (HL) and for unilateral worse-ear fittings for asymmetric HL, as compared to bilateral and unilateral better-ear fittings. In contrast, no differences across laterality categories were observed for short-term self-reported HA usage. Total IOI-HA score was poorer for unilateral fittings of symmetric HL and for unilateral better-ear fittings compared to bilateral for asymmetric HL. We thus conclude that bilateral fittings yield the best short- and long-term outcomes, and while unilateral and bilateral fittings can result in similar outcomes on some measures, we did not identify any HL configuration for which a bilateral fitting would lead to poorer outcomes. However, if a single HA is to be fitted, then our results indicate that a better-ear fitting has a higher probability of long-term HA use persistence than a worse-ear fitting

Dementia and hearing-aid use: a two-way street

ObjectivesHearing-aid use may reduce risk of dementia, but cognitive impairment makes use more challenging. An observed association between reduced hearing-aid use and incident dementia could reflect either or both of these causal paths. The objective was to examine the effects of each path while minimising contamination between paths.MethodsHealth records data from 380,794 Veterans who obtained hearing aids from the US Veterans Affairs healthcare system were analysed. Analysis 1 (n = 72,180) used multivariable logistic regression to model the likelihood of incident dementia 3.5–5 years post hearing-aid fitting for patients free of dementia and mild cognitive impairment (MCI). Analysis 2 (n = 272,748) modelled the likelihood of being a persistent hearing-aid user at 3 years 2 months after fitting, contrasting subgroups by level of cognitive function at the time of fitting. Analysis time windows were optimized relative to dataset constraints. Models were controlled for available relevant predictors.ResultsThe adjusted OR for incident dementia was 0.73 (95% CI 0.66–0.81) for persistent (versus non-persistent) hearing-aid users. The adjusted OR for hearing-aid use persistence was 0.46 (95% CI 0.43–0.48) in those with pre-existing dementia (versus those remaining free of MCI and dementia).ConclusionSubstantial independent associations are observed in both directions, suggesting that hearing-aid use decreases risk of dementia and that better cognitive function predisposes towards persistent use. Research studying protective effects of hearing-aid use against dementia needs to account for cognitive status. Clinically, hearing devices and hearing care processes must be accessible and usable for all, regardless of their cognitive status