Internet competency predicts practical hearing aid knowledge and skills in first-time hearing aid users

Purpose. The purpose of the study was to assess whether Internet competency predicted practical hearing aid knowledge and handling skills in first-time hearing aid users. Method. The design was a prospective, randomized controlled trial of a multimedia educational intervention consisting of interactive video tutorials (or reusable learning objects [RLOs]). RLOs were delivered through DVD for TV or PC, and online. Internet competency was measured at the hearing aid fitting appointment, whereas hearing aid knowledge and practical handling skills were assessed 6 weeks postfitting. Results. Internet competency predicted practical hearing aid knowledge and handling skills, controlling for age, hearing sensitivity, educational status, and gender for the group that received the RLOs. Internet competency was inversely related to the number of times the RLOs were watched. Conclusion. Associations between Internet competency and practical hearing aid knowledge, handling skills, and watching the RLOs fewer times may have arisen because of improved self-efficacy. Therefore, first-time hearing aid users who are more competent Internet users may be better equipped to apply newly learned information to effectively manage their hearing loss

Innovation in the Context of Audiology and in the Context of the Internet

Purpose: This article explores different meanings of innovation within the context of audiology and the internet. Case studies are used to illustrate and elaborate on the new types of innovation and their levels of impact.Method: The article defines innovation, providing case studies illustrating a taxonomy of innovation types.Results: Innovation ranges from minor changes in technology implemented on existing platforms to radical or disruptive changes that provide exceptional benefits and transform markets. Innovations within the context of audiology and the internet can be found across that range. The case studies presented demonstrate that innovations in hearing care can span across a number of innovation types and levels of impact. Considering the global need for improved access and efficiency in hearing care, innovations that demonstrate sustainable impact on a large scale, with the potential to rapidly upscale this impact, should be prioritized.Conclusions: It is unclear presently what types of innovations are likely to have the most profound impacts on audiology in coming years. In the best case, they will lead to more efficient, effective, and widespread availability of hearing health on a global scale

Water Balance of the 1993 Midwest Flood

Throughout the spring and summer months of 1993, extended rainfall throughout much of the Midwestern United States caused record flooding that inundated much of the Upper Mississippi River Basin (UMRB). Precipitation in May was more then twice the normal over an area that extended from southeastern South Dakota across Iowa to eastern Kansas. From early June to the end of July, high amounts of precipitation persisted over the upper Midwest (Wahl, et al., 1993). USGS records indicated that at 45 streamflow gauging stations, the peak discharge recorded during 1993 had recurrence intervals of greater than 100 years. However, because of the natural and man-made changes in the flood region, some sites had less-than-record peak discharges (Parret, et al., 1993). The storage of large volumes of water in reservoirs significantly reduced the peak flow and flood damages downstream from the dams (Southard, 1993). Following the 1993 Midwest flood, President Clinton established the Scientific Assessment and Strategy Team (SAST) on November 24, 1993, to study the effects of the flood and to make recommendations about future flood preparedness. The SAST joined the Interagency Floodplain Management Review Committee (FMRC) on January 10, 1994 (FMRC, 1994). As part of this effort, the SAST project identified a need for a daily water balance of the flooded area to determine how much water fell and how quickly it moved through the landscape. There were two significant policy issues resulting from the flood: (1) how did the flood volume and velocity of flow increase by land use changes associated with agricultural development in the Midwest, including extensive drainage of wetlands; and (2) what plan should be adopted for restoration of failed levee systems. The first of these questions is hydrologic, the second, hydraulic. The hydraulic issues were addressed by the SAST project and related efforts by modeling the motion of water through the main tributaries of the Mississippi and Missouri Rivers where the major levee failures occurred. The hydrologic questions were not so readily addressed because of the huge region affected by the flood, some 700,000 km2 in area. Flood hydrology models are normally applied to regions 100 to 1,000 times smaller than this area. Thus, the need for the present study arose – to model the movement of water through the landscape of the SAST study area by constructing a daily water balance in a series of subwatersheds in the flooded area. A USGS WEB site designated for SAST is located at: http://edcwww2.cr.usgs.gov/sast-home.html . Figure 1.1 shows the location and the extent of the SAST study area. This region covers all of the UMRB above St. Louis and that portion of the Missouri Basin whose drainage enters the Missouri River by watershed (Missouri, Platte, Kansas, Osage, and Gasconade Rivers). The contribution of the remainder of the Missouri Basin was accounted for by using gauged data from tributary flows at the border of the study region. The goal of this project was to calculate the daily water balance for the SAST region for 1993. A Geographic Information System (GIS) was used to determine the balance. GIS offers a technology to formulate more objective and consistent methods to synthesize collected data and to assess water quality and quantity over large areas (Maidment, 1996). The spatial resolution of the SAST region was defined by the location of discharge gauging stations as well as the completeness and quality of the discharge record. The preliminary analysis was performed using daily discharge values recorded at 261 USGS stations from 01/01/1993 to 09/30/1993. The final water balance was estimated for 132 watersheds defined by the stations that have a complete discharge record for all days of 1993. The cumulative storage values were then spatially averaged over 4, 6, and 8 digit hydrologic units (HUC) to provide an alternative way of viewing the water balance. Missouri River at Yankton, SD Platte River at Luisville, NE Kansas River at Desoto, KS Osage River near St. Thomas, MO Gasconade River near Rich Fountain, MO Mississippi River at Inflow Thebes, IL Outflow Figure 1.1 Location and extent of the SAST region

Geographic Visualization of the 1993 Midwest Flood Water Balance

This report documents the construction of three visualization projects based on hydrologic modeling of the 1993 Midwest flood. The modeling procedures and results have been described in “Water Balance of the 1993 Midwest Flood,” by Mizgalewicz and Maidment (1998). In their report, a water balance was calculated for the Upper Mississippi River basin for all of 1993 using streamflow, precipitation, and evapotranspiration data sets. In both this study, and Mizgalewicz’ and Maidment’s study, the Upper Mississippi River basin (UMRB) includes the Mississippi River basin from the river’s headwaters in Minnesota to Cairo, Illinois, and the Lower Missouri River basin below Gavins Point dam, South Dakota, to St. Louis, Missouri (Figure 1.1). Using a digital elevation model of the study area, the daily flow into and out of the basin was calculated, and a series of 365 maps of basin water storage were created. The basin was subdivided into watershed boundaries as delineated in ArcInfo using a digital elevation model and a coverage of U.S. Geological Survey (USGS) stream gaging stations. The water storage values within these watershed boundaries were then spatially averaged into the standard USGS 8-digit hydrologic unit code (HUC) boundaries, and these maps and data sets were used in the construction of several hydrologic visualization projects. As a follow-up to Mizgalewicz’ and Maidment’s study, the water balance data sets and maps were used to create several map-based, computer-generated scenes that depict the catastrophic flooding that occurred in 1983 in the Upper Mississippi/Lower Missouri River basins. Three primary geographic visualization products have been generated during the course of this research: (1) an area-based map animation of the 1993 basin water storage, (2) a point-based map animation of the 1993 water storage, and (3) a line-based map animation of 1993 basin streamflow

The feasibility of an m-health educational programme (m2Hear) to improve outcomes in first-time hearing aid users

© 2020 Crown Copyright. Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of British Society of Audiology, International Society of Audiology, and Nordic Audiological Society. Objective: To (i) assess the delivery, accessibility, usability, acceptability, and adherence, and (ii) identify suitable outcome measures, for a mobile-enhanced multimedia educational programme (m2Hear) in first-time hearing aid users. Design: A prospective, single-centre feasibility study. Study sample: First-time hearing aid users (n = 59), recruited at their initial hearing assessment. Evaluations were made at 1-week and at 10–12 weeks post-hearing aid fitting. Results: m2Hear was most commonly accessed via tablets (42.3%). Usability was high for the System Usability Scale (88.5%), and the uMARS, particularly for the Information (M = 4.7), Functionality (M = 4.5) and Aesthetics (M = 4.2) subscales (maximum score = 5). Participant feedback was positive, with a high percent agreeing that m2Hear aided understanding of hearing aids (98%), held their interest (86%), improved confidence to use hearing aids and communicate (84%), and provided additional information to audiologist’s advice (82%). Learnings about practical hearing aid handling/maintenance skills and how to communicate with others were reportedly used equally in participant’s everyday lives. m2Hear was convenient to use, clear, concise and comprehensive. Outcome measures of social participation resulted in large effect sizes (Cohen’s d > 1.6). Conclusions: A theoretically-driven, personalised and co-designed educational m-health intervention is feasible and beneficial for use in the self-management of hearing loss and hearing aids

The development of an mHealth educational intervention for first-time hearing aid users: combining theoretical and ecologically valid approaches

© 2020 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society. Objective: This paper describes the development of a novel mobile health (mHealth) educational intervention, called m2Hear, designed for first-time hearing aid users based on previously developed educational multimedia videos, or reusable learning objects (RLOs), branded C2Hear. Design: The development of m2Hear used theoretical and ecologically valid approaches. The COM-B model and associated Theoretical Domains Framework were employed to identify specific components (or “active ingredients”) of the original RLOs that facilitate hearing aid use. An mHealth platform was then developed following an iterative, user-centred and participatory design approach. Study sample: Fifteen existing hearing aid users completed synchronous, real-time Think Aloud interviews. A sub-group of these participants (n = 5), along with patient and public involvement panel members (n = 4), subsequently reviewed the usability of the mHealth platform. Results: While factors associated with Capability featured strongly across all RLOs, topics relating to Opportunity and Motivation were also incorporated. The RLOs were broken-down into 42 shorter mobile-enhanced RLOs (or mRLOs). Each mRLO was labelled with a specific user-centred question generated from the Think Aloud interviews. The final mHealth platform was developed following four separate usability iterations. Conclusions: Overall, m2Hear provides greater opportunities for individualised learning and encourages greater interaction to facilitate self-management in first-time hearing aid users

Why medical students choose psychiatry - a 20 country cross-sectional survey

BACKGROUND: Recruitment to psychiatry is insufficient to meet projected mental health service needs world-wide. We report on the career plans of final year medical students from 20 countries, investigating factors identified from the literature which influence psychiatric career choice. METHODS: Cross sectional electronic or paper survey. Subjects were final year medical students at 46 medical schools in participating countries. We assessed students' career intentions, motivations, medical school teaching and exposure to psychiatry. We assessed students' attitudes and personality factors. The main outcome measure was likelihood of specializing in psychiatry. Multilevel logistic regression was used to examine the joint effect of factors upon the main outcome. RESULTS: 2198 of 9135 (24%) of students responded (range 4 to 91%) across the countries. Internationally 4.5% of students definitely considered psychiatry as a career (range 1 to 12%). 19% of students (range 0 to 33%) were "quite likely", and 25% were "definitely not" considering psychiatry. Female gender, experience of mental/physical illness, media portrayal of doctors, and positive attitudes to psychiatry, but not personality factors, were associated with choosing psychiatry. Quality of psychiatric placement (correlation coefficient = 0.22, p < 0.001) and number of placements (correlation coefficient =0.21, p < 0.001) were associated with higher ATP scores. During medical school, experience of psychiatric enrichment activities (special studies modules and university psychiatry clubs), experience of acutely unwell patients and perceived clinical responsibility were all associated with choice of psychiatry.Multilevel logistic regression revealed six factors associated with students choosing psychiatry: importance of own vocation, odds ratio (OR) 3.01, 95% CI 1.61 to 5.91, p < 0.001); interest in psychiatry before medical school, OR 10.8 (5.38 to 21.8, p < 0.001); undertaking a psychiatry special study module, OR 1.45 (1.05 to 2.01, p = 0.03) or elective OR 4.28 (2.87- 6.38, p < 0.001); membership of a university psychiatry club, OR 3.25 (2.87 to 6.38, p < 0.001); and exposure to didactic teaching, OR 0.54 (0.40 to 0.72, p < 0.001). CONCLUSIONS: We report factors relevant to medical student selection and psychiatry teaching which affect career choice. Addressing these factors may improve recruitment to psychiatry internationally

Application of the Behavior Change Wheel within the context of internet-based cognitive behavioral therapy for tinnitus management

Purpose: Although experiencing tinnitus can lead to many difficulties, these can be reduced by using techniques derived from cognitive behavioral therapy. Internet-based cognitive behavioral therapy (ICBT) has been developed to provide an accessible intervention. The aim of this study was to describe how ICBT can facilitate tinnitus management by identifying the active ingredients of the intervention from the perspective of health behavior change. Method: The ICBT intervention was evaluated using the Behavior Change Wheel in eight steps across the following three stages: (1) understanding the behavior, (2) identifying intervention options, and (3) identifying content and implementation options. Results: Target behaviors identified to reduce tinnitus distress, as well as additional problems associated with tinnitus, included goal setting, an increased understanding of tinnitus, encouraging deep breathing and progressive muscle relaxation, identifying and restructuring unhelpful thoughts, engaging in positive imagery, and reducing avoidance behaviors. ICBT provided the required components for individuals to be physically and psychologically capable of adapting to tinnitus, providing social and environmental opportunities to manage hearing loss through practice and training, and facilitated automatic and reflective motivation. Conclusion: Understanding ICBT in the context of the Behavior Change Wheel has helped identify how its effectiveness can be improved and can be used for future tinnitus intervention planning.</p

McGraw-Hill series in water resources and environmental engineering : applied hydrology

xiv, 572 hal.: 23 c