Word-Level Instruction for Deaf and Hard-of-Hearing Students: An Observation Study.

Despite the fact that children's word reading and spelling skills are crucial for developing text-level comprehension and composition, little is known about what teachers do in classrooms to promote deaf and hard-of-hearing (DHH) students' learning of word reading and spelling. This observational study examined strategies teachers of DHH students used when teaching word reading and spelling to DHH students who used spoken English. One day of language arts instruction in 23 kindergartens through second-grade classrooms was observed. Teachers' word-level instruction was coded. Results indicated that teachers spent substantially more time on word-level instruction during decoding and encoding contexts than they did during text reading and writing contexts. In addition, differences were found in teachers' use of strategies depending on the instructional contexts. Teachers utilized phonological strategies considerably more frequently than any other strategy in their word-level instruction.

Promoting cultural awareness, professionalism, and communication skills in medicine through anatomy: The Deaf culture session.

The anatomy curriculum is a place where professionalism can be learned and practiced, including training in cultural competence and communication skills for working with diverse populations. One population that has received little attention in terms of medical education are d/Deaf and hard of hearing (d/DHH) patients, although there is much evidence to support health care disparities in this population. Several major contributing factors include differing views of deafness between medical professionals and those who are culturally Deaf, a lack of understanding of Deaf culture and American Sign Language (ASL) by medical professionals, a lack of educational resources in ASL, and poor experiences in health care. To address this need, a Deaf Culture Applied Anatomy session was incorporated into the first-year curriculum at Morehouse School of Medicine while medical students were studying anatomy of the ear and hearing. Panelists, who were culturally Deaf, hard of hearing, and hearing children of deaf adults, shared their experiences in healthcare, including challenges they faced with communication and care. Surveys were provided to students before and after the panel session. Surveys indicated a lack of knowledge prior to this session, while also demonstrating that this 90-min session improved students' understanding of effective communication with future patients and issues related to deafness. Qualitative feedback also suggested that the students found the session to be personally and professionally beneficial. Implementing the Deaf Culture session was an effective means for introducing students to Deaf culture and working with d/DHH patients.

Goodnight Gorilla: Deaf Student American Sign Language Narrative Renditions After Viewing a Model.

The present study used an observational learning framework to investigate changes in non-native signing deaf children's narrative renditions before (Time 1) and after (Time 2) a single viewing of a signing adult's rendition of the same story. The deaf adult model rendered the picture book Goodnight Gorilla in American Sign Language (ASL) with the pages of the book displayed behind her. We analyzed the details children aged 6-13 years included within their narratives and how they rendered those details. Specifically, we compared their use of depicting constructions (DCs), constructed action (CA), simultaneous use of both DCs and CA, and only lexical signs before and after viewing the model. The deaf adult predominantly and equally used CA and constructed actin paired with DCs and rarely used lexical signs alone during her rendition. After watching the adult rendition, children's renditions were longer and they included more details. Children increased their use of DCs, CA, and to a lesser extent, combinations of DCs and CA. However, half of the children never used DCs paired with CA. Suggestions for pairing ASL content standards with viewings of deaf adult sign language models are discussed.

Superordinate Precision: An Examination of Academic Writing Among Bilingual Deaf and Hard of Hearing Students.

Academic English is an essential literacy skill area for success in post-secondary education and in many work environments. Despite its importance, academic English is understudied with deaf and hard of hearing (DHH) students. Nascent research in this area suggests that academic English, alongside American Sign Language (ASL) fluency, may play an important role in the reading proficiency of DHH students in middle and high school. The current study expands this research to investigate academic English by examining student proficiency with a sub-skill of academic writing called superordinate precision, the taxonomical categorization of a term. Currently there is no research that examines DHH students' proficiency with superordinate precision. Middle and high school DHH students enrolled in bilingual schools for the deaf were assessed on their ASL proficiency, academic English proficiency, reading comprehension, and use of superordinate precision in definitions writing. Findings indicate that student use of superordinate precision in definitions writing was correlated with ASL proficiency, reading comprehension, and academic English proficiency. It is possible that degree of mastery of superordinate precision may indicate a higher overall level of proficiency with academic English. This may have important implications for assessment of and instruction in academic English literacy.

American Sign Language and Academic English: Factors Influencing the Reading of Bilingual Secondary School Deaf and Hard of Hearing Students.

For many years, researchers have sought to understand the reading development of deaf and hard of hearing (DHH) students. Guided by prior research on DHH and hearing students, in this study we investigate the hypothesis that for secondary school DHH students enrolled in American Sign Language (ASL)/English bilingual schools for the deaf, academic English proficiency would be a significant predictor of reading comprehension alongside ASL proficiency. Using linear regression, we found statistically significant interaction effects between academic English knowledge and word reading fluency in predicting the reading comprehension scores of the participants. However, ASL remained the strongest and most consistent predictor of reading comprehension within the sample. Findings support a model in which socio-demographic factors, ASL proficiency, and word reading fluency are primary predictors of reading comprehension for secondary DHH students.

The effect of drug use disorder onset, remission or persistence on an individual's personal social network.

BACKGROUND AND OBJECTIVES: Drug use disorders (DUD) have strong associations with numerous social problems. However, little is known concerning differences between individuals who experience DUD onset, persistence or remission. While the literature is fairly clear on who is most likely to experience DUD onset and persistence, many correlates of DUD remission, including personal social networks, lack the empirical foundation to utilize them in evidence-based intervention or prevention efforts. While small, community samples suggest DUD remission is associated with growth in personal social networks, this conclusion is in need of larger population studies to justify. METHODS: This study used Waves 1 and 2 of the National Epidemiologic Study on Alcohol and Related Conditions (NESARC) to examine whether DUD status is a correlate of personal social networks. RESULTS: Multivariate models showed DUD onset and DUD persistence were related to smaller personal social networks. However, individuals who experience DUD remission showed personal social networks similar to persons who never experienced a DUD. DISCUSSION AND CONCLUSIONS: As one of the first empirical studies of personal social networks among individuals with different stages of DUD using nationally representative data, these findings suggest that by decreasing drug use, personal social networks may be increased, which is a strong trait associated with the social influence necessary with maintaining DUD recovery.

The Experiences of and Teaching Strategies for Deaf and Hard of Hearing Foreign Language Learners: A Systematic Review of the Literature.

Although foreign language (FL) educational experiences for students with disabilities including deaf and hard of hearing (DHH) students, are becoming more common, there is little research available on this topic. The purpose of the present review was to identify research examining DHH students' FL learning experiences and teaching strategies used in the FL class to facilitate language learning. The search showed that few studies have explored this area, and even fewer have met quality standards. Among the existing studies, the results revealed that communication methods in FL class instruction that do not meet the communicative needs of DHH students can hinder learning and lead to demotivation. Conversely, the presence of individualized learning goals and an emphasis on reading and writing, over speaking and listening, appear to support FL learning. Finally, the use of technology is a promising tool for FL instruction.

Acute Onset Optic Disc Hemorrhage Following Pharmacologic Mydriasis.

PURPOSE: The aim was to report 2 unusual cases of optic disc hemorrhage (DH) occurring following pharmacologic mydriasis. OBSERVATION: A 78-year-old woman and 60-year-old man with primary open angle glaucoma developed optic DHs shortly after pupillary dilation. CONCLUSION AND IMPORTANCE: Cycloplegia may cause subtle shifts in vitreous and lamina cribrosa position that may result in the formation of optic DHs in susceptible glaucomatous eyes.

A Call for a Diversity of Perspectives in Deaf Education Research: A Response to Mayer and Trezek (2020).

Scott, Dostal, and Lane-Outlaw challenge findings and conclusions from a literature review by Mayer and Trezek regarding the literacy achievement of deaf children who are educated in schools and programs that espouse bilingual ASL/English instruction. Mayer and Trezek's article appeared in the Winter 2020 American Annals of the Deaf. In addition to responding to Mayer and Trezek's findings and conclusions, Scott et al. outline factors they consider important for all researchers and practitioners who generate and consume knowledge regarding bi- and multilingual deaf education. Specifically, they recommend careful attention to and inclusion of individual- and school-level variables, use of appropriate comparison groups, and valuing of information acquired through various methodologies (both quantitative and qualitative). These recommendations are made in the spirit of improving the state of knowledge and the production and consumption of research that informs policy and practice in bi- and multilingual deaf education.

Evaluating the Relationship of Intraocular Pressure and Anterior Chamber Volume With Use of Prostaglandin Analogues.

PRCIS: In this prospective study, naive prostaglandin use in primary open-angle glaucoma was associated with scleral biomechanical alteration and intraocular pressure (IOP) measuring errors. PURPOSE: The purpose of this study is to determine the effects of naïve use of prostaglandin analogues (PGA) on IOP and anterior chamber volume (ACV), as well as investigate how PGAs might affect corneal and scleral stiffness and their impact on ocular rigidity. MATERIALS AND METHODS: This study was a prospective study of 21 recently diagnosed open-angle glaucoma patients (33 eyes) initiating medical therapy with a topical prostaglandin eye drop. Corneal morphologic and biomechanical parameters as well as IOP were measured at 3 visits over a 4-month period with the following equipment: Pentacam, Corvis ST, Ocular Response Analyzer, Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry. RESULTS: The study demonstrated a significant decrease in mean IOP with initiation of PGA in all 4 tonometers (P<0.0001). The greatest change in IOP occurred in the first 4 weeks of treatment (P<0.0001). The mean ACV showed a significant decrease at visit 2 (P<0.02) and visit 3 (P<0.04) compared with baseline visit 1. However, there was a paradoxical increase in ACV in 37% of eyes at visit 2, despite a significant mean reduction in IOP by GAT and dynamic contour tonometry.The IOP/ACV ratio at visit 1 significantly predicted the reduction in respective measures of IOP, as well as scleral stiffness measured by stiffness parameter-highest concavity. CONCLUSION: In clinical practice, GAT may not be the most appropriate tonometer for measuring IOP in PGA treated eyes due the measurement errors from ocular biomechanical alteration. The IOP/ACV ratio could potentially serve as a new diagnostic parameter to determine the likelihood of PGA treatment success.

Working with Dual Diagnoses: A Survey of Teachers Serving Deaf or Hard of Hearing Children Who Have Autism Spectrum Disorder.

Although a sizable minority of students who are deaf or hard of hearing (DHH) are also diagnosed with autism spectrum disorder (ASD), there is little research examining teachers' feelings of aptitude for working with these students, nor the instructional strategies used with this population. This study reports results from a researcher-designed survey of teachers working with children who are both DHH and have ASD. Our results suggest that teachers working with this population felt under-resourced, under-prepared, and under-supported in their work with dually diagnosed students. Perhaps as a result, participants tended to use instructional strategies common to their certification area. We identify a need for cross-training teachers across disability areas. In addition, we call for research that tests the applicability of practices in either Deaf Education or ASD Education for dually diagnosed children who may have needs that are unique from children either group.

Fingerspelling and Print: Understanding the Word Reading of Deaf Children.

Fingerspelling and its relationship with literacy skills among deaf and hard of hearing children who use American Sign Language is an increasingly popular research topic. However, there is limited research on whether reading interventions that systematically include fingerspelling are more effective for improving literacy skills than reading interventions that do not. In an adapted alternating-treatment single-case study, the authors contrasted the number of words learned under three conditions: a productive fingerspelling condition, in which word reading was taught through activities that emphasized productive fingerspelling; a chaining condition, in which teachers chained written words with receptive fingerspelling; and a sign-to-print condition, in which fingerspelling was not used. Five of the 6 participants learned most of the words taught with no differentiation by condition. Participants could recognize and fingerspell taught words, even if those words were not taught via fingerspelling.

Schooling Effects on Early Literacy Skills of Young Deaf and Hard of Hearing Children.

Already well documented for hearing children, schooling's effects on early literacy skills for young students who are deaf or hard of hearing (DHH) were examined for the first time in the present study. Piecewise growth curve modeling was used to describe 3-, 4-, and 5-year-old students' growth in phonological awareness, letter-word identification, and vocabulary during 2 years of schooling and the intervening summer (N = 56). Amplification mode was cochlear implants for 45% of the sample and hearing aids for 54%. Classroom communication mode was spoken language only (for 61%) or sign language (39%). Across all skills, significant growth occurred during the 2 years of schooling but not during the summer. These findings underscore early education's importance in promoting DHH children's critical early skills. Universal preschool intervention, including during summer, may be important in ensuring that DHH children have an adequate foundation when schooling begins.

Quitting Mental Health Services among Racial and Ethnic Groups of Americans with Depression.

Research on racial/ethnic differences in quitting mental health services has yet to examine the multiple forms of services offered and reasons why racial/ethnic groups quit. Data from the Collaborative Psychiatric Epidemiology Surveys (CPES) examined whether race/ethnicity was related to quitting nine types of mental health services within a multivariate framework, and whether any racial/ethnic differences emerged among 16 assessed reasons for quitting mental health services (N = 437). Odds of quitting mental health services provided by social workers, non-medical health professionals, counselors, psychiatrists, and psychologists varied significantly by race/ethnicity. The most common reasons for quitting services included individuals wanting to handle the problem on their own, getting better, or not needing help anymore. The increased likelihood of quitting services represents an underexplored area for mental health service disparities and calls for improved efforts to retain racial and ethnic minorities in the mental health system.

Accuracy of Human and Veterinary Point-of-Care Glucometers for Use in Rhesus Macaques (Macaca mulatta), Sooty Mangabeys (Cercocebus atys), and Chimpanzees (Pan troglodytes).

Handheld, point-of-care glucometers are commonly used in NHP for clinical and research purposes, but whether these devices are appropriate for use in NHP is unknown. Other animal studies indicate that glucometers should be species-specific, given differences in glucose distribution between RBC and plasma; in addition, Hct and sampling site (venous compared with capillary) influence glucometer readings. Therefore, we compared the accuracy of 2 human and 2 veterinary glucometers at various Hct ranges in rhesus macaques (Macaca mulatta), sooty mangabeys (Cercocebus atys), and chimpanzees (Pan troglodytes) with that of standard laboratory glucose analysis. Subsequent analyses assessed the effect of hypoglycemia, hyperglycemia, and sampling site on glucometer accuracy. The veterinary glucometers overestimated blood glucose (BG) values in all species by 26 to 75 mg/dL. The mean difference between the human glucometers and the laboratory analyzer was 7 mg/dL or less in all species. The human glucometers overestimated BG in hypoglycemic mangabeys by 4 mg/dL and underestimated BG in hyperglycemic mangabeys by 11 mg/dL; similar patterns occurred in rhesus macaques. Hct did not affect glucometer accuracy, but all samples were within the range at which glucometers generally are accurate in humans. BG values were significantly lower in venous than capillary samples. The current findings show that veterinary glucometers intended for companion-animal species are inappropriate for use in the studied NHP species, whereas the human glucometers showed clinically acceptable accuracy in all 3 species. Finally, potential differences between venous and capillary BG values should be considered when comparing and evaluating results.

Cosmetic devices based on active transdermal technologies.

Active transdermal technology, commonly associated with drug delivery, has been used in recent years by the cosmetic industry for the aesthetic restoration of skin and delivery of cosmetic agents. In this article, we provide an overview of the skin's structure, various skin types, skin's self-repair mechanisms that are stimulated from the usage of cosmetic devices and discuss cosmetic applications. Summaries of the most common active transdermal technologies such as microneedles, iontophoresis, sonophoresis, lasers and microdermabrasion will be provided, in relation to the marketed cosmetic devices available that incorporate these technologies. Lastly, we cover combinations of active technologies that allow for more enhanced cosmetic results, and the current limitations of cosmetic devices.

Structure of the N-WASP EVH1 domain-WIP complex: insight into the molecular basis of Wiskott-Aldrich Syndrome.

Missense mutants that cause the immune disorder Wiskott-Aldrich Syndrome (WAS) map primarily to the Enabled/VASP homology 1 (EVH1) domain of the actin regulatory protein WASP. This domain has been implicated in both peptide and phospholipid binding. We show here that the N-WASP EVH1 domain does not bind phosphatidyl inositol-(4,5)-bisphosphate, as previously reported, but does specifically bind a 25 residue motif from the WASP Interacting Protein (WIP). The NMR structure of the complex reveals a novel recognition mechanism-the WIP ligand, which is far longer than canonical EVH1 ligands, wraps around the domain, contacting a narrow but extended surface. This recognition mechanism provides a basis for understanding the effects of mutations that cause WAS.