Interprofessional education activity to improve communication with older adults.

Given the increasing older adult population, students in the health professions need to be trained to work in interprofessional teams to effectively interact with and manage communication difficulties in this population. Through an interprofessional education case study activity focused on communication with a complex older adult patient, 92 students from Communication Sciences and Disorders and Nursing learned about interprofessional collaboration, age-related hearing loss, and communication strategies. Participants completed a knowledge assessment quiz, the Interprofessional Attitudes Scale (IPAS), and a post-activity evaluation survey. Pre- and post-activity results revealed a significant improvement in participants' knowledge of age-related hearing loss and its effects on communication, and significant improvements related to attitudes toward interprofessional education and shared learning on the IPAS. The findings of this experience indicate that the activity was effective in educating students about age-related hearing loss and communicating with older adults. The activity was valuable and had a positive impact on students' attitudes toward collaboration.

Considering Individuals' Hearing Ability Before Administering Cognitive Assessments.

Sensory impairments such as age-related hearing loss and poor eyesight have been associated with a negative impact on cognitive screening test scores. Many researchers use cognitive tests and consider factors such as vision and cardiac issues but do not account for hearing loss. We reviewed published literature in the field of gerontology to determine if hearing loss was considered in human subjects research that involved the administration of a cognitive battery or screening test. We present evidence for the need to consider hearing loss when administering cognitive screening tests, as well as recommendations for practitioners and researchers.

Evaluating Research Transparency and Openness in Communication Sciences and Disorders Journals.

PURPOSE: To improve the credibility, reproducibility, and clinical utility of research findings, many scientific fields are implementing transparent and open research practices. Such open science practices include researchers making their data publicly available and preregistering their hypotheses and analyses. A way to enhance the adoption of open science practices is for journals to encourage or require submitting authors to participate in such practices. Accordingly, the American Speech-Language-Hearing Association's Journals Program has recently announced their intention to promote open science practices. Here, we quantitatively assess the extent to which several journals in communication sciences and disorders (CSD) encourage or require participation in several open science practices by using the Transparency and Openness Promotion (TOP) Factor metric. METHOD: TOP Factors were assessed for 34 CSD journals, as well as several journals in related fields. TOP Factors measure the level of implementation across 10 open science-related practices (e.g., data transparency, analysis plan preregistration, and replication) for a total possible score of 29 points. RESULTS: Collectively, CSD journals had very low TOP Factors (M = 1.4, range: 0-8). The related fields of Psychology (M = 4.0), Rehabilitation (M = 3.2), Linguistics (M = 1.7), and Education (M = 1.6) also had low scores, though Psychology and Rehabilitation had higher scores than CSD. CONCLUSION: CSD journals currently have low levels of encouraging or requiring participation in open science practices, which may impede adoption. Open Science Form: https://doi.org/10.23641/asha.21699458.

Recent breakthroughs in the treatment of chronic hepatitis Delta.

Hepatitis Delta virus (HDV) is responsible for the most aggressive form of chronic hepatitis, which may evolve towards cirrhosis, hepatocellular carcinoma and death within few years. During the last 30 years the only available therapy was interferon or peg-IFN, which was characterized by poor tolerability and modest results. The detailed knowledge of the HDV replication cycle and its interaction with HBV allowed the introduction of new drugs which are currently in phase II or III of experimentation. Basically, bulevirtide, to date the only one approved by EMA, inhibits the entry of the virus into the hepatocytes and hence its intrahepatic spread; lonafarnib inhibits the pharnesylation process of the L-HDAg, which is critical for the assembly of the HDV virion; the nucleic acid polymers (NAPs) mainly block the production/release of HBsAg. The available clinical trials with these compounds showed an excellent anti-viral activity against HDV.

The Impact of Amplification on Cognitive Screening Test Scores.

Hearing loss is associated with cognitive decline in older adults. Research has shown that hearing loss negatively affects cognitive screening test measures as patients may mishear verbally administered questions. The purpose of the current study was to investigate the impact of amplification on performance on a commonly used cognitive screening test. Thirty older adults with hearing loss underwent testing with the Mini-Mental State Examination (MMSE) in three conditions: without hearing aids, with hearing aids, and with a personal listening device (PLD). Performance on the MMSE significantly improved with the use of hearing aids or a PLD. Amplification and the use of communication strategies should be considered when administering cognitive screening measures to older adults. Failure to account for hearing status may lead to invalid results and can increase the likelihood of over-referral for further assessment. [Journal of Gerontological Nursing, 48(7), 31-37.].

The Impact of COVID-19 Home Confinement on Mexican University Students: Emotions, Coping Strategies, and Self-Regulated Learning.

One of the main challenges in higher education is promoting students' autonomous and self-regulated learning, which involves managing their own emotions and learning processes in different contexts and circumstances. Considering that online learning during the COVID-19 pandemic may be an opportunity for university students to take greater responsibility for their learning, it is essential to explore the strategies they have developed in the face of emotional and learning challenges during the health crisis. This study aimed at analyzing the relationships between students' emotions, coping strategies, and self-regulated learning in online learning during COVID-19 home confinement. The participants were 1,290 Mexican students from different universities throughout the country, who answered an online self-report questionnaire from standardized instruments adapted to the pandemic. Data were analyzed with descriptive and inferential analyses, including a structural equation model (SEM). Findings indicate that, although anxiety, boredom, and frustration were present among participants during confinement, the primary emotions were gratitude, joy, and hope. Second, the main coping strategies used by students participating were focused on facing and reassessing the situation. Furthermore, tranquility, hope, gratitude, and joy were positively related to self-regulated learning, although, loneliness and disinterest were negatively related. Finally, it was found that an approach to coping strategies mediated the relationship between emotions and self-regulated learning. Thus, teachers should help students understand the relevance of active coping strategies and use student-centered learning models that promote autonomous and self-regulated learning, considering each learner's needs, during and after confinement.

Readability and Suitability of Spanish-Language Hearing Aid User Guides.

Purpose The purpose of this study was to evaluate the readability and suitability of Spanish-language hearing aid user guides. Method Hearing aid user guides in English and Spanish were downloaded for analysis. Readability for the English guides was calculated using the Flesch Reading Ease Scale and the Flesch-Kincaid Readability Formula, and readability for the Spanish guides was calculated using the Fernandez-Huerta and Spaulding Formula and Fry Graph. The Suitability Assessment of Materials was used to rate the suitability of each Spanish and English pair of hearing aid user guides. Results Of the nine manufacturers that had materials available in English, only five had guides available in Spanish. Although readability for the Spanish and English user guides was similar, both guides were written, on average, at the eighth grade level. Suitability for the analyzed Spanish and English user guides was 78% and 80%, respectively. Conclusions Spanish-language hearing aid user guides were lacking in readability and suitability. Given that patients with limited proficiency in English, including the Hispanic population, are at risk for low health literacy, providers and manufacturers are encouraged to create more Spanish-language materials. User guides in both languages would benefit from revisions to improve readability and suitability. Supplemental Material https://doi.org/10.23641/asha.14569497.

Methodological Considerations for Auditory Training Interventions for Adults With Hearing Loss: A Rapid Review.

Purpose The aim of this study was to evaluate literature on auditory training published since 2013. Method A rapid review or a streamlined approach to systematically identify and summarize relevant studies was performed. Selected health sciences databases were searched using a search strategy developed with the PICO (population, intervention, comparison, and outcome) framework. Studies eligible for inclusion had older adult participants with hearing loss and utilized technology-based auditory training in laboratory or home settings. Results The study quality of most studies was found to be low to moderate, with concentrations between low and moderate. Major issues were related to study design and reporting, such as the need for blinding and a control group, larger sample sizes, and a follow-up for long-term outcomes of auditory training interventions. Wide variability in training approaches, participant backgrounds (e.g., audiograms, hearing aid use), and outcome measures are also noted. Conclusions Evidence on the effectiveness of auditory training is mixed. Future research should include high-quality randomized controlled trials with representative populations; follow-up periods to study long-term effects; and exploration of behavioral, electrophysiological, and self-reported outcome measures. Recommendations for study designs and methodologies are also discussed.

Coronavirus-Related Anxiety, Social Isolation, and Loneliness in Older Adults in Northern California during the Stay-at-Home Order.

This study aimed to determine the prevalence of and associations between anxiety, social isolation, and loneliness in a sample of older adults in Northern California during the stay-at-home order enacted during the COVID-19 pandemic. 514 older adults completed a 24-item survey. Perceived isolation and loneliness were reported in 56.4% and 36.0% of participants, respectively. Loneliness was found to be associated with both social isolation and COVID-19-related anxiety; however, social isolation and coronavirus-related anxiety were unrelated. Healthcare providers, social service providers, and families are encouraged to maintain or increase contact with older adults during the COVID-19 pandemic.

Unmasking misunderstandings: Strategies for better communication with patients.

ABSTRACT: Positive patient outcomes depend on successful communication. Increased use of personal protective equipment such as face masks during the COVID-19 pandemic can exacerbate communication difficulties. This article describes situations in which miscommunications may occur, identifies sources of communication breakdowns, and offers strategies to prevent them in real-life scenarios.

Survey of Hearing Health During the COVID-19 Pandemic: Implications for Service Delivery.

Purpose This study aimed to explore older adults' perceptions of their hearing health during the stay-at-home order issued during the COVID-19 pandemic. Method A 24-item survey was completed by 150 community-dwelling older adults in the United States. Participants were asked about their self-reported hearing status, use of hearing aids and difficulty wearing masks while wearing hearing aids, relative importance of their hearing health, priority of their hearing health during the COVID-19 pandemic, difficulty communicating with masks, and utilization of telepractice services. Results The majority of participants did not wear hearing aids despite reporting that they had at least a little trouble hearing. Most participants reported that their hearing health was important and indicated that they were likely to visit their audiologist for an in-person or virtual visit during the pandemic. Conclusion Audiologists should consider telepractice or remote service delivery options during and after the COVID-19 pandemic to meet the needs of their patients.

An Examination of Effect Sizes and Statistical Power in Speech, Language, and Hearing Research.

Purpose The purpose was to examine and determine effect size distributions reported in published audiology and speech-language pathology research in order to provide researchers and clinicians with more relevant guidelines for the interpretation of potentially clinically meaningful findings. Method Cohen's d, Hedges' g, Pearson r, and sample sizes (n = 1,387) were extracted from 32 meta-analyses in journals in speech-language pathology and audiology. Percentile ranks (25th, 50th, 75th) were calculated to determine estimates for small, medium, and large effect sizes, respectively. The median sample size was also used to explore statistical power for small, medium, and large effect sizes. Results For individual differences research, effect sizes of Pearson r = .24, .41, and .64 were found. For group differences, Cohen's d/Hedges' g = 0.25, 0.55, and 0.93. These values can be interpreted as small, medium, and large effect sizes in speech-language pathology and audiology. The majority of published research was inadequately powered to detect a medium effect size. Conclusions Effect size interpretations from published research in audiology and speech-language pathology were found to be underestimated based on Cohen's (1988, 1992) guidelines. Researchers in the field should consider using Pearson r = .25, .40, and .65 and Cohen's d/Hedges' g = 0.25, 0.55, and 0.95 as small, medium, and large effect sizes, respectively, and collect larger sample sizes to ensure that both significant and nonsignificant findings are robust and replicable.

An Analysis of Nonsignificant Results in Audiology Using Bayes Factors.

Purpose Null hypothesis significance testing is commonly used in audiology research to determine the presence of an effect. Knowledge of study outcomes, including nonsignificant findings, is important for evidence-based practice. Nonsignificant p values obtained from null hypothesis significance testing cannot differentiate between true null effects or underpowered studies. Bayes factors (BFs) are a statistical technique that can distinguish between conclusive and inconclusive nonsignificant results, and quantify the strength of evidence in favor of 1 hypothesis over another. This study aimed to investigate the prevalence of BFs in nonsignificant results in audiology research and the strength of evidence in favor of the null hypothesis in these results. Method Nonsignificant results mentioned in abstracts of articles published in 2018 volumes of 4 prominent audiology journals were extracted (N = 108) and categorized based on whether BFs were calculated. BFs were calculated from nonsignificant t tests within this sample to determine how frequently the null hypothesis was strongly supported. Results Nonsignificant results were not directly tested with BFs in any study. Bayesian re-analysis of 93 nonsignificant t tests found that only 40.86% of findings provided moderate evidence in favor of the null hypothesis, and none provided strong evidence. Conclusion BFs are underutilized in audiology research, and a large proportion of null findings were deemed inconclusive when re-analyzed with BFs. Researchers are encouraged to use BFs to test the validity and strength of evidence of nonsignificant results and ensure that sufficient sample sizes are used so that conclusive findings (significant or not) are observed more frequently. Supplemental Material https://osf.io/b4kc7/.

An Introduction to Calculating Bayes Factors in JASP for Speech, Language, and Hearing Research.

Purpose Evidence-based data analysis methods are important in clinical research fields, including speech-language pathology and audiology. Although commonly used, null hypothesis significance testing (NHST) has several limitations with regard to the conclusions that can be drawn from results, particularly nonsignificant findings. Bayes factors (BFs) can be used to complement NHST and quantify the strength of evidence in favor of 1 hypothesis over another, given the data: commonly, either the alternate hypothesis over the null or the null hypothesis over the alternate. This article provides an introduction to BFs through JASP, a free, open-source, graphics-based statistics package that allows researchers to easily conduct both NHST and Bayesian analyses in a clear and reproducible manner. Method and Results Both traditional NHST analyses and Bayesian equivalents for correlations, t tests, and analyses of variance were conducted in JASP using simulated data, with explanations of analysis options, statistical output, and figures provided. These examples also demonstrate what NHST and BFs can and cannot infer about a data set. Additionally, BFs were calculated from the summary statistics of published nonsignificant results to illustrate how JASP may be useful to consumers of research who only have access to statistics provided in a published study. Conclusions Bayesian analyses are underutilized in speech, language, and hearing research. By complementing traditional NHST analyses with BFs, researchers can directly test for and quantify the strength of evidence during hypothesis testing, thereby drawing stronger conclusions from their research and providing more relevant information for clinicians and researchers in the field.

Effect of Reduced Audibility on Mini-Mental State Examination Scores.

BACKGROUND: The interaction of audition and cognition has been of interest to researchers and clinicians, especially as the prevalence of hearing loss and cognitive decline increases with advancing age. Cognitive screening tests are commonly used to assess cognitive status in individuals reporting changes in memory or function or to monitor cognitive status over time. These assessments are administered verbally, so performance may be adversely affected by hearing loss. Previous research on the impact of reduced audibility on cognitive screening test scores has been limited to older adults with sensorineural hearing loss (SNHL) or young adults with normal hearing and simulated audibility loss. No comparisons have been conducted to determine whether age-related SNHL and its impact on cognitive screening tests is successfully modeled by audibility reduction. PURPOSE: The purpose of this study was to examine the effects of reduced audibility on the Mini-Mental State Examination (MMSE), a common bedside cognitive screening instrument, by comparing performance of cognitively normal older adults with SNHL and young adults with normal hearing. DESIGN: A 1:1 gender-matched case-control design was used for this study. STUDY SAMPLE: Thirty older adults (60-80 years old) with mild to moderately severe SNHL (cases) and 30 young adults (18-35 years old) with normal hearing (controls) served as participants for this study. Participants in both groups were selected for inclusion if their cognitive status was within normal limits on the Montreal Cognitive Assessment. DATA COLLECTION AND ANALYSIS: Case participants were administered a recorded version of the MMSE in background noise at a signal-to-noise ratio of +25-dB SNR. Control participants were administered a digitally filtered version of the MMSE that reflected the loss of audibility (i.e., threshold elevation) of the matched case participant at a signal-to-noise ratio of +25-dB SNR. Performance on the MMSE was scored using standard criteria. RESULTS: Between-group analyses revealed no significant difference in the MMSE score. However, within-group analyses showed that education was a significant effect modifier for the case participants. CONCLUSIONS: Reduced audibility has a negative effect on MMSE score in cognitively intact participants, which contributes to and confirms the findings of earlier studies. The findings suggest that observed reductions in score on the MMSE were primarily due to loss of audibility of the test item. The negative effects of audibility loss may be greater in individuals who have lower levels of educational attainment. Higher levels of educational attainment may offset decreased performance on the MMSE because of reduced audibility. Failure to consider audibility and optimize communication when administering these assessments can lead to invalid results (e.g., false positives or missed information), misdiagnosis, and inappropriate recommendations for medication or intervention.