Individual Differences in Effectiveness of Cochlear Implants in Children Who Are Prelingually Deaf: New Process Measures of Performance

The efficacy of cochlear implants in children who are deaf has been firmly established in the literature. However, the effectiveness of cochlear implants varies widely and is influenced by demographic and experiential factors. Several key findings suggest new directions for research on central auditory factors that underlie the effectiveness of cochlear implants. First, enormous individual differences have been observed in both adults and children on a wide range of audiological outcome measures. Some patients show large increases in speech perception scores after implantation, whereas others display only modest gains on standardized tests. Second, age of implantation and length of deafness affect all outcome measures. Children implanted at younger ages do better than children implanted at older ages, and children who have been deaf for shorter periods do better than children who have been deaf for longer periods. Third, communication mode affects outcome measures. Children from "oral-only" environments do much better on standardized tests that assess phonological processing skills than children who use Total Communication. Fourth, at the present time there are no preimplant predictors of outcome performance in young children. The underlying perceptual, cognitive, and linguistic abilities and skills emerge after implantation and improve over time. Finally, there are no significant differences in audiological outcome measures among current implant devices or processing strategies. This finding suggests that the major source of variance in outcome measures lies in the neural and cognitive information processing operations that the user applies to the signal provided by the implant. Taken together, this overall pattern of results suggests that higher-level central processes such as perception, attention, learning, and memory may play important roles in explaining the large individual differences observed among users of cochlear implants. Investigations of the content and flow of information in the central nervous system and interactions between sensory input and stored knowledge may provide important new insights into the basis of individual differences. Knowledge about the underlying basis of individual differences may also help in developing new intervention strategies to improve the effectiveness of cochlear implants in children who show relatively poor development of oral/aural language skills.     

Working Memory Spans as Predictors of Spoken Word Recognition and Receptive Vocabulary in Children with Cochlear Implants

The present study investigated whether individual differences in working memory could account for a significant proportion of the variance in the open-set word recognition and receptive vocabulary skills of prelingually deafened, pediatric cochlear implant recipients, after the contribution of known predictors was taken into account. The contributions of four measures of working memory were examined separately for children using oral communication (OC) (n = 32) and Total Communication (TC) (n = 29). Wechsler Intelligence Scale for Children-Third Edition (WISC) digit-spans, requiring immediate recall of auditory-only lists in both forwards and backwards directions were, collected. Two versions of a novel "memory span game" were also administered: One required memory for sequences of colored lights; the other assessed memory for colored lights presented in conjunction with auditory color-names. A contribution from working memory was observed only for the span tasks that incorporated an auditory processing component. These results suggest a relationship between working memory and the examined outcome measures that is specific to the auditory modality, partially linked to communication mode, and not related to individual differences in a general-purpose component of working memory.     

Tobacco use in the treatment trenches

As reported here (see “Dirty Words: Smoker, Vaper, Harm Reductionist?” ADAW, Oct. 14, 2019; https://onlinelibrary.wiley.com/doi/10.1002/adaw.32509 ), recently I have focused much of my time on raising alarms about the very high rates of smoking among addiction treatment and recovery populations. In addition to archival research, I have conducted a series of key informant interviews to better understand the roots of our field's ongoing reluctance to address this issue. These interviews with national leaders in the alcohol and drug field confirmed that when presented with statistics about the very high rates of cigarette smoking among treatment and recovery populations, there is widespread consternation about the resulting tobacco‐related mortality and morbidity. Paradoxically, however, this concern has not translated into strong remedial action.     

Nicotine addiction and substance use disorder treatment: The Philadelphia story

The Philadelphia Department of Behavioral Health and its leadership have a well‐deserved reputation for pioneering recovery‐oriented systems of care. Effective Jan. 1, 2019, the agency initiated an aggressive policy to address the problem of nicotine addiction among those receiving substance use disorder (SUD) services in contracted facilities. The policy covers nine detox facilities, 32 short‐term rehabilitation programs, 31 long‐term rehabilitation programs and eight halfway houses.     

People who live apart together (LATs) – how different are they?

‘Living apart together’– that is being in an intimate relationship with a partner who lives somewhere else – is increasingly recognised and accepted as a specific way of being in a couple. On the face of it, this is a far cry from the ‘traditional’ version of couple relationships, where co‐residence in marriage was placed at the centre and where living apart from one's partner would be regarded as abnormal, and understandable only as a reaction to severe external constraints. Some commentators regard living apart together as a historically new family form where LATs can pursue a ‘both/and’ solution to partnership – they can experience both the intimacy of being in a couple, and at the same time continue with pre‐existing commitments. LATs may even de‐prioritize couple relationships and place more importance on friendship. Alternatively, others see LAT as just a ‘stage’ on the way to cohabitation and marriage, where LATs are not radical pioneers moving beyond the family, but are cautious and conservative, and simply show a lack of commitment. Behind these rival interpretations lies the increasingly tarnished spectre of individualisation theory. Is LAT some sort of index for a developing individualisation in practice? In this paper we take this debate further by using information from the 2006 British Social Attitudes Survey. We find that LATs have quite diverse origins and motivations, and while as a category LATs are often among the more liberal in family matters, as a whole they do not show any marked ‘pioneer’ attitudinal position in the sense of leading a radical new way, especially if age is taken into account.     

Biomechanical analysis of loading/unloading a ladder on a truck

Loading/unloading a ladder on vehicles are frequent tasks and involve overhead handling that may expose workers to risk factors of shoulder musculoskeletal disorders. The objective of the present study was to evaluate posture, forces required and perceived exertion when loading and unloading the ladder on a utility truck. Thirteen male overhead line workers from an electric utility in Brazil participated in this study. Shoulder elevation angle was measured using inclinometers. The required force to load/unload the ladder was measured by dynamometer. Subjective assessment of the perceived exertion was recorded to compare the exertion reported during the test conditions to the field conditions. The task of loading/unloading the ladder presented risks of shoulder musculoskeletal disorders (MSDs) to workers because it requires high levels of force (approximately 60% of the maximal force) combined with overhead posture of the shoulders (more than 100° from the neutral posture). Age and height presented to interfere in biomechanical risks presented in load/unload task. There was no significant difference between the subjective exertion during the test conditions and handling the ladder in the field. Ergonomic intervention is recommended to reduce these risks for shoulder MSDs.     

Structuring institutional analysis for urban ecosystems: A key to sustainable urban forest management

A decline in urban forest structure and function in the United States jeopardizes the current focus on developing sustainable cities. A number of social dilemmas—for example, free-rider problems—restrict the sustainable production of ecosystem services and the stock of urban trees from which they flow. However, institutions, or the rules, norms, and strategies that affect human decision-making, resolve many such social dilemmas, and thus, institutional analysis is imperative for understanding urban forest management outcomes. Unfortunately, we find that the definition of institutions varies greatly across and within disciplines, and conceptual frameworks in urban forest management and urban ecosystems research often embed institutions as minor variables. Given the significance of institutional analysis to understanding sustainable rural resource management, this paper attempts to bring clarity to defining, conceptually framing, and operationally analyzing institutions in urban settings with a specific focus on sustainable urban forest management. We conclude that urban ecologists and urban forest management researchers could benefit from applying a working definition of institutions that uniquely defines rules, norms, and strategies, by recognizing the nested nature of operational, collective choice, and constitutional institutions, and by applying the Institutional Analysis and Development framework for analysis of urban social-ecological systems (SESs). Such work promises to spur the desired policy-based research agenda of urban forestry and urban ecology and provide cross-disciplinary fertilization of institutional analysis between rural SESs and urban ecosystems.