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Improving the quality of patient care is a challenge that calls for a multidisciplinary approach, embedding a broad spectrum of knowledge and involving healthcare professionals from diverse backgrounds. The purpose of this paper is to present an innovative approach that implements discrete‐event simulation (DES) as a decision‐supporting tool in the management of Six Sigma quality improvement projects.

A roadmap is designed to assist quality practitioners and health care professionals in the design and successful implementation of simulation models within the define‐measure‐analyse‐design‐verify (DMADV) or define‐measure‐analyse‐improve‐control (DMAIC) Six Sigma procedures.

A case regarding the reorganisation of the flow of emergency patients affected by vertigo symptoms was developed in a large town hospital as a preliminary test of the roadmap. The positive feedback from professionals carrying out the project looks promising and encourages further roadmap testing in other clinical settings.

The roadmap is a structured procedure that people involved in quality improvement can implement to manage projects based on the analysis and comparison of alternative scenarios.

The role of Six Sigma philosophy in improvement of the quality of healthcare services is recognised both by researchers and by quality practitioners; discrete‐event simulation models are commonly used to improve the key performance measures of patient care delivery. The two approaches are seldom referenced and implemented together; however, they could be successfully integrated to carry out quality improvement programs. This paper proposes an innovative approach to bridge the gap and enrich the Six Sigma toolbox of quality improvement procedures with DES.

Hearing loss impacts language and communication, a building block for relationships and society. Most teachers and professionals rarely have a young child with hearing loss in their classroom. The “unknown” can be a source of stress for the professionals and the families alike. Understanding the characteristics of this population of students, the diagnostic process, the possible early intervention supports, and practices to use with young children with hearing loss may help teachers and professionals approach students and families with more confidence. This chapter will outline each of the aforementioned with an emphasis on understanding parental perspective.

While Americans have often believed that the United States has the best health care system in the world and that, as one of the wealthiest nations, we therefore must have the best health care available to our citizens, researchers in medical sociology, public health and health services research have emphasized for decades that America tolerates extremes of wealth and poverty much greater than in many European countries. This toleration of extremes extends to the approach to the delivery of social and health services, as well as to consumer goods. Over 40 million Americans do not have health insurance and thus have limited access to expensive health care services (Morone & Jacobs, 2005b). Even more may have very poor health coverage, so that if a serious illness were to occur, the person would have a very hard time finding care and paying for that care. Even if people have coverage for major health care problems, many people do not have insurance that covers areas of health care such as vision care, dental care and audiology services. While these are not life threatening health care concerns, they are health care concerns that impact quality of life and even ability to achieve. A child who cannot see well has trouble succeeding in school. A person in pain from tooth problems has trouble concentrating on tasks, and poor oral health is one contributor to nutrition concerns among the elderly. Lack of access to hearing aids increases the social isolation of the elderly, but these services are not covered by Medicare, the federal program that does provide access to health care services for most of the elderly in the United States.

Disorders of speech and language include myriad diagnoses that vary in incidence and prevalence across age span and cultures. Disorders can range from those that do not impinge upon general communication, learning or psychosocial function, such as a mild speech disturbance, like a lisp, to global aphasia with a complete lack of communication ability. The short- and long-term effects of these impairments are often directly related to the age at onset, duration, co-morbidities, access to intervention by qualified professionals, and the societal response to the disability. In cultures that take a dim view of any type of deviation from the norm, there may be less access to diagnosis and treatment, as well as a hesitancy to seek out available options for treatment. Additionally, for those countries in which there are larger issues of general health, economic support, and quality of care, the nature of the disability may receive little or no attention simply due to national priorities or limited access to resources. Although, globally, disorders of speech and language are not exclusively limited to those countries with poorer health outcomes, in general, speech and language services may be less accessible or absent in poverty-stricken nations of the world. In many cases, these countries are at greater risk for many of the disorders simply due to environmental and social conditions, such as lack of early access to health care and preventative interventions. This chapter explores Global Perspectives on Speech and Language Impairments.

The purpose of this paper is to investigate the mediating role of psychological problems (stress, anxiety, depression) between hearing impairment (HI) and tinnitus in tinnitus patients. Sample comprised of 110 patients (male, n=70; female, n=40).

The purposive sampling technique was used based on correlational design. Two scales, tinnitus handicap inventory developed by Newman et al. (1996), and depression, anxiety and stress scale developed by Lovibond and Lovibond (1995), were employed to assess tinnitus, anxiety, stress and depression among tinnitus patients.

The study revealed that tinnitus was positively significant correlated with depression (r=0.55, p<0.001), anxiety (r=0.63, p<0.001), stress (r=0.54, p<0.001) and hearing loss (r=0.81, p<0.001). The results also revealed that hearing loss was positively significant predictor for tinnitus (β=20.72, p<0.001). Further, it was revealed that tinnitus was positively significant predicted by anxiety (β=2.62, p<0.001), stress (β=2.33, p<0.001) and depression (β=2.71, p<0.001); the interaction between psychological symptoms and hearing loss was negatively significant predictor for stress (β=−0.51, p<0.001), anxiety (β=−0.57, p<0.001) and depression (β=−0.62, p<0.001). Moreover, it was revealed that female tinnitus patients were more predisposed to stress, anxiety and depression as compared to male tinnitus patients. Results also elaborated that those tinnitus patient who had profound HI were less inclined toward psychological problems as compared to those tinnitus patients who had mild to moderate level of HI. This study would be helpful for the clinical setting to tackle the psychological problems of tinnitus patients.

This study consisted on population from urban cities of Pakistan; therefore, the findings cannot be generalized on overall population. In future, descriptive as well as experimental studies will be beneficial to describe the mechanism of tinnitus across gender in detail. Native tool for measuring gender-related problems would be effective in future as it integrates cultural aspects as well.

There is a consensus across researchers that tinnitus is one of the most important biological problem which initiates various other psychological problem (Minen et al., 2014; Vogel et al., 2014). Numerous studies have been conducted to find out the relationship of tinnitus with various psychological and biological factors (Boi et al., 2012; Li et al., 2014; Marciano et al., 2003; McCormack et al., 2015; Møller et al., 2010; Udupi et al., 2013; Zöger et al., 2006).

The purpose of this paper, using an evidence‐based management theoretical lens, is to examine research impact to provide guidance to supply chain management academics in evidencing and exploiting the outputs, outcomes and impact of their research.

Evidence‐based management theory is examined and applied to types of academic research impact. The distinction between academic and non‐academic impact is developed into a supply chain framework of research outputs, transfer, outcomes, impact and national/international benefits. Impact of supply chain management research is explored through a case study in the English National Health Service. Future opportunities and challenges for supply chain management researchers arising from increasing demand for and supply of evidence are discussed.

Author academic impact and citations are found to be increasingly important building blocks of evidence‐based evaluations of individual academics, journals, research quality assessments of groups and universities, and global rankings of universities. Supply chain management researchers can compare their impact with other areas of academia. Non‐academic impact of research has been assessed by funders of research projects and has spread to research quality assessments of universities.

Bibliometrics provide evidence of author and journal impact that can be used in human resource decisions, research quality assessments and global rankings of universities; this availability enables a debate on appropriate use of academic impact evidence. Supply chain management academics evidencing non‐academic research impact on business, society and economy will enable governments and funders of research to evaluate value for money return on their investment.

This perspective of evidence‐based evaluation of research impact and its implications might encourage debate on academic and non‐academic impact and encourage supply chain researchers to consider evidencing impact in their research design and methodology.

Students with communication disorders present unique challenges to educators working toward fostering an inclusive classroom. For children with speech/language impairments, expressing themselves either academically or socially may present obstacles requiring communicative support and facilitation. For children with hearing loss, full access to educational material will be difficult without technological and/or visual support. Many children may have a combination of disorders, requiring a team of educators and other professionals to provide educational content and classroom support in the most inclusive way possible. This chapter is intended to provide an overview of variety of communication disorders, along with guidelines for improving student access across educational settings.

General education and special education teachers may have limited experience working with students who are deaf/hard of hearing and be unaware of the professionals and specialist who may work with those students. When a student has a hearing loss, there are a variety of additional professionals with whom teachers must collaborate. The roles of these professionals may be different than those experienced by other educators. An understanding of the roles of these various professionals is important to ensuring the most appropriate service provision for students with hearing loss. This chapter will specifically discuss the roles of teachers of the deaf, interpreters, and audiologists as well as some other related service providers within the context of a fictional case scenario.

Roles of special education-related service professionals have changed since the passage of P.L. 94-142. Many children are spending a majority of their day in the general education classroom, however services can be delivered in a variety of settings ranging from the general education classroom to a one-on-one setting. Professionals deliver services based upon the educationally necessary model, which is determined by members of the Individualized Education Program team. Regardless of where services are delivered, when there are multiple related service professionals on a child’s educational team, there is a great deal of collaboration and communication required. A basic framework for ensuring this occurs includes selecting a key communication person or case manager, striving for clarity in communication, setting a schedule for consistent check-ins, removing discipline jargon, and communicating what is important to parents.

Tinnitus patients are among the most vulnerable group to develop psychopathological symptoms over time if left unresolved. This study aims to investigate the role of tinnitus distress between tinnitus magnitude, cognitions and functional difficulties in the development of somatization symptoms among male and female patients experiencing ear-related problems due to lack of proper access to health care.

This study was based on a purposive sampling technique and sample consisted on 159 patients (97 male, 62 female) having tinnitus complaints, with age range 18–87 (M = 47.94, SD = 17.47) years, recruited from various clinics and hospitals of Islamabad, Pakistan, from December 2020 to July 2021.

The findings of this study showed that tinnitus distress is significant positively associated with tinnitus-related magnitude, negative cognitions, functional difficulties and somatization symptoms. Gender-related differences between male and female tinnitus patients revealed that females are more prone to depict higher levels of tinnitus distress, tinnitus magnitude, negative cognitions and somatization symptoms than male patients. Mediation analysis demonstrated that tinnitus distress serves as a mediator between tinnitus magnitude, cognitions, functional difficulties and somatization symptoms.

Cross-sectional nature and self-reporting measures serve as a limitation of the study. An experimental study appears to be vital to ascertain the time-based relationship with tinnitus magnitude in the development of various psychopathological issues. The findings of this study contribute to the literature by highlighting the role of tinnitus distress in the origination of psychopathological symptoms like somatization and need of upgraded health-care systems in Pakistan.

This study has explored the mediating role of tinnitus distress between magnitude, cognitions, functional difficulties and somatization symptoms among Pakistani population, specifically mentioning the development of somatization symptoms among this population, which can contribute in the loss of earning and increased health expenses due to unawareness of proper health-care approach.