Why do some people complain of hearing difficulties when their hearing esholds are normal? How should Audiology professionals respond to their presentation? This problem will be considered in the light of the literature from audiology, psychology, and medical sociology disciplines. The different evidence for and implications of bio-medical and bio psychosocial explanations for such experiences are discussed. In particular the role of help seeking is considered as a coping mechanism and as a key part of the diagnostic case definition applied to this population of audioiogy patients. Two original studies will be presented which consider this phenomenon from different viewpoints. The first explored the lived experience of the patients.Two original studies will be presented which consider this phenomenon from different viewpoints. The first explored the lived experience of the patient who is coping with hearing difficulties and investigated how seeking help forms part of the process of coping.

The purpose of this study was to investigate the effectiveness of a theoretically-grounded reading intervention in children with reading difficulties. Participants were between the ages of 8 to 10 years from a community-based program for children with learning disabilities and a single-case research (SCR) design was employed. An adapted version of the RAVE-O intervention was delivered which focused on instruction in phonology, orthography, semantics, syntax, and morphology in building children’s word-level fluency skills. Norm-referenced word-level reading, decoding, and reading comprehension measures were collected at pre- and post-test, and progress monitoring data via curriculum-based measures were also collected. Overall results based on percentage of non-overlapping data (PND) analyses indicated moderate effects for decoding fluency and reading comprehension and small effects for decoding accuracy and reading fluency. Implications for educators and professionals working with elementary school students identified with reading difficulties are discussed. / Graduate

This interpretive study aims to investigate the difficulties in English academic writing as perceived by Saudi postgraduate students and their English supervisors in an English-speaking country. In accordance with the exploratory nature of the methodological approach adopted in this study, the research design of the current study employs a sequential mixed-methods design. The quantitative phase is represented by the questionnaire whereas semi-structured interviews and document analysis constitute the qualitative phase. From the sample, 275 students were asked to fill in the prepared questionnaire whilst 15 students, of both genders, and 9 supervisors were asked to participate in an interview. Ten samples of students’ written feedback from their supervisors were provided. Data were analysed quantitatively using SPSS descriptive statistics and qualitatively using MAXQDA software. The findings of the current study revealed that Saudi postgraduate students face the following difficulties in their English academic writing: not having sufficient academic vocabulary, avoiding plagiarism, using cohesive devices properly, constructing logical arguments, making coherent links between ideas, and demonstrating critical thinking in their academic writing. Furthermore, the current study highlighted that the difficulties could be attributed to a number of factors, including those related to learners, context, and instruction. Several strategies were proposed that could assist Saudi students in improving their academic writing. Additionally, the lack of academic preparation in the KSA had a negative influence on the proficiency of Saudi postgraduate students in their English academic writing, resulting in disparities between the expectations placed on students in their postgraduate studies in the UK and the actual results achieved by Saudi students. The findings also revealed that EAP courses in the UK often aided students in learning writing techniques; however, these courses have certain limitations. According to the findings of the current study, a theoretical model is suggested to help Saudi postgraduate students in their English academic writing. Based on the study findings, implications are drawn for policy makers and for practice in the education system in Saudi Arabia. Finally, suggestions for further research are provided.

Introduction: This multiphase qualitative study explored the understanding of middle-aged women’s sexuality and sexual difficulties and the way they address these difficulties. Nurses’ and midwives’ role in sexuality-related care was also explored. The need to address the subject was triggered by the multidimensional nature of female sexuality that could not be limited to one single definition; the medicalisation of female sexual problems that is based on the standards of sexual function and dysfunction; the scarcity of research that reflects on women’s subjective views on sexuality and sexual difficulties and the way they address these difficulties. This is particularly crucial at the middle-age where women undergo hormonal and psychosocial changes that may affect their sexual life. Methods: Interviews and focus group discussions were used to capture the narratives of 52 middle-aged women of 40-55 years in phases one and two of the study. They were chosen purposively by education and menopausal status from clinical and non-clinical settings regardless of their marital status and sexual orientation. Additionnally, a sample of 11 nurses and midwives working in the hospital and primary healthcare centres participated in two focus group discussions. Results: Women’s narratives led to a comprehensive understanding of sexuality and sexual problems and the implications for help-seeking. Findings showed how women’s interpretation of sexuality resonates within bio-psychosocial and cultural perspectives driven by double standards and inhibiting sexual socialisation. Women’s sexuality is ‘muted’, conflicting between frustrating experiences, personal expectations and the perception of sexual selves as affected by the middle-age and social myths. Yet, sexuality is central to women’s life where they tend to play a sacrificing role and gain agency. Their sexual difficulties are multifaceted mirroring their inhibitions, relational conflicts, husbands’ sexual problems and contextual burdens. Women would firstly rely on their husbands to discuss together their common sexual issues as nobody can understand their needs more than both of them. In parallel, the gynaecologist is reportedly the first one they consult as they are familiar with him/her. Yet, some do not know who else to turn to for help. Women highlighted many personal, relational and contextual barriers to help-seeking focusing on their husbands’ negative attitude. They also criticised the services offered and the lack of resources. Within this context and in focus group discussions, 11 nurses and midwives reflected on their attitude and behaviour towards sexuality-related care. They had opposing views concerning their involvment in the assessment of patients’ sexual health and identified many barriers to having an effective role in the field. Discussion and implications: This study has a unique contribution in voicing women’s views and concerns as sexuality is underreported and poorly researched in Lebanon. Women’s narratives shed light on many aspects of their sexuality, sexual difficulties and the facilitators and barriers to help-seeking focusing on the role of nurses and midwives in this field. This comprehensive perspective that is contextually based has implications on education, clinical practice and research. It is particularly important to provide middle-aged Lebanese women with a culturally sensitive professional assistance to satisfy their sexual life. In addition, the publication of two papers from the study enriches knowledge in the field. It is of note that in this study sexuality and sexual life are interchangeably used. Nevertheless, sexuality has a broader meaning and encompasses all the thoughts, fantasies, desires, beliefs, attitudes, values, behaviour, practices, roles and relationships (WHO, 2006), whereas sexual life is more related to sexual relationships and activities (Segen's Medical Dictionary, 2012).

After a shift in upper elementary reading instruction that emphasized complex learning using nonfiction text, Texas schools showed low reading comprehension scores among upper elementary students. The purpose of this exploratory single case study was to examine the pedagogical content knowledge of Texas upper elementary teachers who teach nonfiction reading comprehension strategies to at-risk students who do not qualify for special education services. The central research question focused on how teachers view their pedagogical content knowledge while instructing students. The conceptual framework for this study was a combined Shulman's (1986) pedagogical content knowledge model and Thomlinson's (2000) differentiated instruction learning model. Data sources included online questionnaires (N=161), open-ended scenario-based phone or Skype interviews (N=10), and public documents on reading professional development in the state of Texas. Findings from open coding and inductive analysis indicated that the paradigm shift from reading to learn to learning to read is a challenge in the upper elementary classroom, teachers are relying on inadequate professional development to develop their pedagogy and content knowledge, and teachers may be rescuing struggling students rather than differentiating them. Findings may help Texas educators make more informed decisions on pedagogy to promote expository reading comprehension among upper elementary at-risk students and to increase their opportunities for success.

Previous studies have shown some students with good word recognition skills and high levels of reading fluency fail to comprehend what they read.This study examined the explicit teaching of the rule based Question Answer Response (QAR) strategies to overcome specific learning difficulties in reading comprehension. Case study methods were used on five Year 4 students in Western Australia who were at different developmental levels in reading comprehension.The study revealed that within the conceptual framework of the transactional model of reading, the Question Answer Response strategies were effective in improving literal, inferential, critical and creative comprehension at varying levels for each of the five students in the study. The strategies also proved to be an effective way to teach the resolution of anaphoric pronouns that are particularly problematic for students with poor comprehension.The study indicates that the teaching of reading comprehension skills to students with reading comprehension problems through explicit rule based instruction is an important component of classroom-based instruction in the literacy learning area.

Behavioural difficulty is probably the least understood area of special education as it is very problematic to identify a specific cause. Behavioural difficulties are those behaviours that students sometimes exhibit that are inappropriate and unacceptable in the classrooms or schools, as they disrupt the smooth process of teaching and learning. This study investigated primary school teachers' perspectives of the causal factors of students' behavioural problems and what can be done to minimise this problem. The study was carried out in the Madang Province involving two primary schools. From the two schools, twelve teachers (six from each school) participated in the study. The same participants were involved in both the questionnaire and the semi structured interview. The data gathered for the questionnaire and interview were analysed and transcribed respectively. The findings discovered that the family and school factors contributed substantially towards students' inappropriate behaviours. Family factors include parental problems, abuse in the families, and the constant struggle to provide the basic necessities due to the high living cost. School factors, on the other hand, include negative teacher attitudes, teacher lack of knowledge and skills to adapt the curriculum to include social skills, lack of teacher support and encouragement, and peer influences. The findings also discovered that teachers were more bothered about externalising behaviours such as disruption and aggression than internalising behavioural problems like withdrawal and depression displayed by students. Further, teachers' limited pre-service and in-service training and lack of experience in teaching students with behavioural problems contributed significantly for teachers not attending to students who behave inappropriately. Based on the findings identified in the study, several recommendations were made on how to intervene to alleviate this problem. Of particular importance is teacher training at both the pre-service and in-service level. Also government support is needed in terms of funding for training, involving specialists and other resources to respond to student behavioural problems effectively and efficiently. The findings may have particular relevance to future studies in this area and provide teachers with effective and workable intervention strategies for students' behavioural problems in the classrooms.

Sex after breast cancer treatment has hitherto been studied chiefly by quantitative methods, which have found that at least a third of women concerned have sexual difficulties. The reasons for this were not clearly identified, but were usually held to be associated with depressed mood and negative body image. This study gathered information about sex and the couple relationship by means of in-depth interviews with fdteen women, and reports their experiences as they recounted them. All had been treated with breast surgery, four with radiotherapy, nine with chemotherapy and eight with the hormone treatment, tamoxifen. Fourteen had had sex since their treatment, and twelve of these had sexual difficulties they had not been having before the treatment, These difficulties were not connected with either mood changes or body image concerns, but were mainly due to problems with desire and orgasm and to vulva1 and vaginal symptoms. Most women attributed these problems to menopause, whether natural, induced by the chemotherapy or exacerbated by tamoxifen. The couple relationship in this circumstance has not been intensively studied until now. The study found that a positive shift commonly took place in the less stable relationships, so that the couple became closer, and sex, including heterosexual intercourse, became more acceptable to the woman. There was no change in the stable relationships. In both stable and less stable relationships, though intercourse was wished for by the heterosexual women, the sexual difficulties described above inhibited its successful accomplishment. The study also reports the coping methods used by the women and their experience of trying to find information about the subject of sex and sexual difficulties, from health professionals and other sources.

Students who have learning difficulties generate a resource to assist them with their schoolwork. This resource has been delivered in a number of different ways. In the last decade the introduction of inclassroom assistance has been adopted in several states in Australia including the Australian Capital Territory. This method of service delivery of the resource has been considered to be helpful as it allows the student to remain in the classroom while still receiving the necessary assistance. The proponents of this delivery method believe that the students prefer remain in the classroom. Critics of this delivery method consider that it is not easy to address basic skill deficits in the classroom and that students find being helped in the classsroom embarrassing. This study examines the preference for service delivery model of three groups of population, students, classroom teachers and teachers of students with learning difficulties. A survey was used to ascertain the preference of these three groups, why they preferred a model, which model they regarded as most efficacious and why. Other specific questions were asked of each group. Interviews were also conducted with ten percent of each group and also with the principal and the counsellor from each school. Some illumination of school climate and other variables which may affect data was sought from the interviews. Teachers were found to prefer a mixed model of service. Students' results showed a preference for two models over a third, small classes, which was not favoured. Students also saw these two models as most efficacious. Interviews revealed a satisfaction with the service amongst students but some concerns about the delivery of the service and the decision making processes amongst teachers.

Children may have difficulty with learning for a great variety of reasons. In determining these reasons, the diagnostician will need to consider among other intellectual functioning, environmental influences, biological and emotional disorders and cultural differences. What also needs to be included is how students view themselves as people and as students - that is, their feelings of self-worth or self-esteem. Very often the solution to a child's learning problems are looked for in the cognitive areas, when it is this affective aspect of learning that requires attention. There is ample research evidence to show, that children with poor opinions of thier self-worth, are less likely to be doing well at school than children who have a high opinion of themselves. Less clear however, is the actual cause and effect relationship. That is, is it more usual to find low self-esteem causing poor school performance or does poor school performance cause low self-esteem. This study assumes that low self-esteem is likely to be a major cause of poor performance and that any efforts to change a child's opinion of himself in a positive way, will result in improved performance - in this particular case - at reading. As self-esteem is largely learned from interaction with significant others, an attempt was made to influence the self opinions of a group of children by specific counselling of these 'others', here, their parents and teacher. The major thrust of the counselling was directed towards the parents, although it is understood that an equal amount of effort with the teachers of the children involved would have been justified. In a program extending over ten one and one half sessions, parents of an experimental group of children, were counselled in two groups. The aims of the program were to provide parents with an awareness of how their child's self concept is formed, how it affects their achievement in school and how they might influence its change. In the study, this experimental group did not show any significant gain in achievement or self-esteem over the control group. Nevertheless, there emerged a number of useful implications for better practice in the field of educational counselling.