Paying it forward: Four-year analysis of the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program.

Related Articles

Paying it forward: Four-year analysis of the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program.

J Trauma Acute Care Surg. 2017 Apr 27;:

Authors: Zakrison TL, Polk TM, Dixon R, Ekeh AP, Gross KR, Davis KA, Kurek SJ, Stassen NA, Patel MB

Abstract
BACKGROUND: Mentorship programs in surgery are utilized to overcome barriers to clinical and academic productivity, research success, and work-life balance. We sought to determine if the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program has met its goals of fostering academic and personal growth in young acute care surgeons.
METHODS: We conducted a systematic program evaluation of EAST Mentoring Program's first four years. Demographic information was collected from EAST records, mentorship program applications, and mentee-mentor career development plans. We reviewed the career development plans for thematic commonalities and results of a structured, online questionnaire distributed since program inception. A mixed methods approach was used to better understand the program goals from both mentee and mentor perspectives, as well as attitudes and barriers regarding the perceived success of this career development program.
RESULTS: During 2012-2015, 65 mentoring dyads were paired and 60 completed the program. Of 184 surveys distributed, 108 were returned (57% response rate). Respondents were evenly distributed between mentees and mentors (53 vs. 55, p=0.768). In participant surveys, mentoring relationships were viewed to focus on research (45%), 'sticky situations' [e.g., communication, work-life balance] (27%), education (18%), or administrative issues (10%). Mentees were more focused on research and education vs. mentors (74% vs. 50%, p=0.040). Mentees felt that goals were 'always' or 'usually' met vs. mentors (89% vs. 77% p= 0.096). Two barriers to successful mentorship included time and communication, with most pairs communicating by email. Most respondents (91%) planned to continue the relationship beyond the EAST Mentoring Program and recommended the experience to colleagues.
CONCLUSIONS: Mentee satisfaction with the EAST Mentoring Program was high. Mentoring is a beneficial tool to promote success amongst EAST's young members, but differences exist between mentee and mentor perceptions. Revising communication expectations and time commitment to improve career development may help our young acute care surgeons.
LEVEL OF EVIDENCE: VSTUDY TYPE: Epidemiological.

PMID: 28452871 [PubMed - as supplied by publisher]

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Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Related Articles

Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Int Tinnitus J. 2017 Apr 19;20(2):83-87

Authors: Algieri GMA, Leonardi A, Arangio P, Vellone V, Paolo CD, Cascone P

Abstract
ABSTRACT: The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

PMID: 28452718 [PubMed - in process]

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Eocene paleoecology of Adapis parisiensis (Primate, Adapidae): From inner ear to lifestyle.

Related Articles

Eocene paleoecology of Adapis parisiensis (Primate, Adapidae): From inner ear to lifestyle.

Anat Rec (Hoboken). 2017 Apr 27;:

Authors: Bernardi M, Couette S

Abstract
European adapids, especially Adapis parisiensis, have been extensively studied over the past two centuries, essentially for taxonomic and phylogenetic purposes. Analyses of dental, cranial and postcranial morphology have led to various hypotheses about the diet, locomotion and lifestyle of this fossil primate species. As the morphology of Adapis parisiensis is not directly comparable to any extant species, some interpretations are still debated. The inner ear is crucial to several functional parameters, such as auditory acuity, balance, agility, orientation and head motion speed during locomotion. We examined the inner ear morphology of Adapis parisiensis in order to make some functional inferences, using μCT techniques to access the internal morphology without damaging the fossil specimens. We analyzed the length and shape of the cochlea, the size of the oval window, and the size and orientation of the semicircular canals of seven Adapis parisiensis crania. Results indicate that the species was more sensitive to high frequencies than low frequencies. Results for locomotion style are different, depending on the method used. Results about the coefficient of agility are in good agreement with previous studies, proposing a slow/medium slow locomotion for the fossil species. In contrast, angular velocity magnitude (AVM) results show a great range of variation in the locomotor repertory for Adapis parisiensis, probably indicating that the model used is not adapted to the study of the fossil record. A comparison to measurements of extant strepsirhines lead us to conclude that Adapis parisiensis was probably monogamous and solitary, with a small home range. This article is protected by copyright. All rights reserved.

PMID: 28452186 [PubMed - as supplied by publisher]

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Paying it forward: Four-year analysis of the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program.

Related Articles

Paying it forward: Four-year analysis of the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program.

J Trauma Acute Care Surg. 2017 Apr 27;:

Authors: Zakrison TL, Polk TM, Dixon R, Ekeh AP, Gross KR, Davis KA, Kurek SJ, Stassen NA, Patel MB

Abstract
BACKGROUND: Mentorship programs in surgery are utilized to overcome barriers to clinical and academic productivity, research success, and work-life balance. We sought to determine if the Eastern Association for the Surgery of Trauma (EAST) Mentoring Program has met its goals of fostering academic and personal growth in young acute care surgeons.
METHODS: We conducted a systematic program evaluation of EAST Mentoring Program's first four years. Demographic information was collected from EAST records, mentorship program applications, and mentee-mentor career development plans. We reviewed the career development plans for thematic commonalities and results of a structured, online questionnaire distributed since program inception. A mixed methods approach was used to better understand the program goals from both mentee and mentor perspectives, as well as attitudes and barriers regarding the perceived success of this career development program.
RESULTS: During 2012-2015, 65 mentoring dyads were paired and 60 completed the program. Of 184 surveys distributed, 108 were returned (57% response rate). Respondents were evenly distributed between mentees and mentors (53 vs. 55, p=0.768). In participant surveys, mentoring relationships were viewed to focus on research (45%), 'sticky situations' [e.g., communication, work-life balance] (27%), education (18%), or administrative issues (10%). Mentees were more focused on research and education vs. mentors (74% vs. 50%, p=0.040). Mentees felt that goals were 'always' or 'usually' met vs. mentors (89% vs. 77% p= 0.096). Two barriers to successful mentorship included time and communication, with most pairs communicating by email. Most respondents (91%) planned to continue the relationship beyond the EAST Mentoring Program and recommended the experience to colleagues.
CONCLUSIONS: Mentee satisfaction with the EAST Mentoring Program was high. Mentoring is a beneficial tool to promote success amongst EAST's young members, but differences exist between mentee and mentor perceptions. Revising communication expectations and time commitment to improve career development may help our young acute care surgeons.
LEVEL OF EVIDENCE: VSTUDY TYPE: Epidemiological.

PMID: 28452871 [PubMed - as supplied by publisher]

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Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Related Articles

Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

Int Tinnitus J. 2017 Apr 19;20(2):83-87

Authors: Algieri GMA, Leonardi A, Arangio P, Vellone V, Paolo CD, Cascone P

Abstract
ABSTRACT: The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

PMID: 28452718 [PubMed - in process]

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Eocene paleoecology of Adapis parisiensis (Primate, Adapidae): From inner ear to lifestyle.

Related Articles

Eocene paleoecology of Adapis parisiensis (Primate, Adapidae): From inner ear to lifestyle.

Anat Rec (Hoboken). 2017 Apr 27;:

Authors: Bernardi M, Couette S

Abstract
European adapids, especially Adapis parisiensis, have been extensively studied over the past two centuries, essentially for taxonomic and phylogenetic purposes. Analyses of dental, cranial and postcranial morphology have led to various hypotheses about the diet, locomotion and lifestyle of this fossil primate species. As the morphology of Adapis parisiensis is not directly comparable to any extant species, some interpretations are still debated. The inner ear is crucial to several functional parameters, such as auditory acuity, balance, agility, orientation and head motion speed during locomotion. We examined the inner ear morphology of Adapis parisiensis in order to make some functional inferences, using μCT techniques to access the internal morphology without damaging the fossil specimens. We analyzed the length and shape of the cochlea, the size of the oval window, and the size and orientation of the semicircular canals of seven Adapis parisiensis crania. Results indicate that the species was more sensitive to high frequencies than low frequencies. Results for locomotion style are different, depending on the method used. Results about the coefficient of agility are in good agreement with previous studies, proposing a slow/medium slow locomotion for the fossil species. In contrast, angular velocity magnitude (AVM) results show a great range of variation in the locomotor repertory for Adapis parisiensis, probably indicating that the model used is not adapted to the study of the fossil record. A comparison to measurements of extant strepsirhines lead us to conclude that Adapis parisiensis was probably monogamous and solitary, with a small home range. This article is protected by copyright. All rights reserved.

PMID: 28452186 [PubMed - as supplied by publisher]

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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Related Articles

Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Int J Audiol. 2017 Apr 27;:1-7

Authors: Rählmann S, Meis M, Schulte M, Kießling J, Walger M, Meister H

Abstract
OBJECTIVES: Model-based hearing aid development considers the assessment of speech recognition using a master hearing aid (MHA). It is known that aided speech recognition in noise is related to cognitive factors such as working memory capacity (WMC). This relationship might be mediated by hearing aid experience (HAE). The aim of this study was to examine the relationship of WMC and speech recognition with a MHA for listeners with different HAE.
DESIGN: Using the MHA, unaided and aided 80% speech recognition thresholds in noise were determined. Individual WMC capacity was assed using the Verbal Learning and Memory Test (VLMT) and the Reading Span Test (RST).
STUDY SAMPLE: Forty-nine hearing aid users with mild to moderate sensorineural hearing loss divided into three groups differing in HAE.
RESULTS: Whereas unaided speech recognition did not show a significant relationship with WMC, a significant correlation could be observed between WMC and aided speech recognition. However, this only applied to listeners with HAE of up to approximately three years, and a consistent weakening of the correlation could be observed with more experience.
CONCLUSIONS: Speech recognition scores obtained in acute experiments with an MHA are less influenced by individual cognitive capacity when experienced HA users are taken into account.

PMID: 28449597 [PubMed - as supplied by publisher]

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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Related Articles

Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Int J Audiol. 2017 Apr 27;:1-7

Authors: Rählmann S, Meis M, Schulte M, Kießling J, Walger M, Meister H

Abstract
OBJECTIVES: Model-based hearing aid development considers the assessment of speech recognition using a master hearing aid (MHA). It is known that aided speech recognition in noise is related to cognitive factors such as working memory capacity (WMC). This relationship might be mediated by hearing aid experience (HAE). The aim of this study was to examine the relationship of WMC and speech recognition with a MHA for listeners with different HAE.
DESIGN: Using the MHA, unaided and aided 80% speech recognition thresholds in noise were determined. Individual WMC capacity was assed using the Verbal Learning and Memory Test (VLMT) and the Reading Span Test (RST).
STUDY SAMPLE: Forty-nine hearing aid users with mild to moderate sensorineural hearing loss divided into three groups differing in HAE.
RESULTS: Whereas unaided speech recognition did not show a significant relationship with WMC, a significant correlation could be observed between WMC and aided speech recognition. However, this only applied to listeners with HAE of up to approximately three years, and a consistent weakening of the correlation could be observed with more experience.
CONCLUSIONS: Speech recognition scores obtained in acute experiments with an MHA are less influenced by individual cognitive capacity when experienced HA users are taken into account.

PMID: 28449597 [PubMed - as supplied by publisher]

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The reliability of the Adelaide in-shoe foot model

Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Chris Bishop, Susan Hillier, Dominic Thewlis
Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking.



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The reliability of the Adelaide in-shoe foot model

Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Chris Bishop, Susan Hillier, Dominic Thewlis
Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking.



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The reliability of the Adelaide in-shoe foot model

Publication date: July 2017
Source:Gait & Posture, Volume 56
Author(s): Chris Bishop, Susan Hillier, Dominic Thewlis
Understanding the biomechanics of the foot is essential for many areas of research and clinical practice such as orthotic interventions and footwear development. Despite the widespread attention paid to the biomechanics of the foot during gait, what largely remains unknown is how the foot moves inside the shoe. This study investigated the reliability of the Adelaide In-Shoe Foot Model, which was designed to quantify in-shoe foot kinematics and kinetics during walking. Intra-rater reliability was assessed in 30 participants over five walking trials whilst wearing shoes during two data collection sessions, separated by one week. Sufficient reliability for use was interpreted as a coefficient of multiple correlation and intra-class correlation coefficient of >0.61. Inter-rater reliability was investigated separately in a second sample of 10 adults by two researchers with experience in applying markers for the purpose of motion analysis. The results indicated good consistency in waveform estimation for most kinematic and kinetic data, as well as good inter-and intra-rater reliability. The exception is the peak medial ground reaction force, the minimum abduction angle and the peak abduction/adduction external hindfoot joint moments which resulted in less than acceptable repeatability. Based on our results, the Adelaide in-shoe foot model can be used with confidence for 24 commonly measured biomechanical variables during shod walking.



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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Related Articles

Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Int J Audiol. 2017 Apr 27;:1-7

Authors: Rählmann S, Meis M, Schulte M, Kießling J, Walger M, Meister H

Abstract
OBJECTIVES: Model-based hearing aid development considers the assessment of speech recognition using a master hearing aid (MHA). It is known that aided speech recognition in noise is related to cognitive factors such as working memory capacity (WMC). This relationship might be mediated by hearing aid experience (HAE). The aim of this study was to examine the relationship of WMC and speech recognition with a MHA for listeners with different HAE.
DESIGN: Using the MHA, unaided and aided 80% speech recognition thresholds in noise were determined. Individual WMC capacity was assed using the Verbal Learning and Memory Test (VLMT) and the Reading Span Test (RST).
STUDY SAMPLE: Forty-nine hearing aid users with mild to moderate sensorineural hearing loss divided into three groups differing in HAE.
RESULTS: Whereas unaided speech recognition did not show a significant relationship with WMC, a significant correlation could be observed between WMC and aided speech recognition. However, this only applied to listeners with HAE of up to approximately three years, and a consistent weakening of the correlation could be observed with more experience.
CONCLUSIONS: Speech recognition scores obtained in acute experiments with an MHA are less influenced by individual cognitive capacity when experienced HA users are taken into account.

PMID: 28449597 [PubMed - as supplied by publisher]

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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Related Articles

Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity.

Int J Audiol. 2017 Apr 27;:1-7

Authors: Rählmann S, Meis M, Schulte M, Kießling J, Walger M, Meister H

Abstract
OBJECTIVES: Model-based hearing aid development considers the assessment of speech recognition using a master hearing aid (MHA). It is known that aided speech recognition in noise is related to cognitive factors such as working memory capacity (WMC). This relationship might be mediated by hearing aid experience (HAE). The aim of this study was to examine the relationship of WMC and speech recognition with a MHA for listeners with different HAE.
DESIGN: Using the MHA, unaided and aided 80% speech recognition thresholds in noise were determined. Individual WMC capacity was assed using the Verbal Learning and Memory Test (VLMT) and the Reading Span Test (RST).
STUDY SAMPLE: Forty-nine hearing aid users with mild to moderate sensorineural hearing loss divided into three groups differing in HAE.
RESULTS: Whereas unaided speech recognition did not show a significant relationship with WMC, a significant correlation could be observed between WMC and aided speech recognition. However, this only applied to listeners with HAE of up to approximately three years, and a consistent weakening of the correlation could be observed with more experience.
CONCLUSIONS: Speech recognition scores obtained in acute experiments with an MHA are less influenced by individual cognitive capacity when experienced HA users are taken into account.

PMID: 28449597 [PubMed - as supplied by publisher]

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Singing Lessons for Respiratory Health: A Literature Review

Publication date: Available online 29 April 2017
Source:Journal of Voice
Author(s): Rachel B. Goldenberg
ObjectiveSeveral studies have explored the role of music and singing as a treatment for respiratory symptoms. The objective of this paper was to review the current body of literature in regard to the use of singing as both a physiological and a psychological therapy for respiratory disease and assess the role the singing teacher might play in this treatment.Study DesignThis is a literature review, discussion of results and directions for further research.MethodMultiple databases were searched using keywords such as “respiratory,” “physiotherapy,” and “pulmonary” in conjunction with “singing.” Studies that met selection criteria were summarized and analyzed.ResultsSeventeen studies pertaining to multiple conditions including chronic obstructive pulmonary disease, asthma, cystic fibrosis, cancer, Parkinson disease, quadriplegia, and multiple sclerosis were analyzed. All studies reported trends of positive physical and/or quality of life outcomes after a series of singing lessons, regardless of statistical significance. Several noted improvements in maximum expiratory pressure and overall breathing technique. Many studies included open-ended interviews revealing participants' perception of singing as an effective therapy that was fun, improved mood, taught breathing and breath control, was a good exercise for the lungs, and had improved physical functioning.ConclusionsSinging can be used as an adjunctive treatment for respiratory disease, with the best results occurring after long-term study. Group lessons and a strong teacher relationship feed the need for social interaction and support, which can facilitate treatment compliance. Further research is warranted.



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Two cell populations participate in clearance of damaged hair cells from the sensory epithelia of the inner ear

Publication date: Available online 28 April 2017
Source:Hearing Research
Author(s): Keiko Hirose, Mark A. Rutherford, Mark E. Warchol
The cochlea and the vestibular organs are populated by resident macrophages, but their role in inner ear maintenance and pathology is not entirely clear. Resident macrophages in other organs are responsible for phagocytosis of injured or infected cells, and it is likely that macrophages in the inner ear serve a similar role. Hair cell injury causes macrophages to accumulate within proximity of damaged regions of the inner ear, either by exiting the vasculature and entering the labyrinth or by the resident macrophages reorganizing themselves through local movement to the areas of injury. Direct evidence for macrophage engulfment of apoptotic hair cells has been observed in several conditions. Here, we review evidence for phagocytosis of damaged hair cells in the sensory epithelium by tissue macrophages in the published literature and in some new experiments that are presented here as original work. Several studies also suggest that macrophages are not the only phaogocytic cells in the inner ear, but that supporting cells of the sensory epithelium also play an important role in debris clearance. We describe the various ways in which the sensory epithelia of the inner ear are adapted to eliminate damaged and dying cells. A collaborative effort between resident and migratory macrophages as well as neighboring supporting cells results in the rapid and efficient clearance of cellular debris, even in cases where hair cell loss is rapid and complete.



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Two cell populations participate in clearance of damaged hair cells from the sensory epithelia of the inner ear

Publication date: Available online 28 April 2017
Source:Hearing Research
Author(s): Keiko Hirose, Mark A. Rutherford, Mark E. Warchol
The cochlea and the vestibular organs are populated by resident macrophages, but their role in inner ear maintenance and pathology is not entirely clear. Resident macrophages in other organs are responsible for phagocytosis of injured or infected cells, and it is likely that macrophages in the inner ear serve a similar role. Hair cell injury causes macrophages to accumulate within proximity of damaged regions of the inner ear, either by exiting the vasculature and entering the labyrinth or by the resident macrophages reorganizing themselves through local movement to the areas of injury. Direct evidence for macrophage engulfment of apoptotic hair cells has been observed in several conditions. Here, we review evidence for phagocytosis of damaged hair cells in the sensory epithelium by tissue macrophages in the published literature and in some new experiments that are presented here as original work. Several studies also suggest that macrophages are not the only phaogocytic cells in the inner ear, but that supporting cells of the sensory epithelium also play an important role in debris clearance. We describe the various ways in which the sensory epithelia of the inner ear are adapted to eliminate damaged and dying cells. A collaborative effort between resident and migratory macrophages as well as neighboring supporting cells results in the rapid and efficient clearance of cellular debris, even in cases where hair cell loss is rapid and complete.



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Two cell populations participate in clearance of damaged hair cells from the sensory epithelia of the inner ear

Publication date: Available online 28 April 2017
Source:Hearing Research
Author(s): Keiko Hirose, Mark A. Rutherford, Mark E. Warchol
The cochlea and the vestibular organs are populated by resident macrophages, but their role in inner ear maintenance and pathology is not entirely clear. Resident macrophages in other organs are responsible for phagocytosis of injured or infected cells, and it is likely that macrophages in the inner ear serve a similar role. Hair cell injury causes macrophages to accumulate within proximity of damaged regions of the inner ear, either by exiting the vasculature and entering the labyrinth or by the resident macrophages reorganizing themselves through local movement to the areas of injury. Direct evidence for macrophage engulfment of apoptotic hair cells has been observed in several conditions. Here, we review evidence for phagocytosis of damaged hair cells in the sensory epithelium by tissue macrophages in the published literature and in some new experiments that are presented here as original work. Several studies also suggest that macrophages are not the only phaogocytic cells in the inner ear, but that supporting cells of the sensory epithelium also play an important role in debris clearance. We describe the various ways in which the sensory epithelia of the inner ear are adapted to eliminate damaged and dying cells. A collaborative effort between resident and migratory macrophages as well as neighboring supporting cells results in the rapid and efficient clearance of cellular debris, even in cases where hair cell loss is rapid and complete.



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Two cell populations participate in clearance of damaged hair cells from the sensory epithelia of the inner ear

Publication date: Available online 28 April 2017
Source:Hearing Research
Author(s): Keiko Hirose, Mark A. Rutherford, Mark E. Warchol
The cochlea and the vestibular organs are populated by resident macrophages, but their role in inner ear maintenance and pathology is not entirely clear. Resident macrophages in other organs are responsible for phagocytosis of injured or infected cells, and it is likely that macrophages in the inner ear serve a similar role. Hair cell injury causes macrophages to accumulate within proximity of damaged regions of the inner ear, either by exiting the vasculature and entering the labyrinth or by the resident macrophages reorganizing themselves through local movement to the areas of injury. Direct evidence for macrophage engulfment of apoptotic hair cells has been observed in several conditions. Here, we review evidence for phagocytosis of damaged hair cells in the sensory epithelium by tissue macrophages in the published literature and in some new experiments that are presented here as original work. Several studies also suggest that macrophages are not the only phaogocytic cells in the inner ear, but that supporting cells of the sensory epithelium also play an important role in debris clearance. We describe the various ways in which the sensory epithelia of the inner ear are adapted to eliminate damaged and dying cells. A collaborative effort between resident and migratory macrophages as well as neighboring supporting cells results in the rapid and efficient clearance of cellular debris, even in cases where hair cell loss is rapid and complete.



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Two cell populations participate in clearance of damaged hair cells from the sensory epithelia of the inner ear

Publication date: Available online 28 April 2017
Source:Hearing Research
Author(s): Keiko Hirose, Mark A. Rutherford, Mark E. Warchol
The cochlea and the vestibular organs are populated by resident macrophages, but their role in inner ear maintenance and pathology is not entirely clear. Resident macrophages in other organs are responsible for phagocytosis of injured or infected cells, and it is likely that macrophages in the inner ear serve a similar role. Hair cell injury causes macrophages to accumulate within proximity of damaged regions of the inner ear, either by exiting the vasculature and entering the labyrinth or by the resident macrophages reorganizing themselves through local movement to the areas of injury. Direct evidence for macrophage engulfment of apoptotic hair cells has been observed in several conditions. Here, we review evidence for phagocytosis of damaged hair cells in the sensory epithelium by tissue macrophages in the published literature and in some new experiments that are presented here as original work. Several studies also suggest that macrophages are not the only phaogocytic cells in the inner ear, but that supporting cells of the sensory epithelium also play an important role in debris clearance. We describe the various ways in which the sensory epithelia of the inner ear are adapted to eliminate damaged and dying cells. A collaborative effort between resident and migratory macrophages as well as neighboring supporting cells results in the rapid and efficient clearance of cellular debris, even in cases where hair cell loss is rapid and complete.



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Altered spatiotemporal characteristics of gait in older adults with chronic low back pain

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Gregory E Hicks, J. Megan Sions, Peter C. Coyle, Ryan T. Pohlig
Previous studies in older adults have identified that chronic low back pain (CLBP) is associated with slower gait speed. Given that slower gait speed is a predictor of greater morbidity and mortality among older adults, it is important to understand the underlying spatiotemporal characteristics of gait among older adults with CLBP. The purposes of this study were to determine (1) if there are differences in spatiotemporal parameters of gait between older adults with and without CLBP during self-selected and fast walking and (2) whether any of these gait characteristics are correlated with performance of a challenging walking task, e.g. stair negotiation. Spatiotemporal characteristics of gait were evaluated using a computerized walkway in 54 community-dwelling older adults with CLBP and 54 age- and sex-matched healthy controls. Older adults with CLBP walked slower than their pain-free peers during self-selected and fast walking. After controlling for body mass index and gait speed, step width was significantly greater in the CLBP group during the fast walking condition. Within the CLBP group, step width and double limb support time are significantly correlated with stair ascent/descent times. From a clinical perspective, these gait characteristics, which may be indicative of balance performance, may need to be addressed to improve overall gait speed, as well as stair-climbing performance. Future longitudinal studies confirming our findings are needed, as well as investigations focused on developing interventions to improve gait speed and decrease subsequent risk of mobility decline.



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Wearable lower limb haptic feedback device for retraining Foot Progression Angle and Step Width

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Daniel K.Y. Chen, Markus Haller, Thor F. Besier
Technological developments in the last decade have enabled the integration of sensors and actuators into wearable devices for gait interventions to slow the progression of knee osteoarthritis. Wearable haptic gait retraining is one area which has seen promising results for informing modifications of gait parameters for reducing knee adduction moments (KAM) during walking. Two gait parameters which can be easily adjusted to influence KAM include foot progression angle (FPA) and step width (SW). The purpose of this study was to: (1) determine whether a custom haptic ankle bracelet using binary vibrotactile and tactile apparent movement feedback could retrain ten healthy subjects to walk with a modified FPA and SW within a short training session with 80% accuracy; and (2) whether there was a difference between the number of steps required to complete the retraining task based on the two feedback schemes being tested. Retraining multiple gait parameters using a single device was a novel aspect of this work and we found that nine out of ten subjects were able to retrain their gait using the ankle bracelet in both feedback schemes to within 2° and 39mm of target FPA and SW respectively. We also found no difference in the number steps required for completion between the two schemes (p>0.05). Future research will investigate the device performance with patients with knee osteoarthritis and the effective change in KAM by modifying a combination of FPA and SW.



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Altered spatiotemporal characteristics of gait in older adults with chronic low back pain

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Gregory E Hicks, J. Megan Sions, Peter C. Coyle, Ryan T. Pohlig
Previous studies in older adults have identified that chronic low back pain (CLBP) is associated with slower gait speed. Given that slower gait speed is a predictor of greater morbidity and mortality among older adults, it is important to understand the underlying spatiotemporal characteristics of gait among older adults with CLBP. The purposes of this study were to determine (1) if there are differences in spatiotemporal parameters of gait between older adults with and without CLBP during self-selected and fast walking and (2) whether any of these gait characteristics are correlated with performance of a challenging walking task, e.g. stair negotiation. Spatiotemporal characteristics of gait were evaluated using a computerized walkway in 54 community-dwelling older adults with CLBP and 54 age- and sex-matched healthy controls. Older adults with CLBP walked slower than their pain-free peers during self-selected and fast walking. After controlling for body mass index and gait speed, step width was significantly greater in the CLBP group during the fast walking condition. Within the CLBP group, step width and double limb support time are significantly correlated with stair ascent/descent times. From a clinical perspective, these gait characteristics, which may be indicative of balance performance, may need to be addressed to improve overall gait speed, as well as stair-climbing performance. Future longitudinal studies confirming our findings are needed, as well as investigations focused on developing interventions to improve gait speed and decrease subsequent risk of mobility decline.



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Wearable lower limb haptic feedback device for retraining Foot Progression Angle and Step Width

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Daniel K.Y. Chen, Markus Haller, Thor F. Besier
Technological developments in the last decade have enabled the integration of sensors and actuators into wearable devices for gait interventions to slow the progression of knee osteoarthritis. Wearable haptic gait retraining is one area which has seen promising results for informing modifications of gait parameters for reducing knee adduction moments (KAM) during walking. Two gait parameters which can be easily adjusted to influence KAM include foot progression angle (FPA) and step width (SW). The purpose of this study was to: (1) determine whether a custom haptic ankle bracelet using binary vibrotactile and tactile apparent movement feedback could retrain ten healthy subjects to walk with a modified FPA and SW within a short training session with 80% accuracy; and (2) whether there was a difference between the number of steps required to complete the retraining task based on the two feedback schemes being tested. Retraining multiple gait parameters using a single device was a novel aspect of this work and we found that nine out of ten subjects were able to retrain their gait using the ankle bracelet in both feedback schemes to within 2° and 39mm of target FPA and SW respectively. We also found no difference in the number steps required for completion between the two schemes (p>0.05). Future research will investigate the device performance with patients with knee osteoarthritis and the effective change in KAM by modifying a combination of FPA and SW.



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Altered spatiotemporal characteristics of gait in older adults with chronic low back pain

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Gregory E Hicks, J. Megan Sions, Peter C. Coyle, Ryan T. Pohlig
Previous studies in older adults have identified that chronic low back pain (CLBP) is associated with slower gait speed. Given that slower gait speed is a predictor of greater morbidity and mortality among older adults, it is important to understand the underlying spatiotemporal characteristics of gait among older adults with CLBP. The purposes of this study were to determine (1) if there are differences in spatiotemporal parameters of gait between older adults with and without CLBP during self-selected and fast walking and (2) whether any of these gait characteristics are correlated with performance of a challenging walking task, e.g. stair negotiation. Spatiotemporal characteristics of gait were evaluated using a computerized walkway in 54 community-dwelling older adults with CLBP and 54 age- and sex-matched healthy controls. Older adults with CLBP walked slower than their pain-free peers during self-selected and fast walking. After controlling for body mass index and gait speed, step width was significantly greater in the CLBP group during the fast walking condition. Within the CLBP group, step width and double limb support time are significantly correlated with stair ascent/descent times. From a clinical perspective, these gait characteristics, which may be indicative of balance performance, may need to be addressed to improve overall gait speed, as well as stair-climbing performance. Future longitudinal studies confirming our findings are needed, as well as investigations focused on developing interventions to improve gait speed and decrease subsequent risk of mobility decline.



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Wearable lower limb haptic feedback device for retraining Foot Progression Angle and Step Width

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Daniel K.Y. Chen, Markus Haller, Thor F. Besier
Technological developments in the last decade have enabled the integration of sensors and actuators into wearable devices for gait interventions to slow the progression of knee osteoarthritis. Wearable haptic gait retraining is one area which has seen promising results for informing modifications of gait parameters for reducing knee adduction moments (KAM) during walking. Two gait parameters which can be easily adjusted to influence KAM include foot progression angle (FPA) and step width (SW). The purpose of this study was to: (1) determine whether a custom haptic ankle bracelet using binary vibrotactile and tactile apparent movement feedback could retrain ten healthy subjects to walk with a modified FPA and SW within a short training session with 80% accuracy; and (2) whether there was a difference between the number of steps required to complete the retraining task based on the two feedback schemes being tested. Retraining multiple gait parameters using a single device was a novel aspect of this work and we found that nine out of ten subjects were able to retrain their gait using the ankle bracelet in both feedback schemes to within 2° and 39mm of target FPA and SW respectively. We also found no difference in the number steps required for completion between the two schemes (p>0.05). Future research will investigate the device performance with patients with knee osteoarthritis and the effective change in KAM by modifying a combination of FPA and SW.



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Cochlear Celebrates Better Hearing and Speech Month

Cochlear (http://ift.tt/2oInAXh) has launched its annual Million Ear Challenge to raise hearing loss awareness in May, which is also Better Hearing and Speech Month. The company is inviting people to share what they would miss if they woke up in a world without sound through social media with the hashtag #MillionEar. Tony Manna, president of Cochlear Americas, said, "With hearing loss becoming more common as younger people lose hearing due to noise exposure and as baby boomers age, efforts like our #MillionEar Challenge are even more important to raising awareness."

The goal of the initiative is to reach 2 million people in 31 days. When that target is met, Cochlear will celebrate by donating to Hearing Charities of America (HCOA) and the Cochlear Implant Awareness Foundation (CIAF) to help support people with hearing loss. Steven Murphy, executive director of HOCA, said many people live in isolation because of hearing loss, which separates them from people around them and negatively affects their quality of life. "In a majority of cases, technology can solve this problem," Murphy said. "The support from Cochlear's #MillionEar Challenge will help Hearing Charities increase the number of people who receive life-changing hearing assistive devices.

​Cochlear will announce their charitable donation on June 1 through social media. Additional activities surrounding the Million Ear Challenge can be found on the campaign's website (http://ift.tt/2oV6DVt). 

Published: 4/28/2017 1:23:00 PM

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Cochlear Celebrates Better Hearing and Speech Month

Cochlear (http://ift.tt/2oInAXh) has launched its annual Million Ear Challenge to raise hearing loss awareness in May, which is also Better Hearing and Speech Month. The company is inviting people to share what they would miss if they woke up in a world without sound through social media with the hashtag #MillionEar. Tony Manna, president of Cochlear Americas, said, "With hearing loss becoming more common as younger people lose hearing due to noise exposure and as baby boomers age, efforts like our #MillionEar Challenge are even more important to raising awareness."

The goal of the initiative is to reach 2 million people in 31 days. When that target is met, Cochlear will celebrate by donating to Hearing Charities of America (HCOA) and the Cochlear Implant Awareness Foundation (CIAF) to help support people with hearing loss. Steven Murphy, executive director of HOCA, said many people live in isolation because of hearing loss, which separates them from people around them and negatively affects their quality of life. "In a majority of cases, technology can solve this problem," Murphy said. "The support from Cochlear's #MillionEar Challenge will help Hearing Charities increase the number of people who receive life-changing hearing assistive devices.

​Cochlear will announce their charitable donation on June 1 through social media. Additional activities surrounding the Million Ear Challenge can be found on the campaign's website (http://ift.tt/2oV6DVt). 

Published: 4/28/2017 1:23:00 PM

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via IFTTT

Cochlear Celebrates Better Hearing and Speech Month

Cochlear (http://ift.tt/2oInAXh) has launched its annual Million Ear Challenge to raise hearing loss awareness in May, which is also Better Hearing and Speech Month. The company is inviting people to share what they would miss if they woke up in a world without sound through social media with the hashtag #MillionEar. Tony Manna, president of Cochlear Americas, said, "With hearing loss becoming more common as younger people lose hearing due to noise exposure and as baby boomers age, efforts like our #MillionEar Challenge are even more important to raising awareness."

The goal of the initiative is to reach 2 million people in 31 days. When that target is met, Cochlear will celebrate by donating to Hearing Charities of America (HCOA) and the Cochlear Implant Awareness Foundation (CIAF) to help support people with hearing loss. Steven Murphy, executive director of HOCA, said many people live in isolation because of hearing loss, which separates them from people around them and negatively affects their quality of life. "In a majority of cases, technology can solve this problem," Murphy said. "The support from Cochlear's #MillionEar Challenge will help Hearing Charities increase the number of people who receive life-changing hearing assistive devices.

​Cochlear will announce their charitable donation on June 1 through social media. Additional activities surrounding the Million Ear Challenge can be found on the campaign's website (http://ift.tt/2oV6DVt). 

Published: 4/28/2017 1:23:00 PM

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The Effect of a Vocal Loading Test on Cough and Phonation in Patients With Chronic Cough

Publication date: Available online 28 April 2017
Source:Journal of Voice
Author(s): Anne E. Vertigan, Sarah M. Kapela, Ingolf Franke, Peter G. Gibson
Objective/HypothesisTalking is a significant trigger for cough in patients with chronic cough; however, the stimulus required to trigger cough has not been quantified. The aim of this study was to examine the effect of a vocal loading task on phonation and cough behavior in patients with chronic cough and identify change following therapy.Study DesignThis is a prospective observational study.MethodsThis study involved 33 patients with chronic cough. Participants were assessed with the lingWAVES Vocal Loading Test protocol before and after intervention for chronic cough.ResultsAt baseline, almost 40% of patients had impaired vocal function and were unable to complete the vocal loading test. This improved following therapy, with 94% of patients being able to complete the test at follow-up. There was difficulty maintaining phonation, with 60% of the task unvoiced at baseline. This improved following therapy. The vocal loading test triggered coughing in 58% of patients; however, this improved following intervention. Acoustic measures during the vocal loading test did not change following therapy.ConclusionPhonation is an important trigger for cough. Patients with chronic cough demonstrated impaired performance on tests of vocal loading. Most parameters improved following therapy.



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Funciones ejecutivas y trastornos del lenguaje: Implicaciones para la evaluación y la intervención

Publication date: April–June 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 2
Author(s): Sergio Hernández Expósito




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Funciones ejecutivas y trastornos del lenguaje: Implicaciones para la evaluación y la intervención

Publication date: April–June 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 2
Author(s): Sergio Hernández Expósito




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Funciones ejecutivas y trastornos del lenguaje: Implicaciones para la evaluación y la intervención

Publication date: April–June 2017
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 2
Author(s): Sergio Hernández Expósito




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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

.


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Analysis of gait symmetry during over-ground walking in children with autism spectrum disorder

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Jeffrey D. Eggleston, John R. Harry, Robbin A. Hickman, Janet S. Dufek
Gait symmetry is utilized as an indicator of neurologic function. Healthy gait often exhibits minimal asymmetries, while pathological gait exhibits exaggerated asymmetries. The purpose of this study was to examine symmetry of mechanical gait parameters during over-ground walking in children with Autism Spectrum Disorder (ASD). Kinematic and kinetic data were obtained from 10 children (aged 5–12 years) with ASD. The Model Statistic procedure (α=0.05) was used to compare gait related parameters between limbs. Analysis revealed children with ASD exhibit significant lower extremity joint position and ground reaction force asymmetries throughout the gait cycle. The observed asymmetries were unique for each subject. These data do not support previous research relative to gait symmetry in children with ASD. Many individuals with ASD do not receive physical therapy interventions, however, precision medicine based interventions emphasizing lower extremity asymmetries may improve gait function and improve performance during activities of daily living.



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Postural control strategies differ in normal weight and overweight infants

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Danae Dinkel, Kailey Snyder, Victoria Molfese, Anastasia Kyvelidou
BackgroundEvidence suggests obesity can have a negative influence on a child’s motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting.ObjectiveThe purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting.Methods29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infant’s length and weight were measured at 3 months of age (visit 1). Infant’s center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions).ResultsOverweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period.ConclusionsThese findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.



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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

.


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Analysis of gait symmetry during over-ground walking in children with autism spectrum disorder

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Jeffrey D. Eggleston, John R. Harry, Robbin A. Hickman, Janet S. Dufek
Gait symmetry is utilized as an indicator of neurologic function. Healthy gait often exhibits minimal asymmetries, while pathological gait exhibits exaggerated asymmetries. The purpose of this study was to examine symmetry of mechanical gait parameters during over-ground walking in children with Autism Spectrum Disorder (ASD). Kinematic and kinetic data were obtained from 10 children (aged 5–12 years) with ASD. The Model Statistic procedure (α=0.05) was used to compare gait related parameters between limbs. Analysis revealed children with ASD exhibit significant lower extremity joint position and ground reaction force asymmetries throughout the gait cycle. The observed asymmetries were unique for each subject. These data do not support previous research relative to gait symmetry in children with ASD. Many individuals with ASD do not receive physical therapy interventions, however, precision medicine based interventions emphasizing lower extremity asymmetries may improve gait function and improve performance during activities of daily living.



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Postural control strategies differ in normal weight and overweight infants

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Danae Dinkel, Kailey Snyder, Victoria Molfese, Anastasia Kyvelidou
BackgroundEvidence suggests obesity can have a negative influence on a child’s motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting.ObjectiveThe purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting.Methods29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infant’s length and weight were measured at 3 months of age (visit 1). Infant’s center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions).ResultsOverweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period.ConclusionsThese findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.



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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

.


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Analysis of gait symmetry during over-ground walking in children with autism spectrum disorder

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Jeffrey D. Eggleston, John R. Harry, Robbin A. Hickman, Janet S. Dufek
Gait symmetry is utilized as an indicator of neurologic function. Healthy gait often exhibits minimal asymmetries, while pathological gait exhibits exaggerated asymmetries. The purpose of this study was to examine symmetry of mechanical gait parameters during over-ground walking in children with Autism Spectrum Disorder (ASD). Kinematic and kinetic data were obtained from 10 children (aged 5–12 years) with ASD. The Model Statistic procedure (α=0.05) was used to compare gait related parameters between limbs. Analysis revealed children with ASD exhibit significant lower extremity joint position and ground reaction force asymmetries throughout the gait cycle. The observed asymmetries were unique for each subject. These data do not support previous research relative to gait symmetry in children with ASD. Many individuals with ASD do not receive physical therapy interventions, however, precision medicine based interventions emphasizing lower extremity asymmetries may improve gait function and improve performance during activities of daily living.



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Postural control strategies differ in normal weight and overweight infants

Publication date: June 2017
Source:Gait & Posture, Volume 55
Author(s): Danae Dinkel, Kailey Snyder, Victoria Molfese, Anastasia Kyvelidou
BackgroundEvidence suggests obesity can have a negative influence on a child’s motor development and postural control behavior. Little research has examined the impact of infant weight on gross motor behavior, particularly postural control at the onset of sitting.ObjectiveThe purpose of this study was to determine whether normal weight and overweight infants differed in their postural control strategies at the onset of sitting and one-month post onset of sitting.Methods29 infants (n=19 normal weight, n=10 overweight) were recruited to participate in this study. Infant’s length and weight were measured at 3 months of age (visit 1). Infant’s center of pressure (COP) was measured on an AMTI force platform at the onset of sitting (visit 2) and one-month post onset (visit 3). Data were analyzed using linear measures (range and RMS for the anterior/posterior (AP) and medial/lateral (ML) directions, sway path) and nonlinear measures (Sample Entropy in AP and ML directions).ResultsOverweight infants had significantly greater RMS values in the ML direction at visit 2 and reduced Sway Path values in comparison to normal weight infants at visits 2 and 3. Further, there was a significant difference in Sample Entropy as overweight infants increased Sample Entropy from visit 2 to 3 while normal weight infants decreased Sample Entropy values during this time period.ConclusionsThese findings suggest that overweight infants adopt a different postural control strategy. This altered strategy may limit exploration early in development. More research is needed to determine if longitudinal differences continue to emerge.



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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

.


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Assessment of hearing aid algorithms using a master hearing aid: the influence of hearing aid experience on the relationship between speech recognition and cognitive capacity

.


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Few researchers consider hearing loss in healthcare communication: Study

Doctors believe that communication with their patients is important, but most studies of physician/elderly patient communication do not mention that hearing loss may affect this interaction.

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Few researchers consider hearing loss in healthcare communication: Study

Doctors believe that communication with their patients is important, but most studies of physician/elderly patient communication do not mention that hearing loss may affect this interaction.

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Few researchers consider hearing loss in healthcare communication: Study

Doctors believe that communication with their patients is important, but most studies of physician/elderly patient communication do not mention that hearing loss may affect this interaction.

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Electrocochleography in Cochlear Implant Recipients With Residual Hearing: Comparison With Audiometric Thresholds

Objectives: To determine whether electrocochleography (ECoG) thresholds, especially cochlear microphonic and auditory nerve neurophonic thresholds, measured using an intracochlear electrode, can be used to predict pure-tone audiometric thresholds following cochlear implantation in ears with residual hearing. Design: Pure-tone audiometric thresholds and ECoG waveforms were measured at test frequencies from 125 to 4000 Hz in 21 Advanced Bionics cochlear implant recipients with residual hearing in the implanted ear. The “difference” and “summation” responses were computed from the ECoG waveforms measured from two alternating phases of stimulation. The interpretation is that difference responses are largely from the cochlear microphonic while summating responses are largely from the auditory nerve neurophonic. The pure-tone audiometric thresholds were also measured with same equipment used for ECoG measurements. Results: Difference responses were observed in all 21 implanted ears, whereas summation response waveforms were observed in only 18 ears. The ECoG thresholds strongly correlated (r2 = 0.87, n = 150 for difference response; r2 = 0.82, n = 72 for summation response) with audiometric thresholds. The mean difference between the difference response and audiometric thresholds was −3.2 (±9.0) dB, while the mean difference between summation response and audiometric thresholds was −14 (±11) dB. In four out of 37 measurements, difference responses were measured to frequencies where no behavioral thresholds were present. Conclusions: ECoG thresholds may provide a useful metric for the assessment of residual hearing in cochlear implant subjects for whom it is not possible to perform behavioral audiometric testing.

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The Effect of Interaural Mismatches on Contralateral Unmasking With Single-Sided Vocoders

Objectives: Cochlear-implant (CI) users with single-sided deafness (SSD)—that is, one normal-hearing (NH) ear and one CI ear—can obtain some unmasking benefits when a mixture of target and masking voices is presented to the NH ear and a copy of just the masking voices is presented to the CI ear. NH listeners show similar benefits in a simulation of SSD-CI listening, whereby a mixture of target and masking voices is presented to one ear and a vocoded copy of the masking voices is presented to the opposite ear. However, the magnitude of the benefit for SSD-CI listeners is highly variable across individuals and is on average less than for NH listeners presented with vocoded stimuli. One possible explanation for the limited benefit observed for some SSD-CI users is that temporal and spectral discrepancies between the acoustic and electric ears might interfere with contralateral unmasking. The present study presented vocoder simulations to NH participants to examine the effects of interaural temporal and spectral mismatches on contralateral unmasking. Design: Speech-reception performance was measured in a competing-talker paradigm for NH listeners presented with vocoder simulations of SSD-CI listening. In the monaural condition, listeners identified target speech masked by two same-gender interferers, presented to the left ear. In the bilateral condition, the same stimuli were presented to the left ear, but the right ear was presented with a noise-vocoded copy of the interfering voices. This paradigm tested whether listeners could integrate the interfering voices across the ears to better hear the monaural target. Three common distortions inherent in CI processing were introduced to the vocoder processing: spectral shifts, temporal delays, and reduced frequency selectivity. Results: In experiment 1, contralateral unmasking (i.e., the benefit from adding the vocoded maskers to the second ear) was impaired by spectral mismatches of four equivalent rectangular bandwidths or greater. This is equivalent to roughly a 3.6-mm mismatch between the cochlear places stimulated in the electric and acoustic ears, which is on the low end of the average expected mismatch for SSD-CI listeners. In experiment 2, performance was negatively affected by a temporal mismatch of 24 ms or greater, but not for mismatches in the 0 to 12 ms range expected for SSD-CI listeners. Experiment 3 showed an interaction between spectral shift and spectral resolution, with less effect of interaural spectral mismatches when the number of vocoder channels was reduced. Experiment 4 applied interaural spectral and temporal mismatches in combination. Performance was best when both frequency and timing were aligned, but in cases where a mismatch was present in one dimension (either frequency or latency), the addition of mismatch in the second dimension did not further disrupt performance. Conclusions: These results emphasize the need for interaural alignment—in timing and especially in frequency—to maximize contralateral unmasking for NH listeners presented with vocoder simulations of SSD-CI listening. Improved processing strategies that reduce mismatch between the electric and acoustic ears of SSD-CI listeners might improve their ability to obtain binaural benefits in multitalker environments.

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Long-Term Synergistic Interaction of Cisplatin- and Noise-Induced Hearing Losses

Objective: Past experiments in the literature have shown that cisplatin interacts synergistically with noise to create hearing loss. Much of the previous work on the synergistic interaction of noise and cisplatin tested exposures that occurred very close together in time. The present study assessed whether rats that have been exposed to cisplatin continue to show increased susceptibility to noise-induced hearing loss months after conclusion of the cisplatin exposure. Design: Thirty-two Fischer 344/NHsd rats were exposed to one of five conditions: (1) cisplatin exposure followed by immediate cochlear tissue harvest, (2) cisplatin exposure and a 20-week monitoring period before tissue harvest, (3) cisplatin exposure followed immediately by noise exposure, (4) cisplatin exposure followed by noise exposure 16 weeks later, and (5) noise exposure without cisplatin exposure. The cisplatin exposure was an 8-week interval in which cisplatin was given every 2 weeks. Cochlear injury was evaluated using auditory brainstem response thresholds, P1 wave amplitudes, and postmortem outer hair cell counts. Results: The 8-week cisplatin exposure induced little threshold shift or P1 amplitude loss, and a small lesion of missing outer hair cells in the basal half of the cochlea. The rats exposed to noise immediately after the cisplatin exposure interval showed a synergistic interaction of cisplatin and noise. The group exposed to noise 16 weeks after the cisplatin exposure interval also showed more severe threshold shift and outer hair cell loss than control subjects. The controls exposed to cisplatin and monitored for 20 weeks showed little threshold shift or outer hair cell loss, but did show P1 wave amplitude changes over the 20-week monitoring period. Conclusions: The results from the groups exposed to cisplatin followed by noise, combined with the findings from the cisplatin- and noise-only groups, suggest that the cisplatin induced cochlear injuries that were not severe enough to result in threshold shift, but left the cochlea in a state of heightened susceptibility to future injury. The heightened susceptibility to noise injury was still present 16 weeks after the conclusion of the cisplatin exposure.

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Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review

Objectives: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension? Design: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects. Results: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort. Conclusion: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.

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Prevalence, Incidence Proportion, and Heritability for Tinnitus: A Longitudinal Twin Study

Objectives: The purpose of this longitudinal twin study was to explore the effect of tinnitus on hearing thresholds and threshold shifts over two decades and to investigate the genetic contribution to tinnitus in a male twin cohort (n = 1114 at baseline and 583 at follow-up). The hypothesis was that participants with faster hearing deterioration had a higher risk for developing tinnitus and there is an underlying role of genetic influences on tinnitus. Design: Male mono- and dizygotic twin pairs, born between 1914 and 1958 were included. Mixed models were used for comparison of hearing threshold shifts, adjusted for age. A co-twin comparison was made within pairs discordant for tinnitus. The relative influence of genetic and environmental factors was estimated by genetic modeling. Results: The overall prevalence of tinnitus was 13.5% at baseline ( age 50) and 34.4% at follow-up ( age 67). The overall incidence proportion was 27.8%. Participants who reported tinnitus at baseline or at both time points were older. At baseline, the hearing thresholds differed between tinnitus cases and controls at all frequencies. New tinnitus cases at follow-up had the greatest hearing threshold shift at the high-frequency area compared with the control group. Within pairs, the tinnitus twin had poorer hearing than his unaffected co-twin, more so for dizygotic than monozygotic twin pairs. The relative proportion of additive genetic factors was approximately 0.40 at both time points, and the influence of individual-specific environment was 0.56 to 0.61. The influence of genetic factors on tinnitus was largely independent of genetic factors for hearing thresholds. Conclusions: Our hypotheses were confirmed: The fastest hearing deterioration occurred for new tinnitus cases. A moderate genetic influence for tinnitus was confirmed.

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Response to Letter to the Editor: RE: Henry, J.A., Frederick, M., Sell, S, Griest, S., Abrams, H. (2015) Validation of a Novel Combination Hearing Aid and Tinnitus Therapy Device, Ear Hear, 36(1): 42–52

No abstract available

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Sequential Bilateral Cochlear Implantation in Children: Outcome of the Second Implant and Long-Term Use

Objectives: The aim of this retrospective cohort study was to assess speech perception outcomes of second-side cochlear implants (CI2) relative to first-side implants (CI1) in 160 participants who received their CI1 as a child. The predictive factors of CI2 speech perception outcomes were investigated. In addition, CI2 device use predictive models were assessed using the categorical variable of participant’s decision to use CI2 for a minimum of 5 years after surgery. Findings from a prospective study that evaluated the bilateral benefit for speech recognition in noise in a participant subgroup (n = 29) are also presented. Design: Participants received CI2 between 2003 and 2009 (and CI1 between 1988 and 2008), and were observed from surgery to a minimum of 5 years after sequential surgery. Group A (n = 110) comprised prelingually deaf children (severe to profound) with no or little acquired oral language before implantation, while group B (n = 50) comprised prelingually deaf children with acquired language before implantation, in addition to perilingually and postlingually deaf children. Speech perception outcomes included the monosyllable test score or the closed-set Early Speech Perception test score if the monosyllable test was too difficult. To evaluate bilateral benefit for speech recognition in noise, participants were tested with the Hearing in Noise test in bilateral and “best CI” test conditions with noise from the front and noise from either side. Bilateral advantage was calculated by subtracting the Hearing in Noise test speech reception thresholds in noise obtained in the bilateral listening mode from those obtained in the unilateral “best CI” mode. Results: On average, CI1 speech perception was 28% better than CI2 performance in group A, the same difference was 20% in group B. A small bilateral speech perception benefit of using CI2 was measured, 3% in group A and 7% in group B. Longer interimplant interval predicted poorer CI2 speech perception in group A, but only for those who did not use a hearing aid in the interimplant interval in group B. At least 5 years after surgery, 25% of group A and 10% of group B did not use CI2. In group A, prediction factors for nonuse of CI2 were longer interimplant intervals or CI2 age. Large difference in speech perception between the two sides was a predictor for CI2 nonuse in both groups. Bilateral advantage for speech recognition in noise was mainly obtained for the condition with noise near the “best CI”; the addition of a second CI offered a new head shadow benefit. A small mean disadvantage was measured when the noise was located opposite to the “best CI.” However, the latter was not significant. Conclusions: Generally, in both groups, if CI2 did not become comparable with CI1, participants were more likely to choose not to use CI2 after some time. In group A, increased interimplant intervals predicted poorer CI2 speech perception results and increased the risk of not using CI2 at a later date. Bilateral benefit was mainly obtained when noise was opposite to CI2, introducing a new head shadow benefit.

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Effect of Context and Hearing Loss on Time-Gated Word Recognition in Children

Objectives: The purpose of this study was to examine word recognition in children who are hard of hearing (CHH) and children with normal hearing (CNH) in response to time-gated words presented in high- versus low-predictability sentences (HP, LP), where semantic cues were manipulated. Findings inform our understanding of how CHH combine cognitive-linguistic and acoustic-phonetic cues to support spoken word recognition. It was hypothesized that both groups of children would be able to make use of linguistic cues provided by HP sentences to support word recognition. CHH were expected to require greater acoustic information (more gates) than CNH to correctly identify words in the LP condition. In addition, it was hypothesized that error patterns would differ across groups. Design: Sixteen CHH with mild to moderate hearing loss and 16 age-matched CNH participated (5 to 12 years). Test stimuli included 15 LP and 15 HP age-appropriate sentences. The final word of each sentence was divided into segments and recombined with the sentence frame to create series of sentences in which the final word was progressively longer by the gated increments. Stimuli were presented monaurally through headphones and children were asked to identify the target word at each successive gate. They also were asked to rate their confidence in their word choice using a five- or three-point scale. For CHH, the signals were processed through a hearing aid simulator. Standardized language measures were used to assess the contribution of linguistic skills. Results: Analysis of language measures revealed that the CNH and CHH performed within the average range on language abilities. Both groups correctly recognized a significantly higher percentage of words in the HP condition than in the LP condition. Although CHH performed comparably with CNH in terms of successfully recognizing the majority of words, differences were observed in the amount of acoustic-phonetic information needed to achieve accurate word recognition. CHH needed more gates than CNH to identify words in the LP condition. CNH were significantly lower in rating their confidence in the LP condition than in the HP condition. CHH, however, were not significantly different in confidence between the conditions. Error patterns for incorrect word responses across gates and predictability varied depending on hearing status. Conclusions: The results of this study suggest that CHH with age-appropriate language abilities took advantage of context cues in the HP sentences to guide word recognition in a manner similar to CNH. However, in the LP condition, they required more acoustic information (more gates) than CNH for word recognition. Differences in the structure of incorrect word responses and their nomination patterns across gates for CHH compared with their peers with NH suggest variations in how these groups use limited acoustic information to select word candidates.

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Dichotic Digits Test Performance Across the Ages: Results From Two Large Epidemiologic Cohort Studies

Objectives: The Dichotic Digits test (DDT) has been widely used to assess central auditory processing but there is limited information on observed DDT performance in a general population. The purpose of the study was to determine factors related to DDT performance in a large cohort spanning the adult age range. Design: The study was cross-sectional and subjects were participants in the Epidemiology of Hearing Loss Study (EHLS), a population-based investigation of age-related hearing loss, or the Beaver Dam Offspring Study (BOSS), a study of aging in the adult offspring of the EHLS members. Subjects seen during the 4th EHLS (2008 to 2010) or the 2nd BOSS (2010 to 2013) examination were included (N = 3655 participants [1391 EHLS, 2264 BOSS]; mean age = 61.1 years, range = 21 to 100 years). The free and right ear-directed recall DDTs were administered using 25 sets of triple-digit pairs with a 70 dB HL presentation level. Pure-tone audiometric testing was conducted and the pure-tone threshold average (PTA) at 0.5, 1, 2, and 4 kHz was categorized using the worse ear: no loss = PTA ≤ 25 dB HL; mild loss = 25 40 dB HL. Cognitive impairment was defined as a Mini-Mental State Examination score

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Directional Microphone Contralateral Routing of Signals in Cochlear Implant Users: A Within-Subjects Comparison

Objectives: For medical or financial reasons, bilateral cochlear implantation is not always possible in bilaterally deafened patients. In such cases, a contralateral routing of signals (CROS) device could complement the monaural implant. The goal of our study was to compare the benefit of three different conditions: (1) unilateral cochlear implant (CI) alone, (2) unilateral CI complemented with a directional CROS microphone, and (3) bilateral CIs. Design: Twelve bilateral experienced CI users were tested. Speech reception in noise and sound localization were measured in the three above-mentioned conditions. Patients evaluated which condition they presumed to be activated and the subjective benefit on a hearing scale. Results: Compared with the unilateral CI condition, the additional CROS device provided significantly better speech intelligibility in noise when speech signals came from the front or side of the CROS microphone. Only small subjective improvement was observed. Bilateral-activated CIs further improved the hearing performance. This was the only condition where sound localization was possible. Subjective evaluation showed a clear preference for the bilateral CI treatment. Conclusions: In bilateral deafened patients, bilateral implantation is the most preferable form of treatment. However, patients with one implant only could benefit from an additional directional microphone CROS device.

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Children With Cochlear Implants and Their Parents: Relations Between Parenting Style and Children’s Social-Emotional Functioning

Objectives: Parenting a child who has a severe or profound hearing loss can be challenging and at times stressful, and might cause parents to use more adverse parenting styles compared with parents of hearing children. Parenting styles are known to impact children’s social-emotional development. Children with a severe to profound hearing loss may be more reliant on their parents in terms of their social-emotional development when compared with their hearing peers who typically have greater opportunities to interact with and learn from others outside their family environment. Identifying the impact which parenting styles pertain on the social-emotional development of children who have cochlear implants (CIs) could help advance these children’s well-being. Therefore, the authors compared parenting styles of parents with hearing children and of parents with children who have a CI, and examined the relations between parenting styles and two key aspects of children’s social-emotional functioning: emotion regulation and empathy. Design: Ninety-two hearing parents and their children (aged 1 to 5 years old), who were either hearing (n = 46) or had a CI (n = 46), participated in this cross-sectional study. Parents completed questionnaires concerning their parenting styles (i.e., positive, negative and uninvolved), and regarding the extent to which their children expressed negative emotions (i.e., anger and sadness) and empathy. Furthermore, an emotion-regulation task measuring negative emotionality was administered to the children. Results: No differences in reported parenting styles were observed between parents of hearing children and parents of children with a CI. In addition, negative and uninvolved parenting styles were related to higher levels of negative emotionality in both groups of children. No relation was found between positive parenting and children’s social-emotional functioning. Hearing status did not moderate these relationships. Language mediated the relationship between parenting styles and children’s social-emotional functioning. Conclusions: Children’s hearing status did not impact parenting styles. This may be a result of the support that parents of children with a CI receive during their enrollment in the rehabilitation program preceding and after implantation. Rehabilitation programs should dedicate more attention to informing parents about the impact of parenting behaviors on children’s social-emotional functioning. Offering parenting courses as part of the program could promote children’s well-being. Future longitudinal research should address the directionality of the relations between parenting styles and children’s social-emotional functioning.

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Letter to the Editor: Reporting of Data to Inform the Design of a Definitive Trial Re: Henry, J.A., Frederick, M., Sell, S., Griest, S., Abrams, H. (2015). Validation of a Novel Combination Hearing Aid and Tinnitus Therapy Device, Ear Hear, 36(1): 42–52

No abstract available

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Effects of Stimulus Polarity and Artifact Reduction Method on the Electrically Evoked Compound Action Potential

Objective: Previous research from our laboratory comparing electrically evoked compound action potential (ECAP) artifact reduction methods has shown larger amplitudes and lower thresholds with cathodic-leading forward masking (CathFM) than with alternating polarity (AltPol). One interpretation of this result is that the anodic-leading phase used with AltPol elicits a less excitatory response (in contrast to results from recent studies with humans), which when averaged with responses to cathodic-leading stimuli, results in smaller amplitudes. Another interpretation is that the latencies of the responses to anodic- and cathodic-leading pulses differ, which when averaged together, result in smaller amplitudes than for either polarity alone due to temporal smearing. The purpose of this study was to separate the effects of stimulus polarity and artifact reduction method to determine the relative effects of each. Design: This study used a within-subjects design. ECAP growth functions were obtained using CathFM, anodic-leading forward masking (AnodFM), and AltPol for 23 CI recipients (N = 13 Cochlear and N = 10 Advanced Bionics). N1 latency, amplitude, slope of the amplitude growth function, and threshold were compared across methods. Data were analyzed separately for each manufacturer due to inherent differences between devices. Results: N1 latencies were significantly shorter for AnodFM than for CathFM and AltPol for both Cochlear and Advanced Bionics participants. Amplitudes were larger for AnodFM than for either CathFM or AltPol for Cochlear recipients; amplitude was not significantly different across methods for Advanced Bionics recipients. Slopes were shallowest for CathFM for Cochlear subjects, but were not significantly different among methods for Advanced Bionics subjects. Thresholds with AltPol were significantly higher than both FM methods for Cochlear recipients; there was no difference in threshold across methods for the Advanced Bionics recipients. Conclusions: For Cochlear devices, the smaller amplitudes and higher thresholds observed for AltPol seem to be the result of latency differences between polarities. These results suggest that AltPol is not ideal for managing stimulus artifact for ECAP recordings. For the Advanced Bionics group, there were no significant differences among methods for amplitude, slope, or threshold, which suggests that polarity and artifact reduction method have little influence in these devices. We postulate that polarity effects are minimized for symmetrical biphasic pulses that lack an interphase gap, such as those used with Advanced Bionics devices; however, this requires further investigation.

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Normative Wideband Reflectance, Equivalent Admittance at the Tympanic Membrane, and Acoustic Stapedius Reflex Threshold in Adults

Objectives: Wideband acoustic immittance (WAI) measures such as pressure reflectance, parameterized by absorbance and group delay, equivalent admittance at the tympanic membrane (TM), and acoustic stapedius reflex threshold (ASRT) describe middle ear function across a wide frequency range, compared with traditional tests employing a single frequency. The objective of this study was to obtain normative data using these tests for a group of normal-hearing adults and investigate test–retest reliability using a longitudinal design. Design: A longitudinal prospective design was used to obtain normative test and retest data on clinical and WAI measures. Subjects were 13 males and 20 females (mean age = 26 years). Inclusion criteria included normal audiometry and clinical immittance. Subjects were tested on two separate visits approximately 1 month apart. Reflectance and equivalent admittance at the TM were measured from 0.25 to 8.0 kHz under three conditions: at ambient pressure in the ear canal and with pressure sweeps from positive to negative pressure (downswept) and negative to positive pressure (upswept). Equivalent admittance at the TM was calculated using admittance measurements at the probe tip that were adjusted using a model of sound transmission in the ear canal and acoustic estimates of ear-canal area and length. Wideband ASRTs were measured at tympanometric peak pressure (TPP) derived from the average TPP of downswept and upswept tympanograms. Descriptive statistics were obtained for all WAI responses, and wideband and clinical ASRTs were compared. Results: Mean absorbance at ambient pressure and TPP demonstrated a broad band-pass pattern typical of previous studies. Test–retest differences were lower for absorbance at TPP for the downswept method compared with ambient pressure at frequencies between 1.0 and 1.26 kHz. Mean tympanometric peak-to-tail differences for absorbance were greatest around 1.0 to 2.0 kHz and similar for positive and negative tails. Mean group delay at ambient pressure and at TPP were greatest between 0.32 and 0.6 kHz at 200 to 300 μsec, reduced at frequencies between 0.8 and 1.5 kHz, and increased above 1.5 kHz to around 150 μsec. Mean equivalent admittance at the TM had a lower level for the ambient method than at TPP for both sweep directions below 1.2 kHz, but the difference between methods was only statistically significant for the comparison between the ambient method and TPP for the upswept tympanogram. Mean equivalent admittance phase was positive at all frequencies. Test–retest reliability of the equivalent admittance level ranged from 1 to 3 dB at frequencies below 1.0 kHz, but increased to 8 to 9 dB at higher frequencies. The mean wideband ASRT for an ipsilateral broadband noise activator was 12 dB lower than the clinical ASRT, but had poorer reliability. Conclusions: Normative data for the WAI test battery revealed minor differences for results at ambient pressure compared with tympanometric methods at TPP for reflectance, group delay, and equivalent admittance level at the TM for subjects with middle ear pressure within ±100 daPa. Test–retest reliability was better for absorbance at TPP for the downswept tympanogram compared with ambient pressure at frequencies around 1.0 kHz. Large peak-to-tail differences in absorbance combined with good reliability at frequencies between about 0.7 and 3.0 kHz suggest that this may be a sensitive frequency range for interpreting absorbance at TPP. The mean wideband ipsilateral ASRT was lower than the clinical ASRT, consistent with previous studies. Results are promising for the use of a wideband test battery to evaluate middle ear function.

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