ORCID Profile
0000-0001-7312-6593
Current Organisation
Macquarie University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Cognitive Science | Rehabilitation and Therapy (excl. Physiotherapy) | Linguistic Processes (incl. Speech Production and Comprehension) | Developmental Psychology and Ageing
ANZSRC Socio-Economic Objective (SEO)
Disability and Functional Capacity | Learner Development | Communication Across Languages and Culture |
Related Links
Publications
Association between birthweight and hearing loss in older adults
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.MATURITAS.2021.11.008
Abstract: We examined the association between birthweight and objectively measured hearing loss in older men and women. 893 community-dwelling participants aged 50+ years with pure-tone audiometry data and self-reported birthweight were included for cross-sectional analysis. Participants were asked how much they weighed at birth either in pounds and ounces or in kilograms and grams. The pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz (PTA Around 31.9% and 50.0% of participants who self-reported low ( 4.5 kg), respectively, had hearing loss. The odds of experiencing any level of hearing loss (>25 dB HL) after multivariate adjustment was: OR 2.00 (95% CI 1.13-3.56) for low birthweight and OR 2.43 (95% CI 1.23-4.82) for high birthweight, compared with participants in the reference group who self-reported normal birthweight (3.1-4.0 kg). Additionally, participants with high birthweight had 2.4-fold greater odds of having mild hearing loss (25-40 dB HL), while participants with low birthweight had 2.6-fold greater odds of moderate to severe hearing loss. We observed an independent U-shaped association between birthweight and age-related hearing loss, that is, persons born with low or high birthweight had a greater likelihood of experiencing any level of hearing loss in older age. These findings provide further evidence to address an important gap in the literature regarding the influence of foetal growth on the auditory system in later life.
Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss
Publisher: Elsevier BV
Date: 08-2010
Abstract: Identification of modifiable risk factors that could prevent or slow the development of age-related hearing loss (presbycusis) would be valuable. Dietary polyunsaturated fatty acid (PUFA) intake may be related to age-related hearing loss. We aimed to determine the association between dietary intakes of omega-3 (n-3) PUFAs and fish and the risk of presbycusis. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss (1997-1999 to 2002-2004). We collected dietary data by using a semiquantitative food-frequency questionnaire and calculated PUFA and fish intakes. In 2956 participants (aged > or =50 y), we measured presbycusis, which we defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz >25 decibels of hearing loss. There was an inverse association between total n-3 PUFA intake and prevalent hearing loss [odds ratio (OR) per SD increase in energy-adjusted n-3 PUFAs: 0.89 95% CI: 0.81, 0.99]. There was an inverse association between long-chain n-3 PUFAs and incident hearing loss (OR per SD increase in long-chain n-3 PUFAs: 0.76 95% CI: 0.60, 0.97). Participants who had > or =2 servings of fish/wk compared with participants who had or =1 to <2 servings/wk of fish and a reduced risk of a progression of hearing loss (OR: 0.53 95% CI: 0.32, 0.88). There was an inverse association between higher intakes of long-chain n-3 PUFAs and regular weekly consumption of fish and hearing loss. Dietary intervention with n-3 PUFAs could prevent or delay the development of age-related hearing loss.
Ear and hearing care programs for First Nations children
Publisher: Springer Science and Business Media LLC
Date: 19-04-2023
DOI: 10.1186/S12913-023-09338-2
Abstract: Ear and hearing care programs are critical to early detection and management of otitis media (or middle ear disease). Otitis media and associated hearing loss disproportionately impacts First Nations children. This affects speech and language development, social and cognitive development and, in turn, education and life outcomes. This scoping review aimed to better understand how ear and hearing care programs for First Nations children in high-income colonial-settler countries aimed to reduce the burden of otitis media and increase equitable access to care. Specifically, the review aimed to chart program strategies, map the focus of each program against 4 parts of a care pathway (prevention, detection, diagnosis/management, rehabilitation), and to identify the factors that indicated the longer-term sustainability and success of programs. A database search was conducted in March 2021 using Medline, Embase, Global Health, APA PsycInfo, CINAHL, Web of Science Core Collection, Scopus, and Academic Search Premier. Programs were eligible or inclusion if they had either been developed or run at any time between January 2010 to March 2021. Search terms encompassed terms such as First Nations children, ear and hearing care, and health programs, initiatives, c aigns, and services. Twenty-seven articles met the criteria to be included in the review and described a total of twenty-one ear and hearing care programs. Programs employed strategies to: (i) connect patients to specialist services, (ii) improve cultural safety of services, and (iii) increase access to ear and hearing care services. However, program evaluation measures were limited to outputs or the evaluation of service-level outcome, rather than patient-based outcomes. Factors which contributed to program sustainability included funding and community involvement although these were limited in many cases. The result of this study highlighted that programs primarily operate at two points along the care pathway—detection and diagnosis/management, presumably where the greatest need lies. Targeted strategies were used to address these, some which were limited in their approach. The success of many programs are evaluated as outputs, and many programs rely on funding sources which can potentially limit longer-term sustainability. Finally, the involvement of First Nations people and communities typically only occurred during implementation rather than across the development of the program. Future programs should be embedded within a connected system of care and tied to existing policies and funding streams to ensure long term viability. Programs should be governed and evaluated by First Nations communities to further ensure programs are sustainable and are designed to meet community needs.
Hearing and vision impairment and the 5-Year incidence of falls in older adults
Publisher: Oxford University Press (OUP)
Date: 05-03-2016
Abstract: concurrent vision and hearing loss are common in older adults however, epidemiological data on their relationship with the incidence of falls are lacking. we assessed the association between dual sensory impairment (DSI) and incidence of falls. We examined the influence of self-perceived hearing handicap and hearing aid use and risk of falls. a population-based, cohort study of participants followed over 5 years. Blue Mountains, west of Sydney, Australia. one thousand four hundred and seventy-eight participants aged 55 and older at baseline were included in longitudinal analyses. visual impairment was defined as presenting or best-corrected visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold >25 dB HL (500-4,000 Hz, better ear). The shortened version of the hearing handicap inventory for the elderly was administered. Incident falls were assessed over the 12 months before each visit. Cognitive impairment was determined using the Mini-Mental State Examination. five-year incidence of falls was 10.4%. Participants with severe self-perceived hearing handicap versus no hearing handicap had increased risk of incident falls, multivariable-adjusted OR 1.93 (95% confidence intervals, CI, 1.02-3.64). Hearing aid users versus non-users had 75% increased likelihood of incident falls. Participants with co-existing best-corrected visual impairment and mild hearing loss (>25 to ≤40 dB HL) had higher odds of incident falls, OR 2.19 (95% CI 1.03-4.67). After excluding persons with cognitive impairment, this association did not persist. these epidemiological data show that DSI in older adults could significantly increase their risk of falling.
Neurotrophin gene augmentation by electrotransfer to improve cochlear implant hearing outcomes
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.HEARES.2019.06.002
Abstract: This Review outlines the development of DNA-based therapeutics for treatment of hearing loss, and in particular, considers the potential to utilize the properties of recombinant neurotrophins to improve cochlear auditory (spiral ganglion) neuron survival and repair. This potential to reduce spiral ganglion neuron death and indeed re-grow the auditory nerve fibres has been the subject of considerable pre-clinical evaluation over decades with the view of improving the neural interface with cochlear implants. This provides the context for discussion about the development of a novel means of using cochlear implant electrode arrays for gene electrotransfer. Mesenchymal cells which line the cochlear perilymphatic compartment can be selectively transfected with (naked) plasmid DNA using array - based gene electrotransfer, termed 'close-field electroporation'. This technology is able to drive expression of brain derived neurotrophic factor (BDNF) in the deafened guinea pig model, causing re-growth of the spiral ganglion peripheral neurites towards the mesenchymla cells, and hence into close proximity with cochlear implant electrodes within scala tympani. This was associated with functional enhancement of the cochlear implant neural interface (lower neural recruitment thresholds and expanded dynamic range, measured using electrically - evoked auditory brainstem responses). The basis for the efficiency of close-field electroporation arises from the compression of the electric field in proximity to the ganged cochlear implant electrodes. The regions close to the array with highest field strength corresponded closely to the distribution of bioreporter cells (adherent human embryonic kidney (HEK293)) expressing green fluorescent reporter protein (GFP) following gene electrotransfer. The optimization of the gene electrotransfer parameters using this cell-based model correlated closely with in vitro and in vivo cochlear gene delivery outcomes. The migration of the cochlear implant electrode array-based gene electrotransfer platform towards a clinical trial for neurotrophin-based enhancement of cochlear implants is supported by availability of a novel regulatory compliant mini-plasmid DNA backbone (pFAR4 plasmid Free of Antibiotic Resistance v.4) which could be used to package a 'humanized' neurotrophin expression cassette. A reporter cassette packaged into pFAR4 produced prominent GFP expression in the guinea pig basal turn perilymphatic scalae. More broadly, close-field gene electrotransfer may lend itself to a spectrum of potential DNA therapeutics applications benefitting from titratable, localised, delivery of naked DNA, for gene augmentation, targeted gene regulation, or gene substitution strategies.
Parent Perspectives of Ear Health and the Relationship with Children’s Speech and Language in the Longitudinal Study of Indigenous Children
Publisher: MDPI AG
Date: 14-01-2023
Abstract: Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child’s expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children’s expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45 95% CI 0.21–0.99) and receptive language (aOR = 0.24 95% CI 0.09–0.62). Parents were less likely to have concerns about the child’s expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.
Association between diet quality with concurrent vision and hearing impairment in older adults
Publisher: Springer Science and Business Media LLC
Date: 29-10-2014
DOI: 10.1007/S12603-013-0408-X
Abstract: Published literature shows that in idual nutrients could influence the risk of developing vision and hearing loss. There is, however, a lack of population-based data on the relationship between overall patterns of food intake and the presence of concurrent vision and hearing impairment. We aimed to assess the associations between diet quality with the prevalence and 5-year incidence of dual sensory impairment (DSI). Cross-sectional and 5-year longitudinal analyses. Blue Mountains, Sydney, Australia. 2443 participants aged ≥50 from baseline were examined and followed over 5 years. Dietary data were collected using a semi-quantitative food frequency questionnaire. A modified version of the Healthy Eating Index for Australians was developed to determine total diet score (TDS). Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB HL (500-4000 Hz, better ear). After adjusting for age, sex, education, noise exposure, current smoking, and type 2 diabetes, participants in the lowest compared to the highest quintile of TDS had a 2-fold increased likelihood of having prevalent DSI, odds ratio, OR, 2.62 (95% confidence intervals, CI, 1.08-6.36), P-trend=0.04. Significant associations were not observed between TDS and the prevalence of having a single sensory impairment (vision or hearing loss). Baseline TDS was not significantly associated with the 5-year incidence of DSI. Adherence to dietary guidelines was associated with a reduced likelihood of having DSI in cross-sectional, but not in longitudinal analyses. Further studies with adequate power are warranted to assess the prospective relationship between diet quality and DSI.
Delivery of audiological diagnoses for infants
Publisher: Informa UK Limited
Date: 08-07-2022
DOI: 10.1080/14992027.2021.1943547
Abstract: To describe and analyse the linguistic structure of audiological diagnoses for infants, to determine ways to optimise the delivery of diagnostic information to parents during this typically emotive time. This study analysed the linguistic structure of audio-recorded infant diagnostic appointments. Nine appointments conducted by four experienced paediatric audiologists were analysed. Diagnoses of normal hearing were delivered explicitly and in a straightforward manner. Positive aspects of this outcome were highlighted, and audiologists used the pronoun "we," conveying a feeling of teamwork. In contrast, when a hearing loss was diagnosed, the diagnosis included disfluencies and the use of hedging, although positive aspects were also emphasised. In these cases, audiologists used the pronoun "I," thereby taking ownership of the results. Differences in the topics raised by audiologists and parents highlighted a mis-match between the information provided and the information requested. Topics addressed by audiologists were primarily medical and procedural, whereas parents were concerned with causes, treatments and experiential information. The use of the above linguistic strategies may serve to minimise the significance and impact of the diagnosis. Whilst the data are unable to be generalised to other contexts, the study has generated in-depth and nuanced information about diagnosis delivery.
Dual sensory impairment in older adults increases the risk of mortality
Publisher: Public Library of Science (PLoS)
Date: 04-03-2013
The contribution of family history to hearing loss in an older population
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2008
Workplace noise exposure and the prevalence and 10-year incidence of age-related hearing loss
Publisher: Public Library of Science (PLoS)
Date: 30-07-2021
DOI: 10.1371/JOURNAL.PONE.0255356
Abstract: There is paucity of population-based data on occupational noise exposure and risk of age-related hearing loss. Therefore, we assessed cross-sectional and longitudinal associations of past workplace noise exposure with hearing loss in older adults. At baseline, 1923 participants aged 50+ years with audiological and occupational noise exposure data included for analysis. The pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz (PTA 0.5-4KHz ) dB HL in the better ear, established the presence of hearing loss. Participants reported exposure to workplace noise, and the severity and duration of this exposure. Prior occupational noise exposure was associated with a 2-fold increased odds of moderate-to-severe hearing loss: multivariable-adjusted OR 2.35 (95% CI 1.45–3.79). Exposure to workplace noise for years increased the odds of having any hearing loss (OR 2.39, 95% CI 1.37–4.19) and moderate-to-severe hearing loss (OR 6.80, 95% CI 2.97–15.60). Among participants reporting past workplace noise exposure at baseline the 10-year incidence of hearing loss was 35.5% versus 29.1% in those who had no workplace noise exposure. Workplace noise exposure was associated with a greater risk of incident hearing loss during the 10-year follow-up: multivariable-adjusted OR 1.39 (95% CI 1.13–1.71). Prior occupational noise exposure was not associated with hearing loss progression. Workplace noise exposure increased the risk of incident hearing loss in older adults. Our findings underscore the importance of preventive measures which diminish noise exposure in the workplace, which could potentially contribute towards reducing the burden of hearing loss in later life.
Dual sensory impairment and hearing aid use among clients attending low-vision services in Australia: The vision-hearing project
Publisher: SAGE Publications
Date: 15-12-2014
Abstract: Objective: To report the frequency of hearing impairment among vision rehabilitation clients, and to identify patterns of hearing service and aid use. Method: In the Vision-Hearing Project, 300 participants (65+ years) completed interviews and a hearing test at low-vision clinics. Visual impairment was defined as visual acuity /40 (better eye) wearing glasses if owned, and hearing impairment as average pure-tone air conduction threshold dB hearing level (HL) over four frequencies (500, 1000, 2000, 4000 Hz, better ear). Dual sensory impairment (DSI) was defined as presence of both impairments. Results: Bilateral hearing impairment was identified in 79.7% of participants and DSI in 62.1%. Only 59.8% of hearing impaired participants owned hearing aids and 33.8% reported low use ( hr/day). Discussion: Four in five low-vision clients experience hearing impairment, and many have unmet needs. New models of sensory assessment that take account of hearing and vision are needed to support early detection and timely rehabilitation for DSI.
Broadband Photonic RF Channelizer With 92 Channels Based on a Soliton Crystal Microcomb
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 15-09-2020
Adults’ with hearing loss perceived listening ability in daily communication: protocol for a systematic review and qualitative meta-synthesis
Publisher: BMJ
Date: 03-2022
DOI: 10.1136/BMJOPEN-2021-051183
Abstract: Understanding how adults with hearing loss perceive their abilities when listening in daily communication situations is vital to understanding the functional listening challenges associated with hearing loss. The aim of this study is to explore how adults with hearing loss describe their own experiences of the processes, behaviours and components of listening in real-world communication through secondary analysis of published qualitative data. A systematic review and thematic meta-synthesis of qualitative research studies and qualitative components of mixed-methods studies will be conducted. Studies published in English will be identified through searching Medline, PsychInfo, Web of Science, Embase and Google Scholar databases from inception to November 2021. Handsearching of the included studies’ reference lists will be completed. Included articles will be assessed for methodological quality using the Critical Appraisal Skills checklist for qualitative studies. Thematic synthesis will proceed as follows: (1) line-by-line coding to label concepts present in the ‘results’ or ‘findings’ section(s) of the included studies (2) grouping of similar codes into descriptive themes (3) development of higher level analytic themes to develop a new interpretation of the included studies’ findings. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CerQUAL) research approach will be used to establish the degree of confidence that may be placed in synthesis findings and results will be reported alongside the synthesis. Two reviewers will independently undertake screening for eligibility, data extraction and quality appraisal, analysis and GRADE-CERQual assessments. Discrepancies will be resolved through discussion. As secondary data analysis of the published literature, ethical approval is not required. The results will be disseminated in peer-reviewed journals, conference presentations and other research and clinical meetings. This protocol is registered with PROSPERO prospective database of systematic review. CRD42020213389.
Hearing loss impacts on the use of community and informal supports
Publisher: Oxford University Press (OUP)
Date: 06-2010
Abstract: the aim of this study is to estimate the cross-sectional and longitudinal impact of hearing loss on use of community support services and reliance on non-spouse family/friends among older people. Blue Mountains Hearing Study participants (n = 2,956) were assessed for hearing impairment by audiologists in sound-treated booths. Participants were classified as hearing impaired if PTA(0.5-4)( )(kHz) >25 dB HL. Use of services and non-spouse family/friend support was assessed cross-sectionally. Incident use was assessed among survivors at the 5-year follow-up (n = 1,457). a significant cross-sectional association between hearing loss (>25 dB HL) and use of community support services was observed after adjusting for age, sex, living status, self-rated poor health, self-reported hospital admissions, disability in walking and best-corrected visual impairment [odds ratio (OR) 2.12, 95% confidence interval (CI) 1.15-3.90]. Participants with hearing loss who never used a hearing aid were twice as likely to use formal supports as participants without hearing loss (multivariate-adjusted OR 2.25, 95% CI 1.19-4.24). Hearing loss increased the incident need for non-spouse family/friend support or community services (multivariate-adjusted OR 1.49, 95% CI 1.02-2.18). after adjusting for confounding factors, hearing impairment negatively impacted on the independence of older persons by increasing reliance on community or family support.
The effects of smoking and alcohol consumption on age-related hearing loss: The blue mountains hearing study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2010
Long-Term Asymmetric Hearing Affects Cochlear Implantation Outcomes Differently in Adults with Pre- and Postlingual Hearing Loss
Publisher: Public Library of Science (PLoS)
Date: 04-06-2015
Associations between Intake of Dietary Flavonoids and 10-Year Incidence of Age-Related Hearing Loss
Publisher: MDPI AG
Date: 28-10-2020
DOI: 10.3390/NU12113297
Abstract: Dietary flavonoids are vasoactive phytochemicals with promising anti-inflammatory properties. We aimed to assess the associations between baseline intakes of six commonly consumed flavonoid subclasses and 10-year incidence of age-related hearing loss. At baseline, 1691 participants aged 50+ years had information on dietary intakes and hearing status. Hearing loss was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz 25 dB hearing level (HL). Dietary data were collected through a semi-quantitative food frequency questionnaire. The flavonoid content of foods was estimated using US databases. During the 10-year follow-up, 260 (31.6%) new cases of hearing loss (incident) were observed. After multivariable adjustment, participants in the fourth versus first quartile (reference group) of intake of dietary isoflavone had 36% lower risk of incident hearing loss after 10 years: odds ratios (OR) 0.64 (95% confidence intervals, CI, 0.42–0.99) p-value for trend = 0.03. Nonsignificant associations were observed between the other five flavonoid subclasses and 10-year incidence of hearing loss. Our findings do not support the hypothesis that the intake of dietary flavonoids protect against long-term risk of hearing loss. The association with isoflavone intake needs to be confirmed by other population-based studies.
The origin of the 900 Hz spectral peak in spontaneous and sound-evoked round-window electrical activity
Publisher: Elsevier BV
Date: 11-2002
DOI: 10.1016/S0378-5955(02)00281-2
Abstract: We have monitored the spectrum of the (spontaneous) neural noise at the round window (RW) and on the surface of the antero-ventral cochlear nucleus (CN) and the dorsal CN (DCN) of anaesthetised guinea pigs. We have also obtained the average gross extracellular waveform evoked by 20 kHz tone-bursts (0.25 ms and 25 ms) at each of these recording sites, and calculated the spectrum of the average waveforms (SAW). With these tone-bursts, only a small population of neurones in the extreme basal turn of the cochlea near the RW electrode responds, presumably with only a single action potential for each 0.25 ms tone-burst. The RW waveforms recorded between 20 dB and 60 dB SPL were very similar, and are therefore presumably a simple estimate of the shape of the contribution of the firing of a single neurone to the gross RW signal (the unitary potential or UP). In normal animals, the SNN and the SAW were remarkably similar, with peaks at 900 Hz and at 2400 Hz, suggesting that they are not due to neural synchronisation (as suggested previously by others), but are due to an oscillatory waveform produced by each single fibre action potential. Abolition of all spike activity by RW tetrodotoxin left a waveform with only a summating potential and a dendritic potential, and no 900 Hz peak in the SAW or SNN, indicating that the spectral peak is due to neural spiking only. Abolition of the CN contribution to the RW waveforms by CN application of lignocaine or sectioning of the cochlear nerve at the internal meatus (by focal aspiration of the DCN and underlying cochlear nerve) showed that the 900 Hz peak was not simply due to the addition of a delayed and inverted CN contribution: mathematical modelling shows that this would produce a broad spectral peak at about 1200 Hz. Moreover, the 900 Hz spectral peak remains after complete abolition of the CN contribution, although reduced in litude. This residual 900 Hz peak can be traced to an oscillation in the gross waveform due to the presence of two peaks (P(1)* and N(2)*) which follow the intact N(1) peak. The P(1)* and N(2)* peaks were present at the RW, but not at the cochlear nerve as it exits the internal meatus, suggesting that they were not due to double-spiking of some of the neurones, but were probably due to a sub-threshold electrical resonance in the peripheral dendrites. We have successfully modelled the production of the SNN and the compound action potential and SAW in response to 0.25 ms and 25 ms tone-bursts at 20 kHz by including only a d ed 900 Hz resonance in the UP, without refractory effects, preferred intervals or synchronisation in the timing of neural spike generation. Such resonances in other neurones are known to be due to the activation kinetics of the voltage-controlled sodium (Na(+)) channels of these neurones. The presence of such sub-threshold oscillations probably indicates that the peripheral dendrites are devoid of stabilising potassium (K(+)) channels. We also discuss the role of this membrane resonance in generating burst-firing of the cochlear nerve (as with salicylate) and the role of such burst-firing in generating tinnitus.
Using a decision tree approach to determine hearing aid ownership in older adults
Publisher: Informa UK Limited
Date: 18-06-2023
The social spaces of hearing apps: problems, partners and intermediaries
Publisher: SAGE Publications
Date: 26-04-2019
Abstract: This article offers an analysis of the development of three hearing and communication apps, drawing on interviews with people involved in their production. While a central figure in the media studies literature on apps is the self-managing in idual health consumer, this article argues that physical and social environments and relationships within them are central to the way the hearing apps are produced, circulated and used. Often emerging from commercial start-ups, hearing apps become aligned with – or indeed stand in for – various kinds of governmental initiatives, not only in health but also in education and economic development. Partnerships between government, research and commercial organisations and the need to work through app intermediaries to find their end users shaped the way apps create recognisable ‘problems’ to address. This problematising function of apps and its impact on the uptake and use of apps are the key areas for future research.
Aging and Hearing Health: The Life-course Approach
Publisher: Oxford University Press (OUP)
Date: 18-03-2016
Orthographic Learning in Children Who Are Deaf or Hard of Hearing
Publisher: American Speech Language Hearing Association
Date: 28-01-2019
DOI: 10.1044/2018_LSHSS-17-0146
Abstract: The purpose of the current study was to investigate the relationship between orthographic learning and language, reading, and cognitive skills in 9-year-old children who are deaf or hard of hearing (DHH) and to compare their performance to age-matched typically hearing (TH) controls. Eighteen children diagnosed with moderate-to-profound hearing loss who use hearing aids and/or cochlear implants participated. Their performance was compared with 35 age-matched controls with typical hearing. Orthographic learning was evaluated using a spelling task and a recognition task. The children were assessed on measures of reading ability, language, working memory, and paired-associate learning. On average, the DHH group performed more poorly than the TH controls on the spelling measure of orthographic learning, but not on the recognition measure. For both groups of children, there were significant correlations between orthographic learning and phonological decoding and between visual–verbal paired-associate learning and orthographic learning. Although the children who are DHH had lower scores in the spelling test of orthographic learning than their TH peers, measures of their reading ability revealed that they acquired orthographic representations successfully. The results are consistent with the self-teaching hypothesis in suggesting that phonological decoding is important for orthographic learning.
Determinants of the spectrum of the neural electrical activity at the round window: transmitter release and neural depolarisation.
Publisher: Elsevier BV
Date: 04-2004
Patient-reported outcome measures (PROMs) for assessing perceived listening effort in hearing loss: protocol for a systematic review
Publisher: BMJ
Date: 05-2017
Objective measurement of high-level auditory cortical function in children
Publisher: Elsevier BV
Date: 07-2015
DOI: 10.1016/J.IJPORL.2015.04.026
Abstract: This study examined whether the N2 latency of the cortical auditory evoked potential (CAEP) could be used as an objective indicator of temporal processing ability in normally hearing children. The N2 latency was evoked using three temporal processing paradigms: (1) differences in voice-onset-times (VOTs) (2) speech-in-noise using the CV/da/embedded in broadband noise (BBN) with varying signal-to-noise ratios (SNRs) and (3) 16Hz litude-modulated (AM) BBN presented (i) alone and (ii) following an unmodulated BBN, using four modulation depths. Thirty-four school-aged children with normal hearing, speech, language and reading were stratified into two groups: 5-7 years (n=13) and 8-12 years (n=21). The N2 latency shifted significantly and systematically with differences in VOT and SNR, and was significantly different in the two AM-BBN conditions. For children without an N1 peak in the cortical waveform, the N2 peak can be used as a sensitive measure of temporal processing for these stimuli. N2 latency of the CAEP can be used as an objective measure of temporal processing ability in a paediatric population with temporal processing disorder who are difficult to assess via behavioural response.
Beyond audition
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-06-2022
DOI: 10.1097/AUD.0000000000001083
Abstract: Children with hearing loss tend to have poorer psychosocial and quality of life outcomes than their typical-hearing (TH) peers—particularly in the areas of peer relationships and school functioning. A small number of studies for TH children have suggested that group-based music activities are beneficial for prosocial outcomes and help develop a sense of belonging. While one might question whether perceptual limitations would impede satisfactory participation in musical activities, findings from a few studies have suggested that group music activities may have similar benefits for children with hearing loss as well. It is important to note that the effect of music on psychosocial outcomes has primarily been investigated at an anecdotal level. The objective of this study was to explore the effect of a music training program on psychosocial and quality of life outcomes for children with hearing loss. It was hypothesized that music training would provide benefits for domains centered upon peer relationships and prosocial measures. Fourteen children aged 6 to 9 years with prelingual sensorineural hearing loss (SNHL) participated in a 12-week music training program that consisted of group-based face-to-face music therapy supplemented by online music apps. The design was a pseudorandomized, longitudinal study (9 participants were waitlisted, initially serving as a passive control group). Psychosocial wellbeing and quality of life were assessed using a questionnaire battery comprised of the Strengths and Difficulty Questionnaire (SDQ), the Pediatric Quality of Life Inventory, the Hearing Environments and Reflection on Quality of Life (HEAR-QL), and the Glasgow Children’s Benefit Inventory. For comparative purposes, responses were measured from 16 TH children that ranged in age from 6 to 9 years. At baseline, children with SNHL had poorer outcomes for internalizing problems, and all measures of the HEAR-QL compared with the TH children. There were no differences for general psychosocial and physical health. After music training, SDQ internalizing problems such as peer relationships and emotional regulation were significantly reduced for the children with SNHL. There were no changes for any outcomes for the passive control group. Additional benefits were noted for emotional and learning factors on the Glasgow Children’s Benefit Inventory. However, there were no significant changes for any psychosocial and quality of life outcomes as measured by the Pediatric Quality of Life Inventory or HEAR-QL instruments. The present study provides initial evidence that music training has a positive effect on at least some psychosocial and quality of life outcomes for children with hearing loss. As they are at a greater risk of poorer psychosocial and quality of life outcomes, these findings are cause for cautious optimism. Children with hearing loss should be encouraged to participate in group-based musical activities.
Contribution of nonimplanted ear to pitch perception for prelingually deafened cochlear implant recipients
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2014
Cortical reorganisation during a 30-week tinnitus treatment program
Publisher: Public Library of Science (PLoS)
Date: 22-02-2016
Hearing loss in older age and its effect on the individuals, their families and the community
Publisher: S. Karger AG
Date: 2016
DOI: 10.1159/000444561
Prevalence and 5-year incidence of dual sensory impairment in an older Australian population
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1016/J.ANNEPIDEM.2012.02.004
Abstract: To report prevalence and 5-year incidence of dual sensory impairment (DSI), and associated risk factors, in an older population. We included 2015 Blue Mountains Hearing Study participants aged ≥55 years, examined between 1997 and 1999 (baseline) and 2002 and 2004. Hearing thresholds were measured with the use of pure-tone audiometry. Visual acuity was measured with a LogMar chart while the subject wore distance glasses, if they owned a pair. DSI was defined as combined presenting visual acuity (better eye) 25 dB HL. The incidence of DSI was considered by the use of two at-risk subpopulations: (i) participants with no sensory impairment and (ii) with one type of sensory impairment at baseline. The prevalence of DSI was 6% at baseline, increasing from 0% for ages <60 years to 26.8% for ages 80+ years (p for trend <.0001). Five-year DSI incidence was 1.6% in persons with no sensory impairment and 11.3% in those with a single sensory impairment, a 7-fold difference. Among participants with either no sensory impairment or a single sensory impairment at baseline, a significant age-related increase in incident DSI was found (p for trend <.0001 and .0004, respectively). Low education was a significant risk factor for DSI among those with no sensory impairment and those with single sensory impairment, multivariable-adjusted odds ratio (OR, 6.62 95% confidence interval [95% CI], 1.79-24.4) and OR, 2.55 (95% CI, 1.36-4.79), respectively. Aging population trends and the age-related prevalence and incidence of DSI support the implementation of collaborative efforts in service provision between hearing and vision professionals. Active case-finding among older persons with single-sensory impairments may help identify those with DSI and provide timely and appropriate services.
Music training for children with sensorineural hearing loss improves speech-in-noise perception
Publisher: American Speech Language Hearing Association
Date: 22-06-2020
DOI: 10.1044/2020_JSLHR-19-00391
Abstract: A growing body of evidence suggests that long-term music training provides benefits to auditory abilities for typical-hearing adults and children. The purpose of this study was to evaluate how music training may provide perceptual benefits (such as speech-in-noise, spectral resolution, and prosody) for children with hearing loss. Fourteen children aged 6–9 years with prelingual sensorineural hearing loss using bilateral cochlear implants, bilateral hearing aids, or bimodal configuration participated in a 12-week music training program, with nine participants completing the full testing requirements of the music training. Activities included weekly group-based music therapy and take-home music apps three times a week. The design was a pseudorandomized, longitudinal study (half the cohort was wait-listed, initially serving as a passive control group prior to music training). The test battery consisted of tasks related to music perception, music appreciation, and speech perception. As a comparison, 16 age-matched children with typical hearing also completed this test battery, but without participation in the music training. There were no changes for any outcomes for the passive control group. After music training, perception of speech-in-noise, question/statement prosody, musical timbre, and spectral resolution improved significantly, as did measures of music appreciation. There were no benefits for emotional prosody or pitch perception. The findings suggest even a modest amount of music training has benefits for music and speech outcomes. These preliminary results provide further evidence that music training is a suitable complementary means of habilitation to improve the outcomes for children with hearing loss.
Dual sensory impairment in older age
Publisher: SAGE Publications
Date: 19-05-2011
Abstract: Objectives: Hearing and visual impairments are commonly viewed separately in research and service provision, but they often occur together as dual sensory impairment or DSI in older populations. This article examines the frequency and effects of DSI in older age and notes limitations in the evidence. Methods: Search of electronic databases of published papers. Results: DSI diminishes communication and well-being and can cause social isolation, depression, reduced independence, mortality, and cognitive impairment. Discussion: Although intuitively DSI may be expected to have additional impacts over single sensory impairment, research findings are inconclusive. Services and supports required by people with DSI are simply a combination of those required by people with single vision and hearing loss, taking account of the unique communication difficulties posed by DSI.
The inaugural World Report on Hearing
Publisher: Wiley
Date: 26-03-2021
DOI: 10.1111/COA.13756
Abstract: The inaugural World Report on Hearing was recently published by the World Health Organisation, and outlines the burden of hearing loss, and strategies to overcome this through preventative and public health approaches. Here, we identify barriers to wide‐scale adoption, including historic low prioritisation of hearing loss against other public health needs, a lack of a health workforce with relevant training, poor access to assistive technology, and in idual and community‐level stigma and misunderstanding. Overcoming these barriers will require multi‐sector stakeholder collaboration, involving ear and hearing care professionals, patients, communities, industry and policymakers.
Social Connectedness and Perceived Listening Effort in Adult Cochlear Implant Users: A Grounded Theory to Establish Content Validity for a New Patient-Reported Outcome Measure
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2018
DOI: 10.1097/AUD.0000000000000553
Abstract: In iduals with hearing loss often report a need for increased effort when listening, particularly in challenging acoustic environments. Despite audiologists’ recognition of the impact of listening effort on in iduals’ quality of life, there are currently no standardized clinical measures of listening effort, including patient-reported outcome measures (PROMs). To generate items and content for a new PROM, this qualitative study explored the perceptions, understanding, and experiences of listening effort in adults with severe-profound sensorineural hearing loss before and after cochlear implantation. Three focus groups (1 to 3) were conducted. Purposive s ling was used to recruit 17 participants from a cochlear implant (CI) center in the United Kingdom. The participants included adults (n = 15, mean age = 64.1 years, range 42 to 84 years) with acquired severe-profound sensorineural hearing loss who satisfied the UK’s national candidacy criteria for cochlear implantation and their normal-hearing significant others (n = 2). Participants were CI candidates who used hearing aids (HAs) and were awaiting CI surgery or CI recipients who used a unilateral CI or a CI and contralateral HA (CI + HA). Data from a pilot focus group conducted with 2 CI recipients were included in the analysis. The data, verbatim transcripts of the focus group proceedings, were analyzed qualitatively using constructivist grounded theory (GT) methodology. A GT of listening effort in cochlear implantation was developed from participants’ accounts. The participants provided rich, nuanced descriptions of the complex and multidimensional nature of their listening effort. Interpreting and integrating these descriptions through GT methodology, listening effort was described as the mental energy required to attend to and process the auditory signal, as well as the effort required to adapt to, and compensate for, a hearing loss. Analyses also suggested that listening effort for most participants was motivated by a need to maintain a sense of social connectedness (i.e., the subjective awareness of being in touch with one’s social world). Before implantation, low social connectedness in the presence of high listening effort encouraged self-alienating behaviors and resulted in social isolation with adverse effects for participant’s well-being and quality of life. A CI moderated but did not remove the requirement for listening effort. Listening effort, in combination with the improved auditory signal supplied by the CI, enabled most participants to listen and communicate more effectively. These participants reported a restored sense of social connectedness and an acceptance of the continued need for listening effort. Social connectedness, effort-reward balance, and listening effort as a multidimensional phenomenon were the core constructs identified as important to participants’ experiences and understanding of listening effort. The study’s findings suggest: (1) perceived listening effort is related to social and psychological factors and (2) these factors may influence how in iduals with hearing loss report on the actual cognitive processing demands of listening. These findings provide evidence in support of the Framework for Understanding Effortful Listening a heuristic that describes listening effort as a function of both motivation and demands on cognitive capacity. This GT will inform item development and establish the content validity for a new PROM for measuring listening effort.
Improving access to hearing services for people with low vision: Piloting a hearing screening and education model of intervention
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2014
Postgraduate training in audiology improves clinicians’ audiology-related cue utilisation
Publisher: Informa UK Limited
Date: 25-05-2018
DOI: 10.1080/14992027.2018.1476782
Abstract: This study was designed to test whether cue utilisation might be employed as a tool to assess the diagnostic skills of audiologists. The utilisation of cues is a characteristic of expertise and critical for successful diagnoses in clinical settings. However, neither in training nor in practice, is there a means by which the diagnostic skills of audiologists can be assessed objectively and reliably. The study comprised a pre-post training evaluation, controlling for prior exposure to the diagnostic testing tool. Three cohorts of trainee audiologists were evaluated, one of which was tested prior to, and following a two-year training programme (16 participants), while the other two groups acted as controls (23 participants and 20 participants, respectively). Consistent with expectations, cue utilisation increased from the initial to the final stages of training and this effect could not be attributed to cohort nor learning effects. At an applied level, the outcomes provide the basis for a cue-based diagnostic assessment tool that can provide both trainee and practising audiologists with detailed feedback concerning their diagnostic skills.
Severity of age-related hearing loss is associated with impaired activities of daily living
Publisher: Oxford University Press (OUP)
Date: 29-11-2012
Abstract: age-related hearing loss is a common chronic condition hence, it is important to understand its influence on the functional status of older adults. We assessed the association between hearing impairment with activity limitations as assessed by the activities of daily living (ADL) scale. a total of 1,952 Blue Mountains Hearing Study participants aged ≥60 years had their hearing levels measured using pure-tone audiometry. A survey instrument with questions on functional status as determined by the Older Americans Resources and Services ADL scale was administered. one hundred and sixty-four (10.4%) participants reported ADL difficulty. A higher proportion of hearing impaired than non-impaired adults reported difficulties in performing three out of the seven basic ADL and six out of the seven instrumental ADL tasks. After multivariable adjustment, increased severity of hearing loss was associated with impaired ADL (P(trend )= 0.001). Subjects with moderate to severe hearing loss compared with those without, had a 2.9-fold increased likelihood of reporting difficulty in ADL, multivariate-adjusted odds ratio (OR): 2.87 [95% confidence interval (CI): 1.59-5.19]. Participants aged <75 years with hearing loss compared with those without, had 2-fold higher odds of impaired ADL. Having worn or wearing a hearing aid was also associated with a 2-fold increased likelihood of impaired ADL. functional status as measured by a common ADL scale is diminished in older hearing impaired adults. Our findings suggest that severely diminished hearing could make the difference between independence and the need for formal support services or placement.
Older adults’ perceptions of current and future hearing healthcare services in Australia, England, US and Canada
Publisher: The Sax Institute
Date: 02-12-2021
DOI: 10.17061/PHRP3152128
Abstract: A high prevalence of hearing loss in older adults contrasts with a small proportion of people who seek help. Emerging developments in hearing healthcare (HHC) could reduce costs but may not increase access. This study evaluated older adults' perceptions of current and future HHC services in Australia, England, US and Canada to explore potential levers and system improvements. Semi-structured focus groups (n = 47) were conducted, and data were analysed using a directed content analysis. Participants were adults 60 years and older with a) no hearing problems b) hearing problems and hearing aid use and c) hearing problems and no hearing aid use. Perceived barriers, facilitators and preferences were largely consistent across countries, with stigma and trust in HHC being the barriers most often discussed. Although cost and access were consistently deemed important, there may be limited change in help-seeking and HHC uptake unless the key barriers of trust and stigma are addressed. When seeking to undertake transformative change to healthcare it is important to engage recipients of care to understand existing barriers and coproduce a user-centered solution.
The need for improved detection and management of adult-onset hearing loss in Australia
Publisher: Hindawi Limited
Date: 2013
DOI: 10.1155/2013/308509
Abstract: Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being) is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1) early identification of persons with chronic hearing impairment (2) appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss.
Ototoxic hearing loss from antimalarials
Publisher: Elsevier BV
Date: 09-2021
Association between vision and hearing impairment and successful aging over five years
Publisher: No publisher found
Date: 2021
Effects of auditory attention on otoacoustic emissions
Publisher: Acoustical Society of America (ASA)
Date: 10-2016
DOI: 10.1121/1.4969460
Abstract: In humans, auditory efferent control of the cochlea has been implicated in sharpening of frequency tuning, improved detection of signals in noise, and the ability to switch the focus of auditory attention. However, it remains unknown whether the modulation of efferent activity during an auditory attention task depends on the degree of task difficulty. This study aimed to compare the suppression of otoacoustic emissions (OAEs), an objective measure of auditory efferent activation, during a lexical decision task with varying degrees of difficulty, compared with passive auditory listening. Ten normal-hearing 18-35 year-olds were assessed using monosyllabic words and non-words presented in a natural or noise-vocoded (less intelligible) condition. The participants were instructed to press a button every time they heard a non-word. Simultaneously, click evoked-OAEs were obtained from the contralateral ear to the speech stimuli with a probe in the external ear canal. Preliminary results showed that OAEs litudes were suppressed during the lexical decision tasks relative to passive listening. In addition, an effect of task difficulty was found, whereby the less intelligible condition showed stronger suppression. These data suggest that the auditory efferent system is recruited through auditory attention, and that this may play a role in speech perception.
Successful outcomes of cochlear implantation in long-term unilateral deafness: Brain plasticity?
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-09-2013
Dietary glycemic load is a predictor of age-related hearing loss in older adults
Publisher: Elsevier BV
Date: 12-2010
Abstract: Age-related hearing loss is a frequent disability in older adults and nutrition could play a role in the development of this condition. Carbohydrate nutrition [including dietary glycemic index (GI) and load (GL)] may be linked to hearing loss. We aimed to determine the association between carbohydrate nutrition (including mean dietary GI and GL, and the dietary intakes of carbohydrate and sugar), starch, cereal and total fiber, and age-related hearing loss. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss (1997-1999 to 2002-2004). Hearing loss was measured in 2956 participants (aged ≥50 y) and was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz > 25 dB hearing level. Dietary data were collected in a semiquantitative FFQ. A purpose-built database based on Australian GI values was used to calculate the mean GI. A higher mean dietary GI was associated with an increased prevalence of any hearing loss, comparing quintiles 1 (lowest) and 5 (highest), [multivariable-adjusted odds ratio = 1.41 (95% CI = 1.01-1.97)]. Participants in the highest quartile of mean dietary GL intake compared with those in the lowest quartile had a 76% greater risk of developing incident hearing loss (P-trend = 0.04). Higher carbohydrate and sugar intakes were associated with incident hearing loss (P-trend = 0.03 and P-trend = 0.05, respectively). In summary, a high-GL diet was a predictor of incident hearing loss, as was higher intake of total carbohydrate. Hence, high postprandial glycemia might be a potential underlying biological mechanism in the development of age-related hearing loss.
Introducing the Australian Hearing Hub
Publisher: SAGE Publications
Date: 28-07-2017
Melodic Contour Training and Its Effect on Speech in Noise, Consonant Discrimination, and Prosody Perception for Cochlear Implant Recipients
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/352869
Abstract: Cochlear implant (CI) recipients generally have good perception of speech in quiet environments but difficulty perceiving speech in noisy conditions, reduced sensitivity to speech prosody, and difficulty appreciating music. Auditory training has been proposed as a method of improving speech perception for CI recipients, and recent efforts have focussed on the potential benefits of music-based training. This study evaluated two melodic contour training programs and their relative efficacy as measured on a number of speech perception tasks. These melodic contours were simple 5-note sequences formed into 9 contour patterns, such as “rising” or “rising-falling.” One training program controlled difficulty by manipulating interval sizes, the other by note durations. Sixteen adult CI recipients (aged 26–86 years) and twelve normal hearing (NH) adult listeners (aged 21–42 years) were tested on a speech perception battery at baseline and then after 6 weeks of melodic contour training. Results indicated that there were some benefits for speech perception tasks for CI recipients after melodic contour training. Specifically, consonant perception in quiet and question/statement prosody was improved. In comparison, NH listeners performed at ceiling for these tasks. There was no significant difference between the posttraining results for either training program, suggesting that both conferred benefits for training CI recipients to better perceive speech.
Music training improves pitch perception in prelingually deafened children with cochlear implants
Publisher: American Academy of Pediatrics (AAP)
Date: 04-2010
Abstract: The comparatively poor music appreciation in patients with cochlear implants might be ascribed to an inadequate exposure to music however, the effect of training on music perception in prelingually deafened children with cochlear implants remains unknown. This study aimed to investigate whether previous musical education improves pitch perception ability in these children. Twenty-seven children with congenital relingual deafness of profound degree were studied. Test stimuli consisted of 2 sequential piano tones, ranging from C (256 Hz) to B (495 Hz). Children were asked to identify the pitch relationship between the 2 tones (same, higher, or lower). Effects of musical training duration, pitch-interval size, current age, age of implantation, gender, and type of cochlear implant on accuracy of pitch perception were evaluated. The duration of musical training positively correlated with the correct rate of pitch perception. Pitch perception performance was better in children who had a cochlear implant and were older than 6 years than in those who were aged ≤6 years (ie, preschool). Effect of pitch-interval size was insignificant on pitch perception, and there was no correlation between pitch perception and the age of implantation, gender, or type of cochlear implant. Musical training seems to improve pitch perception ability in prelingually deafened children with a cochlear implant. Auditory plasticity might play an important role in such enhancement. This suggests that incorporation of a structured training program on music perception early in life and as part of the postoperative rehabilitation program for prelingually deafened children with cochlear implants would be beneficial. A longitudinal study is needed to show whether improvement of music performance in these children is measurable by use of auditory evoked potentials.
Strategies to improve music perception in cochlear implantees
Publisher: InTech
Date: 27-04-2012
DOI: 10.5772/34358
Changes in US hearing aid regulations: possible benefits and risks to Australia
Publisher: The Sax Institute
Date: 02-12-2021
DOI: 10.17061/PHRP3152132
Abstract: Hearing aids are costly for many Australians with hearing loss who are not eligible for public funding, and are not widely used. The purpose of this article is to describe a recent policy shift from the United States (US) that might improve access to hearing devices and services in Australia. Type of program or service: In 2017, the US legislated the Over-the-Counter Hearing Aid Act of 2017, directing the Food and Drug Administration (FDA) to develop regulations for over-the-counter sale of hearing aids for mild to moderate hearing loss. Changes in the development of hearing devices and changes to service delivery were well underway in the US prior to anticipated release of new FDA regulations, with new technology entrants in the 'hearables' market. For Australians with hearing loss not eligible for public funding, the current hearing health system is expensive and device-centred. If Australia follows suit with regulatory changes for a class of over-the-counter hearing aids, consumers are likely to benefit from access to safe and affordable devices. Additional policies to support access to hearing services are also likely to be needed. The hearing health system in Australia will undergo tremendous change in the coming years because of the introduction of over-the-counter hearing aids in the US. For Australians to benefit, changes to regulations of devices, as well as hearing services and device provision, will be required.
A public health approach to ensure equitable, person-centred solutions to address ear disease, hearing loss and deafness
Publisher: The Sax Institute
Date: 02-12-2021
DOI: 10.17061/PHRP3152133
Risk factors for Australian school-age children in socio-economically disadvantaged populations not passing ear and hearing screening
Publisher: The Sax Institute
Date: 02-12-2021
DOI: 10.17061/PHRP3152130
Abstract: Objectives and importance of study: The consequences of sensorineural hearing loss in young children include poor speech and language development, poor educational outcomes,and delayed socio-emotional development. For children who face socio-economic disadvantage, middle ear disease is more prevalent, access to primary health care is more difficult, and psychosocial and education supports are limited. Because of this, the consequences may be lified. Understanding the risks associated with hearing loss and middle ear dysfunction in underserved populations can enable an earlier, more targeted and cost-effective approach to identifying those with hearing loss and effectively connecting them to systems of care. Retrospective study. This study describes the outcomes of an ear and hearing screening program for children from lower socio-economic backgrounds (n = 2489 mean age 11.0 years, standard deviation 1.74 years) in New South Wales (NSW), Australia, between 2013 and 2016. Screening was conducted in a quiet room, and the test protocol included otoscopy, 226 Hertz (Hz) tympanometry, and pure tone screening at octave frequencies from 500 Hz to 4000 Hz with a referral criterion of 20 decibels hearing level (dB HL) at any one frequency. Outcomes were categorised into 1) pass 2) middle ear dysfunction only and 3) did not pass hearing screen (with or without middle ear dysfunction). Multinomial logistic regression was used to investigate risk factors for hearing loss and middle ear dysfunction. The factors examined were age, gender, socio-educational advantage, quarter of year assessed, non-English speaking background (NESB), Aboriginal status and region. Higher risks of middle ear dysfunction were associated with younger age and seasonal variation, with higher risk in winter and spring months (July-September and October-December, compared with January-March). There were no differences between those from NESB and those with English as a first language, between the Aboriginal population and non-Aboriginal population, or between those who resided within or outside a major city. More than one in 10 school-age children from lower socio-economic backgrounds experience hearing loss (11.5%). Targeted ear and hearing screening programs offer an opportunity to identify hearing loss during critical learning years and seasons, mitigating longer-term effects on education, and social and mental health.
Relationship of Type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss
Publisher: Wiley
Date: 05-2009
DOI: 10.1111/J.1464-5491.2009.02710.X
Abstract: Type 2 diabetes and associated microvascular abnormalities are postulated to affect hearing. Our study reports on the relationship between Type 2 diabetes and the prevalence, 5-year incidence and progression of hearing impairment in a representative, older, Australian population. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss conducted in a defined suburban area, west of Sydney. Hearing loss was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz > 25 decibels hearing level (dB HL) in the better ear (bilateral hearing loss). Type 2 diabetes was defined from reported physician-diagnosed diabetes or fasting blood glucose > or = 7.0 mmol/l. Age-related hearing loss was present in 50.0% of diabetic participants (n = 210) compared with 38.2% of non-diabetic participants (n = 1648), odds ratio (OR) 1.55 [95% confidence interval (CI) 1.11-2.17], after adjusting for multiple risk factors. A relationship of diabetes duration with hearing loss was also demonstrated. After 5 years, incident hearing loss occurred in 18.7% of participants with, and 18.0% of those without diabetes, adjusted OR 1.01 (CI 0.54-1.91). Progression of existing hearing loss (> 5 dB HL), however, was significantly greater in participants with newly diagnosed diabetes (69.6%) than in those without diabetes (47.8%) over this period, adjusted OR 2.71 (CI 1.07-6.86). Type 2 diabetes was associated with prevalent, but not incident hearing loss in this older population. Accelerated hearing loss progression over 5 years was more than doubled in persons newly diagnosed with diabetes. These data explore further reported links between Type 2 diabetes and age-related hearing loss.
Access to adults’ hearing aids
Publisher: WHO Press
Date: 20-08-2019
Study protocol for the validation of a new patient-reported outcome measure (PROM) of listening effort in cochlear implantation: the Listening Effort Questionnaire-Cochlear Implant (LEQ-CI)
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2018-028881
Abstract: Listening effort may be defined as the cognitive resources needed to understand an auditory message. A sustained requirement for listening effort is known to have a negative impact on in iduals’ sense of social connectedness, well-being and quality of life. A number of hearing-specific patient-reported outcome measures (PROMs) exist currently however, none adequately assess listening effort as it is experienced in the listening situations of everyday life. The Listening Effort Questionnaire-Cochlear Implant (LEQ-CI) is a new, hearing-specific PROM designed to assess perceived listening effort as experienced by adult CI patients. It is the aim of this study to conduct the first psychometric evaluation of the LEQ-CI’s measurement properties. This study is a phased, prospective, multi-site validation study in a UK population of adults with severe-profound sensorineural hearing loss who meet local candidacy criteria for CI. In phase 1, 250 CI patients from four National Health Service CI centres will self-complete a paper version of the LEQ-CI. Factor analysis will establish unidimensionality and Rasch analysis will evaluate item fit, differential item functioning, response scale ordering, targeting of persons and items, and reliability. Classical test theory methods will assess acceptability/data completeness, scaling assumptions, targeting and internal consistency reliability. Phase 1 results will inform refinements to the LEQ-CI. In phase 2, a new s le of adult CI patients (n=100) will self-complete the refined LEQ-CI, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the Fatigue Assessment Scale to assess construct validity. This study was approved by the Abertawe Bro Morgannwg University Health Board/Swansea University Joint Study Review Committee and the Newcastle and North Tyneside 2 Research Ethics Committee, Ref: 18/NE/0320. Dissemination will be in high-quality journals, conference presentations and SEH’s doctoral dissertation.
Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis
Publisher: Public Library of Science (PLoS)
Date: 25-10-2022
DOI: 10.1371/JOURNAL.PONE.0276265
Abstract: Hearing loss (HL) can affect communication in complex ways. Understanding how adults with HL reflect on and conceptualise the way they listen (metacognition) is required if interventions, and the outcome measures used to evaluate them, are to address barriers to functional communication arising from HL. This study describes how adults with HL experience and report the processes, behaviours, and components of listening, as presented in published studies. Systematic review and meta-synthesis of qualitative studies. Systematic searches identified English-language, peer-reviewed journal articles reporting the results of qualitative or mixed-methods studies of adults’ with HL perceived listening abilities. Medline, PsychInfo, Web of Science, Embase, and Google Scholar were searched from inception to November 2021. Handsearching reference lists of included studies identified additional studies for inclusion. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to appraise studies’ methodological quality. Data from included studies were analysed using thematic meta-synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CERQual) approach assessed confidence in the review findings. Two reviewers independently completed all screening and quality appraisal. Thematic meta-synthesis and GRADE CERQual assessment was completed by one reviewer and confirmed by a second reviewer. Discrepancies were resolved through discussion. Data from 46 studies were included in the review. Thematic meta-synthesis identified six descriptive themes: 1) perceived listening ability 2) external modifiers 3) psychosocial impacts of hearing loss 4) communication partner perspectives 5) self-efficacy for listening and 6) cognitive load. GRADE CERQual ratings for descriptive themes ranged from low to moderate confidence. Descriptive themes were related by analytic themes of liminality and reciprocity. Adults with HL provide in-depth accounts of components and processes of listening, with studies reporting both cognitive and affective experiences consistent with theoretical models of metacognition. The findings will inform content generation for a hearing-specific patient-reported outcome measure of perceived listening ability in everyday communication.
The World Health Organization's World Report on Hearing
Publisher: Cambridge University Press (CUP)
Date: 05-2020
Effectiveness of Computer-Based Auditory Training for Adult Cochlear Implant Users: A Randomized Crossover Study
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/23312165211025938
Abstract: The aim of this study was to assess whether a computer-based speech-in-noise auditory training (AT) program would lead to short- and long-term changes in trained and untrained measures of listening, cognition, and quality of life. A secondary aim was to assess whether directly training the underlying cognitive abilities required for speech perception in noise, using a computer-based visual training (VT) program without the auditory component, would elicit comparable outcomes as the AT program. A randomized crossover study with repeated measures was conducted with 26 adult cochlear implant users. Participants completed either 6 weeks of speech perception in noise training followed by 6 weeks of masked text recognition training, or vice versa. Outcome measures were administered twice before each training program, as well as twice after the completion of each program. The test battery was designed to evaluate whether training led to improvements in listening abilities, cognitive abilities, or quality of life. Mixed-effects models were conducted to analyze whether changes occurred on the trained tasks and on untrained outcome measures after training. Statistically significant improvements were shown for verbal recognition performance during both training programs, in particular for consonants in words, and during the first 2 weeks of training. This on-task learning, however, did not lead to clear improvements in outcomes measured beyond the training programs. This suggests that experienced cochlear implant users may not show transfer of on-task learning to untrained tasks after computer-based auditory and visual training programs such as the ones used in this study.
An interdisciplinary approach to enhance children’s listening, learning, and wellbeing in the classroom
Publisher: Frontiers Media SA
Date: 07-09-2023
Cochlear implantation in Auditory Neuropathy Spectrum Disorder
Publisher: InTech
Date: 27-04-2012
DOI: 10.5772/38670
A practical guide to cochlear implantation in adults with long durations of monaural sound deprivation
Publisher: Informa UK Limited
Date: 05-05-2016
DOI: 10.3109/14992027.2016.1166399
Abstract: This paper aims to summarize published findings by the authors and integrate these within current literature to support clinical guidelines when choosing an ear for cochlear implantation in adults with long-term monaural sound deprivation. Four retrospective cohort studies based on data collected in five cochlear implantation centres with adults with bilateral hearing loss who used a single hearing aid for at least 15 years prior to unilateral or bilateral cochlear implantation. Review, integration and interpretation of retrospective cohort studies to support clinical recommendations. In this population, the prelingual nature of the hearing loss and the duration of bilateral significant hearing loss were the most reliable predictors of cochlear implantation outcomes. Importantly, the duration of sound deprivation in the ear to be implanted was not a significant predictor of speech recognition scores after cochlear implantation and should carry less weight in making recommendations. In most adults with postlingual hearing loss and long-term monaural sound deprivation, the sound-deprived sound deprivation ear should be preferred for implantation. For adults with prelingual deafness and monaural sound deprivation, the decision should weigh the risks of obtaining poorer results with the cochlear implant compared to the benefits of accessing binaural hearing.
A national survey of hearing loss in the Philippines
Publisher: SAGE Publications
Date: 07-2020
Abstract: This study aimed to estimate the prevalence of hearing loss in the Philippines using a nationally representative s le. A cross-sectional national survey was undertaken utilizing a 3-stage stratified cluster design. Participants in the present study comprised 2275 adults and children with pure tone hearing assessment results. Prevalence of moderate or worse hearing loss, defined as 4FA ≥41 dBHL, was 7.5% in children years, 14.7% in adults between 18 and 65 years, and 49.1% in adults years. Factors associated with greater risk of moderate hearing loss in the better ear were presence of a middle ear condition (adjusted odds ratio = 2.39, 95% confidence interval = 1.49-3.85) and socioeconomic status (household income adjusted odds ratio = 1.64, 95% confidence interval = 1.23-2.19). Age was also associated with increased risk, with adjusted odds ratios varying with age category. Prevalence of wax occlusion and outer and middle ear disease was 12.2% and 14.2%, respectively. Prevalence of hearing loss, outer, and middle ear disease appear comparatively high in the Philippines when compared with rates reported in high-income countries. Higher proportions of severe to profound hearing loss were also identified, indicating that there is both an increased prevalence and severity of hearing loss in this population.
Dual Sensory Impairment (DSI)
Publisher: SAGE Publications, Inc.
Date: 2019
Examining relationships between parent‐reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children
Publisher: Wiley
Date: 04-04-2023
DOI: 10.1002/HPJA.719
Abstract: Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent‐reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent‐reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0‐5 years 2008) predictors of being free of parent‐reported ear symptoms in both Waves 2 and 3. A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16 95% CI 1.19‐3.93) and those with no ear symptoms (aOR = 2.94 95% CI, 1.59‐5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income–government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. These findings suggest relationships between different sociodemographic and health factors and parent‐reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent‐reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.
The association between reduced GFR and hearing loss: A cross-sectional population-based study
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1053/J.AJKD.2010.05.015
Abstract: Chronic kidney disease (CKD) has long been associated with hearing loss in certain syndromes. Reported evidence to date has come from only small observational studies. We present the first community-based study to show an association between nonsyndromal CKD and hearing loss. Cross-sectional population-based study to examine the relationship between CKD and age-related hearing loss. The Blue Mountains Hearing Study is a survey of age-related hearing loss conducted in 1997-2004 a total of 2,564 participants had audiometric testing and complete renal data. Moderate CKD, defined as estimated glomerular filtration rate (eGFR) 25 dB for measurements at frequencies of 0.5, 1.0, 2.0, and 4.0 kHz. Baseline biochemistry tests, including serum creatinine, were performed. Pure-tone audiometry was performed in sound-treated booths. Moderate CKD was present in 513 of 2,564 participants. Of persons with moderate CKD, 279 (54.4%) had measured hearing loss compared with 581 (28.3%) with eGFR ≥60 mL/min/1.73 m(2). Moderate CKD was independently associated with hearing loss (OR, 1.43 95% CI, 1.10-1.84 P = 0.006) after adjusting for age sex noise exposure education diabetes, hypertension, and stroke histories and smoking. Participants with eGFR <45 mL/min/1.73 m(2) had the highest prevalence of hearing loss (73%) compared with those with eGFR ≥90 mL/min/1.73 m(2) (19% multivariate adjusted OR, 2.4 [95% CI, 1.3-4.5]). Analyses were repeated after excluding participants reporting furosemide use (a known ototoxic agent) the association between moderate CKD and hearing loss remained significant (multivariate adjusted OR, 1.40 [95% CI, 1.08-1.83] P = 0.01). The present study is not longitudinal and does not permit causal inference from the observed associations. Moderate CKD per se was associated independently with hearing loss. Recognizing this link could lead to earlier hearing assessment with appropriate interventions to preserve the hearing of patients with CKD.
Deconvolution of magnetic acoustic change complex (mACC)
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.CLINPH.2014.03.003
Abstract: The aim of this study was to design a novel experimental approach to investigate the morphological characteristics of auditory cortical responses elicited by rapidly changing synthesized speech sounds. Six sound-evoked magnetoencephalographic (MEG) responses were measured to a synthesized train of speech sounds using the vowels /e/ and /u/ in 17 normal hearing young adults. Responses were measured to: (i) the onset of the speech train, (ii) an F0 increment (iii) an F0 decrement (iv) an F2 decrement (v) an F2 increment and (vi) the offset of the speech train using short (jittered around 135ms) and long (1500ms) stimulus onset asynchronies (SOAs). The least squares (LS) deconvolution technique was used to disentangle the overlapping MEG responses in the short SOA condition only. Comparison between the morphology of the recovered cortical responses in the short and long SOAs conditions showed high similarity, suggesting that the LS deconvolution technique was successful in disentangling the MEG waveforms. Waveform latencies and litudes were different for the two SOAs conditions and were influenced by the spectro-temporal properties of the sound sequence. The magnetic acoustic change complex (mACC) for the short SOA condition showed significantly lower litudes and shorter latencies compared to the long SOA condition. The F0 transition showed a larger reduction in litude from long to short SOA compared to the F2 transition. Lateralization of the cortical responses were observed under some stimulus conditions and appeared to be associated with the spectro-temporal properties of the acoustic stimulus. The LS deconvolution technique provides a new tool to study the properties of the auditory cortical response to rapidly changing sound stimuli. The presence of the cortical auditory evoked responses for rapid transition of synthesized speech stimuli suggests that the temporal code is preserved at the level of the auditory cortex. Further, the reduced litudes and shorter latencies might reflect intrinsic properties of the cortical neurons to rapidly presented sounds. This is the first demonstration of the separation of overlapping cortical responses to rapidly changing speech sounds and offers a potential new biomarker of discrimination of rapid transition of sound.
How the world’s children hear
Publisher: Wiley
Date: 04-2020
Abstract: School hearing screening may mitigate the effects of childhood hearing loss through early identification and intervention. This study provides an overview of existing school hearing screening programs around the world, identifies gaps in the literature, and develops priorities for future research. A structured search of the PubMed, Embase, and Cochrane Library databases. A total of 65 articles were included according to predefined inclusion criteria. Parameters of interest included age groups screened, audiometric protocols, referral criteria, use of adjunct screening tests, rescreening procedures, hearing loss prevalence, screening test sensitivity and specificity, and loss to follow‐up. School hearing screening is mandated in few regions worldwide, and there is little accountability regarding whether testing is performed. Screening protocols differ in terms of screening tests included and thresholds used. The most common protocols included a mix of pure tone screening (0.5, 1, 2, and 4 kHz), otoscopy, and tympanometry. Estimates of region‐specific disease prevalence were methodologically inaccurate, and rescreening was poorly addressed. Loss to follow‐up was also a ubiquitous concern. There is an urgent need for standardized school hearing screening protocol guidelines globally, which will facilitate more accurate studies of hearing loss prevalence and determination of screening test sensitivity and specificity. In turn, these steps will increase the robustness with which we can study the effects of screening and treatment interventions, and they will support the development of guidelines on the screening, diagnostic, and rehabilitation services needed to reduce the impact of childhood hearing loss.
Assessing cochlear length using cone beam computed tomography in adults with cochlear implants
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2018
DOI: 10.1097/MAO.0000000000001934
Abstract: One hundred CBCT temporal bone images of ears implanted with Cochlear straight or perimodiolar arrays were reviewed by two independent examiners. Outer-wall length, based on the position of the straight array within the cochlea and the reported average length of the organ of Corti, was 27.44 to 35.91 mm (mean = 32.24 mm). Inner-wall length, based on the position of the perimodiolar array and the reported average length of the spiral ganglion, ranged from 17.8 to 22.24 mm (mean = 19.43 mm). A novel method for calculating outer- and inner-wall cochlear length using CBCT images has been developed which is feasible in clinical settings.
Dietary intake of cholesterol is positively associated and use of cholesterol-lowering medication is negatively associated with prevalent age-related hearing loss
Publisher: Elsevier BV
Date: 07-2011
Abstract: We aimed to assess associations between dietary intake of fats (saturated and monounsaturated fats and cholesterol) and certain food groups (butter, margarine, and nuts) with the prevalence, incidence, and progression of age-related hearing loss. We also aimed to investigate the link between serum lipids and cholesterol-lowering medication (statins) and hearing loss. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss. Hearing loss was measured in 2956 participants (aged ≥50 y) and was defined as the pure-tone average (PTA) of frequencies 0.5, 1.0, 2.0, and 4.0 kHz > 25 dB hearing level (PTA(0.5-4 kHz)). Dietary data were collected using a semiquantitative FFQ. After multivariable adjustment, the likelihood of prevalent hearing loss increased from the lowest (reference) to the highest quartile of dietary cholesterol intake (P-trend = 0.04). Among persons self-reporting statin use (n = 274), a 48% reduced odds of prevalent hearing loss was observed after multivariable adjustment [OR = 0.52 (95% CI = 0.29-0.93)]. Participants in the second and 3rd quartiles of dietary monounsaturated fat intake compared with those in the first quartile (reference) had a significantly reduced risk of hearing loss progression 5 y later [multivariable-adjusted OR = 0.39 (95% CI = 0.21-0.71)] and [OR = 0.51 (95% CI = 0.29-0.91)], respectively. Our results suggest that a diet high in cholesterol could have adverse influences on hearing, whereas treatment with statins and consumption of monounsaturated fats may have a beneficial influence.
Deconvolution of overlapping cortical auditory evoked potentials recorded using short stimulus onset-asynchrony ranges
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.CLINPH.2013.09.031
Abstract: The first aim of this study is to validate the theoretical framework of least-squares (LS) deconvolution on experimental data. The second is to investigate the waveform morphology of the cortical auditory evoked potential (CAEP) for five stimulus onset-asynchronies (SOAs) and effects of alternating stimulus frequency in normally hearing adults. Eleven adults (19-55 years) with normal hearing were investigated using tone-burst stimuli of 500 and 2000 Hz with SOAs jittered around 150, 250, 450, and 850 ms in a paired-interval paradigm with fixed or alternating stimulus frequency. The LS deconvolution technique disentangled the overlapping responses, which then provided the following insights. The CAEP litude reached a minimum value for SOAs jittered around 450 ms, in contrast with significantly larger litudes for SOAs jittered around 150 and 850 ms. Despite this, longer latencies of N1 and P2 consistently occurred for decreasing SOAs. Alternating stimulus frequency significantly increased the litude of the CAEP response and decreased latencies for SOAs jittered around 150 ms. Effects of SOAs and alternating stimuli on CAEP litude can be modelled using a quantitative model of latent inhibition. LS deconvolution allows correction for cortical response overlap. The litude of the CAEP is sensitive to SOA and stimulus frequency alternation. CAEPs are emerging as an important tool in the objective evaluation of hearing aid and cochlear implant fittings. Responses to closely spaced stimuli provide objective information about integration and inhibition mechanisms in the auditory cortex.
Hearing aids for Ménière's syndrome: Implications of hearing fluctuation
Publisher: Georg Thieme Verlag KG
Date: 05-2008
DOI: 10.3766/JAAA.19.5.5
Abstract: Background: Hearing fluctuation imposes the biggest challenge in the fitting of hearing aids for patients with Ménière's syndrome. Purpose: This study shows that the problem maybe be overcome by allowing the patients to test their own hearing and to program their own hearing aids to adjust for hearing fluctuation. Research Design and Study S le: A group of 40 participants diagnosed with Ménière's syndrome were fitted with Widex Senso Diva hearing aids and were provided with a portable Senso Programmer 3 (SP3) that allowed them to measure their own hearing thresholds at up to 14 different frequencies and to program their own devices. Intervention: The participants were instructed to test their hearing three times a day for 8 weeks and to program their hearing aids according to the measured thresholds. Data Collection and Analysis: All participants recorded some degree of hearing fluctuation during the 8-week trial. Results and Conclusions: Among participants, 70 percent continued to program their hearing aids on a regular basis and reported great satisfaction with lification because they are now able to adjust their own devices when their hearing fluctuates.
Co-occurring hearing loss and cognitive decline in older adults
Publisher: Frontiers Media SA
Date: 24-12-2021
DOI: 10.3389/FNAGI.2021.794787
Abstract: Hearing loss and cognitive impairments are both highly prevalent neurological complications for older adults. While there is growing evidence to suggest that these two conditions are interrelated, little research has been conducted that directly examines the progression and developmental trajectories of these complications contemporaneously. The aim of the study is to identify the distinct trajectory profiles for hearing loss and cognitive function in an older population over a 10-year period. Through dual trajectory modeling, the interrelationship, co-occurring movements, and overlaps between these two complications were examined. We also investigated the influence of hearing aid ownership on cognitive function trajectories. We utilized longitudinal data from 1,445 participants in the Blue Mountains Hearing Study (aged 55+ years) involving repeated measures from a population-based survey with audiometric hearing assessments. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). The group-based trajectory modeling (GBTM) identified three trajectory profiles for both hearing loss and cognitive function in two older age groups (55–69 years and 70+ years). The outputs from the dual trajectories models showed the conditional probability for “no hearing loss” trajectories to be around 90% more likely to have “high-normal” cognitive function, demonstrating co-occurring overlap. In contrast, for “moderate to severe hearing loss” trajectories, the conditional probability drops to 65% and 79% for the 55–69 age group and 70+ age group respectively. There was also an increasing probability for “cognitive decline” conditional on the severity of hearing loss with 6.7%, 7.5%, and 8.7% for no hearing loss, mild hearing loss, and moderate to severe hearing loss trajectory groups. While we did not find any statistically significant difference in the influence of hearing aid use in the cognitive function trajectories, there was a consistent greater representation of non-hearing aid users in the trajectories with poorer cognitive function. This study found GBTM to identify trajectories that were in agreement with our current understanding of hearing loss and cognitive impairment in older adults. This study also adds to the existing evidence-base as dual trajectories demonstrated co-occurrence in developmental changes in these two common neurological complications for the older population.
Objective Assessment of Listening Effort: Coregistration of Pupillometry and EEG
Publisher: SAGE Publications
Date: 28-07-2017
Listening-Based Communication Ability in Adults With Hearing Loss: A Scoping Review of Existing Measures
Publisher: Frontiers Media SA
Date: 10-03-2022
DOI: 10.3389/FPSYG.2022.786347
Abstract: Hearing loss in adults has a pervasive impact on health and well-being. Its effects on everyday listening and communication can directly influence participation across multiple spheres of life. These impacts, however, remain poorly assessed within clinical settings. Whilst various tests and questionnaires that measure listening and communication abilities are available, there is a lack of consensus about which measures assess the factors that are most relevant to optimising auditory rehabilitation. This study aimed to map current measures used in published studies to evaluate listening skills needed for oral communication in adults with hearing loss. A scoping review was conducted using systematic searches in Medline, EMBASE, Web of Science and Google Scholar to retrieve peer-reviewed articles that used one or more linguistic-based measure necessary to oral communication in adults with hearing loss. The range of measures identified and their frequency where charted in relation to auditory hierarchies, linguistic domains, health status domains, and associated neuropsychological and cognitive domains. 9121 articles were identified and 2579 articles that reported on 6714 discrete measures were included for further analysis. The predominant linguistic-based measure reported was word or sentence identification in quiet (65.9%). In contrast, discourse-based measures were used in 2.7% of the articles included. Of the included studies, 36.6% used a self-reported instrument purporting to measures of listening for communication. Consistent with previous studies, a large number of self-reported measures were identified ( n = 139), but 60.4% of these measures were used in only one study and 80.7% were cited five times or fewer. Current measures used in published studies to assess listening abilities relevant to oral communication target a narrow set of domains. Concepts of communicative interaction have limited representation in current measurement. The lack of measurement consensus and heterogeneity amongst the assessments limit comparisons across studies. Furthermore, extracted measures rarely consider the broader linguistic, cognitive and interactive elements of communication. Consequently, existing measures may have limited clinical application if assessing the listening-related skills required for communication in daily life, as experienced by adults with hearing loss.
Decision-Making in Audiology: Balancing Evidence-Based Practice and Patient-Centered Care
Publisher: SAGE Publications
Date: 28-07-2017
Dietary antioxidant intake is associated with the prevalence but not incidence of age-related hearing loss
Publisher: Springer Science and Business Media LLC
Date: 11-07-2011
DOI: 10.1007/S12603-011-0119-0
Abstract: Diet is one of the few modifiable risk factors for age-related hearing loss. We aimed to examine the link between dietary and supplement intakes of antioxidants, and both the prevalence and 5-year incidence of measured hearing loss. Cross-sectional and 5-year longitudinal analyses. Blue Mountains, Sydney, Australia. 2,956 Blue Mountains Hearing Study participants aged 50+ at baseline, examined during 1997-9 to 2002-4. Age-related hearing loss was measured and defined as the pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz >25 dB HL. Dietary data were collected in a semi-quantitative food frequency questionnaire, and intakes of α-carotene β-carotene β-cryptoxanthin lutein and zeaxanthin lycopene vitamins A, C and E iron and zinc were calculated. After adjusting for age, sex, smoking, education, occupational noise exposure, family history of hearing loss, history of diagnosed diabetes and stroke, each standard deviation (SD) increase in dietary vitamin E intake was associated with a 14% reduced likelihood of prevalent hearing loss, odds ratio, OR, 0.86 (95% confidence interval, CI, 0.78-0.98). Those in the highest quintile of dietary vitamin A intake had a 47% reduced risk of having moderate or greater hearing loss (>40 dB HL) compared to those in the lowest quintile of intake, multivariable-adjusted OR 0.53 (CI 0.30-0.92), P for trend = 0.04. However, dietary antioxidant intake was not associated with the 5-year incidence of hearing loss. Dietary vitamin A and vitamin E intake were significantly associated with the prevalence of hearing loss. However, dietary antioxidant intake did not increase the risk of incident hearing loss. Further large, prospective studies are warranted to assess these relationships in older adults.
Development and validation of DeciBHAL-US
Publisher: Elsevier BV
Date: 02-2022
A scoping review of global aminoglycoside antibiotic overuse
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.SAPHARM.2021.10.004
Abstract: Aminoglycosides are widely used, broad-spectrum antibiotics with significant potential for ototoxicity. Global efforts to prevent ototoxicity must account for aminoglycoside overuse and non-prescription use. The goals of this study were to a) estimate the prevalence of aminoglycoside overuse by synthesizing evidence on self-medication, over the counter (OTC) availability, and household antibiotic storage for later use, and to report the specific aminoglycosides used and the predictors of overuse, and b) leverage this information to comment on potential risk of ototoxicity. Two systematic search strings were conducted to extract peer-reviewed articles published from 2005 to 2020. The first focused on overuse of aminoglycoside antibiotics. The second focused on potentially ototoxic effects of aminoglycosides related to drug overuse. A total of 26 articles were included (first search string: n = 21 second search string: n = 5). The prevalence of aminoglycoside self-medication was high and household storage and OTC availability of aminoglycosides was common. Gentamicin was the most commonly overused aminoglycoside. No studies provided information on antibiotic dosing or resultant toxicities, including ototoxicity. The limited available evidence indicates that antibiotic overuse (self-medication, home storage, and non-prescription availability) is relatively common, especially in low resource settings, and that aminoglycoside antibiotics comprise a variable, but concerning, proportion of non-prescribed antibiotics. Additional evidence is needed to evaluate the relationship between these dispensing patterns and ototoxicity.
Risk Factors and Impacts of Incident Tinnitus in Older Adults
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.ANNEPIDEM.2009.09.002
Abstract: We used a representative older population-based cohort to establish the predictors and impacts of tinnitus. A total of 1,214 participants of the Blue Mountains Hearing Study were followed for 5 years (1997-1999 to 2002-2004). The presence of tinnitus was assessed by an audiologist-administered questionnaire. Hearing impairment was defined as the pure tone average (PTA)(0.5-4KHz)>25 dB HL, in the better ear. Quality of life was measured by use of the Short Form 36-item Health Survey (SF-36). Depression was assessed using either the SF-36 (Mental Health Index, subscale) and the Center for Epidemiologic Studies Depression Scale. Symptomatic dizziness and hearing loss were significant risk factors for incident tinnitus, multivariable-adjusted odds ratio, 2.41 (95% confidence interval, 1.62-3.58) and odds ratio 2.31 (95% confidence interval, 1.46-3.66), respectively. Incident tinnitus cases demonstrated significantly lower mean SF-36 scores compared with subjects without tinnitus and were more likely to be depressed as assessed by both the Mental Health Index and Center for Epidemiologic Studies Depression Scale. Incident tinnitus was predicted by two otological risk factors, dizziness and hearing loss. Temporal data documented diminished quality of life and psychological well-being in those subjects experiencing tinnitus. This finding highlights the importance of effective intervention strategies to prevent potentially debilitating morbidity associated with tinnitus.
Prevalence of aminoglycoside-induced hearing loss in drug-resistant tuberculosis patients
Publisher: Elsevier BV
Date: 07-2021
A protocol for the Hearing impairment in Adults: A Longitudinal Outcomes Study (HALOS)
Publisher: Public Library of Science (PLoS)
Date: 16-03-2023
DOI: 10.1371/JOURNAL.PONE.0283171
Abstract: Often considered an “invisible disability”, hearing loss is one of the most prevalent chronic diseases and the third leading cause for years lived with disability worldwide. Hearing loss has substantial impacts on communication, psychological wellbeing, social connectedness, cognition, quality of life, and economic independence. The Hearing impairment in Adults: a Longitudinal Outcomes Study (HALOS) aims to evaluate the: (1) impacts of hearing devices (hearing aids and/or cochlear implants), (2) differences in timing of these interventions and in long-term outcomes between hearing aid and cochlear implant users, and (3) cost-effectiveness of early intervention for adult-onset hearing loss among hearing device users. HALOS is a mixed-methods study collecting cross-sectional and longitudinal data on health and social outcomes from 908 hearing aid and/or cochlear implant users aged ≥40 years, recruited from hearing service providers across Australia. The quantitative component will involve an online survey at baseline (time of recruitment), 24-months, and 48-months and will collect audiological, health, psychosocial, functional and employment outcomes using validated instruments. The qualitative component will be conducted in a subset of participants at baseline and involve semi-structured interviews to understand the patient journey and perspectives on the Australian hearing service model. This study has been approved by the Macquarie University Human Research Ethics Committee (ID: 11262) and Southern Adelaide Local Health Network (ID: LNR/22/SAC/88). Dissemination of results: Study findings will be disseminated to participants via a one-page summary, and to the public through publications in peer-reviewed journals and presentations at conferences. Australia New Zealand Clinical Trial Registry (ANZCTR) registration number: ACTRN12622000752763 .
Perceptual gating of a brainstem reflex facilitates speech understanding in human listeners
Publisher: Cold Spring Harbor Laboratory
Date: 06-2020
DOI: 10.1101/2020.05.31.115444
Abstract: Navigating “cocktail party” situations by enhancing foreground sounds over irrelevant background information is typically considered from a cortico-centric perspective. However, subcortical circuits, such as the medial olivocochlear (MOC) reflex that modulates inner ear activity itself, have le opportunity to extract salient features from the auditory scene prior to any cortical processing. To understand the contribution of auditory subcortical nuclei and the cochlea, physiological recordings were made along the auditory pathway while listeners differentiated non(sense)-words and words. Both naturally-spoken and intrinsically-noisy, vocoded speech — filtering that mimics processing by a cochlear implant—significantly activated the MOC reflex, whereas listening to speech-in-background noise revealed instead engagement of midbrain and cortical resources. An auditory periphery model reproduced these speech degradation-specific effects, providing a rationale for goal-directed gating of the MOC reflex to enhance representation of speech features in the auditory nerve. Our data reveals the co-existence of two strategies in the auditory system that may facilitate speech understanding in situations where the speech signal is either intrinsically degraded or masked by extrinsic auditory information.
Cross-modal functional connectivity supports speech understanding in cochlear implant users
Publisher: Oxford University Press (OUP)
Date: 20-08-2023
Abstract: Sensory deprivation can lead to cross-modal cortical changes, whereby sensory brain regions deprived of input may be recruited to perform atypical function. Enhanced cross-modal responses to visual stimuli observed in auditory cortex of postlingually deaf cochlear implant (CI) users are hypothesized to reflect increased activation of cortical language regions, but it is unclear if this cross-modal activity is “adaptive” or “mal-adaptive” for speech understanding. To determine if increased activation of language regions is correlated with better speech understanding in CI users, we assessed task-related activation and functional connectivity of auditory and visual cortices to auditory and visual speech and non-speech stimuli in CI users (n = 14) and normal-hearing listeners (n = 17) and used functional near-infrared spectroscopy to measure hemodynamic responses. We used visually presented speech and non-speech to investigate neural processes related to linguistic content and observed that CI users show beneficial cross-modal effects. Specifically, an increase in connectivity between the left auditory and visual cortices—presumed primary sites of cortical language processing—was positively correlated with CI users’ abilities to understand speech in background noise. Cross-modal activity in auditory cortex of postlingually deaf CI users may reflect adaptive activity of a distributed, multimodal speech network, recruited to enhance speech understanding.
Long-term monaural auditory deprivation and bilateral cochlear implants
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2012
Relative Importance of Monaural Sound Deprivation and Bilateral Significant Hearing Loss in Predicting Cochlear Implantation Outcomes
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
Short-term hearing fluctuation in Meniere's disease
Publisher: Informa UK Limited
Date: 2009
DOI: 10.1080/14992020802716778
Abstract: This study aimed to assess the extent and implications of short-term hearing fluctuation in Meniere's disease. Thirty-six subjects diagnosed with Meniere's were recruited to measure their own hearing using in-situ audiometry via a hearing aid (Widex Diva) and a portable programmer (SP3). Self-hearing tests measuring up to 14 frequency bands were conducted three times a day over eight weeks using the expanded Sensogram. Twenty-three ears showed low frequency fluctuation while ten fluctuated in mid frequencies with some 'double peak' audiogram configurations. Eight ears in the later stages of Meniere's, contrary to expected, also recorded fluctuation across all frequencies. Self-hearing testing Meniere's ears over eight weeks revealed great hearing fluctuation with significant changes in audiogram configuration. It suggests that as endolymphatic hydrops progresses through the cochlea, low frequency fluctuation is followed by fluctuation in the mid frequencies, leading to fluctuation across all frequencies. Use of a self-hearing test may facilitate diagnosis and hearing aid fitting for this population, as clinical audiograms may not provide accurate information of hearing fluctuation.
Reliability of the Home Hearing Test: Implications for Public Health
Publisher: Georg Thieme Verlag KG
Date: 2018
DOI: 10.3766/JAAA.17092
Depressive symptoms in older adults with hearing impairments: The blue mountains study: Letters to the editor
Publisher: Wiley
Date: 30-06-2009
Transient focal cooling at the round window and cochlear nucleus shows round window CAP originates from cochlear neurones alone.
Publisher: Elsevier BV
Date: 12-2004
Assessing spectral and temporal processing in children and adults using Temporal Modulation Transfer Function (TMTF), Iterated Ripple Noise (IRN) perception, and Spectral Ripple Discrimination (SRD)
Publisher: Georg Thieme Verlag KG
Date: 02-2014
DOI: 10.3766/JAAA.25.2.9
Abstract: Background: There are many clinically available tests for the assessment of auditory processing skills in children and adults. However, there is limited data available on the maturational effects on the performance on these tests. Purpose: The current study investigated maturational effects on auditory processing abilities using three psychophysical measures: temporal modulation transfer function (TMTF), iterated ripple noise (IRN) perception, and spectral ripple discrimination (SRD). Research Design: A cross-sectional study. Three groups of subjects were tested: 10 adults (18–30 yr), 10 older children (12–18 yr), and 10 young children (8–11 yr) Data Collection and Analysis: Temporal envelope processing was measured by obtaining thresholds for litude modulation detection as a function of modulation frequency (TMTF 4, 8, 16, 32, 64, and 128 Hz). Temporal fine structure processing was measured using IRN, and spectral processing was measured using SRD. Results: The results showed that young children had significantly higher modulation thresholds at 4 Hz (TMTF) compared to the other two groups and poorer SRD scores compared to adults. The results on IRN did not differ across groups. Conclusions: The results suggest that different aspects of auditory processing mature at different age periods and these maturational effects need to be considered while assessing auditory processing in children.
Dizziness and vertigo in an older population: The Blue Mountains prospective cross-sectional study
Publisher: Wiley
Date: 12-2009
DOI: 10.1111/J.1749-4486.2009.02025.X
Abstract: We aimed to reassess the prevalence and personal burden of dizziness/vertigo, and to assess the relationship with hearing loss and tinnitus in older adults. Prospective cross-sectional study. Blue Mountains region, west of Sydney, Australia. We examined 2751 of 2956 (aged 50+ years) Blue Mountains Hearing Study participants. Audiologists screened participants for reported dizziness using a single question. Questions from the Dizziness Handicap Inventory were used to assess the impacts of dizziness/vertigo. Hearing impairment was determined as the pure-tone average of audiometric hearing thresholds at 500, 1000, 2000 and 4000 Hz (PTA(0.5-4 KHz)), defining any hearing loss as PTA(0.5-4 KHz) >25 dB HL. Presence of tinnitus was assessed by a positive response to a single question. Quality of life was measured using the Short Form 36-item Health Survey (SF-36). Each SF-36 dimension was scored from 0 (worst possible health state) to 100 (best possible health state). Prevalences of dizziness/vertigo, vestibular vertigo and non-vestibular vertigo were 36.2%, 10.0% and 14.2%, respectively. Of the dizziness/vertigo reports, 27.7% and 39.3%, respectively, were attributed to vestibular and non-vestibular vertigo. Tinnitus was associated with dizziness, odds ratio, OR, 1.99 (95% confidence interval, CI, 1.68-2.35). However, hearing loss was not associated with dizziness/vertigo. Participants reporting dizziness/vertigo had lower quality of life scores (P < 0.0001). Participants reporting vestibular vertigo were more likely than those with non-vestibular vertigo to report higher DHI scale scores or a greater handicap. Our findings highlight the burden imposed by dizziness, indicating dizziness/vertigo are important public health care issues.
Prior exposure to speech rapidly modulates cortical processing of high-level linguistic structure
Publisher: Cold Spring Harbor Laboratory
Date: 25-01-2022
DOI: 10.1101/2022.01.25.477669
Abstract: Neural activity has been shown to track hierarchical linguistic units in connected speech and these responses can be directly modulated by changes in speech intelligibility caused by spectral degradation. In the current study, we manipulate prior knowledge to increase the intelligibility of physically identical speech sentences and test the hypothesis that the tracking responses can be enhanced by this intelligibility improvement. Cortical magnetoencephalography (MEG) responses to intelligible speech followed by either the same (matched) or different (unmatched) unintelligible speech were measured in twenty-three normal hearing participants. Driven by prior knowledge, cortical coherence to “abstract” linguistic units with no accompanying acoustic cues (phrases and sentences) was enhanced relative to the unmatched condition, and was lateralized to the left hemisphere. In contrast, cortical responses coherent to word units, aligned with acoustic onsets, were bilateral and insensitive to contextual information changes. No such coherence changes were observed when prior experience was not available (unintelligible speech before intelligible speech). This dissociation suggests that cerebral responses to linguistic information are directly affected by intelligibility, which in turn are powerfully shaped by physical cues in speech. These results provide an objective and sensitive neural index of speech intelligibility, and explain why previous studies have reported no effect of prior knowledge on cortical entrainment.
Qualitative, multimethod study of behavioural and attitudinal responses to cochlear implantation from the patient and healthcare professional perspective in Australia and the UK: study protocol
Publisher: BMJ
Date: 05-2018
Culturally safe speech-language supports for First Nations children
Publisher: Informa UK Limited
Date: 22-11-2023
Serum homocysteine and folate concentrations are associated with prevalent age-related hearing loss
Publisher: Elsevier BV
Date: 08-2010
Abstract: Elevated total serum homocysteine (tHcy) concentrations associated with vitamin B-12 or folate deficiencies may adversely affect blood flow to the cochlea, leading to age-related hearing loss (presbycusis). However, only 2 small cross-sectional studies have assessed the link between folate, vitamin B-12, or tHcy and presbycusis. We aimed to determine both the cross-sectional and longitudinal association between serum concentrations of folate, vitamin B-12, or tHcy and risk of age-related hearing loss. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss (1997-1999 to 2002-2004). Presbycusis was measured in 2956 participants (aged >or=50 y) and was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz >25 dB hearing level (HL). Serum concentrations of folate, vitamin B-12, and tHcy were determined from blood s les. Participants with elevated tHcy (>20 micromol/L) concentrations had a 64% increased likelihood of prevalent hearing loss (>25 dB HL) [multivariate-adjusted odds ratio (OR) 1.64 95% CI, 1.06-2.53]. Low serum folate levels ( 25-40 dB HL), multivariate-adjusted [OR 1.37 (CI 1.04-1.81)]. Serum vitamin B-12, however, was not significantly associated with prevalent hearing loss. Serum folate, vitamin B-12, and tHcy concentrations were also not significantly associated with an increased risk of incident hearing loss. Serum concentrations of tHcy and folate were associated with age-related hearing loss cross-sectionally, but no temporal links were observed, which could be due to insufficient study power. Further, large prospective studies will be required in the future to assess these associations.
Adults’ cochlear implant journeys through care: a qualitative study
Publisher: Springer Science and Business Media LLC
Date: 24-05-2020
DOI: 10.1186/S12913-020-05334-Y
Abstract: Cochlear implants (CIs) can provide a sound sensation for those with severe sensorineural hearing loss (SNHL), benefitting speech understanding and quality of life. Nevertheless, rates of implantation remain low, and limited research investigates journeys from traditional hearing aids to implantable devices. Fifty-five adults (≥ 50 years), hearing aid users and/or CI users, General Practitioners, and Australian and United Kingdom audiologists took part in a multi-methods study. Focus groups, interviews, and surveys were thematically analysed. One hundred forty-three data-capture events disclosed 2 themes: 1) “ The burden of hearing loss and the impact of Cochlear Implants ”, and 2) “ Professional Support and Practice, and HCPs Roles and Responsibilities” . Care experience can include convoluted, complex journeys towards cochlear implantation. The significant impact of this, as hearing loss progresses, motivates people to consider implants, but they and healthcare professionals need clear supported with defined referral pathways, and less system complexity.
Choice of Ear for Cochlear Implantation in Adults With Monaural Sound-Deprivation and Unilateral Hearing Aid
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2012
Lateralized cerebral processing of abstract linguistic structure in clear and degraded speech
Publisher: Oxford University Press (OUP)
Date: 09-09-2021
Abstract: Human cortical activity measured with magnetoencephalography (MEG) has been shown to track the temporal regularity of linguistic information in connected speech. In the current study, we investigate the underlying neural sources of these responses and test the hypothesis that they can be directly modulated by changes in speech intelligibility. MEG responses were measured to natural and spectrally degraded (noise-vocoded) speech in 19 normal hearing participants. Results showed that cortical coherence to “abstract” linguistic units with no accompanying acoustic cues (phrases and sentences) were lateralized to the left hemisphere and changed parametrically with intelligibility of speech. In contrast, responses coherent to words/syllables accompanied by acoustic onsets were bilateral and insensitive to intelligibility changes. This dissociation suggests that cerebral responses to linguistic information are directly affected by intelligibility but also powerfully shaped by physical cues in speech. This explains why previous studies have reported widely inconsistent effects of speech intelligibility on cortical entrainment and, within a single experiment, provided clear support for conclusions about language lateralization derived from a large number of separately conducted neuroimaging studies. Since noise-vocoded speech resembles the signals provided by a cochlear implant device, the current methodology has potential clinical utility for assessment of cochlear implant performance.
Screening, Education, and Rehabilitation Services for Hearing Loss Provided to Clients with Low Vision: Measured and Perceived Value Among Participants of the Vision-Hearing Project
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
DOI: 10.1097/AUD.0000000000000351
Abstract: Combined vision and hearing impairment, termed dual sensory impairment (DSI), is associated with poorer health outcomes compared with a single sensory loss alone. Separate systems of care exist for visual and hearing impairment which potentially limit the effectiveness of managing DSI. To address this, a Hearing Screening Education Model (HSEM) was offered to older adults attending a low-vision clinic in Australia within this pilot study. The present study aimed to evaluate the benefits of seeking help on hearing handicap, self-perceived health, and use of community services among those identified with unmet hearing needs after participation in the HSEM. Of 210 older adults ( years of age) who completed the HSEM and were referred for follow-up, 169 returned for a follow-up interview at least 12 months later. Of these, 68 (40.2%) sought help, and the majority were seen by a hearing healthcare provider (89.7%). Changes in hearing handicap, quality of life, and reliance on community services between the baseline and 12-month follow-up were compared between those who sought help and those who did not. In addition, the perceived value of the HSEM was assessed. Results showed that there was no significant difference in hearing handicap between those who sought help (mean change −1.02 SD = 7.97, p = 0.3) and those who did not (mean change 0.94 SD = 7.68, p = 0.3), p = 0.18. The mental component of the SF-36 worsened significantly between baseline and follow-up measures across the whole group (mean change −2.49 SD = 9.98, p = 0.002). This was largely driven by those not seeking help, rather than those seeking help, but was not significantly different between the two groups. Those who sought help showed a significant reduction in the use of community services compared with those who did not. Further, all participants positively viewed the HSEM’s underlying principle of greater integration between vision and hearing services. These findings suggest a need to further develop and evaluate integrated models of healthcare for older adults with DSI. It also highlights the importance of using broader measures of benefit, other than use of hearing aids to evaluate outcomes of hearing healthcare programs.
The use of cortical auditory evoked potentials to evaluate neural encoding of speech sounds in adults
Publisher: Georg Thieme Verlag KG
Date: 09-2006
DOI: 10.3766/JAAA.17.8.3
Abstract: There has been considerable recent interest in the use of cortical auditory evoked potentials (CAEPs) as an electrophysiological measure of human speech encoding in in iduals with normal as well as impaired auditory systems. The development of such electrophysiological measures such as CAEPs is important because they can be used to evaluate the benefits of hearing aids and cochlear implants in infants, young children, and adults that cannot cooperate for behavioral speech discrimination testing. The current study determined whether CAEPs produced by seven different speech sounds, which together cover a broad range of frequencies across the speech spectrum, could be differentiated from each other based on response latency and litude measures. CAEPs were recorded from ten adults with normal hearing in response to speech stimuli presented at a conversational level (65 dB SPL) via a loudspeaker. Cortical responses were reliably elicited by each of the speech sounds in all participants. CAEPs produced by speech sounds dominated by high-frequency energy were significantly different in litude from CAEPs produced by sounds dominated by lower-frequency energy. Significant effects of stimulus duration were also observed, with shorter duration stimuli producing larger litudes and earlier latencies than longer duration stimuli. This research demonstrates that CAEPs can be reliably evoked by sounds that encompass the entire speech frequency range. Further, CAEP latencies and litudes may provide an objective indication that spectrally different speech sounds are encoded differently at the cortical level.
Long-term monaural auditory deprivation and bilateral cochlear implants
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 15-02-2012
Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.MATURITAS.2012.03.010
Abstract: We aimed to determine the prospective association between measured hearing impairment, self-reported hearing handicap and hearing aid use with quality of life. 829 Blue Mountains Hearing Study participants (≥ 55 years) were examined between 1997-1999 and 2007-2009. The shortened version of the hearing handicap inventory was administered. Hearing levels were measured using pure-tone audiometry. Quality of life was assessed using the 36-Item Short-Form Survey (SF-36) higher scores reflect better quality of life. Hearing impairment at baseline compared with no impairment was associated with lower mean SF-36 mental composite score 10 years later (multivariable-adjusted p=0.03). Physical composite score and mean scores for seven of the eight SF-36 domains after 10-year follow-up were significantly lower among participants who self-reported hearing handicap at baseline. Differences in the adjusted means between participants with and without hearing handicap ranged from 2.7 (physical composite score) to 10.4 units ('role limitations due to physical problems' domain). In iduals who developed incident hearing impairment compared to those who did not, had adjusted mean scores 9.5- and 7.7-units lower in the 'role limitation due to physical problems', and 'bodily pain' domains, respectively, at the 10-year follow-up. Hearing aid users versus non-users at baseline showed a 1.82-point (p=0.03) and 3.32-point (p=0.01) increase in SF-36 mental composite score and mental health domain over the 10-year follow-up, respectively. Older adults with self-perceived hearing handicap constitute a potential risk group for overall deterioration in quality of life, while hearing aid use could help improve the well-being of hearing impaired adults.
Alternative pathways for hearing care may address disparities in access
Publisher: Frontiers Media SA
Date: 25-11-2021
DOI: 10.3389/FDGTH.2021.740323
Abstract: Background/Objectives: Low-uptake of hearing aids among older adults has long dogged the hearing care system in the U.S. and other countries. The introduction of over-the-counter hearing aids is set to disrupt the predominantly high-cost, specialty clinic-based delivery model of hearing care with the hope of increasing accessibility and affordability of hearing care. However, the current model of hearing care delivery may not be reaching everyone with hearing loss who have yet to use hearing aids. In this study, we examine the group of people who do not use hearing aids and describe their characteristics and health care utilization patterns. We also consider what other healthcare pathways may be utilized to increase access to hearing treatment. Design: Cross-sectional, the 2017 Medicare Current Beneficiary Survey. Setting: Non-institutionalized adults enrolled in Medicare, the U.S. public health insurance program for older adults (65 years and older) and those with qualifying medical conditions and disabilities. Participants: A nationally representative s le of 7,361 Medicare beneficiaries with self-reported trouble hearing and/or hearing aid use. Measurements: Survey-weighted proportions described the population characteristics and health care utilization of those with hearing loss by hearing aid use, and the characteristics of those with untreated hearing loss by health care service type utilized. Results: Women, racial/ethnic minorities, and low-income Medicare beneficiaries with self-reported hearing trouble were less likely to report using hearing aids than their peers. Among those who do not use hearing aids, the most commonly used health care services were obtaining prescription drugs (64%) and seeing a medical provider (50%). Only 20% did not access either service in the past year. These in iduals were more likely to be young and to have higher educational attainment and income. Conclusion: Alternative models of care delivered through pharmacies and general medical practices may facilitate access to currently underserved populations as they are particularly high touch-points for Medicare beneficiaries with untreated hearing trouble. As care needs will vary across a spectrum of hearing loss, alternative models of hearing care should look to complement not substitute for existing access pathways to hearing care.
Five-year incidence and progression of hearing impairment in an older population
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2011
Monitoring Alpha Oscillations and Pupil Dilation across a Performance-Intensity Function
Publisher: Frontiers Media SA
Date: 24-05-2016
Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five years later
Publisher: Oxford University Press (OUP)
Date: 16-05-2012
Abstract: we aimed to assess both cross-sectional and temporal links between measured hearing impairment and self-perceived hearing handicap, and health outcomes. in total, 811 Blue Mountains Hearing Study participants (Sydney, Australia) aged ≥55 years were examined twice (1997-99 and 2002-04). Hearing levels were measured with pure-tone audiometry. The shortened version of the hearing handicap inventory (HHIE-S) was administered, scores ≥8 defined hearing handicap. baseline hearing impairment was strongly associated with 7 of the 10 HHIE-S questions, 5 years later. In iduals with and without hearing impairment at baseline reported that they felt embarrassed and/or frustrated by their hearing problem, and that it h ered their personal/social life, multivariable-adjusted OR: 11.5 (CI: 3.5-38.1), OR: 6.3 (CI: 2.5-15.7) and OR: 6.0 (CI: 2.1-17.5), respectively, 5 years later. Hearing-impaired, compared with non-hearing-impaired adults had a significantly higher risk of developing moderate or severe hearing handicap, OR: 3.35 (CI: 1.91-5.90) and OR: 6.60 (CI: 1.45-30.00), respectively. Cross-sectionally (at wave 2), hearing handicap increased the odds of depressive symptoms and low self-rated health by 80 and 46%, respectively. older, hearing-impaired adults were significantly more likely to experience emotional distress and social engagement restrictions (self-perceived hearing handicap) directly due to their hearing impairment.
Low body mass index and jaw movement are protective of hearing in users of personal listening devices
Publisher: Wiley
Date: 04-2013
DOI: 10.1002/LARY.23955
Abstract: Sound pressure level delivered through personal listening devices (PLDs) and reaching the ear drum might be affected by body size and jaw movements. This study aimed to investigate whether jaw movement and/or smaller body mass index (BMI) resulted in decrease of sound pressure level within the ear canals of PLD users via an earbud earphone. Case series. Forty-five normal-hearing subjects (16 males mean age, 23.3 years) participated in this study. A probe-microphone system was used to measure sound pressure level in the external ear canal with music delivered from a media player via an earbud earphone. Test materials consisted of two 20-second excerpts from a heavy metal music piece. Subjects were instructed to adjust the volume of the media player to conform to three conditions for sound pressure measurement: comfortable, loud, and maximum. Measurements were then repeated while subjects mimicked chewing action under the same listening conditions. Sound pressure levels were significantly lower when measured with jaw movement than without jaw movement (P < .05). Sound pressure levels monitored with/without jaw movement were generally lower in subjects with a BMI<23 than those with a BMI ≥ 23 (P < .05). Jaw movement and low BMI (<23) reduced the overall sound level of PLDs at the ear canal. Sound pressure levels detected in the external ear canal of our subjects using earbud earphones were significantly lower under conditions of jaw movement/BMI <23. Our research invites further studies on a larger group of PLD users to correlate these variables with hearing threshold shifts over time.
Frequency-specific electrocochleography indicates that presynaptic and postsynaptic mechanisms of auditory neuropathy exist
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2008
Understanding degraded speech leads to perceptual gating of a brain stem reflex in human listeners
Publisher: Public Library of Science (PLoS)
Date: 20-10-2021
DOI: 10.1371/JOURNAL.PBIO.3001439
Abstract: The ability to navigate “cocktail party” situations by focusing on sounds of interest over irrelevant, background sounds is often considered in terms of cortical mechanisms. However, subcortical circuits such as the pathway underlying the medial olivocochlear (MOC) reflex modulate the activity of the inner ear itself, supporting the extraction of salient features from auditory scene prior to any cortical processing. To understand the contribution of auditory subcortical nuclei and the cochlea in complex listening tasks, we made physiological recordings along the auditory pathway while listeners engaged in detecting non(sense) words in lists of words. Both naturally spoken and intrinsically noisy, vocoded speech—filtering that mimics processing by a cochlear implant (CI)—significantly activated the MOC reflex, but this was not the case for speech in background noise, which more engaged midbrain and cortical resources. A model of the initial stages of auditory processing reproduced specific effects of each form of speech degradation, providing a rationale for goal-directed gating of the MOC reflex based on enhancing the representation of the energy envelope of the acoustic waveform. Our data reveal the coexistence of 2 strategies in the auditory system that may facilitate speech understanding in situations where the signal is either intrinsically degraded or masked by extrinsic acoustic energy. Whereas intrinsically degraded streams recruit the MOC reflex to improve representation of speech cues peripherally, extrinsically masked streams rely more on higher auditory centres to denoise signals.
Speech recognition outcomes following bilateral cochlear implantation in adults aged over 50 years old
Publisher: Informa UK Limited
Date: 06-04-2016
DOI: 10.3109/14992027.2016.1152403
Abstract: To examine the speech recognition benefit of bilateral cochlear implantation over unilateral implantation in adults aged over 50 years old, and to identify potential predictors of successful bilateral implantation in this group. Retrospective cohort study using data collected during standard clinical practice. Bilateral performance was compared to the unilateral performance with the first and second implanted ear and examined in relation to potential predictive variables. Sixty-seven cochlear implant users who received a second implant after the age of 50 years old. Participants obtained significantly greater speech recognition scores with the use of bilateral cochlear implants compared to the use of each in idual implant. The score obtained with the first implanted ear was the most reliable predictor of the score obtained with the second and with bilateral implants. Older adults can obtain speech recognition benefits from sequential bilateral cochlear implantation.
Visual and hearing impairment and retirement in older adults
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.MATURITAS.2017.03.318
Abstract: Impaired vision and hearing are common among older adults and have been shown to reduce functional independence and to reduce quality of life. This cohort study investigated the cross-sectional and temporal associations between objectively measured dual sensory impairment (DSI) and retirement from employment. 2409 Blue Mountains Eye Study participants aged 55+ years at baseline were included for analyses. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold >25dB HL (500-4000Hz, better ear). Employment status was questioned at each examination over 10 years. At baseline, 650 (27.0%) were employed and 1759 (73.0%) were retired. Cross-sectional analysis showed that participants with moderate to severe hearing loss, compared with those with normal hearing, had greater odds of being retired (multivariable-adjusted OR 1.96 95% CI 1.05-3.66). Participants presenting with concurrent visual impairment and moderate to severe hearing loss versus participants with no sensory loss had a significantly lower mean retirement age, 57.1 versus 58.7 years (multivariable-adjusted p-value=0.04). Participants with any hearing loss at baseline had significantly higher odds of being retired by the 10-year follow-up (age-sex adjusted OR 1.82 95% CI 1.00-3.30) this became marginally non-significant after adjusting for all other covariates (multivariable-adjusted OR 1.74 95% CI 0.95-3.17). No associations were observed between DSI and the incidence of retirement. Sensory impairment in older adults was independently associated with the decision to retire.
Barriers and Facilitators to Cochlear Implant Uptake in Australia and the United Kingdom
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-07-2019
DOI: 10.1097/AUD.0000000000000762
Abstract: Hearing loss (HL) affects a significant proportion of adults aged years by impairing communication and social connectedness and, due to its high prevalence, is a growing global concern. Cochlear implants (CIs) are effective devices for many people with severe or greater sensorineural HL who experience limited benefits from hearing aids. Despite this, uptake rates globally are low among adults. This multimethod, multicountry qualitative study aimed to investigate the barriers and facilitators to CI uptake among adults aged ≥50 years. Adult CI and hearing aid users with postlingual severe or greater sensorineural HL, general practitioners, and audiologists were recruited in Australia using purposive s ling, and a comparative s le of audiologists was recruited in England and Wales in the United Kingdom. Participants were interviewed in idually, or in a focus group, completed a demographic questionnaire and a qualitative survey. Data were analyzed using thematic analysis. A total of 143 data capture events were collected from 55 participants. The main barriers to CI uptake related to patients’ concerns about surgery and loss of residual hearing. Limited knowledge of CIs, eligibility criteria, and referral processes acted as barriers to CIs assessment referrals by healthcare professionals. Facilitators for CI uptake included patients’ desire for improved communication and social engagement, and increased healthcare professional knowledge and awareness of CIs. There are numerous complex barriers and facilitators to CI uptake. Knowledge of these can inform the development of targeted strategies to increase CI referral and surgery for potential beneficiaries.
Rasch Analysis of the Listening Effort Questionnaire—Cochlear Implant
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-05-2021
DOI: 10.1097/AUD.0000000000001059
Abstract: Listening effort may be defined as the attentional and cognitive resources needed to understand an auditory message, modulated by motivation. Despite the use of hearing devices such as hearing aids or cochlear implants (CIs), the requirement for high listening effort remains a challenge for in iduals with hearing loss. The Listening Effort Questionnaire—Cochlear Implant (LEQ-CI) is a hearing-specific patient-reported outcome measure (PROM), which has been designed for use in the CI candidacy and rehabilitation process to assess perceived listening effort in everyday life in adults with severe-profound hearing loss. The LEQ-CI has been developed in line with international consensus-based standards for best practice in PROM construction. The aim of this study was to improve the measurement precision of the LEQ-CI and to assess its psychometric measurement properties. A field test was undertaken with 330 CI patients from five National Health Service auditory implant centers in the United Kingdom. Participants were adults (≥18 years of age), had a severe-profound hearing loss, and met the UK candidacy criteria for cochlear implantation specified by the National Institute for Health and Care Excellence (NICE). Participants completed and returned an anonymized 29-item (each with a 5- or 7-point response option), draft version of the LEQ-CI (LEQ-CI 29 ) and a demographic questionnaire. Rasch analysis was undertaken using Winsteps software and the partial credit model to assess rating scale function and item fit. Results informed refinements to produce a 21-item version (LEQ-CI 21 ), which underwent a further Rasch analysis. The s le was predominantly female: 60.3% (n = 191). Median age of participants was 66 (range 21 to 89) years, with 7.3% (n = 24) of respondents being CI candidates and 92.7% (n = 306) being CI recipients. Mean duration of implantation was 3.8 (SD = 4.8) years. Initial Rasch analysis of the LEQ-CI 29 revealed poor rating scale functioning. Collapsing the 5- and 7-point rating scales to 3- and 4-point scales and removing eight items produced a 21-item PROM (LEQ-CI 21 ). Rasch analysis of the LEQ-CI 21 showed good fit to the Rasch measurement model. No items showed misfit and dimensionality analysis supported the existence of a single Rasch dimension, defined as perceived listening effort in daily life. Person reliability was 0.91 and the person separation index was 3.28, establishing four levels of person ability. The item separation index was 9.69, confirming the item hierarchy. No items showed differential item functioning for gender or age. The item difficulty range was –0.81 to 1.05, the person ability range for nonextreme persons was –3.54 to 2.49, and the mean person ability was –0.31. Overall, the LEQ-CI 21 was found to meet the Rasch model criteria for interval-level measurement. The LEQ-CI 21 is the first PROM to be developed specifically for the measurement of perceived listening effort and one of the first patient-reported outcome measures for use with CI patients to be developed using Rasch analysis. The LEQ-CI 21 has the potential to be used as a research tool and in clinical practice to evaluate perceived listening effort in daily life. Further psychometric evaluation of the LEQ-CI 21 is planned.
Incidence and Predictors of Hearing Aid Use and Ownership Among Older Adults With Hearing Loss
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.ANNEPIDEM.2011.03.005
Abstract: The reasons are not clear as to why people who need hearing aids and possess them do not use them. We aimed to describe the incidence and predictors of hearing aid ownership and use among older adults. We included 2,015 Blue Mountains Hearing Study participants aged ≥55 years who were examined between 1997 and 1999 and 2002 and 2004. Hearing levels were measured with pure-tone audiometry. The 5-year incidence of hearing aid use and ownership was 8.1% and 8.5%, respectively. Age was associated with incident hearing aid ownership and use, multivariable-adjusted odds ratio (OR) per decade increase in age of 1.79 (95% confidence interval [CI], 1.21-2.64) and of 1.66 (95% CI, 1.15-2.40), respectively. Any level of hearing loss (HL) at baseline predicted a 2.8-fold increased likelihood of using a hearing aid at follow-up. Hearing handicap was associated with 7% increased likelihood of incident aid use. Key reasons provided for not obtaining/using a hearing aid were: not recommended one (8.0%), its high cost (1.7%), and believing that they did not need one (9.0%). Incident hearing aid ownership and usage was relatively low among hearing impaired adults. Age, question-defined hearing handicap, and measured HL were significant predictors of incident hearing aid use/ownership.
Dual-task walking performance in older persons with hearing impairment
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2018
DOI: 10.1097/AUD.0000000000000489
Abstract: Adults with “hearing loss” have an increased falls risks. There may be an association between hearing impairment and walking performance under dual-task (DT) and triple-task (TT) conditions. The aim of this study was to identify DT and TT effects on walking speed, step length, and cadence in adults with hearing impairment, previous falls, and physical limitations. The observational study included 73 community-dwelling older people seeking audiology services. Data were collected on sociodemographic characteristics, previous falls, fear of falling, physical limitations, and walking performance under three task conditions. Differences between the task conditions (single task [ST], DT, and TT) and the hearing groups were analyzed with a two-way ANOVA with repeated measures. The influence of fall risks and limited physical functioning on walking under ST, DT, and TT conditions was analyzed with ANOVAs, with ST, DT, and TT performance as repeated measurement factor (i.e., walking speed, step length and Cadence × Previous falls, or short physical performance battery × Hearing Groups). Walking speed was reduced accompanied by decreased step length and increased cadence in people with more severe hearing loss. Larger negative effects on DT and TT walking were found with increasing hearing loss (speed and cadence decreased with higher DT costs). Highest DT costs were found for the walking-manual conditions. These results were accompanied by small effects of older age and more comorbidities. This first screening data of walking performance under different conditions for people with hearing loss warrants the need for development and investigation of training interventions to improve walking abilities. DT training may be beneficial to enhance motor and cognitive flexibility and to reduce fall risks.
Incidence, persistence, and progression of tinnitus symptoms in older adults: The blue mountains hearing study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2010
Global burden of ototoxic hearing loss associated with platinum-based cancer treatment
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.CANEP.2022.102203
Abstract: Platinum-based chemotherapeutic agents cisplatin and carboplatin are widely used in cancer treatment worldwide and may result in ototoxic hearing loss. The high incidence of cancer and salient ototoxic effects of platinum-based compounds pose a global public health threat. The purpose of this study was twofold. First, to estimate the prevalence of ototoxic hearing loss associated with treatment with cisplatin and/or carboplatin via a systematic review and meta-analysis. Second, to estimate the annual global burden of ototoxic hearing loss associated with exposure to cisplatin and/or carboplatin. For the systematic review, three databases were searched (Ovid Medline, Ovid Embase, and Web of Science Core Collection) and studies that reported prevalence of objectively measured ototoxic hearing loss in cancer patients were included. A random effects meta-analysis determined pooled prevalence (95% confidence intervals [CI]) of ototoxic hearing loss overall, and estimates were stratified by treatment and patient attributes. Estimates of ototoxic hearing loss burden were created with published global estimates of incident cancers often treated with platinum-based compounds and cancer-specific treatment rates. Eighty-seven records (n = 5077 in iduals) were included in the meta-analysis. Pooled prevalence of ototoxic hearing loss associated with cisplatin and/or carboplatin exposure was 43.17% [CI 37.93-48.56%]. Prevalence estimates were higher for regimens involving cisplatin (cisplatin only: 49.21% [CI 42.62-55.82%] cisplatin & carboplatin: 56.05% [CI 45.12-66.43%]) versus carboplatin only (13.47% [CI 8.68-20.32%]). Our crude estimates of burden indicated approximately one million in iduals worldwide are likely exposed to cisplatin and/or carboplatin, which would result in almost half a million cases of hearing loss per year, globally. There is an urgent need to reduce impacts of ototoxicity in cancer patients. This can be partially achieved by implementing existing strategies focused on primary, secondary, and tertiary hearing loss prevention. Primary ototoxicity prevention via otoprotectants should be a research and policy priority.
Identification of different subtypes of auditory neuropathy using electrocochleography
Publisher: Springer Japan
Date: 2009
A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives
Publisher: Springer Science and Business Media LLC
Date: 06-03-2018
Hearing AIDS and the brain
Publisher: Hindawi Limited
Date: 2014
DOI: 10.1155/2014/518967
K(+) currents produce P(1) in the RW CAP: evidence from DC current bias, K(+) channel blockade and recordings from cochlea and brainstem.
Publisher: Elsevier BV
Date: 04-2004
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Linkage Projects - Grant ID: LP140100468
Start Date: 04-2015
End Date: 04-2018
Amount: $183,000.00
Funder: Australian Research Council
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