Perinatal hipoxic ischemic injury in the auditory pathway and the effect of several neuroprotective agents

192 p.

Stream segregation on a single electrode as a function of pulse rate in cochlear implant listeners.

While cochlear implants (CIs) usually provide high levels of speech recognition in quiet, speech recognition in noise remains challenging. To overcome these difficulties, it is important to understand how implanted listeners separate a target signal from interferers. Stream segregation has been studied extensively in both normal and electric hearing, as a function of place of stimulation. However, the effects of pulse rate, independent of place, on the perceptual grouping of sequential sounds in electric hearing have not yet been investigated. A rhythm detection task was used to measure stream segregation. The results of this study suggest that while CI listeners can segregate streams based on differences in pulse rate alone, the amount of stream segregation observed decreases as the base pulse rate increases. Further investigation of the perceptual dimensions encoded by the pulse rate and the effect of sequential presentation of different stimulation rates on perception could be beneficial for the future development of speech processing strategies for CIs.

Sign of the Times, November 2013 - February 2014

Newsletter produced by Deaf Services Commission of Iowa

Práticas educativas parentais de crianças com deficiência auditiva e de linguagem

Comportamentos de pais e de filhos influenciam-se mutuamente. Crianças com alterações de linguagem relacionadas ou não à perda auditiva, podem apresentar dificuldades de relacionamento com os irmãos e seus pares. Assim, a investigação das práticas educativas parentais e do repertório comportamental infantil é fundamental para a busca de intervenções efetivas para essas crianças. O estudo tem como objetivos: (a) comparar o repertório positivo e negativo de mães e crianças com deficiência auditiva (DA) e distúrbio de linguagem (DL); (b) comparar cada uma das deficiências com grupo não clinico; (c) correlacionar comportamentos para cada uma das deficiências. Participaram deste estudo 72 mães, cujos filhos apresentavam da (n = 27), DL (n = 19) ou compunha uma população não clínica (n = 26). O instrumento utilizado foi o Roteiro de Entrevista de Habilidades Sociais Educativas Parentais, que avalia a ocorrência de habilidades sociais aplicáveis às práticas educativas. Os resultados evidenciaram a associação entre práticas positivas e habilidades sociais, bem como entre práticas negativas e problemas de comportamento. O grupo de DL não apresentou mais problemas que as crianças não clínicas, sugerindo a participação de intervenções de caráter preventivo, facilitando a inclusão social. Por outro lado as crianças com da apresentaram menos habilidades sociais, bem como suas mães, menos habilidades sociais educativas. Este estudo evidencia a importância da metodologia empregada na reabilitação de crianças com distúrbios da comunicação, sobretudo para aquelas com da visando o beneficio de programas educativos de promoção do repertório parental positivo integrados aos objetivos da fonoterapia.

Training courses for teachers through the distance learning: practice reports used virtual environment TELEDUC

This paper describes the experiences of long-distance courses, it focused on the continuing education of basic education teachers in all Brazilian territory. Such courses were offered by CECEMCA (Center for Continuing Education in Mathematics Education, Science and Environment), linked to the Universidade Estadual Paulista Julio de Mesquita Filho - Campus de Rio Claro during 15/01/2009 to 30/11/2009. The subjects report to the theme of Education, Geography and Environment, it was organized in four courses: "Introduction to Cartography," Environment and climate change - thinking a new paradigm of sustainable green planet "," Remote Sensing in environmental studies Environment "and" Methodological Alternatives for Inclusive Classroom: Experimenting with visual and hearing impairments". So, we show here, the feasibility and importance of distance learning tools for education, specifically teacher training, based on the results obtained in these courses.

Down Syndrome: Neuropsychological phenotype and mitochondrial DNA

Introduction. Down Syndrome (DS) is the most known autosomal trisomy, due to the presence in three copies of chromosome 21. Many studies were designed to identify phenotypic and clinical consequences related to the triple gene dosage. However, the general conclusion is a senescent phenotype; in particular, the most features of physiological aging, such as skin and hair changes, vision and hearing impairments, thyroid dysfunction, Alzheimer-like dementia, congenital heart defects, gastrointestinal malformations, immune system changes, appear in DS earlier than in normal age-matched subjects. The only established risk factor for the DS is advanced maternal age, responsible for changes in the meiosis of oocytes, in particular the meiotic nondisjunction of chromosome 21. In this process mitochondria play an important role since mitochondrial dysfunction, due to a variety of extrinsic and intrinsic influences, can profoundly influence the level of ATP generation in oocytes, required for a correct chromosomal segregation. Aim. The aim of this study is to investigate an integrated set of molecular genetic parameters (sequencing of complete mtDNA, heteroplasmy of the mtDNA control region, genotypes of APOE gene) in order to identify a possible association with the early neurocognitive decline observed in DS. Results. MtDNA point mutations do not accumulate with age in our study sample and do not correlate with early neurocognitive decline of DS subjects. It seems that D-loop heteroplasmy is largely not inherited and tends to accumulate somatically. Furthermore, in our study sample no association of cognitive impairment and ApoE genotype is found. Conclusions. Overall, our data cast some doubts on the involvement of these mutations in the decline of cognitive functions observed in DS.

Evaluación del tiempo de reacción en velocistas con y sin discapacidad auditiva: aplicaciones para la inclusión

Este trabajo de investigación trata de aportar luz al estudio del tiempo de reacción (TR) en velocistas con y sin discapacidad auditiva desde las Ciencias del Deporte. El planteamiento del presente estudio surgió al cuestionarnos la existencia de las diferencias en cuanto al TR visual y auditivo aplicado a velocistas con y sin discapacidad auditiva, pensando en el desarrollo futuro de competiciones inclusivas entre ambos colectivos. Por ello, este estudio trata de resolver las dificultades que los velocistas con discapacidad se encuentran habitualmente en las competiciones. A priori, los atletas con discapacidad auditiva compiten en inferioridad de condiciones como consecuencia de una salida que no parece la más adecuada para ellos (desde los tacos, han de mirar hacia la pistola del juez o el movimiento de un rival). El documento se divide en tres partes. En la primera parte se realiza la pertinente revisión del marco teórico y justificación del estudio. La segunda parte se centra en los objetivos de la investigación, el material y el método, donde se muestran los resultados, discusión y conclusiones del estudio realizado, así como las limitaciones del presente trabajo y sus futuras líneas de investigación. La tercera parte corresponde a la bibliografía y la cuarta parte a los anexos. En la primera parte, presentamos el marco teórico compuesto por cinco capítulos organizan la fundamentación que hemos realizado como revisión sobre los aspectos más destacados del TR, determinado por las características de la tarea y otros factores que influyen en el TR como objeto de nuestro estudio. Después exponemos los principales aspectos estructurales y funcionales del sistema nervioso (SN) relacionados con el TR visual y auditivo. Tras ello se expone la realidad del deporte para personas con discapacidad auditiva, indagando en sus peculiaridades y criterios de elegibilidad que tiene ese colectivo dentro del ámbito deportivo. A continuación abordamos el estudio de la salida de velocidad en el atletismo, como aspecto clave que va a guiar nuestra investigación, especialmente los parámetros determinantes en la colocación de los tacos de salida para atletas con y sin discapacidad auditiva, la posición de salida y la propia colocación de los estímulos en dicha situación. Es la segunda parte se desarrolla el trabajo de investigación que tiene como objetivos estudiar los valores de TR visual simple manual, TR en salida de tacos y los tiempos de desplazamiento a los 10m y 20m de velocistas con y sin discapacidad auditiva, así como analizar las posibles diferencias en TR según posición y tipo de estímulo luminoso, respecto a ambos grupos de atletas. Como tercer objetivo de estudio se evalúa cualitativamente, por parte de los propios atletas, el dispositivo luminoso utilizado. La toma de datos de este estudio se llevó a cabo entre los meses de febrero y mayo del 2014, en el módulo de atletismo del Centro de Alto Rendimiento Joaquín Blume (Madrid), con dos grupos de estudio, uno de 9 velocistas con discapacidad auditiva (VDA), conformando éstos el 60% de toda la población en España, según el número de las licencias de la FEDS en la modalidad de atletismo (velocistas, pruebas de 100 y 200 m.l.), en el momento del estudio, y otro de 13 velocistas sin discapacidad (VsDA) que se presentaron de manera voluntaria con unos mismos criterios de inclusión para ambos grupos. Para la medición y el registro de los datos se utilizaron materiales como hoja de registro, Medidor de Tiempo de Reacción (MTR), tacos de salida, ReacTime®, dispositivo luminoso conectado a los tacos de salida, células fotoeléctricas, ordenador y software del ReacTime, y cámara de video. La metodología utilizada en este estudio fue de tipo correlacional, analizando los resultados del TR simple manual según vía sensitiva (visual y auditiva) entre los dos grupos de VDA y VsDA. También se estudiaron los TR desde la salida de tacos en función de la colocación del dispositivo luminoso (en el suelo y a 5 metros, vía visual) y pistola de salida atlética (vía auditiva) así como el tiempo de desplazamiento a los 10m (t10m) y 20m (t20m) de ambos grupos de velocistas. Finalmente, se desarrolló y llevó a cabo un cuestionario de evaluación por parte de los atletas VDA con el objetivo de conocer el grado de satisfacción después de haber realizado la serie de experimentos con el dispositivo luminoso y adaptado para sistemas de salida en la velocidad atlética. Con el objetivo de comprobar la viabilidad de la metodología descrita y probar en el contexto de análisis real el protocolo experimental, se realizó un estudio piloto con el fin de conocer las posibles diferencias del TR visual desde los tacos de salida en velocistas con discapacidad auditiva, usando para dicha salida un estímulo visual mediante un dispositivo luminoso coordinado con la señal sonora de salida (Soto-Rey, Pérez-Tejero, Rojo-González y Álvarez-Ortiz, 2015). En cuanto a los procedimientos estadísticos utilizados, con el fin de analizar la distribución de los datos y su normalidad, se aplicó la prueba de Kolmogorov-Smirnof, dicha prueba arrojó resultados de normalidad para todas las variables analizadas de las situaciones experimentales EA, EVsuelo y EV5m. Es por ello que en el presente trabajo de investigación se utilizó estadística paramétrica. Como medidas descriptivas, se calcularon el máximo, mínimo, media y la desviación estándar. En relación a las situaciones experimentales, para estudiar las posibles diferencias en las variables estudiadas dentro de cada grupo de velocistas (intragrupo) en la situación experimental 1 (MTR), se empleó una prueba T de Student para muestras independientes. En las situaciones experimentales 2, 3 y 4, para conocer las diferencias entre ambos grupos de velocistas en cada situación, se utilizó igualmente la prueba T para muestras independientes, mientras que un ANOVA simple (con post hoc Bonferroni) se utilizó para analizar las diferencias para cada grupo (VDA y VsDA) por situación experimental. Así mismo, se utilizó un ANOVA de medidas repetidas, donde el tipo de estímulo (situación experimental) fue la variable intra-grupo y el grupo de velocistas participantes (VDA y VsDA) la entre-grupo, realizándose esta prueba para evaluar en cada situación el TR, t1m0 y t20m y las interacciones entre las variables. Para el tratamiento estadístico fue utilizado el paquete estadístico SPSS 18.0 (Chicago, IL, EEUU). Los niveles de significación fueron establecidos para un ≤0.05, indicando el valor de p en cada caso. Uno de los aspectos más relevantes de este trabajo es la medición en diferentes situaciones, con instrumentación distinta y con situaciones experimentales distintas, del TR en velocistas con y sin discapacidad auditiva. Ello supuso el desarrollo de un diseño de investigación que respondió a las necesidades planteadas por los objetivos del estudio, así como el desarrollo de instrumentación específica (Rojo-Lacal, Soto-Rey, Pérez-Tejero y Rojo-González, 2014; Soto-Rey et al., 2015) y distintas situaciones experimentales que reprodujeran las condiciones de práctica y competición real de VsDA y VDA en las pruebas atléticas de velocidad, y más concretamente, en las salidas. El análisis estadístico mostró diferencias significativas entre los estímulos visuales y sonoros medidos con el MTR, siendo menor el TR ante el estímulo visual que ante el sonoro, tanto para los atletas con discapacidad auditiva como para los que no la presentaron (TR visual, 0.195 s ± 0.018 vs 0.197 s ± 0.022, p≤0.05; TR sonoro 0.230 s ± 0.016 vs 0.237 s ± 0.045, p≤0.05). Teniendo en cuenta los resultados según población objeto de estudio y situación experimental, se registraron diferencias significativas entre ambas poblaciones, VDA y VsDA, siendo más rápidos los VDA que VsDA en la situación experimental con el estímulo visual en el suelo (EVsuelo, 0.191 ±0.025 vs 0.210 ±0.025, p≤0.05, respectivamente) y los VsDA en la situación experimental con el estímulo auditivo (EA, 0.396 ±0.045 vs 0.174 ±0.021, p≤0.05), aunque sin diferencias entre ambos grupos en la situación experimental con el estímulo visual a 5m de los tacos de salida. Es de destacar que en el TR no hubo diferencias significativas entre EA para VsDA y EVsuelo para VDA. El ANOVA simple registró diferencias significativas en todas las situaciones experimentales dentro de cada grupo y para todas las variables, por lo que estadísticamente, las situaciones experimentales fueron diferentes entre sí. En relación al de ANOVA medidas repetidas, la prueba de esfericidad se mostró adecuada, existiendo diferencias significativas en las varianzas de los pares de medias: el valor de F indicó que existieron diferencias entre las diferentes situaciones experimentales en cuanto a TR, incluso cuando éstas se relacionaban con el factor discapacidad (factor interacción, p≤0,05). Por ello, queda patente que las situaciones son distintas entre sí, también teniendo en cuenta la discapacidad. El η2 (eta al cuadrado, tamaño del efecto, para la interacción) indica que el 91.7% de la variación se deben a las condiciones del estudio, y no al error (indicador de la generalización de los resultados del estudio). Por otro lado, la evaluación del dispositivo luminoso fue positiva en relación a la iluminación, comodidad de uso, ubicación, color, tamaño, adecuación del dispositivo y del equipamiento necesario para adaptar al sistema de salida. La totalidad de los atletas afirman rotundamente que el dispositivo luminoso favorecería la adaptación al sistema de salida atlética para permitir una competición inclusiva. Asimismo concluyen que el dispositivo luminoso favorecería el rendimiento o mejora de marca en la competición. La discusión de este estudio presenta justificación de las diferencias demostradas que el tipo de estímulo y su colocación son clave en el TR de esta prueba, por lo que podríamos argumentar la necesidad de contar con dispositivos luminosos para VDA a la hora de competir con VsDA en una misma prueba, inclusiva. El presente trabajo de investigación ha demostrado, aplicando el método científico, que el uso de estos dispositivos, en las condiciones técnicas y experimentales indicadas, permite el uso por parte del VDA, usando su mejor TR visual posible, que se muestra similar (ns) al TR auditivo de VsDA, lo que indica que, para competiciones inclusivas, la salida usando el semáforo (para VDA) y la salida habitual (estímulo sonoro) para VsDA, puede ser una solución equitativa en base a la evidencia demostrada en este estudio. De esta manera, y como referencia, indicar que la media de los TR de los velocistas en la final de los 100 m.l. en los Juegos Olímpicos de Londres 2012 fue de 0.162 ±0.015. De esta manera, creemos que estos parámetros sirven de referencia a técnicos deportivos, atletas y futuros trabajos de investigación. Las aplicaciones de este trabajo permitirán modificaciones y reflexiones en forma de apoyo al entrenamiento y la competición para el entrenador, o juez de salida en la competición que, creemos, es necesaria para proporcionar a este colectivo una atención adecuada en las salidas, especialmente en situaciones inclusivas de práctica. ABSTRACT This research aims to study of reaction time (RT) in sprinters with and without hearing impairment from the Sports Science perspective. The approach of this study came asking whether there were differences in the visual and auditory RT applied to sprinters with and without hearing impairment, thinking about the future development of inclusive competition between the two groups. Therefore, this study attempts to resolve the difficulties commonly founded by sprinters with hearing impairments during competitions. A priori, sprinters with hearing impairment would compete in a disadvantage situation as a result of the use of a staring signal not suitable for them (from the blocks, they have to look to the judge´s pistol or the movement of an opponent). The document is divided into three parts. In the first part of the review of relevant theoretical framework and justification of the study is presented. The second part focuses on the research objectives, material and method, where results, discussion and conclusions of the study, as well as the limitations of this study and future research are presented. The third part contains references and the fourth, annexes. In the first part, we present the theoretical framework consisting of five chapters, organizing the state of the art of RT, determined by the characteristics of the task and other factors that influence the RT as object of our study. Then we present the main structural and functional aspects of the nervous system associated with visual and auditory RT. After that, sport for people with hearing disabilities is presented, investigating its peculiarities and eligibility criteria is that group within the deaf sport. Finally, we discuss the theoretical foundation of the study of start speed in athletics as a key aspect that will guide our research, especially the determining parameters in placing the starting blocks for athletes with and without hearing impairment, the starting position and the actual placement of stimuli in such a situation. The second part of the research aims to study the values of simple manual visual RT, RT start from blocks and travel times up to 10m and 20m of sprinters with and without hearing impairment, and to analyze possible differences in RT as position and type of light stimulus with respect to both groups of athletes. The third objective of the study is to assess the pertinence of the lighting device developed and used in the study, in a qualitatively way by athletes themselves. Data collection for this study was carried out between February and May 2014, in the Athletics module at the High Performance Centre Joaquin Blume (Madrid) with the two study groups: 9 sprinters with hearing impairments(VDA, reaching 60% of the population in Spain, according to the number of licenses for athletics at FEDS: sprint, 100 and 200 m.l., at the time of the study), and another 13 sprinters without disability (VsDA) who voluntarily presented themselves, with same inclusion criteria for both groups. For measuring and data collection materials such as recording sheet, gauge reaction time (MTR), starting blocks, ReacTime®, luminous device connected to the starting blocks, photocells, computer and software ReacTime, and video camera were used. The methodology used in this study was correlational, analyzing the results of simple manual RT according sensory pathway (visual and auditory) between the two groups (VsDA and VDA). Also auditory and visual RT was studied depending the placement of the start light signal (on the ground and 5 meters, visual pathway) and athletic start gun signal (auditory pathway, conventional situation) and travel time up to 10m (t10m) and 20m (t20m) for both groups of sprinters. Finally, we developed and carried out an evaluation questionnaire for VDA athletes in order to determine the degree of satisfaction after completing the series of experiments with lighting device and adapted to start systems in athletic speed. In order to test the feasibility of the methodology described and tested in the context of real analysis of the experimental protocol, a pilot study in order to know the possible differences visual RT from the starting blocks in sprinters with hearing impairments was performed, to said output using a visual stimulus coordinated by a lighting device with sound output signal (Soto-Rey Perez-Tejero, Rojo-González y Álvarez-Ortiz, 2015). For the statistical procedures, in order to analyze the distribution of the data and their normality, Kolmogorov-Smirnov test was applied, this test yielded normal results for all variables analyzed during EA, EVsuelo and EV5m experimental situations. Parametric statistics were used in this research. As descriptive measures, the maximum, minimum, mean and standard deviation were calculated. In relation to experimental situations, to study possible differences in the variables studied in each group sprinters (intragroup) in the experimental situation 1 (MTR), a Student t test was used for independent samples. Under the experimental situations 2, 3 and 4, to know the differences between the two groups of sprinters in every situation, the T test for independent samples was used, while a simple ANOVA (with post hoc Bonferroni) was used to analyze differences for each group (VDA and VsDA) by experimental situation. Likewise, a repeated measures ANOVA, where the type of stimulus (experimental situation) was variable intra-group and participants sprinters group (VDA and VsDA) the variable between-group, was performed to assess each situation for RT, t10m and t20m, and also interactions between variables. For the statistical treatment SPSS 18.0 (Chicago, IL, USA) was used. Significance levels were set for  ≤0.05, indicating the value of p in each case. One of the most important aspects of this work is the measurement of RT in sprinters with and without hearing impairment in different situations, with different instrumentation and different experimental situations. This involved the development of a research design that responded to the needs raised by the study aims and the development of specific instrumentation (Rojo-Lacal, Soto-Rey Perez-Tejero and Rojo-Gonzalez, 2014; Soto-Rey et al., 2015) and different experimental situations to reproduce the conditions of practical and real competition VsDA and VDA in athletic sprints, and more specifically, at the start. Statistical analysis showed significant differences between the visual and sound stimuli measured by the MTR, with lower RT to the visual stimulus that for sound, both for athletes with hearing disabilities and for those without (visual RT, 0.195 s ± 0.018 s vs 0.197 ± 0.022, p≤0.05; sound RT 0.230 s ± 0.016 vs 0.237 s ± 0.045, p≤0.05). Considering the results according to study population and experimental situation, significant differences between the two populations, VDA and VsDA were found, being faster the VDA than VsDA in the experimental situation with the visual stimulus on the floor (EVsuelo, recorded 0.191 s ± 0.025 vs 0.210 s ± 0.025, p≤0.05, respectively) and VsDA in the experimental situation with the auditory stimulus (EA, 0.396 s ± 0.045 vs 0.174 s ± 0.021, p≤0.05), but no difference between groups in the experimental situation with the 5m visual stimulus to the starting blocks. It is noteworthy that no significant differences in EA and EVsuelo between VsDA to VDA, respectively, for RT. Simple ANOVA showed significant differences in all experimental situations within each group and for all variables, so statistically, the experimental situations were different. Regarding the repeated measures ANOVA, the sphericity test showed adequate, and there were significant differences in the variances of the pairs of means: the value of F indicated that there were differences between the different experimental situations regarding RT, even when they were related to the disability factor (factor interaction, p≤0.05). Therefore, it is clear that the situations were different from each other, also taking into account impairment. The η2 (eta squared, effect size, for interaction) indicates that 91.7% of the variation is due to the conditions of the study, not by error (as indicator of the generalization potential of the study results). On the other hand, evaluation of the light signal was positively related to lighting, ease of use, location, color, size, alignment device and equipment necessary to adapt the start system. All the athletes claim strongly in favor of the lighting device adaptation system to enable athletic competition inclusive. Also they concluded that light device would enhance performance or would decrease their RT during the competition. The discussion of this study justify the type of stimulus and the start light positioning as key to the RT performance, so that we could argue the need for lighting devices for VDA when competing against VsDA the same competition, inclusive. This research has demonstrated, applying the scientific method, that the use of these devices, techniques and given experimental conditions, allows the use of the VDA, using his best visual RT, shown similar (ns) auditory RT of VsDA, indicating that for inclusive competitions, the start signal using the light (for VDA) and the usual start (sound stimulus) to VsDA can be an equitable solution based on the evidence shown in this study. Thus, and as a reference, indicate that the average of the RT sprinters in the 100 m. final at the 2012 Summer Olympic Games was 0.162 s ± 0.015. Thus, we believe that these parameters become a reference to sports coaches, athletes and future research. Applications of this work will allow modifications and reflections in the form of support for training and competition for the coach, or judge, as we believe is necessary to provide adequate attention to VDA in speed starts, especially in inclusive practice situations.

Personal factors, communication and vision predict social participation in older adults

Social isolation is a predictor of morbidity and mortality in older people. Speech pathologists often consider that communication disabilities associated with normal ageing (sensory loss, language and discourse changes) contribute to social isolation. The aims of this study were to describe the functioning of older people using the International Classification of Functioning, Disability and Health (WHO, 2001) as a conceptual framework for language and sensory functioning, communicative activity, and social participation, and to explore the relationship between communication (both at an impairment level and an activity level), social participation and personal factors (demographics and emotional health). In a prospective study, 47 women and 28 men aged 62 to 98 years (mean=74 yrs) completed objective and subjective assessments of functioning and participation, and provided personal information. Assessments were individually conducted in a face- to-face interview situation with the primary researcher, who was a speech pathologist. Assessments revealed the sample had predominantly mild hearing and vision impairments, unimpaired naming ability, frequent involvement in a wide range of communication activities, and variable social network size and social activities participation. Social participation was shown to be associated with vision, communication activities, age, education and emotional health. Naming and hearing impairments were not reliable predictors of social participation. It was concluded that professionals interested in maintaining and improving social participation of older people could well consider these predictors in community-directed interventions. Speech pathologists should therefore promote older people's involvement in everyday communicative activities while also limiting the impact of communication-related impairments, so that social participation is maintained in our ageing population.

Sign of the TIME E-News, October-December 2016

Newsletter produced by Deaf Services Commission of Iowa

An analysis of pre-reading strategies in deaf/hard of hearing students

This literature review evaluates print knowledge ability in normally hearing pre-readers with and without specific language impairments. It then discusses implications of print knowledge ability in students who are deaf or hard of hearing and early intervention strategies.

Hearing impairment affects older people’s ability to drive in the presence of distracters

OBJECTIVES: To investigate the effects of hearing impairment and distractibility on older people's driving ability, assessed under real-world conditions. DESIGN: Experimental cross-sectional study. SETTING: University laboratory setting and an on-road driving test. PARTICIPANTS: One hundred seven community-living adults aged 62 to 88. Fifty-five percent had normal hearing, 26% had a mild hearing impairment, and 19% had a moderate or greater impairment. ---------- MEASUREMENTS: Hearing was assessed using objective impairment measures (pure-tone audiometry, speech perception testing) and a self-report measure (Hearing Handicap Inventory for the Elderly). Driving was assessed on a closed road circuit under three conditions: no distracters, auditory distracters, and visual distracters. RESULTS: There was a significant interaction between hearing impairment and distracters, such that people with moderate to severe hearing impairment had significantly poorer driving performance in the presence of distracters than those with normal or mild hearing impairment. CONCLUSION: Older adults with poor hearing have greater difficulty with driving in the presence of distracters than older adults with good hearing.

Modest visual impairments and headlamp glare reduce pedestrian visability at night

Background: This study investigated the effects of experimentally induced visual impairment, headlamp glare and clothing on pedestrian visibility. Methods: 28 young adults (M=27.6±4.7 yrs) drove around a closed road circuit at night while pedestrians walked in place at the roadside. Pedestrians wore either black clothing, black clothing with a rectangular vest consisting of 1325 cm2 of retroreflective tape, or the same amount of tape positioned on the extremities in a configuration that conveyed biological motion (“biomotion”). Visual impairment was induced by goggles containing either blurring lenses, simulated cataracts, or clear lenses; visual acuity for the cataract and blurred lens conditions was matched. Drivers pressed a response pad when they first recognized that a pedestrian was present. Sixteen participants drove around the circuit in the presence of headlamp glare while twelve drove without glare. Results: Visual impairment, headlamp glare and pedestrian clothing all significantly affected drivers’ ability to recognize pedestrians (p<0.05). The simulated cataracts were more disruptive than blur, even though acuity was matched across the two manipulations. Pedestrians were recognized more often and at longer distances when they wore “biomotion” clothing than either the vest or black clothing, even in the presence of visual impairment and glare. Conclusions: Drivers’ ability to see and respond to pedestrians at night is degraded by modest visual impairments even when vision meets driver licensing requirements; glare further exacerbates these effects. Clothing that includes retroreflective tape in a biological motion configuration is relatively robust to visual impairment and glare.

A sense of control : virtual communities for people with mobility impairments

The purpose of this book is to show why we should be concerned about virtual communities for people with physical, or more particularly mobility, impairments. The well-being model through a virtual community introduced here goes towards advancing the work begun by others, by adding for example a socio-political component. The model presented here provides practical insights into how strategic community investment can support people with disabilities and their families. Virtual communities are about engagement, quality of life and support, not just about information. The role of information technology in building and raising community capacity and social capital in socially and economically disadvantaged communities is also examined. Practical insights are offered into community support for people with chronic illness.