A hearing aid orientation pamphlet for clinical use with first-time hearing aid users

This paper discusses the use of a pamphlet to help first-time hearing aid users adjust to their hearing aids.

The effect of talker age and gender on speech perception of pediatric cochlear implant users

Most clinically-employed speech materials for testing hearing impaired individuals are recordings made by adult male talkers. The author examined the possible effect of talker age and gender on the speech perception of children through the use of 1) two speech perception tests, each with four talker types (adult males, adult females, 10-12 year olds, 5-7 year olds), and 2) two groups of pediatric listeners: normal-hearing (NH) and cochlear implant users (CI).

The effect of talker age and gender on speech perception of pediatric hearing aid users

Even though pediatric hearing aid (HA) users listen most often to female talkers, clinically-used speech tests primarily consist of adult male talkers' speech. Potential effects of age and/or gender of the talker on speech perception of pediatric HA users were examined using two speech tests, hVd-vowel identification and CNC word recognition, and using speech materials spoken by four talker types (adult males, adult females, 10-12 year old girls, and 5-7 year old girls). For the nine pediatric HA users tested, word scores for the male talker's speech were higher than those for the female talkers, indicating that talker type can affect word recognition scores and that clinical tests may over-estimate everyday speech communication abilities of pediatric HA users.

Subjective and objective measures of adult bimodal users' listening

Inconsistencies exist between traditional objective measures such as speech recognition and localization, and subjective reports of bimodal benefit. The purpose of this study was to expand the set of objective measures of bimodal benefit to include non-traditional listening tests, and to examine possible correlations between objective measures of auditory perception and subjective satisfaction reports.

Amygdala and ventromedial prefrontal cortex are inversely coupled during regulation of negative affect and predict the diurnal pattern of cortisol secretion among older adults

Among younger adults, the ability to willfully regulate negative affect, enabling effective responses to stressful experiences, engages regions of prefrontal cortex (PFC) and the amygdala. Because regions of PFC and the amygdala are known to influence the hypothalamic-pituitary-adrenal axis, here we test whether PFC and amygdala responses during emotion regulation predict the diurnal pattern of salivary cortisol secretion. We also test whether PFC and amygdala regions are engaged during emotion regulation in older (62- to 64-year-old) rather than younger individuals. We measured brain activity using functional magnetic resonance imaging as participants regulated (increased or decreased) their affective responses or attended to negative picture stimuli. We also collected saliva samples for 1 week at home for cortisol assay. Consistent with previous work in younger samples, increasing negative affect resulted in ventral lateral, dorsolateral, and dorsomedial regions of PFC and amygdala activation. In contrast to previous work, decreasing negative affect did not produce the predicted robust pattern of higher PFC and lower amygdala activation. Individuals demonstrating the predicted effect (decrease s attend in the amygdala), however, exhibited higher signal in ventromedial prefrontal cortex (VMPFC) for the same contrast. Furthermore, participants displaying higher VMPFC and lower amygdala signal when decreasing compared with the attention control condition evidenced steeper, more normative declines in cortisol over the course of the day. Individual differences yielded the predicted link between brain function while reducing negative affect in the laboratory and diurnal regulation of endocrine activity in the home environment.

Official warnings on thromboembolism risk with oral contraceptives fail to inform users adequately

Following the 1995 “pill scare” relating to the risk of venous thrombosis from taking second- or third-generation oral contraceptives, the Committee on Safety of Medicines (CSM) withdrew their earlier recommended restrictions on the use of third-generation pills and published recommended wording to be used in patient information leaflets. However, the effectiveness of this wording has not been tested. An empirical study (with 186 pill users, past users, and non-users) was conducted to assess understanding, based on this wording, of the absolute and relative risk of thrombosis in pill users and in pregnancy. The results showed that less than 12% of women in the (higher education) group fully understood the absolute levels of risk from taking the pill and from being pregnant. Relative risk was also poorly understood, with less than 40% of participants showing full understanding, and 20% showing no understanding. We recommend that the CSM revisit the wording currently provided to millions of women in the UK.

Involving users in expert system development

The ultimate criterion of success for interactive expert systems is that they will be used, and used to effect, by individuals other than the system developers. A key ingredient of success in most systems is involving users in the specification and development of systems as they are being built. However, until recently, system designers have paid little attention to ascertaining user needs and to developing systems with corresponding functionality and appropriate interfaces to match those requirements. Although the situation is beginning to change, many developers do not know how to go about involving users, or else tackle the problem in an inadequate way. This paper discusses the need for user involvement and considers why many developers are still not involving users in an optimal way. It looks at the different ways in which users can be involved in the development process and describes how to select appropriate techniques and methods for studying users. Finally, it discusses some of the problems inherent in involving users in expert system development, and recommends an approach which incorporates both ethnographic analysis and formal user testing.

Fracture incidence in relation to the pattern of use of hormone therapy in postmenopausal women

Context: Evidence is limited on the effects of different patterns of use of postmenopausal hormone therapy on fracture incidence and particularly on the effects of ceasing use. Objective: To investigate the effect of different patterns of hormone therapy use on fracture incidence. Design, Setting, and Participants: Prospective study of 138737 postmenopausal women aged 50 to 69 years recruited from the UK general population in 19961998 (the Million Women Study) and followed up for 1.9 to 3.9 years (average, 2.8 years) for fracture incidence. Main Outcome Measure: Adjusted relative risk (RR) for incident fracture (except fracture of the fingers, toes, and ribs) in hormone therapy users compared with never users at baseline. Results: A total of 5197 women (3.7%) reported 1 or more fractures, 79% resulting from falls. Current users of hormone therapy at baseline had a significantly reduced incidence of fracture (RR, 0.62; 95% confidence interval [CI], 0.58-0.66; P<.001). This protection was evident soon after hormone therapy began, and the RR decreased with increasing duration of use (P=.001). Among current users at baseline the RR of fracture did not vary significantly according to whether estrogen-only, estrogen-progestin, or other types of hormones were used (RR [95% CI], 0.64 [0.58-0.71], 0.58 [0.53-0.64], and 0.67 [0.56-0.80], respectively; P=19), nor did it vary significantly according to estrogen dose or estrogen or progestin constituents. The RR associated with current use of hormone therapy did not vary significantly according to 11 personal characteristics of study participants, including their age at menopause, body mass index, and physical activity. Past users of hormone therapy at baseline experienced no significant protection against fractures (RR, 1.07; 95% CI, 0.99-1.15); incidence rates returned to those of never-users within about a year of ceasing use. Conclusions: All types of hormone therapy studied confer substantial protection against fracture while they are used. This protection appears rapidly after use commences and wears off rapidly after use ceases. The older women are, the greater is their absolute reduction in fracture incidence while using hormone therapy.