Caracterização do perfil audiológico de escolares de escola pública do município de Bauru/SP

Muitos dos problemas auditivos não são notados por pais e professores. Este fato prejudica a aprendizagem da criança principalmente no ambiente escolar. Por isso, programas de triagem auditiva podem ser utilizados com o intuito de detectar e, posteriormente, diagnosticar escolares a fim de que se possa prevenir ou minimizar o impacto a que possíveis sequelas auditivas venham prejudicar o rendimento escolar da criança. Hoje em dia podemos contar com programas que permitem o melhor acompanhamento de populações que necessitam de cuidados preventivos e curativos, e a audição é um aspecto muito importante que pode ser avaliado quando estes programas são colocados em prática. O Programa Nacional de Reorientação da Formação Profissional em Saúde (Pró-Saúde), que visou reorientar a formação profissional, teve como objetivo integrar ensino-serviço e promover atenção básica por meio da abordagem integral do processo saúde-doença. Ambientes externos podem ser utilizados por alunos e professores universitários para que possam colocadas em prática ações que possibilitem a humanização das práticas de atenção a saúde e a integralidade das mesmas, por meio da articulação de ações e serviços de saúde, preventivos e curativos, individuais e coletivos. A escola é considerada um dos ambientes que este trabalho pode ser realizado. O Programa Saúde na Escola (PSE) abre o ambiente escolar com a finalidade de contribuir para a formação integral dos estudantes da rede pública de educação básica por meio de ações de prevenção, promoção e atenção à saúde. Sendo um estudo do tipo retrospectivo transversal, como objetivo principal caracterizar o perfil audiológico de escolares de escola pública do município de Bauru SP, contando com a integração de profissionais da área da saúde e educação no ambiente escolar, o que teve como base os programas citados acima. A triagem auditiva foi realizada com a aplicação dos seguintes procedimentos: imitanciometria, inspeção visual do meato acústico externo, emissões otoacústicas por produto de distorção e audiometria tonal liminar. Observou-se que do total de 652 estudantes, a grande maioria (97,1%) dos participantes com faixa etária entre 10 e 18 anos, apresentaram audição normal. Em 2,9% desta população foi encontrada alguma alteração auditiva temporária. Com a exceção de um único participante, portador de perda auditiva sensorioneural. Apesar de encontrarmos muitas crianças e adolescentes com audição normal, o que mais ressalta a importância deste trabalho é a necessidade da triagem auditiva em ambientes escolares e, essencialmente, o acompanhamento das mesmas nesta faixa etária, já que são escassos os estudos referentes a ela. Apesar das poucas alterações auditivas encontradas serem passageiras, são exatamente estas que interferem no bom rendimento escolar e outros fatores.

Tympanometric findings in children at school entry: A normative study

This study presents tympanometric normative data for Australian children at school entry in view of the lack of age-specific population-based data for this group. Participants were 327 children (164 boys, 163 girls) aged between 5 and 6 years, who had no history of middle ear infection, and passed pure-tone screening at 20 dB HL. Normative values for static admittance (SA), ear canal volume (ECV), tympanometric peak pressure, tympanometric width (TW) and tympanometric gradient were established. Based on these normative data, the use of the ASHA (1997) guidelines for medical referral, in which ECV > 1.0 ml in the presence of a flat tympanogram, SA < 0.3 ml, or TW > 200 daPa may not provide the best criteria for Australian children aged between 5 and 6 years. If SA < 0.3 ml were used instead of SA < 0.16 ml, a greater proportion of Australian children would have failed tympanometry, thus increasing the false alarm rate.

Habitat type and density influence vocal signal design in satin bowerbirds

This study provided a thorough test of the acoustic adaptation hypothesis using a within-species comparison of call structure involving a wide range of habitat types, an objective measure of habitat density and direct measures of habitat-related attenuation. The structure of the bower advertisement call of the satin bowerbird was measured in 16 populations from throughout the species' range and related to the habitat type and density at each site. Transmission of white noise, pure tones and different bowerbird dialects was measured in five of six habitat types inhabited by satin bowerbirds. Bowerbird advertisement call structure converged in similar habitats but diverged among different habitats; this pattern was apparent at both continent-wide and local geographical scales. Bowerbirds' call structures differed with changes in habitat density, consistent with the acoustic adaptation hypothesis. Lower frequencies and less frequency modulation were utilized in denser habitats such as rainforest and higher frequencies and more frequency modulation were used in the more open eucalypt-dominated habitats. The white noise and pure tone transmission measurements indicated that different habitats varied in their sound transmission properties in a manner consistent with the observed variation in satin bowerbird vocalizations. There was no effect of geographical proximity of recording locations, nor was there the predicted inverse relationship between frequency and body size. These findings indicate that the transmission qualities of different habitats have had a major influence on variation in vocal phenotypes in this species. In addition, previously published molecular data for this species suggest that there is no effect of genetic relatedness on call similarity among satin bowerbird populations.

Contralateral influences of wideband inhibition on the effect of onset asynchrony as a cue for auditory grouping

Onset asynchrony is an important cue for segregating sound mixtures. A harmonic of a vowel that begins before the other components contributes less to vowel quality. This asynchrony effect can be partly reversed by accompanying the leading portion of the harmonic with an octave-higher captor tone. The original interpretation was that the captor and leading portion formed a perceptual group, but it has recently been shown that the captor effect depends on neither a common onset time nor harmonic relations with the leading portion. Instead, it has been proposed that the captor effect depends on wideband inhibition in the central auditory system. Physiological evidence suggests that such inhibition occurs both within and across ears. Experiment 1 compared the efficacy of a pure-tone captor presented in the same or opposite ear to the vowel and leading harmonic. Contralateral presentation was at least as effective as ipsilateral presentation. Experiment 2 used multicomponent captors in a more comprehensive evaluation of harmonic influences on captor efficacy. Three captors with different fundamental frequencies were used, one of which formed a consecutive harmonic series with the leading harmonic. All captors were equally effective, irrespective of the harmonic relationship. These findings support and refine the inhibitory account. © 2007 Acoustical Society of America.

Spectral pattern, grouping, and the pitches of complex tones and their components

Harmonically related components are typically heard as a unified entity with a rich timbre and a pitch corresponding to the fundamental frequency. Mistuning a component generally has four consequences: (i) the global pitch of the complex shifts in the same direction as the mistuning; (ii) the component makes a reduced contribution to global pitch; (iii) the component is heard out as a separate sound with a pure timbre; (iv) its pitch differs from that of a pure tone of equal frequency in a small but systematic way. Local interactions between neighbouring components cannot explain these effects; instead they are usually explained in terms of the global operation of a single harmonic-template mechanism. However, several observations indicate that separate mechanisms govern the selection of spectral components for perceptual fusion and for the computation of global pitch. First, an increase in mistuning causes a harmonic to be heard out before it begins to be excluded from the computation of global pitch. Second, a single even harmonic added to an odd-harmonic complex is typically more salient than its odd neighbours. Third, the mistuning of a component in frequency-shifted stimuli, or stimuli with a moderate spectral stretch, results in changes in salience and component pitch like those seen for harmonic stimuli. Fourth, the global pitch of frequency-shifted stimuli is predicted well by the weighted fit of a harmonic template, but, with the exception of the lowest component, the fusion of individual partials for shifted stimuli is best predicted by the common pattern of spectral spacing. Fifth, our sensitivity to spectral pattern is surprisingly resistant to random variations in component spacing induced by applying mistunings to several harmonics at once. These findings are evaluated in the context of an autocorrelogram model of the proposed pitch/grouping dissociation. © S. Hirzel Verlag · EAA.

The influence of adaptation and inhibition on the effects of onset asynchrony on auditory grouping

Onset asynchrony is an important cue for auditory scene analysis. For example, a harmonic of a vowel that begins before the other components contributes less to the perceived phonetic quality. This effect was thought primarily to involve high-level grouping processes, because the contribution can be partly restored by accompanying the leading portion of the harmonic (precursor) with a synchronous captor tone an octave higher, and hence too remote to influence adaptation of the auditory-nerve response to that harmonic. However, recent work suggests that this restoration effect arises instead from inhibitory interactions relatively early in central auditory processing. The experiments reported here have reevaluated the role of adaptation in grouping by onset asynchrony and explored further the inhibitory account of the restoration effect. Varying the frequency of the precursor in the range ± 10% relative to the vowel harmonic (Experiment 1), or introducing a silent interval from 0 to 320 ms between the precursor and the vowel (Experiment 2), both produce effects on vowel quality consistent with those predicted from peripheral adaptation or recovery from it. However, there were some listeners for whom even the smallest gap largely eliminated the effect of the precursor. Consistent with the inhibitory account of the restoration effect, a contralateral pure tone whose frequency is close to that of the precursor is highly effective at restoring the contribution of the asynchronous harmonic (Experiment 3). When the frequencies match, lateralization cues arising from binaural fusion of the precursor and contralateral tone may also contribute to this restoration. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

A novel binaural pitch elicited by phase-modulated noise:MEG and psychophysical observations

Binaural pitches are auditory percepts that emerge from combined inputs to the ears but that cannot be heard if the stimulus is presented to either ear alone. Here, we describe a binaural pitch that is not easily accommodated within current models of binaural processing. Convergent magnetoencephalography (MEG) and psychophysical measurements were used to characterize the pitch, heard when band-limited noise had a rapidly changing interaural phase difference. Several interesting features emerged: First, the pitch was perceptually lateralized, in agreement with the lateralization of the evoked changes in MEG spectral power, and its salience depended on dichotic binaural presentation. Second, the frequency of the pure tone that matched the binaural pitch lay within a lower spectral sideband of the phase-modulated noise and followed the frequency of that sideband when the modulation frequency or center frequency and bandwidth of the noise changed. Thus, the binaural pitch depended on the processing of binaural information in that lower sideband.

Case study: auditory brain responses in a minimally verbal child with autism and cerebral palsy

An estimated 30% of individuals with autism spectrum disorders (ASD) remain minimally verbal into late childhood, but research on cognition and brain function in ASD focuses almost exclusively on those with good or only moderately impaired language. Here we present a case study investigating auditory processing of GM, a nonverbal child with ASD and cerebral palsy. At the age of 8 years, GM was tested using magnetoencephalography (MEG) whilst passively listening to speech sounds and complex tones. Where typically developing children and verbal autistic children all demonstrated similar brain responses to speech and nonspeech sounds, GM produced much stronger responses to nonspeech than speech, particularly in the 65–165 ms (M50/M100) time window post-stimulus onset. GM was retested aged 10 years using electroencephalography (EEG) whilst passively listening to pure tone stimuli. Consistent with her MEG response to complex tones, GM showed an unusually early and strong response to pure tones in her EEG responses. The consistency of the MEG and EEG data in this single case study demonstrate both the potential and the feasibility of these methods in the study of minimally verbal children with ASD. Further research is required to determine whether GM's atypical auditory responses are characteristic of other minimally verbal children with ASD or of other individuals with cerebral palsy.

Pulsed parabolic equation model of acoustic transmission (PPEMAT)

Underwater sound is very important in the field of oceanography where it is used for remote sensing in much the same way that radar is used in atmospheric studies. One way to mathematically model sound propagation in the ocean is by using the parabolic-equation method, a technique that allows range dependent environmental parameters. More importantly, this method can model sound transmission where the source emits either a pure tone or a short pulse of sound. Based on the parabolic approximation method and using the split-step Fourier algorithm, a computer model for underwater sound propagation was designed and implemented. This computer model differs from previous models in its use of the interactive mode, structured programming, modular design, and state-of-the-art graphics displays. In addition, the model maximizes the efficiency of computer time through synchronization of loosely coupled dual processors and the design of a restart capability. Since the model is designed for adaptability and for users with limited computer skills, it is anticipated that it will have many applications in the scientific community.

Functional outcomes in the Cleft Care UK study - Part 3:oral health and audiology

OBJECTIVES: To compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies. SETTING AND SAMPLE POPULATION: Two UK-based cross-sectional studies of 5-year-olds born with non-syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low-volume operators. CCUK children were treated in a centralized, high volume operator system. MATERIALS AND METHODS: Oral health data were collected using a standardized proforma. Hearing was assessed using pure tone audiometry and middle ear status by otoscopy and tympanometry. ENT and hearing history were collected from medical notes and parental report. RESULTS: Oral health was assessed in 264 of 268 children (98.5%). The mean dmft was 2.3, 48% were caries free, and 44.7% had untreated caries. There was no evidence this had changed since the CSAG survey. Oral hygiene was generally good, 96% were enrolled with a dentist. Audiology was assessed in 227 of 268 children (84.7%). Forty-three per cent of children received at least one set of grommets--a 17.6% reduction compared to CSAG. Abnormal middle ear status was apparent in 50.7% of children. There was no change in hearing levels, but more children with hearing loss were managed with hearing aids. CONCLUSIONS: Outcomes for dental caries and hearing were no better in CCUK than in CSAG, although there was reduced use of grommets and increased use of hearing aids. The service specifications and recommendations should be scrutinized and implemented.

Tone-evoked ABR in full-term and preterm neonates with normal hearing

This study was designed to investigate the feasibility of applying tone-ABRs in the nursery and neonatal intensive care unit (NICU), and to provide normative tone-ABR data from neonates. Normative tone-ABR latency data were determined. The study obtained intensity series of tone-ABRs from thirty preterm neonates and twenty fullterm neonates who had confirmed normal peripheral auditory function after passing both an OAE and ABR screening examination. ABRs were collected in response to 500, 1500, and 4000 Hz tone bursts at 70, 50, 30, and 20 dB nHL. Mean wave V latencies were compared between groups, ears, and by gender. Responses to tone bursts of 20 and 30 dB nHL were detected in 97% and 100% of all ears respectively, in addition to responses to the higher-intensity stimuli. Preterm neonates` ABRs showed significantly longer latencies than those of the full-term infants. Tone-ABR evaluation was found to be both feasible and reliable as a measure of auditory function in neonates.

The effects of sildenafil on rectal sensitivity and tone in patients with the irritable bowel syndrome

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of the build-up and resetting of auditory stream segregation on temporal discrimination

The tendency to hear a tone sequence as 2 or more streams (segregated) builds up, but a sudden change in properties can reset the percept to 1 stream (integrated). This effect has not hitherto been explored using an objective measure of streaming. Stimuli comprised a 2.0-s fixed-frequency inducer followed by a 0.6-s test sequence of alternating pure tones (3 low [L]-high [H] cycles). Listeners compared intervals for which the test sequence was either isochronous or the H tones were slightly delayed. Resetting of segregation should make identifying the anisochronous interval easier. The HL frequency separation was varied (0-12 semitones), and properties of the inducer and test sequence were set to the same or different values. Inducer properties manipulated were frequency, number of onsets (several short bursts vs. one continuous tone), tone:silence ratio (short vs. extended bursts), level, and lateralization. All differences between the inducer and the L tones reduced temporal discrimination thresholds toward those for the no-inducer case, including properties shown previously not to affect segregation greatly. Overall, it is concluded that abrupt changes in a sequence cause resetting and improve subsequent temporal discrimination. (PsycINFO Database Record © 2009 APA, all rights reserved)

Influence of diabetes on natriuretic peptide thresholds in screening for Stage B heart failure

CONTEXT: Natriuretic peptide (NP) has been shown to be an effective screening tool to identify patients with Stage B heart failure and to have clinical value in preventing heart failure progression. The impact of associated metabolic confounders on the screening utility of NP needs clarification.

OBJECTIVE: To assess the impact of diabetes mellitus (DM) on NP screening for asymptomatic Stage B heart failure.

MATERIALS AND METHODS: The study population consisted of 1368 asymptomatic patients with cardiovascular risk factors recruited from general practice as part of the STOP-HF trial. B-type NP (BNP) was quantified at point-of-care.

RESULTS: BNP was found to be as accurate for detecting Stage B heart failure in DM patients compared to non-DM patients (AUC 0.75 [0.71,0.78] and 0.77 [0.72,0.82], respectively). However, different BNP thresholds are required to achieve the same level of diagnostic sensitivity in DM compared with non-DM patients. To achieve 80% sensitivity a difference of 5-ng/L lower is required for patients with DM.

CONCLUSION: Although a significantly different BNP threshold is detected for patients with DM, the BNP concentration difference is small and unlikely to warrant a clinically different diagnostic threshold.