Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 129
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
Ear Hear ; 45(6): 1585-1599, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39004788

RESUMEN

OBJECTIVES: Cochlear implants (CI) are remarkably effective, but have limitations regarding the transformation of the spectro-temporal fine structures of speech. This may impair processing of spoken emotions, which involves the identification and integration of semantic and prosodic cues. Our previous study found spoken-emotions-processing differences between CI users with postlingual deafness (postlingual CI) and normal hearing (NH) matched controls (age range, 19 to 65 years). Postlingual CI users over-relied on semantic information in incongruent trials (prosody and semantics present different emotions), but rated congruent trials (same emotion) similarly to controls. Postlingual CI's intact early auditory experience may explain this pattern of results. The present study examined whether CI users without intact early auditory experience (prelingual CI) would generally perform worse on spoken emotion processing than NH and postlingual CI users, and whether CI use would affect prosodic processing in both CI groups. First, we compared prelingual CI users with their NH controls. Second, we compared the results of the present study to our previous study ( Taitlebaum-Swead et al. 2022 ; postlingual CI). DESIGN: Fifteen prelingual CI users and 15 NH controls (age range, 18 to 31 years) listened to spoken sentences composed of different combinations (congruent and incongruent) of three discrete emotions (anger, happiness, sadness) and neutrality (performance baseline), presented in prosodic and semantic channels (Test for Rating of Emotions in Speech paradigm). Listeners were asked to rate (six-point scale) the extent to which each of the predefined emotions was conveyed by the sentence as a whole (integration of prosody and semantics), or to focus only on one channel (rating the target emotion [RTE]) and ignore the other (selective attention). In addition, all participants performed standard tests of speech perception. Performance on the Test for Rating of Emotions in Speech was compared with the previous study (postlingual CI). RESULTS: When asked to focus on one channel, semantics or prosody, both CI groups showed a decrease in prosodic RTE (compared with controls), but only the prelingual CI group showed a decrease in semantic RTE. When the task called for channel integration, both groups of CI users used semantic emotional information to a greater extent than their NH controls. Both groups of CI users rated sentences that did not present the target emotion higher than their NH controls, indicating some degree of confusion. However, only the prelingual CI group rated congruent sentences lower than their NH controls, suggesting reduced accumulation of information across channels. For prelingual CI users, individual differences in identification of monosyllabic words were significantly related to semantic identification and semantic-prosodic integration. CONCLUSIONS: Taken together with our previous study, we found that the degradation of acoustic information by the CI impairs the processing of prosodic emotions, in both CI user groups. This distortion appears to lead CI users to over-rely on the semantic information when asked to integrate across channels. Early intact auditory exposure among CI users was found to be necessary for the effective identification of semantic emotions, as well as the accumulation of emotional information across the two channels. Results suggest that interventions for spoken-emotion processing should not ignore the onset of hearing loss.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Sordera , Emociones , Percepción del Habla , Humanos , Adulto , Masculino , Femenino , Persona de Mediana Edad , Sordera/rehabilitación , Sordera/psicología , Adulto Joven , Estudios de Casos y Controles , Anciano , Semántica
2.
Ear Hear ; 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39219019

RESUMEN

OBJECTIVES: Older adults use semantic context to generate predictions in speech processing, compensating for aging-related sensory and cognitive changes. This study aimed to gauge aging-related changes in effort exertion related to context use. DESIGN: The study revisited data from Harel-Arbeli et al. (2023) that used a "visual-world" eye-tracking paradigm. Data on efficiency of context use (response latency and the probability to gaze at the target before hearing it) and effort exertion (pupil dilation) were extracted from a subset of 14 young adults (21 to 27 years old) and 13 older adults (65 to 79 years old). RESULTS: Both age groups showed a similar pattern of context benefits for response latency and target word predictions, however only the older adults group showed overall increased pupil dilation when listening to context sentences. CONCLUSIONS: Older adults' efficient use of spoken semantic context appears to come at a cost of increased effort exertion.

3.
Age Ageing ; 53(5)2024 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-38706392

RESUMEN

Cognitive decline, mental health and mindset factors can all affect the autonomy and well-being of older adults. As the number of older adults across the globe increases, interventions to improve well-being are urgently needed. Improvisational theatre (improv) and improv-based interventions are well-suited to address this need. Studies have shown that participation in improv-based interventions has a positive impact on mental health indicators, including depressive symptoms, well-being and social connectedness, as well as cognitive skills such as attention and memory. In addition, improv-based interventions have been beneficial for people with dementia, improving positive affect, self-esteem and communication. In this article, we describe improvisational theatre, or improv, and the reasons it has emerged from a form of spontaneous theatre that involves playfulness and creativity to an important tool to effect behavioural change in individuals and groups. We then review the literature on the effects of improv in ageing populations, with a focus on social, emotional and cognitive functioning. Finally, we make recommendations on designing improv-based interventions so that future research, using rigorous quantitative methods, larger sample sizes and randomised controlled trials, can expand the use of improv in addressing important factors related to autonomy and well-being in older adults.


Asunto(s)
Envejecimiento , Salud Mental , Humanos , Envejecimiento/psicología , Anciano , Cognición , Creatividad , Factores de Edad , Autonomía Personal , Emociones , Envejecimiento Saludable/psicología
4.
Cogn Emot ; : 1-14, 2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38785380

RESUMEN

Processing of emotional speech in the absence of visual information relies on two auditory channels: semantics and prosody. No study to date has investigated how blindness impacts this process. Two theories, Perceptual Deficit, and Sensory Compensation, yiled different expectations about the role of visual experience (or its lack thereof) in processing emotional speech. To test the effect of vision and early visual experience on processing of emotional speech, we compared individuals with congenital blindness (CB, n = 17), individuals with late blindness (LB, n = 15), and sighted controls (SC, n = 21) on identification and selective-attention of semantic and prosodic spoken-emotions. Results showed that individuals with blindness performed at least as well as SC, supporting Sensory Compensation and the role of cortical reorganisation. Individuals with LB outperformed individuals with CB, in accordance with Perceptual Deficit, supporting the role of early visual experience. The LB advantage was moderated by executive functions (working-memory). Namely, the advantage was erased for individuals with CB who showed higher levels of executive functions. Results suggest that vision is not necessary for processing of emotional speech, but early visual experience could improve it. The findings support a combination of the two aforementioned theories and reject a dichotomous view of deficiencies/enhancements of blindness.

5.
Cogn Emot ; : 1-10, 2024 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-38764186

RESUMEN

Older adults process emotional speech differently than young adults, relying less on prosody (tone) relative to semantics (words). This study aimed to elucidate the mechanisms underlying these age-related differences via an emotional speech-in-noise test. A sample of 51 young and 47 older adults rated spoken sentences with emotional content on both prosody and semantics, presented on the background of wideband speech-spectrum noise (sensory interference) or on the background of multi-talker babble (sensory/cognitive interference). The presence of wideband noise eliminated age-related differences in semantics but not in prosody when processing emotional speech. Conversely, the presence of babble resulted in the elimination of age-related differences across all measures. The results suggest that both sensory and cognitive-linguistic factors contribute to age-related changes in emotional speech processing. Because real world conditions typically involve noisy background, our results highlight the importance of testing under such conditions.

6.
Psychol Sci ; 33(3): 424-432, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35175871

RESUMEN

Attachment security has consistently been found to correlate with relaxed exploration, openness, and mindful attention to incoming information. The present studies explored whether contextually infusing a sense of attachment security (security priming) can improve hearing in young and older adults. In Study 1, participants (29 young, 30 older) performed a standardized pure-tone audiometric-thresholds test twice. In the security-priming condition, a picture of a participant's security-enhancing figure was presented throughout the task. In the control condition, a picture of an unknown person (matched in sex, age, and facial expression) was used as a neutral prime. Study 2 (14 young, 14 older) was almost identical, except that it was preregistered and the neutral prime was a circle. In both studies, participants performed better (had lower hearing thresholds) in the security-priming condition. The current study is the first to show that attachment security improves sensory perception, and these results have meaningful implications for theory and clinical hearing tests.


Asunto(s)
Audición , Ruido , Anciano , Audiometría de Tonos Puros/métodos , Humanos , Sonido
7.
Ear Hear ; 43(4): 1378-1389, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35030551

RESUMEN

OBJECTIVES: The processing of emotional speech calls for the perception and integration of semantic and prosodic cues. Although cochlear implants allow for significant auditory improvements, they are limited in the transmission of spectro-temporal fine-structure information that may not support the processing of voice pitch cues. The goal of the current study is to compare the performance of postlingual cochlear implant (CI) users and a matched control group on perception, selective attention, and integration of emotional semantics and prosody. DESIGN: Fifteen CI users and 15 normal hearing (NH) peers (age range, 18-65 years) 1istened to spoken sentences composed of different combinations of four discrete emotions (anger, happiness, sadness, and neutrality) presented in prosodic and semantic channels-T-RES: Test for Rating Emotions in Speech. In three separate tasks, listeners were asked to attend to the sentence as a whole, thus integrating both speech channels (integration), or to focus on one channel only (rating of target emotion) and ignore the other (selective attention). Their task was to rate how much they agreed that the sentence conveyed each of the predefined emotions. In addition, all participants performed standard tests of speech perception. RESULTS: When asked to focus on one channel, semantics or prosody, both groups rated emotions similarly with comparable levels of selective attention. When the task was called for channel integration, group differences were found. CI users appeared to use semantic emotional information more than did their NH peers. CI users assigned higher ratings than did their NH peers to sentences that did not present the target emotion, indicating some degree of confusion. In addition, for CI users, individual differences in speech comprehension over the phone and identification of intonation were significantly related to emotional semantic and prosodic ratings, respectively. CONCLUSIONS: CI users and NH controls did not differ in perception of prosodic and semantic emotions and in auditory selective attention. However, when the task called for integration of prosody and semantics, CI users overused the semantic information (as compared with NH). We suggest that as CI users adopt diverse cue weighting strategies with device experience, their weighting of prosody and semantics differs from those used by NH. Finally, CI users may benefit from rehabilitation strategies that strengthen perception of prosodic information to better understand emotional speech.


Asunto(s)
Implantación Coclear , Implantes Cocleares , Percepción del Habla , Adolescente , Adulto , Anciano , Emociones , Humanos , Lenguaje , Persona de Mediana Edad , Semántica , Adulto Joven
8.
Int J Lang Commun Disord ; 57(5): 1023-1049, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35714104

RESUMEN

'Dysarthria' is a group of motor speech disorders resulting from a disturbance in neuromuscular control. Most individuals with dysarthria cope with communicative restrictions due to speech impairments and reduced intelligibility. Thus, language-sensitive measurements of intelligibility are important in dysarthria neurological assessment. The Frenchay Dysarthria Assessment, 2nd edition (FDA-2), is a validated tool for the identification of the nature and patterns of oro-motor movements associated with different types of dysarthria. The current study conducted a careful culture- and linguistic-sensitive adaption of the two intelligibility subtests of the FDA-2 to Hebrew (words and sentences) and performed a preliminary validation with relevant clinical populations. First, sets of Hebrew words and sentences were constructed, based on the criteria defined in FDA-2, as well as on several other factors that may affect performance: emotional valence, arousal and familiarity. Second, the new subtests were validated in healthy older adults (n = 20), and in two clinical groups (acquired dysarthria, n = 15; and developmental dysarthria, n = 19). Analysis indicated that the new subtests were found to be specific and sensitive, valid and reliable, as scores significantly differ between healthy older adults and adults with dysarthria, correlated with other subjective measures of intelligibility, and showed high test-retest reliability. The words and sentences intelligibility subtests can be used to evaluate speech disorders in various populations of Hebrew speakers, thus may be an important addition to the speech-language pathologist's toolbox, for clinical work as well as for research purposes. WHAT THIS PAPER ADDS: What is already known on the subject 'Dysarthria' is a group of disorders reflecting impairments in the strength, speed and precision of movements required for adequate control of the various speech subsystems. Reduced speech intelligibility is one of the main consequences of all dysarthria subtypes, irrespective of their underlying cause. Indeed, most individuals with dysarthria cope with communicative restrictions due to speech impairments. Thus, language-sensitive measurements of intelligibility are important in dysarthria assessment. The FDA-2's words and sentences subtests present standardized and validated tools for the identification of the nature and patterns of oro-motor movements associated with different types of dysarthria. What this paper adds to existing knowledge The lack of assessment tools in Hebrew poses challenges to clinical evaluation as well as research purposes. The current study conducted a careful culture- and linguistic-sensitive adaption of the FDA-2 intelligibility subtests to Hebrew and performed a preliminary validation with relevant clinical populations. First, sets of Hebrew words and sentences were constructed, based on the criteria defined in FDA-2, as well as on several other factors that may affect performance: emotional valence, arousal and familiarity. Second, the new subtests were validated in healthy older adults (n = 20), and in two clinical groups (adults with acquired dysarthria, n = 15; and young adults with developmental dysarthria, n = 19). What are the potential or actual clinical implications of this work? Analyses indicated that the new word and sentence subtests are specific, sensitive, valid and reliable. Namely, (1) they successfully differentiate between healthy individuals and individuals with dysarthria; (2) they correlate with other subjective measures of intelligibility; and (3) they show high test-retest reliability. The words and sentences intelligibility subtests can be used to evaluate speech disorders in various populations of Hebrew speakers. Thus, they may be an important addition to the speech-language pathologist's toolbox, for clinical and research purposes. The methods described here can be emulated for the adaptation of speech assessment tools to other languages.


Asunto(s)
Disartria , Inteligibilidad del Habla , Anciano , Disartria/psicología , Humanos , Lingüística , Reproducibilidad de los Resultados , Trastornos del Habla/complicaciones , Medición de la Producción del Habla/métodos , Adulto Joven
9.
Psychol Sci ; 32(9): 1442-1451, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34383576

RESUMEN

Age-related changes in decision making have been attributed to deterioration of cognitive skills, such as learning and memory. On the basis of past research showing age-related decreases in the ability to inhibit irrelevant information, we hypothesize that these changes occur, in part, because of older adults' tendency to give more weight to low-level, subordinate, and goal-irrelevant information than younger adults do. Consistent with this hypothesis, our findings demonstrated that young adults are willing to pay more for a product with superior end attributes than a product with superior means attributes (Study 1, N = 200) and are more satisfied after an experience with superior end than means attributes (Study 2, N = 399). Young adults are also more satisfied with a goal-relevant than with a goal-irrelevant product (Study 3, N = 201; Study 4, N = 200, preregistered). Importantly, these effects were attenuated with age. Implications for research on construal level and aging, as well as implications for policymakers, are discussed.


Asunto(s)
Envejecimiento , Señales (Psicología) , Anciano , Humanos , Aprendizaje , Motivación , Adulto Joven
10.
Int J Audiol ; 60(5): 319-321, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33063553

RESUMEN

OBJECTIVE: COVID-19 social isolation restrictions have accelerated the need to adapt clinical assessment tools to telemedicine. Remote adaptations are of special importance for populations at risk, e.g. older adults and individuals with chronic medical comorbidities. In response to this urgent clinical and scientific need, we describe a remote adaptation of the T-RES (Oron et al. 2020; IJA), designed to assess the complex processing of spoken emotions, based on identification and integration of the semantics and prosody of spoken sentences. DESIGN: We present iT-RES, an online version of the speech-perception assessment tool, detailing the challenges considered and solution chosen when designing the telehealth tool. We show a preliminary validation of performance against the original lab-based T-RES. STUDY SAMPLE: A between-participants design, within two groups of 78 young adults (T-RES, n = 39; iT-RES, n = 39). RESULTS: i-TRES performance closely followed that of T-RES, with no group differences found in the main trends, identification of emotions, selective attention, and integration. CONCLUSIONS: The design of iT-RES mapped the main challenges for remote auditory assessments, and solutions taken to address them. We hope that this will encourage further efforts for telehealth adaptations of clinical services, to meet the needs of special populations and avoid halting scientific research.


Asunto(s)
Audiología/métodos , Audiometría del Habla/métodos , COVID-19 , Telemedicina/métodos , Reconocimiento de Voz , Adulto , Atención , Emociones , Femenino , Humanos , Masculino , Cuarentena , SARS-CoV-2 , Semántica , Percepción del Habla , Adulto Joven
11.
Int J Lang Commun Disord ; 56(5): 1026-1036, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34331497

RESUMEN

BACKGROUND: It is unclear whether oral diadochokinetic rate (oral-DDK) performance is affected by different languages within a multilingual country. AIMS: This study investigated the effects of age, sex, and stimulus type (real word in L1, L2 vs. non-word) on oral-DDK rates among healthy Malaysian-Malay speakers in order to establish language- and age-sensitive norms. The second aim was to compared the nonword 'pataka' oral-DDK rates produced by Malaysian-Malay speakers on currently available normative data for Hebrew speakers and Malaysian-Mandarin speakers. METHODS & PROCEDURES: Oral-DDK performance of 90 participants (aged 20-77 years) using nonword ('pataka'), Malay real word ('patahkan'), and English real word ('buttercake') was audio recorded. The number of syllables produced in 8 seconds was calculated. Mixed analysis of variance (ANOVA) was conducted to examine the effects of stimulus type (nonword, Malay, and English real word), sex (male, female), age (younger, 20-40 years; middle, 41-60 years; older, ≥61 years), and their interactions on the oral-DDK rate. Data obtained were also compared with the raw data of Malaysian-Mandarin and Hebrew speakers from the previous studies. OUTCOMES & RESULTS: A normative oral-DDK rate has been established for healthy Malaysian-Malay speakers. The oral-DDK rate was significantly affected by stimuli (p < 0.001). Malay real word showed the slowest rate, whereas there was no significant difference between English real word and nonword. The oral-DDK rate for Malay speakers was significantly higher than Mandarin and Hebrew speakers across stimuli (all p < 0.01). Interestingly, oral-DDK rates were not affected by age group for Malay speakers. CONCLUSIONS & IMPLICATIONS: Stimuli type and language affect the oral-DDK rate, indicating that speech-language therapists should consider using language-specific norms when assessing multilingual speakers. WHAT THIS PAPER ADDS: What is already known on the subject Age, sex, and language are factors that need to be considered when developing oral-DDK normative protocol. It is unclear whether oral-DDK performance is affected by different languages within a multilingual country. What this paper adds to existing knowledge No ageing effect across real word versus nonword on oral-DDK performance was observed among Malaysian-Malay speakers, contrasting with current available literature that speech movements slow down as we age. Additionally, Malaysian-Malay speakers have faster oral-DDK rates than Malaysian-Mandarin and Hebrew speakers across all stimuli. What are the potential or actual clinical implications of this work? Establishing normative data of different languages will enable speech-language therapists to select the appropriate reference dataset based on the language mastery of these multilingual speakers.


Asunto(s)
Multilingüismo , Envejecimiento , Femenino , Humanos , Lenguaje , Masculino , Habla , Medición de la Producción del Habla
12.
Int J Audiol ; 59(3): 195-207, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31663391

RESUMEN

Objective: Understanding communication difficulties related to tinnitus, by identifying tinnitus-related differences in the perception of spoken emotions, focussing on the roles of semantics (words), prosody (tone of speech) and their interaction.Study sample and design: Twenty-two people-with-tinnitus (PwT) and 24 people-without-tinnitus (PnT) listened to spoken sentences made of different combinations of four discrete emotions (anger, happiness, sadness, neutral) presented in the prosody and semantics (Test for Rating Emotions in Speech). In separate blocks, listeners were asked to attend to the sentence as a whole, integrating both speech channels (gauging integration), or to focus on one channel only (gauging identification and selective attention). Their task was to rate how much they agree the sentence conveys each of the predefined emotions.Results: Both groups identified emotions similarly, and performed with similar failures of selective attention. Group differences were found in the integration of channels. PnT showed a bias towards prosody, whereas PwT weighed both channels equally.Conclusions: Tinnitus appears to impact the integration of the prosodic and semantic channels. Three possible sources are suggested: (a) sensory: tinnitus may reduce prosodic cues. (b) Cognitive: tinnitus-related reduction in cognitive processing.


Asunto(s)
Emociones , Semántica , Percepción del Habla , Acúfeno/psicología , Adulto , Atención , Comprensión , Señales (Psicología) , Femenino , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Habla , Análisis y Desempeño de Tareas
13.
Crim Behav Ment Health ; 29(2): 94-110, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30916846

RESUMEN

BACKGROUND: Several variables have been evidenced for their association with violent reoffending. Resultant interventions have been suggested, yet the rate of recidivism remains high. Alexithymia, characterised by deficits in emotion processing and verbal expression, might interact with these other risk factors to affect outcomes. AIM: Our goal was to examine the role of alexithymia as a possible moderator of risk factors for violent offender recidivism. Our hypothesis was that, albeit with other risk factors, alexithymia increases the risk of violent reoffending. METHOD: We conducted a systematic literature review, using terms for alexithymia and violent offending and their intersection. RESULTS: (a) No study that directly tests the role of alexithymia in conjunction with other potential risk factors for recidivism and actual violent recidivism was uncovered. (b) Primarily alexithymia researchers and primarily researchers into violence have separately found several clinical features in common between aspects of alexithymia and violence, such as impulsivity (total n = 24 studies). (c) Other researchers have established a relationship between alexithymia and both dynamic and static risk factors for violent recidivism (n = 16 studies). CONCLUSION: Alexithymia may be a possible moderator of risk of violent offence recidivism. Supplementing offenders' rehabilitation efforts with assessments of alexithymia may assist in designing individually tailored interventions to promote desistance among violent offenders.


Asunto(s)
Síntomas Afectivos , Crimen/estadística & datos numéricos , Criminales/psicología , Emociones , Reincidencia , Violencia/psicología , Agresión/psicología , Humanos , Masculino , Recurrencia , Medición de Riesgo , Factores de Riesgo , Violencia/estadística & datos numéricos
14.
Psychogeriatrics ; 19(5): 491-504, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30746830

RESUMEN

Older adults tend to underutilise mental health services. Mental health literacy plays a critical role in identifying and overcoming barriers to accessing mental health care. The ability to recognise mental illness is an essential component of mental health literacy, with important implications to whether the person will seek professional help. We conducted a review of the literature on older adults' abilities to recognise mental illness. Of the 421 papers that were retrieved in the comprehensive search in PubMed, 32 studies met inclusion criteria. Studies were heterogeneous in terms of target population and methodology, yet findings show that older adults are less likely to correctly recognise mental disorders. Cueing older participants with mental labels improved their recognition abilities. Recognition was particularly poor among immigrant and ethnic/racial older adults, likely due to linguistic and cultural barriers. Our findings demonstrate that older adults show low levels of mental illness recognition and tend to view some illnesses as normal parts of aging. Findings emphasise the need for developing educational programs tailored by the specific phenomenology, conceptualisations and cultural meanings of mental illness among older adults, with attention to informal sources of information and social networks.


Asunto(s)
Envejecimiento , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Trastornos Mentales , Anciano , Humanos
15.
Diabet Med ; 35(12): 1735-1741, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30091149

RESUMEN

AIM: To study the association between serum albumin and cholesterol levels at hospital admission and incident hypoglycaemia among people admitted to internal medicine units. METHODS: In this cross-sectional analysis, we examined the electronic medical records of people hospitalized in internal medicine departments. Data extracted included all glucose measurements as well as serum albumin and cholesterol, which were measured upon admission. A hypoglycaemia event was recorded for a given person if at least one glucose measurement of ≤ 3.9 mmol/l was recorded during the hospital stay. Regression analysis was used to determine which clinical measures predict hypoglycaemia. RESULTS: During the acquisition period, 45 224 people (mean age 68.9 ± 17.8 years, 49.4% male, 21.1% diabetes mellitus) were discharged from internal medicine units. Hypoglycaemia was documented in 7.5% of these individuals (15.4% of people with diabetes vs. 5.5% of those without; P < 0.001). Logistic regression showed that both serum albumin [odds ratio (OR) 0.908, 95% confidence interval (CI) 0.896-0.919; P < 0.001) and cholesterol (OR 0.938, 95% CI 0.896-0.981; P = 0.005] were significantly associated with incident hypoglycaemia. Results remained significant even after controlling for age, sex, average glucose during hospitalization, length of hospital stay, acute infection upon admission, diabetes status, haemoglobin, white blood cell count and C-reactive levels. A combination of hypoalbuminaemia (< 35 g/l) and hypocholesterolaemia (< 3.37 mmol/l) upon admission greatly increased the risk of incident hypoglycaemia (OR 2.544, 95% CI 2.096-3.088; P < 0.001). CONCLUSION: Hypoalbuminaemia and hypocholesterolaemia predict incident hypoglycaemia in the hospital setting among people with and without diabetes mellitus.


Asunto(s)
Colesterol/sangre , Hipoglucemia/epidemiología , Medicina Interna , Admisión del Paciente/estadística & datos numéricos , Albúmina Sérica/análisis , Anciano , Anciano de 80 o más Años , Glucemia , Estudios Transversales , Diabetes Mellitus/sangre , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/epidemiología , Femenino , Medicina General/estadística & datos numéricos , Unidades Hospitalarias/estadística & datos numéricos , Humanos , Hipoglucemia/sangre , Incidencia , Medicina Interna/estadística & datos numéricos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Albúmina Sérica/metabolismo
16.
Clin Exp Nephrol ; 22(1): 151-158, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28456864

RESUMEN

BACKGROUND: Dialysis patients have a suboptimal response to hepatitis B (HBV) vaccination. This study aimed to compare the immunogenicity of two vaccines: the third-generation Sci-B-Vac™ vs. the second-generation Engerix B®. The cohort included two groups of dialysis patients: naïve and previously vaccinated non-responders. Primary endpoints were antibody titers ≥10 IU/L at 3 and 7 month post-vaccination. Secondary objectives were seroprotection rates in vaccine-naïve patients and in previously vaccinated non-responders. METHODS: Eighty-six patients were assigned to vaccine (Sci-B-Vac™ or Engerix B®) using computer-generated randomization, stratified by age, gender, diabetes, and previous HBV vaccination. Sci-B-Vac™ was administered in three doses, 10 µg, at 0, 1, and 6 months in naïve patients; or 20 µg in previously vaccinated non-responders. Engerix B® included four doses, 40 µg at 0, 1, 2, and 6 months. RESULTS: Each group had 43 patients. Seroconversion was 69.8% with Engerix B® vs. 73.2% with Sci-B-Vac™. Antibody titers at 7 months were higher with Sci-B-Vac™ (266.4 ± 383.9, median 53.4) than with Engerix® (193.2 ± 328.9, median 19). However, these differences were not significant, perhaps due to a suboptimal sample size. CONCLUSIONS: This study suggests comparable immunogenicity for both vaccines. Thus, we cannot reject the null hypothesis that there is no difference in seroconversion by vaccine type. It is noteworthy that naïve patients were vaccinated with a standard dose of Sci-B-Vac™, while Engerix B® was administered at a double dose. Similarly, although mean antibody titer levels in the Sci-B-Vac™ group were higher than in the Engerix® group, this difference did not reach significance. Consequently, a future clinical trial should recruit a larger cohort of patients, using a standard double-dose protocol in both groups.


Asunto(s)
Proteínas de la Cápside/inmunología , Vacunas contra Hepatitis B/inmunología , Enfermedades Renales/inmunología , Enfermedades Renales/terapia , Diálisis Renal , Anciano , Anciano de 80 o más Años , Proteínas de la Cápside/efectos adversos , Estudios de Cohortes , Femenino , Hepatitis B/prevención & control , Vacunas contra Hepatitis B/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Seroconversión
17.
Clin Linguist Phon ; 32(3): 193-212, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28727493

RESUMEN

The Hebrew IPA charts describe the sibilants /s, z/ as 'alveolar fricatives', where the place of articulation on the palate is the alveolar ridge. The point of constriction on the tongue is not defined - apical (tip) or laminal (blade). Usually, speech and language pathologists (SLPs) use the apical placement in Hebrew articulation therapy. Some researchers and SLPs suggested that acceptable /s, z/ could be also produced with the laminal placement (i.e. the tip of the tongue approximating the lower incisors). The present study focused at the clinical level, attempting to determine the prevalence of these alternative points of constriction on the tongue for /s/ and /z/ in three different samples of Hebrew-speaking young adults (total n = 242), with typical articulation. Around 60% of the participants reported using the laminal position, regardless of several speaker-related variables (e.g. tongue-thrust swallowing, gender). Laminal production was more common in /s/ (than /z/), coda (than onset) position of the sibilant, mono- (than di-) syllabic words, and with non-alveolar (than alveolar) adjacent consonants. Experiment 3 revealed no acoustical differences between apical and laminal productions of /s/ and of /z/. From a clinical perspective, we wish to raise the awareness of SLPs to the prevalence of the two placements when treating Hebrew speakers, noting that tongue placements were highly correlated across sibilants. Finally, we recommend adopting a client-centred practice, where tongue placement is matched to the client. We further recommend selecting targets for intervention based on our findings, and separating between different prosodic positions in treatment.


Asunto(s)
Hueso Paladar , Fonética , Logopedia/métodos , Lengua/fisiología , Adulto , Femenino , Humanos , Israel , Masculino , Acústica del Lenguaje , Medición de la Producción del Habla , Adulto Joven
18.
Lang Speech ; 61(1): 113-134, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-28610466

RESUMEN

Assessments of oral-diadochokinetic rates are commonly performed to evaluate oral-motor skills. However, the appropriate administration protocol is not defined, and varies across therapists, clinics and laboratories. In three experiments and an auxiliary one, this study analyzes the effects of brief (motor) practice and visual feedback on the performance of 98 younger (20-40 years old) and 78 older adults (over 65) with the sequential motion rate (SMR) version. Overall rates were significantly faster for younger over older adults. Irrespective of age-group, averaged performance was significantly better on the second round, but the third round was found to be superfluous, across experiments and age-groups. Visual feedback (using a mirror) was found to be detrimental for younger adults, eliminating the advantage reaped from a practice round. For older adults, visual feedback did not alter the effect of a practice round. Sensory (visual) degradation is presented as a possible source for this age-related difference. We discuss these findings and suggest an administration protocol for younger and older adults with the SMR version, including a total of two rounds and no visual feedback.


Asunto(s)
Envejecimiento/psicología , Señales (Psicología) , Retroalimentación Sensorial , Retroalimentación Formativa , Destreza Motora , Boca/fisiología , Pruebas de Articulación del Habla/métodos , Percepción Visual , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Humanos , Tiempo de Reacción , Factores de Tiempo , Adulto Joven
19.
Int J Lang Commun Disord ; 52(3): 301-310, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-27432555

RESUMEN

BACKGROUND: Oral-diadochokinesis (oral-DDK) tasks are extensively used in the evaluation of motor speech abilities. Currently, validated normative data for older adults (aged 65 years and older) are missing in Hebrew. The effect of task stimuli (non-word versus real-word repetition) is also non-clear in the population of older adult Hebrew speakers. AIMS: (1) To establish a norm for oral-DDK rate for older adult (aged 65 years and older) Hebrew speakers, and to investigate the possible effect of age and gender on performance rate; and (2) to examine the effects of stimuli (non-word versus real word) on oral-DDK rates. METHODS & PROCEDURES: In experiment 1, 88 healthy older Hebrew speakers (60-95 years, 48 females and 40 males) were audio-recorded while performing an oral-DDK task (repetition of /pataka/), and repetition rates (syllables/s) were coded. In experiment 2, the effect of real-word repetition was evaluated. Sixty-eight older Hebrew speakers (aged 66-95 years, 43 females and 25 males) were asked to repeat 'pataka' (non-word) and 'bodeket' (Hebrew real word). OUTCOMES & RESULTS: Experiment 1: Oral-DDK performance for older adult Hebrew speakers was 5.07 syllables/s (SD = 1.16 syllables/s), across age groups and gender. Comparison of this data with Hebrew norms for younger adults (and equivalent data in English) shows the following gradient of oral-DDK rates: ages 15-45 > 65-74 > 75-86 years. Gender was not a significant factor in our data. Experiment 2: Repetition of real words was faster than that of non-words, by 13.5%. CONCLUSIONS & IMPLICATIONS: The paper provides normative values for oral-DDK rates for older Hebrew speakers. The data show the large impact of ageing on oro-motor functions. The analysis further indicates that speech and language pathologists should consider separate norms for clients of 65-74 years and those of 75-86 years. Hebrew rates were found to be different from English norms for the oldest group, shedding light on the impact of language on these norms. Finally, the data support using a dual-protocol (real- and non-word repetition) with older adults to improve differential diagnosis of normal and pathological ageing in this task.


Asunto(s)
Envejecimiento , Apraxias/diagnóstico , Apraxias/terapia , Trastornos de la Articulación/diagnóstico , Trastornos de la Articulación/terapia , Judíos , Lenguaje , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Israel , Masculino , Valores de Referencia , Factores Sexuales , Pruebas de Articulación del Habla , Medición de la Producción del Habla
20.
J Adolesc ; 53: 127-140, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27718380

RESUMEN

The quality of the adolescent-parent relationship is closely related to the adolescent's sense of entitlement. Study 1 (458 central-Israel adolescents, 69% girls, ages: 11-16) developed the sense of relational entitlement among adolescents toward their parents (SREap, adapted from the original SRE on adults' romantic relationships) and provided initial validity evidence of its three-factor structure: exaggerated, restricted and assertive - replicating the SRE's factor structure. Studies 2-5 (1237 adolescents, 56% girls) examined the link between the SREap factors and relevant psychological measures. Exaggerated and restricted SREap factors were associated with attachment insecurities. Restricted and exaggerated entitlement factors were related to higher levels of emotional problems, and lower levels of: wellbeing, positive mood and life satisfaction. Conversely, assertive entitlement was related to higher life satisfaction and self-efficacy and lower levels of emotional problems. The findings also indicate that SREap is not merely a form of narcissism. The implications of SREap are discussed.


Asunto(s)
Adaptación Psicológica , Conducta del Adolescente/psicología , Relaciones Padres-Hijo , Padres/psicología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Narcisismo , Autoeficacia , Encuestas y Cuestionarios
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA