The Impact of Amplification on Cognitive Screening Test Scores.

Hearing loss is associated with cognitive decline in older adults. Research has shown that hearing loss negatively affects cognitive screening test measures as patients may mishear verbally administered questions. The purpose of the current study was to investigate the impact of amplification on performance on a commonly used cognitive screening test. Thirty older adults with hearing loss underwent testing with the Mini-Mental State Examination (MMSE) in three conditions: without hearing aids, with hearing aids, and with a personal listening device (PLD). Performance on the MMSE significantly improved with the use of hearing aids or a PLD. Amplification and the use of communication strategies should be considered when administering cognitive screening measures to older adults. Failure to account for hearing status may lead to invalid results and can increase the likelihood of over-referral for further assessment. [Journal of Gerontological Nursing, 48(7), 31-37.].

The role of vitamin E acetate (VEA) and its derivatives in the vaping associated lung injury: systematic review of evidence.

Small scale observational evidence suggested that Vitamin E (VE) might play beneficial role in human and animal respiratory conditions of various origin by stabilizing surfactant functions. The intra-aleveolar VE level is directly proportionate to the lung's response to inflammation. Electronic cigarette or vaping associated lung injury was a dominantly respiratory syndrome in the United States with seemingly strong association between potential Vitamin E acetate inhalation exposure and the onset of symptoms. This systematic review intended to assess if there was previous evidence of any potential respiratory/gastrointestinal toxicity associated with Vitamin E acetate or any of its derivatives. A systematic review was constructed and prospectively registered at PROSPERO to search important clinical databases between 2000 and 2020 for full text human articles investigating the effect of VEA or any of its derivatives administered via any route (oral/parenteral/aerosolised) in adults with any respiratory conditions. Out of 363 records investigating the effect of VEA and/or its derivatives/isomers in (any) lung injury (inflammatory, oxidative, infective, asthma/COPD) seven articles qualified. The papers reported various surrogate outcomes (APACHEII score, spirometry, etc) with equivocal results. There was one case report of harmful exposure to both Vitamin E (intramuscular) and Vitamin E acetate (topical). The present review found evidence of neither harm nor any significant clinical improvement associated with the administration of VEA or any derivatives via any route in adult inflammatory lung conditions however, the articles were of low-level evidence. Further studies are needed to correct flaws in research to explore the role of Vitamin E in pulmonology.

Smouldering ashes: burning questions after the outbreak of electronic cigarette or vaping-associated lung injury (EVALI).

In the summer of 2019, the Center for Disease Control and Prevention (CDC) declared an emergency of electronic cigarettes and/or vaping (vaping)-associated lung injury (EVALI) in the USA. The outbreak abated by January 2020, which the CDC attributed to heightened public awareness, 'user actions to reduce risk' and potentially the removal of vitamin E acetate (VEA) from vaping products (VEA is an oily chemical cutting agent, strongly associated with the disease). Even though the EVALI outbreak appears to be over, numerous epidemiological and medical questions are left still open. First, why were there practically no cases outside the USA, which represents nearly a quarter of the global vaping market? Comparative studies to map the differences in device/fluids/user habits between countries might be needed urgently. Second, what is the pathomechanism that sickens vapers irrespective of VEA exposure? VEA was only confirmed in about half of the cases and the presumed toxicity is yet to be determined. Aetiology/epidemiology focused research is needed to investigate/interpret the broader context to explain the outbreak. Third, could any socioeconomic/environmental factors have influenced the course of the outbreak? Finally, what should we expect in the years to come? Was EVALI a serious but reversible emergency medicine condition or is vaping as detrimental to long-term health as smoking? Besides the complex legislative, regulatory, ethical aspects of EVALI, biomedical research is also difficult: in-vitro experiments have limited inferential value to real real-life vaping due to its complexity; user habits are self-reported and under-researched; there is an active black market pouring unknown quality counterfeit products and, in the USA, federal restrictions limit cannabis research. Vaping is a toxicological, multidimensional conundrum; therefore, stringent quality control, transparent legal/ethical boundaries, meticulous international research and user education are paramount to prevent potential future outbreaks and determine the parameters safe vaping (if these exist).

Evaluating long-term patterns of decreasing groundwater discharge through a lake-bottom permeable reactive barrier.

Identifying and quantifying groundwater exchange is critical when considering contaminant fate and transport at the groundwater/surface-water interface. In this paper, areally distributed temperature and point seepage measurements are used to efficiently assess spatial and temporal groundwater discharge patterns through a glacial-kettle lakebed area containing a zero-valent iron permeable reactive barrier (PRB). Concern was that the PRB was becoming less permeable with time owing to biogeochemical processes within the PRB. Patterns of groundwater discharge over an 8-year period were examined using fiber-optic distributed temperature sensing (FO-DTS) and snapshot-in-time point measurements of temperature. The resulting thermal maps show complex and uneven distributions of temperatures across the lakebed and highlight zones of rapid seepage near the shoreline and along the outer boundaries of the PRB. Repeated thermal mapping indicates an increase in lakebed temperatures over time at periods of similar stage and surface-water temperature. Flux rates in six seepage meters permanently installed on the lakebed in the PRB area decreased on average by 0.021 md-1 (or about 4.5 percent) annually between 2004 and 2015. Modeling of diurnal temperature signals from shallow vertical profiles yielded mean flux values ranging from 0.39 to 1.15 md-1, with stronger fluxes generally related to colder lakebed temperatures. The combination of an increase in lakebed temperatures, declines in direct seepage, and observations of increased cementation of the lakebed surface provide in situ evidence that the permeability of the PRB is declining. The presence of temporally persistent rapid seepage zones is also discussed.

An overview of geophysical technologies appropriate for characterization and monitoring at fractured-rock sites.

Geophysical methods are used increasingly for characterization and monitoring at remediation sites in fractured-rock aquifers. The complex heterogeneity of fractured rock poses enormous challenges to groundwater remediation professionals, and new methods are needed to cost-effectively infer fracture and fracture-zone locations, orientations and properties, and to develop conceptual site models for flow and transport. Despite the potential of geophysical methods to "see" between boreholes, two issues have impeded the adoption of geophysical methods by remediation professionals. First, geophysical results are commonly only indirectly related to the properties of interest (e.g., permeability) to remediation professionals, and qualitative or quantitative interpretation is required to convert geophysical results to hydrogeologic information. Additional demonstration/evaluation projects are needed in the site remediation literature to fully transfer geophysical methods from research to practice. Second, geophysical methods are commonly viewed as inherently risky by remediation professionals. Although it is widely understood that a given method may or may not work at a particular site, the reasons are not always clear to end users of geophysical products. Synthetic modeling tools are used in research to assess the potential of a particular method to successfully image a target, but these tools are not widely used in industry. Here, we seek to advance the application of geophysical methods to solve problems facing remediation professionals with respect to fractured-rock aquifers. To this end, we (1) provide an overview of geophysical methods applied to characterization and monitoring of fractured-rock aquifers; (2) review case studies showcasing different geophysical methods; and (3) discuss best practices for method selection and rejection based on synthetic modeling and decision support tools.

Diabetes and Hearing Impairment: Knowledge, Attitudes, and Practices Among Providers and Patients.

PURPOSE: The purpose of this study was to assess the knowledge, attitudes, and practices among providers and patients regarding hearing impairment and screening referrals in people with diabetes. METHODS: A cross-sectional survey design among health care providers and patients at an academic medical center in Oklahoma was used to gather knowledge, attitudes, and practices data. RESULTS: Only 25.6% of providers selected hearing impairment as a complication of diabetes, whereas 96.7% selected retinopathy, kidney dysfunction, and foot infection. Reported barriers to referring patients for hearing impairment screenings were being unfamiliar with recommended screening frequency (57.3%) and existence of higher priorities (35.4%). When asked to select parts of the body affected by diabetes, 21.0% of patients surveyed selected ears, 88.0% selected feet, and 85.0% selected eyes and kidneys. Fewer patients reported being told hearing impairment is a complication of diabetes compared to retinopathy (8.1% vs 85.9%). Additionally, 24.2% of patients reported having a hearing impairment screening, and 96.0% reported having a dilated eye exam. CONCLUSIONS: Most providers and patients at an academic medical center are unaware of the relationship between diabetes and hearing impairment. Providers reported there are several barriers that need to be overcome to refer patients to audiologists.

AuD-degree holders in tenure-track positions: survey of program chairpersons and AuD-degree holders.

BACKGROUND: The doctor of audiology (AuD) degree is now the entry-level degree for the profession of audiology. Typically, AuD programs train professionals for clinical careers, while those offering PhDs educate students for university teaching and research positions. Some in the communication sciences and disorders have predicted that there could be a shortage of PhDs in academic institutions over the next decade as senior faculty members with PhDs retire, AuD programs expand, and likely fewer students complete PhD degrees or elect to pursue careers in academia. If a PhD shortage becomes a reality, then one solution might be to include AuDs as candidates for vacant academic tenure-track positions. PURPOSE: To survey AuD-degree holders' (AuDs') and program chairpersons' (chairs') views about AuDs in academic tenure-track positions. RESEARCH DESIGN: National Internet survey Data Collection and Analysis: Two questionnaires were designed for this study. One was e-mailed to 1575 "AuDs in general" (randomly sampled from the American Academy of Audiology Membership Directory) and 132 "AuDs in academia." The other was e-mailed to 64 chairs from programs offering the AuD. The two surveys included similar questions so that comparisons could be made across groups. Potential respondents were e-mailed an informational letter inviting them to participate by completing a survey on SurveyMonkey within a 2 wk period in March and April 2010. This process resulted in three data sets: (1) AuDs in general, (2) AuDs in academia, and (3) program chairs. RESULTS: Return rates were 25, 26, and 45% for the three sampling methods for recruiting AuDs in general, AuDs in academia, and program chairs, respectively. Of the respondents, few AuDs held academic tenure-track positions or had achieved rank and tenure success in them. Those AuDs in academia usually had to meet the same or similarly rigorous criteria (with heavier emphasis on teaching than on research) for advancement as did PhD faculty. Overall, AuDs tended to believe that AuDs could be appointed to and succeed at tenure-track positions; chairs reported that such appointments were not permitted in most programs, did not personally believe that AuDs should hold these positions, and felt that AuDs would have more difficulty than PhDs in achieving success in them. Obstacles to AuDs' success in tenure-track positions reported by all three groups included lack of research skills and mentors, biases from faculty within and outside of audiology departments, and poorer pay than could be earned in the private sector. CONCLUSIONS: Considerable variability existed in the types of and titles for faculty positions held by AuDs in academia. Few AuDs were employed in tenure-track positions. Contrary to many of the chairs' responses, most AuDs felt they would be successful in such positions. Many of the AuDs suggested that universities with AuD programs should add more research and mentorship opportunities and tenure tracks for clinicians. Most respondents believed there is a need for both AuDs and PhDs in academic programs. These findings should be of interest to AuDs, chairs, and other stakeholders in academia, and the survey responses identified some areas warranting future investigation.

Hearing aid affordability in the United States.

PURPOSE: Substantial out-of-pocket costs for hearing aids constitute a barrier to hearing health care accessibility for older adults among whom prevalence of hearing loss is high. This study is the first to estimate the proportion of Americans with functional hearing loss for which out-of-pocket expenditures for hearing aids would be unaffordable at current average costs and determine how affordability varies by sociodemographic factors. MATERIALS AND METHODS: We utilized data from the 2016 American Community Survey to determine the proportion of adults with functional hearing loss for whom hearing aids would constitute ≥3% of annual income or have post-purchase income below a poverty standard. Chi-square tests were used to identify differences in affordability outcomes by sociodemographic characteristics. RESULTS: Results indicated that an average bundled cost of $2500 would constitute a catastrophic expense for 77% of Americans with functional hearing loss (N = 7,872,292) and would add an additional 4% of the population into poverty for the year (N = 423,548). Affordability outcomes varied significantly by age, race, sex, educational attainment and geographic location. CONCLUSIONS: Hearing aids were unaffordable for three-fourths of Americans with functional hearing loss, and their purchase would result in impoverishment for hundreds of thousands of individuals. Reductions in out-of-pocket hearing aid costs to $500 or $1000 would alleviate affordability issues for many Americans with hearing loss. Future federal and state policy should address poor rates of insurance coverage for hearing care, specifically among Medicare and Medicaid, to reduce out-of-pocket costs for hearing care particularly for older adults.Implications for rehabilitationAn average out-of-pocket hearing care cost of $2500 was unaffordable for over three quarters of Americans with functional hearing loss.Hearing care affordability varied significantly by demographic characteristics such as age, sex, gender, educational attainment and geographic region.Affordability constitutes a significant barrier to hearing care accessibility in the United States, where most costs of hearing aids and rehabilitation are statutorily excluded from insurance coverage, including the largest insurer of Americans, Medicare.

Field evaluation of semi-automated moisture estimation from geophysics using machine learning.

Geophysical methods can provide three-dimensional (3D), spatially continuous estimates of soil moisture. However, point-to-point comparisons of geophysical properties to measure soil moisture data are frequently unsatisfactory, resulting in geophysics being used for qualitative purposes only. This is because (1) geophysics requires models that relate geophysical signals to soil moisture, (2) geophysical methods have potential uncertainties resulting from smoothing and artifacts introduced from processing and inversion, and (3) results from multiple geophysical methods are not easily combined within a single soil moisture estimation framework. To investigate these potential limitations, an irrigation experiment was performed wherein soil moisture was monitored through time, and several surface geophysical datasets indirectly sensitive to soil moisture were collected before and after irrigation: ground penetrating radar, electrical resistivity tomography (ERT), and frequency domain electromagnetics (FDEM). Data were exported in both raw and processed form, and then snapped to a common 3D grid to facilitate moisture prediction by standard calibration techniques, multivariate regression, and machine learning. A combination of inverted ERT data, raw FDEM, and inverted FDEM data was most informative for predicting soil moisture using a random regression forest model (one-thousand 60/40 training/test cross-validation folds produced root mean squared errors ranging from 0.025-0.046 cm3/cm3). This cross-validated model was further supported by a separate evaluation using a test set from a physically separate portion of the study area. Machine learning was conducive to a semi-automated model-selection process that could be used for other sites and datasets to locally improve accuracy.

Evaluation of Models for Estimating Hydraulic Conductivity in Glacial Aquifers with NMR Logging.

Nuclear magnetic resonance (NMR) logging is a promising method for estimating hydraulic conductivity (K). During the past ∼60 years, NMR logging has been used for petroleum applications, and different models have been developed for deriving estimates of permeability. These models involve calibration parameters whose values were determined through decades of research on sandstones and carbonates. We assessed the use of five models to derive estimates of K in glacial aquifers from NMR logging data acquired in two wells at each of two field sites in central Wisconsin, USA. Measurements of K, obtained with a direct push permeameter (DPP), KDPP , were used to obtain the calibration parameters in the Schlumberger-Doll Research, Seevers, Timur-Coates, Kozeny-Godefroy, and sum-of-echoes (SOE) models so as to predict K from the NMR data; and were also used to assess the ability of the models to predict KDPP . We obtained four well-scale calibration parameter values for each model using the NMR and DPP measurements in each well; and one study-scale parameter value for each model by using all data. The SOE model achieved an agreement with KDPP that matched or exceeded that of the other models. The Timur-Coates estimates of K were found to be substantially different from KDPP . Although the well-scale parameter values for the Schlumberger-Doll, Seevers, and SOE models were found to vary by less than a factor of 2, more research is needed to confirm their general applicability so that site-specific calibration is not required to obtain accurate estimates of K from NMR logging data.

GW/SW-MST: A Groundwater/Surface-Water Method Selection Tool.

Groundwater/surface-water (GW/SW) exchange and hyporheic processes are topics receiving increasing attention from the hydrologic community. Hydraulic, chemical, temperature, geophysical, and remote sensing methods are used to achieve various goals (e.g., inference of GW/SW exchange, mapping of bed materials, etc.), but the application of these methods is constrained by site conditions such as water depth, specific conductance, bed material, and other factors. Researchers and environmental professionals working on GW/SW problems come from diverse fields and rarely have expertise in all available field methods; hence there is a need for guidance to design field campaigns and select methods that both contribute to study goals and are likely to work under site-specific conditions. Here, we present the spreadsheet-based GW/SW-Method Selection Tool (GW/SW-MST) to help practitioners identify methods for use in GW/SW and hyporheic studies. The GW/SW-MST is a Microsoft Excel-based decision support tool in which the user selects answers to questions about GW/SW-related study goals and site parameters and characteristics. Based on user input, the tool indicates which methods from a toolbox of 32 methods could potentially contribute to achieving the specified goals at the site described.

Is mother-child transmission a possible vehicle for xylitol prophylaxis in acute otitis media?

OBJECTIVE: Xylitol can be a prophylaxis for acute otitis media (AOM), especially when administered via chewing gum, but that vehicle has limitations for children. This review sought evidence for links of mother-child transmission of bacteria and as a vehicle for xylitol as a prophylaxis for dental caries and its translation to AOM in infants and young children. DESIGN: Qualitative systematic review. METHOD: Combining output from 43 search strings used earlier and submitting 20 new strings to PubMed resulted in 14 studies (six were excluded; eight were included). Included studies had to be published in English-language, peer-reviewed journals; involve mothers using xylitol; and assess bacteria or caries in their children. Evaluation forms were completed for search, retrieval, and quality assessment of included studies. RESULTS: The studies showed that mothers' chewing xylitol gum was a prophylaxis against bacteria and caries in their children. A mother-child transmission model was presented as a possible vehicle for use in comprehensive prevention programs for AOM. CONCLUSIONS: Potential for xylitol use to prevent AOM warrants further study. A mother-child model may apply to AOM for transmission of bacteria and as a prophylaxis, but alternative vehicles like nasal sprays should be investigated for ease of use and effectiveness.

Assessment of NMR Logging for Estimating Hydraulic Conductivity in Glacial Aquifers.

Glacial aquifers are an important source of groundwater in the United States and require accurate characterization to make informed management decisions. One parameter that is crucial for understanding the movement of groundwater is hydraulic conductivity, K. Nuclear magnetic resonance (NMR) logging measures the NMR response associated with the water in geological materials. By utilizing an external magnetic field to manipulate the nuclear spins associated with 1 H, the time-varying decay of the nuclear magnetization is measured. This logging method could provide an effective way to estimate K at submeter vertical resolution, but the models that relate NMR measurements to K require calibration. At two field sites in a glacial aquifer in central Wisconsin, we collected a total of four NMR logs and obtained measurements of K in their immediate vicinity with a direct-push permeameter (DPP). Using a bootstrap algorithm to calibrate the Schlumberger-Doll Research (SDR) NMR-K model, we estimated K to within a factor of 5 of the DPP measurements. The lowest levels of accuracy occurred in the lower-K (K < 10-4  m/s) intervals. We also evaluated the applicability of prior SDR model calibrations. We found the NMR calibration parameters varied with K, suggesting the SDR model does not incorporate all the properties of the pore space that control K. Thus, the expected range of K in an aquifer may need to be considered during calibration of NMR-K models. This study is the first step toward establishing NMR logging as an effective method for estimating K in glacial aquifers.

Xylitol as a prophylaxis for acute otitis media: systematic review.

A systematic review was conducted to evaluate evidence regarding xylitol, a sugar alcohol, as a prophylaxis for acute otitis media (AOM) in children. The authors searched PubMed and other databases to identify evidence. Criteria for included studies were: appear in English-language, peer-reviewed journals; at least quasi-experimental designs; use xylitol; and present outcome data. The authors completed evaluation forms for the included studies at all phases of the review. The authors reviewed 1479 titles and excluded 1435. Abstracts and full texts were reviewed for the remaining 44; four randomized controlled trials met inclusion criteria. Xylitol was a generally well accepted prophylaxis for AOM with few side effects when administered via chewing gum or syrup at 10 g/day given five times daily. Meta-analysis revealed significant treatment effects (Risk ratio = 0.68; 95% confidence interval = 0.57 to 0.83). Xylitol can be a prophylaxis for AOM, but warrants further study, especially of vehicles other than chewing gum for young children, and information is needed regarding cost, duration of administration required, and expected long-term effects.

Does the evidence support use of the Baha implant system (Baha) in patients with congenital unilateral aural atresia?

PURPOSE: To determine if the evidence supports the recommendation of Baha implant systems (Bahas) over unaided conditions in persons with conductive hearing loss due to congenital unilateral aural atresia (CUAA), and if laboratory measures predict patient benefit and satisfaction. RESEARCH DESIGN: A systematic review. METHODS: The authors constructed and submitted search strings to PubMed and other electronic databases to identify studies in peer-reviewed journals that were at an appropriate level of evidence (systematic reviews, randomized controlled trials, or nonrandomized intervention studies); used outcome measures assessing audibility, localization, or speech-recognition in noise; included patients with CUAA using Bahas; and had intrepretable data. References of all retrieved articles were also hand searched for relevant studies. Evaluation forms were completed by the authors for each of the included studies at all phases of the review including quality assessment and data extraction. RESULTS: The authors reviewed 88 retrieved titles and excluded four that had no relevance to the topic and 67 that were duplicates. Abstracts were reviewed for the remaining 17, and six nonrelevant studies were excluded. The remaining 11 articles were retrieved for full-text review; only three studies met inclusion criteria and were analyzed further. The three studies were not appropriate for a meta-analysis due to limited data, too few participants, and insufficient presentations of results. Qualitative analysis revealed inconsistent findings across audiometric measures, and few significant differences were noted with and without Bahas, yet most participants believed that Bahas improved their quality of life. Laboratory measures did not always predict patient benefit and satisfaction with Bahas. CONCLUSIONS: Results were limited for this narrow population having CUAA and the specific criteria used for this review. Audiologic measures generally failed to predict patients' success and/or satisfaction with their Bahas, but most of the included studies showed that patients perceived some benefits. Ideally, clinical decision making should include the highest levels of scientific evidence. However, when evidence is unavailable or does not support a clear-cut recommendation for a particular treatment across patients, as seems to be the case for the use of Bahas with CUAA, then clinicians must rely more heavily on clinical expertise and individual patient preferences in guiding clinical decision making.

National survey of pediatricians' opinions about and practices for acute otitis media and xylitol use.

BACKGROUND: Acute otitis media (AOM) is the main reason for physician visits and antibiotic prescriptions in children. Pediatricians (Peds) are gatekeepers for services and sources of information for families. The 2004 American Academy of Pediatrics/American Academy of Family Physicians (AAP/AAFP) Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Media recommended preventative and management measures for Peds' practice. Treatments for AOM (antimicrobial therapy and surgery) sometimes have questionable effectiveness, risks, and high costs. Thus, Peds should consider using prophylactics for AOM that are easy to administer, cost-effective, and have minimal side effects. Xylitol, a naturally occurring sugar alcohol, is widely used to prevent AOM and for other health conditions in Europe, and as a dental caries prophylaxis in the United States. It would be helpful to know Peds' attitudes and practices to identify barriers to xylitol's use as a prophylaxis for AOM in the United States. PURPOSE: To conduct a national survey of Peds in the United States to evaluate how closely they adhered to the AAP/AAFP guideline, and their knowledge and opinions about xylitol use. RESEARCH DESIGN: A randomized, national postal survey. METHOD: A 48-item questionnaire developed for this study was mailed to a random sample of 506 Peds within the United States during spring 2009. It assessed Peds' demographics, adherence to the guideline, and knowledge and opinions about and use of xylitol as a prophylaxis for AOM in children. RESULTS: The questionnaire response rate was 22% (98 useable/506 mailed - 63 returned undeliverable). Participants were about equal for gender, and almost all were in private practice for over 10 yr. Most had pediatric patients with at least one bout of AOM annually. The majority adhered to the guideline (e.g., almost all routinely assessed and managed patients' pain for AOM and encouraged prevention by recommending that families reduce risk factors). Most used and were comfortable with otoscopy for diagnosing AOM, but not tympanometry. Almost all believed that conductive hearing loss could hinder speech-language and academic development, and AOM could reduce quality of life of children. They also believed that those under 6 mo of age with AOM should receive antibacterial therapy beginning with amoxicillin but did not use complementary and alternative medicine (CAM). Only about half knew about medical uses for xylitol, but of those, most were aware of its use in chewing gum to prevent AOM but had not used it with patients. They were not sure of xylitol's effectiveness or appropriate dosages but cited stomach cramping and diarrhea as possible side effects. Most would use xylitol if evidence supported it and wanted information about it via reprints or electronically. Few agreed that audiologists are important in diagnosing/managing AOM. CONCLUSIONS: Most of these Peds adhered to the AAP/AAFP guideline. They were not using CAMs like xylitol for preventing AOM in children. Future research should focus on prevention and the use of xylitol as a possible prophylaxis regimen for AOM in patients.

Predictors of Hearing Aid Use in the Advanced Digital Era: An Investigation of Benefit, Satisfaction, and Self-Efficacy.

BACKGROUND: Untreated sensorineural hearing loss (SNHL) has been linked to depression, social isolation, anxiety, and a reduction in health-related quality of life (QoL), and is independently associated with cognitive decline. Only one in five persons with SNHL pursues amplification; 76-97% of those having hearing aids report regular or occasional use. Although hearing aid use during all waking hours is advocated for children, recommendations for adults are not as clear. Treatment outcomes, including benefit, satisfaction, and self-efficacy with hearing aids, may be predictors of self-reported hearing aid use, which is useful in clinical practice. PURPOSE: The aim of this study was to determine average hours of self-reported daily hearing aid use by adults and if treatment outcome measures of benefit, satisfaction, and self-efficacy with hearing aids can predict self-reported daily hearing aid use in adults. RESEARCH DESIGN: The present study was a prospective cross-sectional survey with retrospective chart review. STUDY SAMPLE: The study sample consisted of 152 experienced adult advanced digital technology (ADT) hearing aid users between 18 and 90 years of age who were patients in a two-office private practice in California. DATA COLLECTION AND ANALYSIS: A postal survey was sent to 500 experienced adult ADT hearing aid users. Participants completed the Visual Analog Scale for Daily Use of Hearing Aids (VASuse) and validated measures of (1) self-efficacy, (2) satisfaction, and (3) benefit. Retrospective data were collected for all respondents via chart review. Multivariable linear regression was used to explore relationships between treatment outcomes and hearing aid use. RESULTS: Experienced hearing aid users wore their hearing aids an average of 12.0 h/day. Daily hearing aid use was significantly associated with residual participation restriction (RPR) on the International Outcome Inventory for Hearing Aids (IOI-HA) item 5 (p = 0.02). The VASuse was significantly associated with the IOI-HA factor 1, "Me and My Hearing Aids" (p = 0.03), an aggregate measure of satisfaction, benefit, and QoL. CONCLUSIONS: Participants reported wearing their hearing aids an average of 12.0 h/day. Self-reported daily hearing aid use was associated with a combination of satisfaction, benefit, and increased QoL, and with RPR. The interconnectedness of satisfaction, benefit, and QoL positively affected hearing aid use, and greater levels of RPR seemed to discourage hearing aid use. If hearing aid owners are inconsistent or nonusers, then counseling and outcome measures should be used in the domains of satisfaction, benefit, and QoL. Future research should involve additional ADT hearing aid users with different experience levels across various study sites.

Characterizing the diverse hydrogeology underlying rivers and estuaries using new floating transient electromagnetic methodology.

The hydrogeology below large surface water features such as rivers and estuaries is universally under-informed at the long reach to basin scales (tens of km+). This challenge inhibits the accurate modeling of fresh/saline groundwater interfaces and groundwater/surface water exchange patterns at management-relevant spatial extents. Here we introduce a towed, floating transient electromagnetic (TEM) system (i.e. FloaTEM) for rapid (up to 15 km/h) high resolution electrical mapping of the subsurface below large water bodies to depths often a factor of 10 greater than other towed instruments. The novel FloaTEM system is demonstrated at a range of diverse 4th through 6th-order riverine settings across the United States including 1) the Farmington River, near Hartford, Connecticut; 2) the Upper Delaware River near Barryville, New York; 3) the Tallahatchie River near Shellmound, Mississippi; and, 4) the Eel River estuary, on Cape Cod, near Falmouth, Massachusetts. Airborne frequency-domain electromagnetic and land-based towed TEM data are also compared at the Tallahatchie River site, and streambed geologic scenarios are explored with forward modeling. A range of geologic structures and pore water salinity interfaces were identified. Process-based interpretation of the case study data indicated FloaTEM can resolve varied sediment-water interface materials, such as the accumulation of fines at the bottom of a reservoir and permeable sand/gravel riverbed sediments that focus groundwater discharge. Bedrock layers were mapped at several sites, and aquifer confining units were defined at comparable resolution to airborne methods. Terrestrial fresh groundwater discharge with flowpaths extending hundreds of meters from shore was also imaged below the Eel River estuary, improving on previous hydrogeological characterizations of that nutrient-rich coastal exchange zone. In summary, the novel FloaTEM system fills a critical gap in our ability to characterize the hydrogeology below surface water features and will support more accurate prediction of groundwater/surface water exchange dynamics and fresh-saline groundwater interfaces.

Geophysical Assessment of a Proposed Landfill Site in Fredericktown, Missouri.

In cooperation with the U.S. Environmental Protection Agency (EPA), the U.S. Geological Survey (USGS) collected numerous types of geophysical data at a site in Fredericktown, Missouri, in June 2018. Various geophysical surveys were collectively used to help evaluate the overall suitability of the site for use as a mine waste-soil and sediment repository, and to evaluate the suite of geophysical methods for rapid collection and preliminary assessment of sites with shallow sediments. Land-based geophysical methods, which included frequency-domain electromagnetic induction (FDEM), electrical resistivity tomography (ERT), horizontal-to-vertical spectral ratio passive seismic (HVSR), and shear-wave refraction, were used to determine the depths to crystalline bedrock and characterize the overlying unconsolidated sediments (or regolith). Water-borne FDEM profiles and forward-looking infrared (FLIR) thermal image surveys were conducted along the Fredericktown City Lake shoreline to identify locations of potential interactions between groundwater and surface water. Sediment temperature profilers were installed at two locations along the shoreline to characterize shallow unconsolidated sediment thermal properties and support the interpretation of the other geophysical surveys. Geophysical reconnaissance methods including the FDEM and HVSR methods, were used to rapidly evaluate the vertical and lateral extent of overburden, or unconsolidated sediments, overlying the bedrock at the site. The results of these methods were compared to reference geophysical methods of ERT and shear-wave refraction surveys that have greater accuracy and are more labor intensive and time-consuming. A goal of the project was the evaluation of the validity and reliability of this suite of reconnaissance geophysical methods as a means by which shallow (less than 3 meters (m)) sediments can be rapidly assessed. Two orthogonal ERT survey profiles, which used 28 electrodes spaced 1 m apart in dipole-dipole and combined Wenner-Schlumberger configurations, were collected to determine the subsurface resistivity. The results were inverted to produce electrical resistivity profiles that were compared to the FDEM and HVSR survey results. The FDEM data were collected along cleared paths through the proposed disposal cell locations. The data were inverted to generate depth-dependent estimates of electrical conductivity along the transects. An analysis of the depth of investigation (DOI) indicated the FDEM imaged to depths of about 3 m below land surface. The ERT, FDEM, and HVSR indicated the depth to crystalline bedrock was approximately 1.5 m below land surface with shallower and deeper areas. Results from this investigation indicate this suite of methods will likely perform well at sites with shallow depths to bedrock and strong conductivity and acoustic impedance contrasts, where the FDEM and HVSR methods can provide estimates of the depth to bedrock, and ERT and shear-wave refraction surveys might not be worth the added time and expense.