The effect of the Ambulatory Integration of the Medical and Social (AIMS) model on health risk and depression.

Social needs are factors for health risk and depression that may negatively impact health outcomes and costly services use. Care management addresses social needs that can reduce health risk and depression. An exploratory study of the 5-step Ambulatory Integration of the Medical and Social Model (AIMS) was conducted to examine the effect of steps completed as part of AIMS on patients' depression and health risk outcomes at 6-months. Results reveal steps central to AIMS are significantly related to lower depression and health risk, suggesting AIMS is a valuable intervention for reducing health risk and depression.

Hearing and vision health for people with dementia in residential long term care: Knowledge, attitudes and practice in England, South Korea, India, Greece, Indonesia and Australia.

OBJECTIVES: Up to 90% of people with dementia in long term care (LTC) have hearing and/or vision impairment. Hearing/vision difficulties are frequently under-recognised or incompletely managed. The impacts of hearing/vision impairment include more rapid cognitive decline, behavioural disturbances, reduced quality of life, and greater care burden. This research investigated LTC staff knowledge, attitudes and practice regarding hearing/vision care needs for residents with dementia. METHODS: A survey of staff in LTC facilities in England, South Korea, India, Greece, Indonesia and Australia. Respondents used a five-point scale to indicate agreement or YES/NO response to questions regarding sensory-cognitive care knowledge (what is known); attitudes (what is thought); practice (what is done). RESULTS: Respondents reported high awareness of hearing/vision care needs, although awareness of how to identify hearing/vison difficulties or refer for assessment was low. Most felt that residents were not able to use hearing/vision devices effectively due to poor fit, being poorly tolerated or lost or broken devices. A substantial minority of respondents reported low confidence in supporting use of assistive hearing/vision devices, with lack of training the main reason. Most staff did not undertake routine checking of hearing/vision devices, and it was rare for facilities to have designated staff responsible for sensory needs. Variation among countries was not significant after accounting for staff experience and having received dementia training. CONCLUSIONS: There is a need to improve sensory support for people with dementia in LTC facilities internationally. Practice guidelines and training to enhance sensory-cognitive knowledge, attitudes and practice in professional care teams is called for.

Crucial Music Components Needed for Speech Perception Enhancement of Pediatric Cochlear Implant Users: A Systematic Review and Meta-Analysis.

BACKGROUND: Although many clinicians have attempted music training for the hearing-impaired children, no specific effects have yet been reported for individual music components. This paper seeks to discover specific music components that help in improving speech perception of children with cochlear implants (CI) and to identify the effective training periods and methods needed for each component. METHOD: While assessing 5 electronic databases, that is, ScienceDirect, Scopus, PubMed, CINAHL, and Web of Science, 1,638 articles were found initially. After the screening and eligibility assessment stage based on the Participants, Intervention, Comparisons, Outcome, and Study Design (PICOS) inclusion criteria, 18 of 1,449 articles were chosen. RESULTS: A total of 18 studies and 14 studies (209 participants) were analyzed using a systematic review and meta-analysis, respectively. No publication bias was detected based on an Egger's regression result even though the funnel plot was asymmetrical. The results of the meta-analysis revealed that the largest improvement was seen for rhythm perception, followed by the perception of pitch and harmony and smallest for timbre perception after the music training. The duration of training affected the rhythm, pitch, and harmony perception but not the timbre. Interestingly, musical activities, such as singing, produced the biggest effect size, implying that children with CI obtained the greatest benefits of music training by singing, followed by playing an instrument and achieved the smallest effect by only listening to musical stimuli. Significant improvement in pitch perception helped with the enhancement of prosody perception. CONCLUSION: Music training can improve the music perception of children with CI and enhance their speech prosody. Long training duration was shown to provide the largest training effect of the children's perception improvement. The children with CI learned rhythm and pitch better than they did with harmony and timbre. These results support the finding of past studies that with music training, both rhythm and pitch perception can be improved, and it also helps in the development of prosody perception.

Social representation of hearing aids among people with hearing loss: an exploratory study.

OBJECTIVE: The aim of the current study was to examine the social representation (SR) of hearing aids in people with hearing loss (PHL) in India, the Republic of Korea (ROK), the United Kingdom (UK), and the United States of America (US). DESIGN: The study used a cross-sectional survey design. The data collected by using a free association task were analysed qualitatively (i.e. content analysis) and quantitatively (i.e. chi-square analysis, similarities analysis, prototypical analysis). STUDY SAMPLE: 424 participants with hearing loss. RESULTS: The most commonly reported categories across all countries were "beneficial," "cost and time," and "appearance and design." Approximately 50% of the associations reported were negative. There were variations in terms of the categories that were predominant in the SR of each country. "Others actions and attitude" category was predominantly reported by PHL in India. "Disturbance" and "dissatisfaction" of hearing aids and the "repairs and maintenance of hearing aids" categories were mainly reported from the ROK and the US, respectively. CONCLUSIONS: The current results highlight the main aspects that PHL report spontaneously when they think about hearing aids. The findings will help to further inform public health campaigns and will contribute to develop culturally appropriate media materials regarding hearing aids.

Evaluation of wireless Bluetooth devices to improve recognition of speech and sentences when using a mobile phone in bone conduction device recipients.

OBJECTIVE: To evaluate the effect of a wireless Bluetooth device (WBD) in word and sentence recognition in patients with bone conduction devices (BCDs) while using mobile phones. METHODS: We performed a prospective study evaluating speech and sentence recognition in both quiet and noised conditions. A total of nine patients, audiologically eligible for BCDs, were included. Based on their hearing impairment type and severity, subjects were divided into "BCD only" and "BCD with HA" groups. The speech and sentence recognition scores of each condition were compared by nonparametric methods. RESULTS: Both the "BCD only" and "BCD with HA" groups had higher scores in the quiet condition than in the noised condition in word and sentence recognition tests, irrespective of whether the WBD was used. The benefit from using a WBD was greater in the noised condition. There were significant differences in the word recognition test results before and after using the WBD in the "BCD only" group, and in both the word and sentence recognition tests results before and after using the WBD bimodally in the noised condition in the "BCD with HA" group. CONCLUSION: WBDs improve word and sentence recognition in adult BCD bone recipients when they use mobile phones. WBD use provides additional benefits in "BCD with HA" patients in a bimodal situation.

Sound pressure levels generated at risk volume steps of portable listening devices: types of smartphone and genres of music.

BACKGROUND: The present study estimated the sound pressure levels of various music genres at the volume steps that contemporary smartphones deliver, because these levels put the listener at potential risk for hearing loss. METHODS: Using six different smartphones (Galaxy S6, Galaxy Note 3, iPhone 5S, iPhone 6, LG G2, and LG G3), the sound pressure levels for three genres of K-pop music (dance-pop, hip-hop, and pop-ballad) and a Billboard pop chart of assorted genres were measured through an earbud for the first risk volume that was at the risk sign proposed by the smartphones, as well as consecutive higher volumes using a sound level meter and artificial mastoid. RESULTS: The first risk volume step of the Galaxy S6 and the LG G2, among the six smartphones, had the significantly lowest (84.1 dBA) and highest output levels (92.4 dBA), respectively. As the volume step increased, so did the sound pressure levels. The iPhone 6 was loudest (113.1 dBA) at the maximum volume step. Of the music genres, dance-pop showed the highest output level (91.1 dBA) for all smartphones. Within the frequency range of 20~ 20,000 Hz, the sound pressure level peaked at 2000 Hz for all the smartphones. CONCLUSIONS: The results showed that the sound pressure levels of either the first volume step or the maximum volume step were not the same for the different smartphone models and genres of music, which means that the risk volume sign and its output levels should be unified across the devices for their users. In addition, the risk volume steps proposed by the latest smartphone models are high enough to cause noise-induced hearing loss if their users habitually listen to music at those levels.

Racial-Ethnic Variation in Mental Health Service Utilization Among People with a Major Affective Disorder and a Criminal History.

Using a nationally representative sample, this study examined the extent to which the utilization of various mental health services was associated with racial-ethnic identity among people with major affective disorders who have a criminal history. Approximately 33.7 % of the sample received any type of mental health services in a given year. Multivariate models indicated that married Blacks and Latinos were less likely to use specialty mental health care than their white counterparts. To provide equitable mental health treatment for vulnerable subgroups of this population, mental health professionals should account for the heterogeneity of mental health care in diverse cultural contexts.

Preferred listening levels of mobile phone programs when considering subway interior noise.

Today, people listen to music loud using personal listening devices. Although a majority of studies have reported that the high volume played on these listening devices produces a latent risk of hearing problems, there is a lack of studies on "double noise exposures" such as environmental noise plus recreational noise. The present study measures the preferred listening levels of a mobile phone program with subway interior noise for 74 normal-hearing participants in five age groups (ranging from 20s to 60s). The speakers presented the subway interior noise at 73.45 dB, while each subject listened to three application programs [Digital Multimedia Broadcasting (DMB), music, game] for 30 min using a tablet personal computer with an earphone. The participants' earphone volume levels were analyzed using a sound level meter and a 2cc coupler. Overall, the results showed that those in their 20s listened to the three programs significantly louder with DMB set at significantly higher volume levels than for the other programs. Higher volume levels were needed for middle frequency compared to the lower and higher frequencies. We concluded that any potential risk of noise-induced hearing loss for mobile phone users should be communicated when users listen regularly, although the volume level was not high enough that the users felt uncomfortable. When considering individual listening habits on mobile phones, further study to predict total accumulated environmental noise is still needed.

Racial/ethnic variation in health care satisfaction: The role of acculturation.

This study examined the role of acculturation and racial/ethnic variation in health care satisfaction among four different racial/ethnic groups. The study sample consisted of 41,560 adults from the 2011 California Health Interview Survey. Health care satisfaction was measured via two questions regarding doctors' listening and explanations. Guided by Andersen's behavioral model of health care use, multivariate logistic regressions were conducted. Hispanic and Asian respondents showed the lowest levels of satisfaction with their doctors' listening and explanations, respectively. Acculturation was found to be a significant predictor of health care satisfaction. Health care professionals should develop ways of expanding culturally competent health care professionals, who are aware of racial/ethnic variation in health care satisfaction.

Examining the links between therapeutic jurisprudence and mental health court completion.

Research demonstrates that mental health courts (MHCs) lead to improved outcomes compared to traditional criminal court processes. An underlying premise of MHCs is therapeutic jurisprudence (TJ). However, no research, to our knowledge, has examined whether MHC outcomes are predicted by TJ principles as theorized. In the present study, we examined whether principles measured at the onset of MHC enrollment (knowledge, perceived voluntariness, and procedural justice) predicted MHC completion (graduation). Using structural equation modeling with MHC participants from four courts, a significant, direct relationship between TJ and MHC completion was found, such that higher levels of TJ were associated with higher rates of success. Although this direct effect became nonsignificant when mediator variables were included, a significant indirect path remained, such that increased levels of initial perceived voluntariness and procedural justice, and MHC knowledge, led to decreased rates of new arrests, prison, MHC bench warrants, and increased court compliance, which, in turn, led to a higher likelihood of MHC graduation.

The association between criminal history and mental health service use among people with serious mental illness.

This study examined the extent to which a criminal history is associated with the use of various mental health services as well as related service use predictors among people with serious mental illness (SMI). Data were obtained from the National Comorbidity Survey Replication. The sample consisted of 1,588 adults with SMI, including major depressive disorder (n = 1,398) and bipolar disorder (n = 190). Chi square tests were conducted to compare respondent characteristics based upon the presence/absence of a criminal history. Logistic regression analyses were conducted to examine various mental health services usage among respondents while controlling for predisposing, enabling, and need factors. Approximately 30 % of respondents reported a criminal history. Those with a criminal history were more likely to use specialty mental health services (OR = 1.42, p < 0.05). Findings suggest that the criminal justice system may be serving as a substantial referrer to mental health services or that there is higher morbidity among people with SMI who have been justice involved.

The Effects of Music-Based Auditory Training on Hearing-Impaired Older Adults With Mild Cognitive Impairment.

OBJECTIVES: The present study aimed to determine the effect of music-based auditory training on older adults with hearing loss and decreased cognitive ability, which are common conditions in the older population. METHODS: In total, 20 older adults diagnosed with both mild-to-moderately severe hearing loss and mild cognitive impairment (MCI) participated. Half of this group were randomly assigned to the auditory training group (ATG), and the other half were designated as the control group (CG). For the ATG, a 40-minute training session (10 minutes for singing a song, 15 minutes for playing instruments, and 15 minutes for playing games with music discrimination) was conducted twice a week for 8 weeks (for a total of 16 sessions). To confirm the training effects, all participants were given tests pre- and post-training, and then a follow-up test was administered 2 weeks after the training, using various auditory and cognitive tests and a self-reporting questionnaire. RESULTS: The ATG demonstrated significant improvement in all auditory test scores compared to the CG. Additionally, there was a notable enhancement in cognitive test scores post-training, except for the digit span tests. However, there was no statistically significant difference in the questionnaire scores between the two groups, although the ATG did score higher post-training. CONCLUSION: The music-based auditory training resulted in a significant improvement in auditory function and a partial enhancement in cognitive ability among elderly patients with hearing loss and MCI. We anticipate that this music-based approach will be adopted for auditory training in clinical settings due to its engaging and easy-to-follow nature.

Meta-Analysis Exploring the Effects of Music Training in Cochlear Implant Users by Age.

BACKGROUND AND OBJECTIVES: The present study aimed to explore meaningful change in the musical performance of cochlear implant (CI) users according to age after receiving music training compared to the other CI users who did not receive any music training and normal hearing (NH) listeners. Materials and. METHODS: Article search was conducted from five journal databases. In accordance with PICOS criteria, 29 articles and 15 articles were included for the CI and NH groups, respectively. A total of 44 articles consisting of 407 CI users and 486 NH participants were then analyzed. Using the data gathered from pre- and post-training, meta-analysis was applied by the random-effects model, and then piecewise meta-regression was employed. RESULTS: CI users with music training showed better performance than those without the training across all ages. The curve change in musical performance when training showed that the CI users was similar to the general pattern of NH performance, indicating that the CI users gained benefits from music training and developed perceptual ability, even though it was not as high as the level of NH counterparts. CONCLUSIONS: This finding supports the benefits of active engagement with music for both CI users and NH listeners, while noting the important role of music as one of the primary aural rehabilitation approaches.

Factors Influencing the Korean Version of the Digit-in-Noise Test.

BACKGROUND AND OBJECTIVES: The digits-in-noise (DIN) test was developed as a simple and time-efficient hearing-in-noise test worldwide. The Korean version of the DIN (K-DIN) test was previously validated for both normal-hearing and hearing-impaired listeners. This study aimed to explore the factors influencing the outcomes of the K-DIN test further by analyzing the threshold (representing detection ability) and slope (representing test difficulty) parameters for the psychometric curve fit. Subjects and. METHODS: In total, 35 young adults with normal hearing participated in the K-DIN test under the following four experimental conditions: 1) background noise (digit-shaped vs. pink noise); 2) gender of the speaker (male vs. female); 3) ear side (right vs. left); and 4) digit presentation levels (55, 65, 75, and 85 dB). The digits were presented using the method of constant stimuli procedure. Participant responses to the stimulus trials were used to fit a psychometric function, and the threshold and slope parameters were estimated according to pre-determined criteria. The accuracy of fit performance was determined using the root-mean-square error calculation. RESULTS: The listener's digit detection ability (threshold) was slightly better with pink noise than with digit-shaped noise, with similar test difficulties (slopes) across the digits. Gender and the tested ear side influenced neither the detection ability nor the task difficulty. Additionally, lower presentation levels (55 and 65 dB) elicited better thresholds than the higher presentation levels (75 and 85 dB); however, the test difficulty varied slightly across the presentation levels. CONCLUSIONS: The K-DIN test can be influenced by stimulus factors. Continued research is warranted to understand the accuracy and reliability of the test better, especially for its use as a promising clinical measure.

Contralateral bone conducted sound wave propagation on the skull bones in fresh frozen cadaver.

The study aimed to investigate the efficient pathway for BC sound transmission by measuring vibrations on the opposite side of the skull bone, referred to as the mastoid position. The realistic contralateral transmission pathway of bone conduction (BC) vibrations is investigated through each osseous structure in the midlines of the fresh-frozen whole head. BC stimulation is applied to the mastoid using a bone vibrator, and acceleration responses are observed on the contralateral mastoid bone and seven midline points of skull bones using triaxial accelerometers. The study finds that the range showing the highest contralateral transmission efficiency of bone vibration is the intermediate frequency range with contralateral direction. Within this range, a significant amplitude of acceleration response is measured at the face-side points and the back and upper parts of the head. The thesis suggests that signal transmission from the specific midline to the mastoid can be more efficient than the conventional configuration of BC from the mastoid to the mastoid.

Audiovocal integration in adults who stutter.

BACKGROUND: Altered auditory feedback can facilitate speech fluency in adults who stutter. However, other findings suggest that adults who stutter show anomalies in 'audiovocal integration', such as longer phonation reaction times to auditory stimuli and less effective pitch tracking. AIMS: To study audiovocal integration in adults who stutter using the pitch-shift paradigm. METHODS & PROCEDURES: Fourteen adult stuttering participants and 16 normally fluent adults produced the vowel /a/while monitoring their own voice through earphones. Unanticipated pitch-shifts were applied in the upward or downward direction for 500 ms. OUTCOMES & RESULTS: Short latency pitch-shift responses (or pitch-shift responses) were elicited in all participants. In stuttering participants, vocal response onset latency was significantly delayed and amplitude tended to be reduced. CONCLUSIONS & IMPLICATIONS: Atypical audiovocal responses could be associated with stuttering. It is not clear how audiovocal integration influences stuttering, but could signal inadequate activation of internal models.

Systematic Review and Meta-Analysis of the Application of Virtual Reality in Hearing Disorders.

BACKGROUND AND OBJECTIVES: Trendy technologies, such as artificial intelligence, virtual reality (VR), and augmented reality (AR) are being increasingly used for hearing loss, tinnitus, and vestibular disease. Thus, we conducted this systematic review and meta-analysis to identify the possible benefits of the use of VR and AR technologies in patients with hearing loss, tinnitus, and/or vestibular dysfunction, with the aim of suggesting potential applications of these technologies for both researchers and clinicians. MATERIALS AND METHODS: Published articles from 1968 to 2022 were gathered from six electronic journal databases. Applying our specified inclusion and/or exclusion criteria, 23 studies were analyzed. As only one article on hearing loss and two articles on tinnitus were found, 20 studies on vestibular dysfunction were only finally included for the meta-analysis. Standardized mean differences (SMDs) were chosen as estimates to compare the studies. A funnel plot and Egger's regression analysis were used to identify any risk of bias. RESULTS: High heterogeneity (I2: 83%, τ2: 0.5431, p<0.01) was identified across the studies on vestibular dysfunction. VR-based rehabilitation was significantly effective for individuals with vestibular disease (SMDs: 0.03, 95% confidence interval [CI]: -0.08 to 0.15, p<0.05). A subgroup analysis revealed that only improvement in the subjective questionnaire was meaningful and statistically significant (SMDs: -0.66, 95% CI: -1.10 to -0.22). CONCLUSIONS: VR-based vestibular rehabilitation showed potential for subjective rating measures like Dizziness Handicap Index. The negative effect of aging on vestibular disease was indirectly confirmed. More clinical trials and an evidence-based approach are needed to confirm the implementation of state-of-the-art technology for hearing loss and tinnitus, representative diseases in neurotology.

Efficacy of the Digit-in-Noise Test: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Although the digit-in-noise (DIN) test is simple and quick, little is known about its key factors. This study explored the considerable components of the DIN test through a systematic review and meta-analysis. MATERIALS AND METHODS: After six electronic journal databases were screened, 14 studies were selected. For the meta-analysis, standardized mean difference was used to calculate effect sizes and 95% confidence intervals. RESULTS: The overall result of the meta-analysis showed an effect size of 2.224. In a subgroup analysis, the patient's hearing status was found to have the highest effect size, meaning that the DIN test was significantly sensitive to screen for hearing loss. In terms of the length of the presenting digits, triple digits had lower speech recognition thresholds (SRTs) than single or pairs of digits. Among the types of background noise, speech-spectrum noise provided lower SRTs than multi-talker babbling. Regarding language variance, the DIN test showed better performance in the patient's native language(s) than in other languages. CONCLUSIONS: When uniformly developed and well validated, the DIN test can be a universal tool for hearing screening.

Analysis of the Knowledge, Attitudes, and Practice Model of Healthcare Professionals on Hearing Loss at Elderly Dementia Residences in Korea.

Due to a lack of knowledge about age-related hearing loss, its early identification and appropriate intervention are not being carried out in the field of dementia care. Since the untreated hearing loss of the elderly leads to a more rapid cognitive decline, the present study aimed to understand the hearing-related knowledge, attitudes, and practices of healthcare professionals in long-term care (LTC) facilities in Korea. A total of 557 workers (104 facility managers and 453 healthcare professionals) in residential LTC participated in this cross-sectional multicenter survey study. The Korean version of the knowledge, attitudes, and practice (KAP) on-line survey with a five-point scale or yes/no response was applied as the experimental tool. The results of structural equation modeling showed that knowledge significantly affected the attitudes and health-seeking practices of the facility manager, and allied healthcare professionals demonstrated similar results, which showed the significant effects of that knowledge on attitudes and health-seeking practices. This clearly indicated that sufficient knowledge is the driving force for the health-seeking practices and positive attitudes of both the facility manager and the healthcare professionals. Thus, we suggest that a further step, such as the development of comprehensive and professional guidelines regarding hearing care information for these professionals in residential LTC facilities, should be followed, and believe that this effort could lead to improving hearing-related knowledge, attitudes, and practices in order to clinically and politically care for the elderly population.

The value of having an initial word recognition score for a precise prognosis of idiopathic sudden sensorineural hearing loss.

OBJECTIVE: Although the hearing thresholds of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) closely relate to the prognosis that results in progressive floor effects, many studies have usually used hearing thresholds as the main outcome of the measurement of prognostic factors. The present study aimed to identify the prognostic factors related to initial hearing tests and speculates the effects of word recognition score (WRS) on the prognoses for patients with ISSNHL. METHODS: Between March 2011 and November 2020, we retrospectively reviewed chart profiles of 2,636 ISSNHL patients. The 180 patients who met the inclusion criteria were asked to participate in the present study. Based on their initial WRS, all these patients were divided into good WRS (GW) and poor WRS (PW) groups with 52% as the cut-off points. Demographic, clinical, and audiological variables, such as age, onset time, duration of treatment, gender, ear side, comorbidities (i.e., hypertension, diabetes mellitus, tinnitus, dizziness), hearing configuration (i.e., ascending, descending, flat, irregular, and profound), treatment options (i.e., systemic corticosteroid therapy per oral, intratympanic steroid injection, and hyperbaric oxygen therapy), and WRS were analyzed as being underlying prognostic factors. RESULTS: Both groups showed significantly different distributions for hearing thresholds and hyperbaric oxygen therapy (HBOT) as general characteristics. The results of a multivariate logistic regression analysis showed that the odds ratio (OR) of age (OR: 0.96, 95% CI: 0.59 - 24.25), duration of treatment (OR: 0.98, 95% CI: 0.96 - 1.00), ascending configuration (OR: 4.97, 95% CI: 1.64 - 16.62), irregular configuration (OR: 4.58, 95% CI: 1.62 - 13.79), and WRS (OR: 1.01, 95% CI: 1.00 - 1.02) were the significant prognostic factors for all the patients. Further analysis of those patients with WRS under 52% cut-off points showed that an ascending configuration (OR: 5.87, 95% CI: 1.18 - 35.99), irregular configuration (OR: 8.03, 95% CI: 1.69 - 46.30), and WRS (OR: 1.05, 95% CI: 1.01 - 1.10) significantly affected the prognosis. As the initial WRS of ISSNHL patients decreased, the OR of the WRS itself increased. These results suggested that the importance of WRS as the prognostic factor was stressed for PW patients. CONCLUSION: The age, duration of treatment, initial hearing configuration (ascending and irregular types), and WRS were the significant prognostic factors for patients with ISSNHL. It was learned that WRS could be a remarkable prognostic factor to consider, especially for ISSNHL patients with poor WRS.