1
|
Roy A, Bradlow A, Souza P. Effect of frequency compression on fricative perception between normal-hearing English and Mandarin listeners. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2024; 155:3957-3967. [PMID: 38921646 DOI: 10.1121/10.0026435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/26/2024] [Indexed: 06/27/2024]
Abstract
High-frequency speech information is susceptible to inaccurate perception in even mild to moderate forms of hearing loss. Some hearing aids employ frequency-lowering methods such as nonlinear frequency compression (NFC) to help hearing-impaired individuals access high-frequency speech information in more accessible lower-frequency regions. As such techniques cause significant spectral distortion, tests such as the S-Sh Confusion Test help optimize NFC settings to provide high-frequency audibility with the least distortion. Such tests have been traditionally based on speech contrasts pertinent to English. Here, the effects of NFC processing on fricative perception between English and Mandarin listeners are assessed. Small but significant differences in fricative discrimination were observed between the groups. The study demonstrates possible need for language-specific clinical fitting procedures for NFC.
Collapse
Affiliation(s)
- Abhijit Roy
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois 60208, USA
| | - Ann Bradlow
- Department of Linguistics, Northwestern University, Evanston, Illinois 60208, USA
| | - Pamela Souza
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois 60208, USA
| |
Collapse
|
2
|
Micaletti F, Escoffre JM, Kerneis S, Bouakaz A, Galvin JJ, Boullaud L, Bakhos D. Microbubble-assisted ultrasound for inner ear drug delivery. Adv Drug Deliv Rev 2024; 204:115145. [PMID: 38042259 DOI: 10.1016/j.addr.2023.115145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
Treating pathologies of the inner ear is a major challenge. To date, a wide range of procedures exists for administering therapeutic agents to the inner ear, with varying degrees of success. The key is to deliver therapeutics in a way that is minimally invasive, effective, long-lasting, and without adverse effects on vestibular and cochlear function. Microbubble-assisted ultrasound ("sonoporation") is a promising new modality that can be adapted to the inner ear. Combining ultrasound technology with microbubbles in the middle ear can increase the permeability of the round window, enabling therapeutic agents to be delivered safely and effectively to the inner ear in a targeted manner. As such, sonoporation is a promising new approach to treat hearing loss and vertigo. This review summarizes all studies on the delivery of therapeutic molecules to the inner ear using sonoporation.
Collapse
Affiliation(s)
- Fabrice Micaletti
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044 Tours, France.
| | | | - Sandrine Kerneis
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044 Tours, France
| | - Ayache Bouakaz
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - John J Galvin
- Faculty of medicine, Université de Tours, 10 boulevard Tonnellé, 37044 Tours, France; House Institute Foundation, 2100 W 3rd Street, Suite 111, Los Angeles, CA 90057, USA
| | - Luc Boullaud
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044 Tours, France
| | - David Bakhos
- ENT and Cervico-Facial Surgery Department, University Hospital Center of Tours, 2 Boulevard Tonnellé, 37044 Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Faculty of medicine, Université de Tours, 10 boulevard Tonnellé, 37044 Tours, France; House Institute Foundation, 2100 W 3rd Street, Suite 111, Los Angeles, CA 90057, USA
| |
Collapse
|
3
|
Dhrruvakumar S, Kooknoor V, ShajiKumar S, Veerabhadrappa RC. Adaptation and Validation of the Perceptual Performance Test in Malayalam. J Audiol Otol 2024; 28:44-51. [PMID: 37953516 PMCID: PMC10808384 DOI: 10.7874/jao.2023.00073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/24/2023] [Accepted: 06/29/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The discrepancies between the objective and subjective measurements used to select and fit hearing aids indirectly impact the perceived benefit and perception in the presence of noise. This study aimed to bridge the gap between objective and subjective measurements in hearing aid fitting by adapting and validating the "Perceptual Performance Test (PPT)" in Malayalam. Subjects and. METHODS Standardized Malayalam-language sentences were used to adapt PPT and administer it to 65 native Malayalam speakers (30 normal and 35 hearing impaired). Performance and perception speech recognition thresholds in noise (SRTN) and Performance-Perceptual Discrepancy (PPDIS) were evaluated at various noise levels along with Hearing Handicap Inventory for the Elderly (HHIE) or Adults (HHIA). RESULTS Both perceptual and performance SRTNs were better among normal-hearing individuals than in the hearing-impaired group. Moreover, the participants with hearing impairment were found to have a significant effect of noise level on both the measures, which was otherwise not seen among normal-hearing individuals. The normative criteria for PPDIS were established to categorize the individuals as under-, over-, or accurate estimators. The performance and perception outcomes varied significantly between groups (normal hearing and hearing impaired) and across noise levels. Furthermore, there was a positive correlation between perceptual and performance SRTNs with emotional and social subscales and total HHIE/A scores. Additionally, a negative association was noted between PPDIS values and HHIE/A scores. CONCLUSIONS The adapted test is a valid and reliable tool for evaluating the benefit of hearing aids. PPDIS can provide crucial information to audiologists regarding an individual's judgement about their hearing ability, with an explanation for the discrepancy between objective and subjective reports of hearing impairments.
Collapse
Affiliation(s)
| | - Vishal Kooknoor
- Department of Audiology, JSS Institute of Speech and Hearing, Mysore, India
| | | | | |
Collapse
|
4
|
Pryce H, Smith SK, Burns-O'Connell G, Knibb R, Greenwood R, Shaw R, Hussain S, Banks J, Hall A, Straus J, Noble S. Protocol for the development and validation of a patient-reported experience measure (PREM) for people with hearing loss: the PREM-HeLP. BMJ Open 2023; 13:e075229. [PMID: 38030247 PMCID: PMC10689349 DOI: 10.1136/bmjopen-2023-075229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Hearing loss is a common chronic health condition and adversely affects communication and social function resulting in loneliness, social isolation and depression. We know little about the patient experience of living with hearing loss and their views on the quality of the audiology service. In this study, we will develop and validate the first patient-reported experience measure (PREM) to understand patients' experiences of living with hearing loss and their healthcare interactions with audiology services. METHODS AND ANALYSIS We will develop the PREM in three phases: (1) development of PREM prototype (items/statements) derived from previous qualitative work and narrative review, (2) cognitive interview testing of the PREM prototype using a 'think aloud' technique to examine the acceptability and comprehensibility of the tool and refine accordingly and (3) psychometric testing of the modified PREM with 300 participants to assess the reliability and validity of the tool using Rasch analyses with sequential item reduction. Eligible participants will be young people and adults aged 16 years and over who have hearing loss. Participants will be recruited from three clinical sites located in England (Bath, Bristol) and Scotland (Tayside) and non-clinical settings (eg, lip-reading classes, residential care settings, national charity links, social media). ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022; ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales (HCRW) Approval (approval date: 14 June 2022; IRAS project ID: 308816). Findings will be shared with our patient and public involvement groups, academics, audiology communities and services and local commissioners via publications and presentations. The PREM will be made available to clinicians and researchers without charge.
Collapse
Affiliation(s)
- Helen Pryce
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Sian Karen Smith
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Georgina Burns-O'Connell
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Rebecca Knibb
- School of Psychology, Aston University, Birmingham, UK
| | - Rosemary Greenwood
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rachel Shaw
- School of Psychology, Aston University, Birmingham, UK
| | - Saira Hussain
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Jonathan Banks
- Social & Community Medicine, University of Bristol, Bristol, UK
| | - Amanda Hall
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| |
Collapse
|
5
|
Pryce H, Smith SK, Burns-O'Connell G, Shaw R, Hussain S, Banks J, Hall A, Knibb R, Greenwood R, Straus J. Protocol for a qualitative study exploring the lived experience of hearing loss and patient reported experience in the UK: the HeLP study. BMJ Open 2023; 13:e069363. [PMID: 37286313 DOI: 10.1136/bmjopen-2022-069363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Worldwide, hearing loss is a significant public health issue and one of the most common chronic health conditions experienced by older adults. Hearing loss is associated with communication difficulties, social withdrawal, isolation and lower quality of life. Although hearing aid technology has improved significantly, the workload of managing hearing aids has increased. The aim of this qualitative study is to develop a novel theory of people's lived experience of hearing loss across the lifespan. METHODS Eligible participants will be young people and adults aged 16 years and above who have a hearing loss and carers/family members of people with a hearing loss. This study will use individual, in-depth face-to-face or online interviews. With participants' permission, interviews will be audio-recorded and transcribed verbatim. A grounded theory approach to concurrent data gathering and analysis will develop grouped codes and categories and link these to provide a novel theory to describe the experience of hearing loss. ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022 ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales Approval (approval date: 14 June 2022; IRAS project ID: 308816). The research will inform the development of a Patient Reported Experience Measure to improve the information and support given to patients. Findings will be disseminated through peer-reviewed articles and at academic conferences, as well as to our patient and public involvement groups, healthcare professionals, audiology services and local commissioners.
Collapse
Affiliation(s)
- Helen Pryce
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Sian Karen Smith
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | | | - Rachel Shaw
- Aston University School of Psychology, Birmingham, UK
- Aston Institute of Health & Neurodevelopment, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Saira Hussain
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Jonathan Banks
- University Hospitals Bristol and Weston NHS Foundation Trust, National Institute for Health Research, Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Amanda Hall
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Rebecca Knibb
- Aston University School of Psychology, Birmingham, UK
| | - Rosemary Greenwood
- Psychology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jean Straus
- Patient and Public Involvement Representative and Lead, HeLP study, London, UK
| |
Collapse
|
6
|
Sanchez VA, Shuey MM, Dinh PC, Monahan PO, Fosså SD, Sesso HD, Dolan ME, Einhorn LH, Vaughn DJ, Martin NE, Feldman DR, Kroenke K, Fung C, Frisina RD, Travis LB. Patient-Reported Functional Impairment Due to Hearing Loss and Tinnitus After Cisplatin-Based Chemotherapy. J Clin Oncol 2023; 41:2211-2226. [PMID: 36626694 PMCID: PMC10489421 DOI: 10.1200/jco.22.01456] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/25/2022] [Accepted: 11/16/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE Cisplatin is widely used and highly ototoxic, but patient-reported functional impairment because of cisplatin-related hearing loss (HL) and tinnitus has not been comprehensively evaluated. PATIENTS AND METHODS Testicular cancer survivors (TCS) given first-line cisplatin-based chemotherapy completed validated questionnaires, including the Hearing Handicap Inventory for Adults (HHIA) and Tinnitus Primary Function Questionnaire (TPFQ), each of which quantifies toxicity-specific functional impairment. Spearman correlations evaluated associations between HL and tinnitus severity and level of functional handicap quantified with the HHIA and TPFQ, respectively. Associations between HL or tinnitus and five prespecified adverse health outcomes (cognitive dysfunction, fatigue, depression, anxiety, and overall health) were evaluated. RESULTS HL and tinnitus affected 137 (56.4%) and 147 (60.5%) of 243 TCS, respectively. Hearing aids were used by 10% TCS (14/137). Of TCS with HL, 35.8% reported clinically significant functional impairment. Severe HHIA-assessed functional impairment was associated with cognitive dysfunction (odds ratio [OR], 10.62; P < .001), fatigue (OR, 5.48; P = .003), and worse overall health (OR, 0.19; P = .012). Significant relationships existed between HL severity and HHIA score, and tinnitus severity and TPFQ score (P < .0001 each). TCS with either greater hearing difficulty or more severe tinnitus were more likely to report cognitive dysfunction (OR, 5.52; P = .002; and OR, 2.56; P = .05), fatigue (OR, 6.18; P < .001; and OR, 4.04; P < .001), depression (OR, 3.93; P < .01; and OR, 3.83; P < .01), and lower overall health (OR, 0.39; P = .03; and OR, 0.46; P = .02, respectively). CONCLUSION One in three TCS with HL report clinically significant functional impairment. Follow-up of cisplatin-treated survivors should include routine assessment for HL and tinnitus. Use of the HHIA and TPFQ permit risk stratification and referral to audiologists as needed, since HL adversely affects functional status and is the single largest modifiable risk factor for cognitive decline and dementia in the general population.
Collapse
Affiliation(s)
| | - Megan M. Shuey
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Paul C. Dinh
- Department of Medical Oncology, Indiana University, Indianapolis, IN
| | - Patrick O. Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN
| | | | - Howard D. Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA
| | | | | | - David J. Vaughn
- Department of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Neil E. Martin
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA
| | | | | | - Chunkit Fung
- J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | | | - Lois B. Travis
- Department of Medical Oncology, Indiana University, Indianapolis, IN
| |
Collapse
|
7
|
Sanchez VA, Dinh PC, Rooker J, Monahan PO, Althouse SK, Fung C, Sesso HD, Einhorn LH, Dolan ME, Frisina RD, Travis LB. Prevalence and risk factors for ototoxicity after cisplatin-based chemotherapy. J Cancer Surviv 2023; 17:27-39. [PMID: 36637632 DOI: 10.1007/s11764-022-01313-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Ototoxicity is a prominent side effect of cisplatin-based chemotherapy. There are few reports, however, estimating its prevalence in well-defined cohorts and associated risk factors. METHODS Testicular cancer (TC) survivors given first-line cisplatin-based chemotherapy completed validated questionnaires. Descriptive statistics evaluated the prevalence of ototoxicity, defined as self-reported hearing loss and/or tinnitus. We compared patients with and without tinnitus or hearing loss using Chi-square test, two-sided Fisher's exact test, or two-sided Wilcoxon rank sum test. To evaluate ototoxicity risk factors, a backward selection logistic regression procedure was performed. RESULTS Of 145 TC survivors, 74% reported ototoxicity: 68% tinnitus; 59% hearing loss; and 52% reported both. TC survivors with tinnitus were more likely to indicate hypercholesterolemia (P = 0.008), and difficulty hearing (P < .001). Tinnitus was also significantly related to age at survey completion (OR = 1.79; P = 0.003) and cumulative cisplatin dose (OR = 5.17; P < 0.001). TC survivors with hearing loss were more likely to report diabetes (P = 0.042), hypertension (P = 0.007), hypercholesterolemia (P < 0.001), and family history of hearing loss (P = 0.044). Risk factors for hearing loss included age at survey completion (OR = 1.57; P = 0.036), hypercholesterolemia (OR = 3.45; P = 0.007), cumulative cisplatin dose (OR = 1.94; P = 0.049), and family history of hearing loss (OR = 2.87; P = 0.071). CONCLUSIONS Ototoxicity risk factors included age, cisplatin dose, cardiovascular risk factors, and family history of hearing loss. Three of four TC survivors report some type of ototoxicity; thus, follow-up of cisplatin-treated survivors should include routine assessment for ototoxicity with provision of indicated treatments. IMPLICATIONS FOR CANCER SURVIVORS Survivors should be aware of risk factors associated with ototoxicity. Referrals to audiologists before, during, and after cisplatin treatment is recommended.
Collapse
Affiliation(s)
- Victoria A Sanchez
- Department of Otolaryngology-Head & Neck Surgery, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, FL, 33612, USA.
| | - Paul C Dinh
- Department of Medical Oncology, Indiana University, Indianapolis, IN, USA
| | - Jennessa Rooker
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Sandra K Althouse
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Chunkit Fung
- J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Lawrence H Einhorn
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Robert D Frisina
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Lois B Travis
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| |
Collapse
|
8
|
Picou EM. Hearing Aid Benefit and Satisfaction Results from the MarkeTrak 2022 Survey: Importance of Features and Hearing Care Professionals. Semin Hear 2022; 43:301-316. [PMCID: PMC9715311 DOI: 10.1055/s-0042-1758375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The hearing aid market is rapidly evolving with advancements in features and potential changes in service delivery models, including the new over-the-counter device category. Data from the MarkeTrak 2022 survey indicate most hearing aid owners report regular quality-of-life benefits from hearing aids, even more than in previous surveys. The increased likelihood of hearing aid benefits might be attributable to modern hearing aid features advancements, such as wireless connectivity and rechargeable batteries. Hearing aid satisfaction rates have been relatively stable over the years, indicating that more than 80% of hearing aid owners are satisfied with their devices. Hearing aid satisfaction rates do not appreciably vary by fitting channel; hearing aid owners fitted in person, fitted remotely, or self-fit are similarly likely to report high satisfaction with their device. However, only respondents in the in-person channel gave establishment ratings (reflecting their willingness to recommend) that resulted and reflected a positive net promoter score. Given the potential for net promoter scores to be related to brand growth and customer loyalty, this finding has implications for the development of over-the-counter hearing aid service-delivery models. Additional work is warranted to explore the factors that negatively affect hearing aid owners' satisfaction with the companies delivering limited services.
Collapse
Affiliation(s)
- Erin M. Picou
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee,Address for correspondence Erin M. Picou, Au.D., Ph.D. 1215 21st Avenue S, Room 8310, Nashville, TN 37232
| |
Collapse
|
9
|
Long L, Tang Y. Urinary pyrethroid metabolite and hearing threshold shifts of adults in the United States: A cross-sectional study. PLoS One 2022; 17:e0275775. [PMID: 36251636 PMCID: PMC9576071 DOI: 10.1371/journal.pone.0275775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/25/2022] [Indexed: 11/14/2022] Open
Abstract
Hearing loss (HL) is a global health problem with a high prevalence and profound socioeconomic impact. Pyrethroids are one of the most commonly used insecticides. Although previous studies have reported the relationship between pyrethroids and neurotoxicity, little is known about the effect of pyrethroid exposure on the auditory system among the general population. This study is aimed to investigate the association of pyrethroid exposure with hearing threshold shifts of adults in the United States. A total of 726 adults, aged from 20 to 69 years from the 2011-2012 National Health and Nutrition Examination Survey (NHANES) data were included in the study. Urinary 3-phenoxybenzoic acid (3-PBA), a general pyrethroid metabolite, was used as a biomarker for pyrethroid exposure. HL was defined as a pure-tone average (PTA) at 0.5, 1, 2, 4 kHz ≥ 20 dB in the better ear. Analyses by using multivariate linear regressions were conducted to explore the associations of urinary 3-PBA with PTA hearing threshold shifts. There were no statistically significant correlations between Ln-transformed 3-PBA and either low-frequency or high-frequency hearing thresholds after adjusting for age, gender, race/ethnicity, education level, firearm noise exposure, occupational noise exposure, recreational noise exposure, serum cotinine, BMI, hypertension, and diabetes. However, associations of 3-PBA with both low-frequency and high-frequency hearing thresholds depended on age (P interaction < 0.0396 and 0.0017, respectively). Positive associations between Ln-transformed 3-PBA and both low-frequency and high-frequency hearing thresholds were observed in participants aged 20-39 years after adjusting confounders (β = 1.53, 95% CI: 0.04-3.01, and β = 3.14, 95% CI: 0.99-5.29, respectively) with the highest tertile (≥ 0.884 μg/g creatinine) of 3-PBA compared with the lowest tertile (< 0.407 μg/g creatinine). The possibility of interaction between 3-PBA and age on the hearing threshold shifts indicated that pyrethroid insecticides were prone to be more toxic to auditory system in younger adults than in older ones. Further studies will be required to confirm these findings.
Collapse
Affiliation(s)
- Lili Long
- Department of Otorhinolaryngology, Sichuan University Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yuedi Tang
- Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- * E-mail:
| |
Collapse
|
10
|
Li Z, Lai X, Lai J, Qi M, Yuan L, Zeng X, Ji F. Correction of the Estimated Hearing Level of NB Chirp ABR in Normal Hearing Population. Audiol Neurootol 2022; 27:388-396. [PMID: 35443242 DOI: 10.1159/000523918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The narrowband chirp (NB Chirp), a frequency-specific sound stimulus signal obtained by limiting the frequency bandwidth based on chirp, is applied to the frequency specified auditory brainstem response (fsABR) increasingly. Although some studies demonstrated that NB Chirp-evoked auditory brainstem response (NB Chirp ABR) causes a better neural response than tone burst-evoked auditory brainstem response and is preferred for fsABR, there is little known about how to better estimate an individual's hearing level through the threshold of NB Chirp ABR. The present study intended to compare the accuracy and deviation of NB Chirp ABR corrected by different approaches in estimating the hearing level of people with normal hearing. METHODS A total of 66 volunteers with normal hearing were randomly divided into a model group (n = 26), test group 1 (n = 20), and test group 2 (n = 20). The model group was used to calculate the threshold difference between NB Chirp ABR and pure-tone audiometry at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz, as well as the regression equation, providing a reference for the correction of estimated hearing level of NB Chirp ABR. Test group 1 was used to observe the accuracy and deviation of the "noncorrection (N)," "threshold difference (A1)," and "regression equation (A2)" methods in correcting the estimated hearing level of NB Chirp ABR. Test group 2 was used to replicate the analysis of test group 1 to verify the repeatability of the experimental results. All data were analyzed using SPSS 24.0. RESULTS Test group 1 and test group 2 had similar results. First, the accuracy of the estimated hearing level of N was significantly higher than that of A1 or A2. Second, compared with "0," the deviation of the estimated hearing level of N was bigger than that of A1 or A2 at 500 Hz and 1,000 Hz, while similar at 2,000 Hz and 4,000 Hz. Finally, there was no significant difference in the deviation of the estimated hearing level between A1 and A2 at 500 Hz and 1,000 Hz. CONCLUSION Among people with normal hearing, it was necessary to correct NB Chirp ABR at 500 Hz and 1,000 Hz for lower deviation of the estimated hearing level. Both correction approaches based on threshold difference and regression equation can be used.
Collapse
Affiliation(s)
- Zhicheng Li
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China,
| | - Xiaofen Lai
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Department of Otolaryngology-Head & Neck Surgery, He Xian Memorial Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Jinmei Lai
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Department of Otolaryngology-Head & Neck Surgery, Quanzhou Hospital of Traditional Chinese Medicine, Quanzhou, China
| | - Min Qi
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lianxiong Yuan
- Department of Scientific Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiangli Zeng
- Department of Otolaryngology-Head & Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Fei Ji
- ColIege of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
11
|
Li W, Zhao Z, Lu Z, Ruan W, Yang M, Wang D. The prevalence and global burden of hearing loss in 204 countries and territories, 1990-2019. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:12009-12016. [PMID: 34558041 DOI: 10.1007/s11356-021-16582-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
We aimed to describe the global prevalence and temporal trends of hearing loss. We collected detailed information of hearing loss from the Global Burden of Disease study between 1990 and 2019. Average annual percentage changes (AAPCs) in hearing loss age-standardized prevalence rate (ASPR), by sex, region, and category, were calculated to quantify the temporal prevalence trends. Globally, the prevalent cases of hearing loss increased from 7514.97×105 in 1990 to 14566.62×105 in 2019, and the ASPR increased from 173.33×102 per 100,000 in 1990 to 177.56×102 per 100,000 in 2019. The years lived with disability (YLDs) increased from 220080.97×102 in 1990 to 402353.05×102 in 2019. The AAPC was 83.27 (95% CI 70.66, 95.88) ×10-3 in prevalence and -72.87 (95% CI -92.18, -53.56) ×10-3 in YLDs. Significant correlations of AAPCs with ASPR (r=-0.60, p<0.001), and age-standardized YLD rate (r=-0.43, p=0.0012 for YLD<455, r=0.32, p<0.001 for YLD≥455) were detected. The YLDs of hearing loss owing to occupational noise (HLOON) increased from 39334.39 (95% UI 26881.04, 55999.67) ×102 in 1990 to 70014.49 (98% UI 47605.62, 100593.43) ×102 in 2019, and the increasing AAPC was observed for females and aged between 15 and 49 years old in global and most regions. The age effect was under zero in 7 age groups, the period effect of hearing loss prevalence was increasing and the birth cohort effect was decreasing with the time advance. The number of cases and ASPR of hearing loss in the world is still growing. Efforts to control hearing loss, especially HLOON, are imminent.
Collapse
Affiliation(s)
- Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhiya Zhao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wenyu Ruan
- Shangluo Central Hospital, Shangluo, Shanxi, 726000, People's Republic of China
| | - Meng Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430000, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
| |
Collapse
|
12
|
O'Neill ER, Basile JD, Nelson P. Individual Hearing Outcomes in Cochlear Implant Users Influence Social Engagement and Listening Behavior in Everyday Life. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4982-4999. [PMID: 34705529 DOI: 10.1044/2021_jslhr-21-00249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The goal of this study was to assess the listening behavior and social engagement of cochlear implant (CI) users and normal-hearing (NH) adults in daily life and relate these actions to objective hearing outcomes. METHOD Ecological momentary assessments (EMAs) collected using a smartphone app were used to probe patterns of listening behavior in CI users and age-matched NH adults to detect differences in social engagement and listening behavior in daily life. Participants completed very short surveys every 2 hr to provide snapshots of typical, everyday listening and socializing, as well as longer, reflective surveys at the end of the day to assess listening strategies and coping behavior. Speech perception testing, with accompanying ratings of task difficulty, was also performed in a lab setting to uncover possible correlations between objective and subjective listening behavior. RESULTS Comparisons between speech intelligibility testing and EMA responses showed poorer performing CI users spending more time at home and less time conversing with others than higher performing CI users and their NH peers. Perception of listening difficulty was also very different for CI users and NH listeners, with CI users reporting little difficulty despite poor speech perception performance. However, both CI users and NH listeners spent most of their time in listening environments they considered "not difficult." CI users also reported using several compensatory listening strategies, such as visual cues, whereas NH listeners did not. CONCLUSION Overall, the data indicate systematic differences between how individual CI users and NH adults navigate and manipulate listening and social environments in everyday life.
Collapse
Affiliation(s)
- Erin R O'Neill
- Department of Psychology, University of Minnesota, Twin Cities, Minneapolis
| | - John D Basile
- Department of Biomedical Engineering, University of Minnesota, Twin Cities, Minneapolis
| | - Peggy Nelson
- Department of Speech-Language-Hearing Sciences, Center for Applied and Translational Sensory Science (CATSS), University of Minnesota, Twin Cities, Minneapolis
| |
Collapse
|
13
|
Davidson A, Marrone N, Wong B, Musiek F. Predicting Hearing Aid Satisfaction in Adults: A Systematic Review of Speech-in-noise Tests and Other Behavioral Measures. Ear Hear 2021; 42:1485-1498. [PMID: 33883425 DOI: 10.1097/aud.0000000000001051] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Adults with hearing loss report a wide range of hearing aid satisfaction that does not significantly correlate to degree of hearing loss. It is not clear which auditory behavioral factors do contribute to hearing aid satisfaction. While poor speech understanding in noise is known to contribute to dissatisfaction, there are many categories of this type of assessment. The purpose of this systematic review is to answer the question, "Are behavioral pre-fitting measures using speech and nonspeech materials related to hearing aid satisfaction among adults?" DESIGN Six electronic databases were searched to find peer-reviewed studies published before June 2020. The included studies reported on the relationship between auditory behavioral measures and hearing aid satisfaction alone or globally with other outcome domains among adults with hearing loss. Six types of behavioral prefitting measures were evaluated: speech recognition in quiet (% correct), speech recognition in noise (% correct), reception thresholds for speech-in-noise, speech-based subjective ratings, dichotic speech tests, and tests using nonspeech material. Each relevant study was independently reviewed by two reviewers. Methodological quality was evaluated in each included study using the American Speech-Language-Hearing Association's level of evidence ratings. RESULTS There were 1342 articles identified in the systematic review process. After duplicates were removed and specific inclusion criteria were applied, 21 studies were included. All studies included had a 0 to 4 methodological quality rating indicating weak to moderate internal validity. The tests that showed potential for clinical application due to significant correlations with satisfaction were the QuickSIN, the synthetic sentence identification, the hearing in noise test, and the acceptable noise level test. Audibility, as measured by degree of hearing loss, was not significantly correlated to hearing aid satisfaction in the 13 studies that reported on this measure. CONCLUSIONS Based on this review, results indicated that speech-in-noise tests had the highest associations to hearing aid satisfaction, suggesting a greater role for assessment of speech-in-noise perception in auditory rehabilitation. This is an important finding for clinical practice, given that audibility was not a significant factor in predicting satisfaction. Overall, the results from this review show a need for well-designed, high-quality, prospective studies assessing the predictive value of prefitting measures on hearing aid satisfaction with current hearing aid models.
Collapse
Affiliation(s)
- Alyssa Davidson
- The University of Arizona Speech, Language, and Hearing Sciences, Tucson, Arizona, USA.,Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Nicole Marrone
- The University of Arizona Speech, Language, and Hearing Sciences, Tucson, Arizona, USA
| | - Bryan Wong
- The University of Arizona Speech, Language, and Hearing Sciences, Tucson, Arizona, USA
| | - Frank Musiek
- The University of Arizona Speech, Language, and Hearing Sciences, Tucson, Arizona, USA
| |
Collapse
|
14
|
Brewster KK, Hu MC, Wall MM, Brown PJ, Zilcha-Mano S, Roose SP, Stein A, Golub JS, Rutherford BR. Age-Related Hearing Loss, Neuropsychological Performance, and Incident Dementia in Older Adults. J Alzheimers Dis 2021; 80:855-864. [PMID: 33579835 DOI: 10.3233/jad-200908] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Age-related hearing loss (HL) has been associated with dementia, though the neurocognitive profile of individuals with HL is poorly understood. OBJECTIVE To characterize the neurocognitive profile of HL. METHODS N = 8,529 participants from the National Alzheimer's Coordinating Center ≥60 years and free of cognitive impairment who were characterized as Untreated-, Treated-, or No HL. Outcomes included executive function (Trail Making Test [TMT] Part B), episodic memory (Immediate/Delayed Recall), language fluency (Vegetables, Boston Naming Test), and conversion to dementia. Regression models were fit to examine associations between HL and neurocognitive performance at baseline. Cox proportional hazards models examined the links between HL, neurocognitive scores, and development of dementia over follow-up. RESULTS At baseline, those with Untreated HL (versus No HL) had worse neurocognitive performance per standardized difference on executive function (TMT Part B [mean difference = 0.05 (95% CI 0.00, 0.10)]) and language fluency (Vegetables [mean difference = -0.07 (95% CI -0.14, -0.01)], Boston Naming Test [mean difference = -0.07 (95% CI -0.13, -0.01)]). No differences in these neurocognitive performance scores were demonstrated between Treated HL and No HL groups other than MMSE [mean difference = -0.06 (95% CI -0.12, 0.00)]. Through follow-up, executive dysfunction differed by hearing group (χ2(2) = 46.08, p < 0.0001) and was present among 39.12% in No HL, 44.85% in Untreated HL, and 49.40% in Treated HL. Worse performance across all cognitive domains predicted incident dementia. CONCLUSION The observed association between Untreated HL and lower cognitive ability that improved when hearing aids were worn may reflect an inability to hear the test instructions. Future studies using cognitive assessments validated for use in HL are needed to evaluate the neuropsychological profile of HL and identify individuals at risk for dementia.
Collapse
Affiliation(s)
- Katharine K Brewster
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mei-Chen Hu
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Melanie M Wall
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Patrick J Brown
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Sigal Zilcha-Mano
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.,University of Haifa, Haifa, Israel
| | - Steven P Roose
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Alexandra Stein
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Justin S Golub
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Bret R Rutherford
- New York State Psychiatric Institute, New York, NY, USA.,Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| |
Collapse
|
15
|
Meijerink JFJ, Pronk M, Kramer SE. Experiences With and Lessons Learned From Developing, Implementing, and Evaluating a Support Program for Older Hearing Aid Users and Their Communication Partners in the Hearing Aid Dispensing Setting. Am J Audiol 2020; 29:638-647. [PMID: 32946251 DOI: 10.1044/2020_aja-19-00072] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The SUpport PRogram (SUPR) study was carried out in the context of a private academic partnership and is the first study to evaluate the long-term effects of a communication program (SUPR) for older hearing aid users and their communication partners on a large scale in a hearing aid dispensing setting. The purpose of this research note is to reflect on the lessons that we learned during the different development, implementation, and evaluation phases of the SUPR project. Procedure This research note describes the procedures that were followed during the different phases of the SUPR project and provides a critical discussion to describe the strengths and weaknesses of the approach taken. Conclusion This research note might provide researchers and intervention developers with useful insights as to how aural rehabilitation interventions, such as the SUPR, can be developed by incorporating the needs of the different stakeholders, evaluated by using a robust research design (including a large sample size and a longer term follow-up assessment), and implemented widely by collaborating with a private partner (hearing aid dispensing practice chain).
Collapse
Affiliation(s)
- Janine F. J. Meijerink
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology—Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, the Netherlands
| | - Marieke Pronk
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology—Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, the Netherlands
| | - Sophia E. Kramer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Otolaryngology—Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, the Netherlands
| |
Collapse
|
16
|
Gregory S, Billings J, Wilson D, Livingston G, Schilder AG, Costafreda SG. Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer's disease dementia: A qualitative study. SAGE Open Med 2020; 8:2050312120904572. [PMID: 32166027 PMCID: PMC7054731 DOI: 10.1177/2050312120904572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives: Hearing aid usage supports communication and independence; however, many do
not use their hearing aids. This study explored the experiences of hearing
aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using
thematic analysis. Ten people (six males, age range 75–86 years old) with
mild cognitive impairment or Alzheimer’s disease who had been fitted with
hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to
using hearing aids, (2) practical aspects of hearing aids, (3) benefits of
hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the
experience of using hearing aids. This population may benefit from targeted
strategies to support use of hearing aids. The findings from this study can
inform future research to optimise use of hearing aids in this
population.
Collapse
Affiliation(s)
- Sarah Gregory
- Centres for Dementia Prevention and Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Danielle Wilson
- Oxford Imaging Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | | | | |
Collapse
|
17
|
Coco L, Ingram M, Marrone N. Qualitative research methods to investigate communication within a group aural rehabilitation intervention. Int J Audiol 2019; 58:651-660. [PMID: 31329481 PMCID: PMC6917821 DOI: 10.1080/14992027.2019.1608377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Objective: Aural Rehabilitation (AR) aims to minimise negative effects of hearing loss. However, there has been limited study of the lived experience of clients receiving Aural Rehabilitation services, particularly for disparity populations. The purpose of this study is to demonstrate the use of an innovative qualitative approach to investigating communication in an AR setting among Hispanic/Latino older adult dyads. Design: We developed a qualitative phenomenology approach using observation methods to document and analyse how individuals experience living with acquired hearing loss within group AR. Trained observers collected systematic, detailed notes on observations of participants over the course of a 5-week community-based AR intervention. In partnership with audiologists, Community Health Workers facilitated the intervention, which focussed on decreasing negative communication impacts of hearing loss for families. Audiometric data and subjective hearing disability results, using the HHIE-S Spanish version, are presented as additional context for observation outcomes. Study sample: Participants were older Hispanic/Latino adults with hearing loss and their frequent communication partners (five dyads). Results: Four themes related to the experience of communication emerged among dyads in the intervention: (i) emotions related to hearing loss (ii) communication dynamics, (iii) self-management of hearing loss, and (iv) hearing health advocacy. Conclusions: A mixed methods approach that includes group observation would contribute substantially to comprehensively evaluating group AR interventions.
Collapse
Affiliation(s)
- Laura Coco
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Maia Ingram
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | - Nicole Marrone
- Department of Speech, Language, and Hearing Sciences, College of Science, University of Arizona, Tucson, AZ
| |
Collapse
|