scholarly journals Home-Based Speech Perception Monitoring for Clinical Use With Cochlear Implant Users

2021 ◽  
Vol 15 ◽  
Author(s):  
Astrid van Wieringen ◽  
Sara Magits ◽  
Tom Francart ◽  
Jan Wouters
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Home Environment ◽  
Clinical Care ◽  
Summary Score ◽  
Additional Information ◽  
Part Of Speech ◽  
Home Based ◽  
Phoneme Identification ◽  
At Home

Speech-perception testing is essential for monitoring outcomes with a hearing aid or cochlear implant (CI). However, clinical care is time-consuming and often challenging with an increasing number of clients. A potential approach to alleviating some clinical care and possibly making room for other outcome measures is to employ technologies that assess performance in the home environment. In this study, we investigate 3 different speech perception indices in the same 40 CI users: phoneme identification (vowels and consonants), digits in noise (DiN) and sentence recognition in noise (SiN). The first two tasks were implemented on a tablet and performed multiple times by each client in their home environment, while the sentence task was administered at the clinic. Speech perception outcomes in the same forty CI users showed that DiN assessed at home can serve as an alternative to SiN assessed at the clinic. DiN scores are in line with the SiN ones by 3–4 dB improvement and are useful to monitor performance at regular intervals and to detect changes in auditory performance. Phoneme identification in quiet also explains a significant part of speech perception in noise, and provides additional information on the detectability and discriminability of speech cues. The added benefit of the phoneme identification task, which also proved to be easy to administer at home, is the information transmission analysis in addition to the summary score. Performance changes for the different indices can be interpreted by comparing against measurement error and help to target personalized rehabilitation. Altogether, home-based speech testing is reliable and proves powerful to complement care in the clinic for CI users.

scholarly journals The relationship between the home environment and children’s physical activity and sedentary behaviour at home

2021 ◽  
Author(s):  
◽  
Michael P. R. Sheldrick
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Home Environment ◽  
Physical Factors ◽  
Home Based ◽  
Children's Home ◽  
Environment Study ◽  
The Relationship ◽  
Children’S Physical Activity ◽  
At Home

Increasing children’s physical activity (PA) and reducing their sedentary behaviour are considered important preventative measures for obesity and several other health risk factors in children. Given children spend significant time at home, an improved understanding of these behaviours in the home environment would provide invaluable insight for interventions. Therefore, the overarching aim of this thesis was to provide new insight into how the home environment is related to children’s home-based PA and sedentary behaviour. Study 1 investigated the relationship between sufficient moderate-to-vigorous physical activity (MVPA) (≥60 min·day–1) and excessive screen-time (≥2 h·day–1) with lifestyle factors in children, and found they were associated with healthy and unhealthy factors, respectively. This study highlighted the importance of meeting PA and screen-time recommendations in relation to important health-related lifestyle factors, which is of concern, as few children were shown to meet such recommendations. Identifying the correlates of children’s behaviours is an important stage in intervention development, therefore studies 2-5 focussed on improving understanding of children’s PA and sedentary behaviour at home. Study 2 demonstrated the validity and reliability of HomeSPACE-II, a novel instrument for measuring physical factors that influence children’s home-based PA and sedentary behaviour. Using HomeSPACE-II, study 3 showed that the physical home environment is related to children’s home-based PA and sedentary behaviour. Given the established influence of social and individual factors on children’s behaviour and their confounding effects in study 3, study 4 investigated the influence of social and individual factors on: (i) children’s home-based PA and sedentary behaviour, and; (ii) the home physical environment. Study 4 revealed that parental and child activity preferences and priorities, as well as parental rules were associated with children’s home-based PA and sedentary behaviour and the physical home environment. Study 5 found clusters of social and physical factors at home, which were associated with children’s home-based PA and sedentary behaviour as well as background characteristics in the expected directions.

scholarly journals Logatome Discrimination in Cochlear Implant Users: Subjective Tests Compared to the Mismatch Negativity

2010 ◽  
Vol 10 ◽  
pp. 329-339 ◽  
Author(s):  
Torsten Rahne ◽  
Michael Ziese ◽  
Dorothea Rostalski ◽  
Roland Mühler
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Mismatch Negativity ◽  
Speech Intelligibility ◽  
Event Related Potentials ◽  
Normal Hearing ◽  
Discrimination Test ◽  
Speech Database ◽  
Automated Speech Recognition ◽  
Related Potentials

This paper describes a logatome discrimination test for the assessment of speech perception in cochlear implant users (CI users), based on a multilingual speech database, the Oldenburg Logatome Corpus, which was originally recorded for the comparison of human and automated speech recognition. The logatome discrimination task is based on the presentation of 100 logatome pairs (i.e., nonsense syllables) with balanced representations of alternating “vowel-replacement” and “consonant-replacement” paradigms in order to assess phoneme confusions. Thirteen adult normal hearing listeners and eight adult CI users, including both good and poor performers, were included in the study and completed the test after their speech intelligibility abilities were evaluated with an established sentence test in noise. Furthermore, the discrimination abilities were measured electrophysiologically by recording the mismatch negativity (MMN) as a component of auditory event-related potentials. The results show a clear MMN response only for normal hearing listeners and CI users with good performance, correlating with their logatome discrimination abilities. Higher discrimination scores for vowel-replacement paradigms than for the consonant-replacement paradigms were found. We conclude that the logatome discrimination test is well suited to monitor the speech perception skills of CI users. Due to the large number of available spoken logatome items, the Oldenburg Logatome Corpus appears to provide a useful and powerful basis for further development of speech perception tests for CI users.

scholarly journals Risk factors associated with physician trainee concern over missed educational opportunities during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny S. Lou ◽  
Charles W. Goss ◽  
Bradley A. Evanoff ◽  
Jennifer G. Duncan ◽  
Thomas Kannampallil
Keyword(s):  
Risk Factors ◽  
Clinical Education ◽  
Medical Center ◽  
Clinical Care ◽  
Academic Medical Center ◽  
Clinical Work ◽  
Educational Opportunities ◽  
Missed Opportunities ◽  
Physician Trainee ◽  
At Home

Abstract Background The COVID-19 pandemic resulted in a transformation of clinical care practices to protect both patients and providers. These changes led to a decrease in patient volume, impacting physician trainee education due to lost clinical and didactic opportunities. We measured the prevalence of trainee concern over missed educational opportunities and investigated the risk factors leading to such concerns. Methods All residents and fellows at a large academic medical center were invited to participate in a web-based survey in May of 2020. Participants responded to questions regarding demographic characteristics, specialty, primary assigned responsibility during the previous 2 weeks (clinical, education, or research), perceived concern over missed educational opportunities, and burnout. Multivariable logistic regression was used to assess the relationship between missed educational opportunities and the measured variables. Results 22% (301 of 1375) of the trainees completed the survey. 47% of the participants were concerned about missed educational opportunities. Trainees assigned to education at home had 2.85 [95%CI 1.33–6.45] greater odds of being concerned over missed educational opportunities as compared with trainees performing clinical work. Trainees performing research were not similarly affected [aOR = 0.96, 95%CI (0.47–1.93)]. Trainees in pathology or radiology had 2.51 [95%CI 1.16–5.68] greater odds of concern for missed educational opportunities as compared with medicine. Trainees with greater concern over missed opportunities were more likely to be experiencing burnout (p = 0.038). Conclusions Trainees in radiology or pathology and those assigned to education at home were more likely to be concerned about their missed educational opportunities. Residency programs should consider providing trainees with research or at home clinical opportunities as an alternative to self-study should future need for reduced clinical hours arise.

scholarly journals Dying at home of Covid-19: Meeting the need for home-based care

2020 ◽  
pp. 106409
Author(s):  
Cara Kiernan Fallon ◽  
Madison K. Kilbride
Keyword(s):  
Home Based ◽  
Dying At Home ◽  
Home Based Care ◽  
At Home

scholarly journals Initiation of therapy for obstructive sleep apnea syndrome: a randomized comparison of outcomes of telemetry-supported home-based vs. sleep lab-based therapy initiation

2021 ◽  
Author(s):  
Ingo Fietze ◽  
Sebastian Herberger ◽  
Gina Wewer ◽  
Holger Woehrle ◽  
Katharina Lederer ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Control Group ◽  
Sleep Laboratory ◽  
Home Therapy ◽  
Home Management ◽  
Therapy Initiation ◽  
Home Based ◽  
Obstructive Sleep ◽  
At Home

Abstract Purpose Diagnosis and treatment of obstructive sleep apnea are traditionally performed in sleep laboratories with polysomnography (PSG) and are associated with significant waiting times for patients and high cost. We investigated if initiation of auto-titrating CPAP (APAP) treatment at home in patients with obstructive sleep apnea (OSA) and subsequent telemonitoring by a homecare provider would be non-inferior to in-lab management with diagnostic PSG, subsequent in-lab APAP initiation, and standard follow-up regarding compliance and disease-specific quality of life. Methods This randomized, open-label, single-center study was conducted in Germany. Screening occurred between December 2013 and November 2015. Eligible patients with moderate-to-severe OSA documented by polygraphy (PG) were randomized to home management or standard care. All patients were managed by certified sleep physicians. The home management group received APAP therapy at home, followed by telemonitoring. The control group received a diagnostic PSG, followed by therapy initiation in the sleep laboratory. The primary endpoint was therapy compliance, measured as average APAP usage after 6 months. Results The intention-to-treat population (ITT) included 224 patients (110 home therapy, 114 controls); the per-protocol population (PP) included 182 patients with 6-month device usage data (89 home therapy, 93 controls). In the PP analysis, mean APAP usage at 6 months was not different in the home therapy and control groups (4.38 ± 2.04 vs. 4.32 ± 2.28, p = 0.845). The pre-specified non-inferiority margin (NIM) of 0.3 h/day was not achieved (p = 0.130); statistical significance was achieved in a post hoc analysis when NIM was set at 0.5 h/day (p < 0.05). Time to APAP initiation was significantly shorter in the home therapy group (7.6 ± 7.2 vs. 46.1 ± 23.8 days; p < 0.0001). Conclusion Use of a home-based telemonitoring strategy for initiation of APAP in selected patients with OSA managed by sleep physicians is feasible, appears to be non-inferior to standard sleep laboratory procedures, and facilitates faster access to therapy.

scholarly journals What does effective end-of-life care at home for children look like? A qualitative interview study exploring the perspectives of bereaved parents

2021 ◽  
pp. 026921632110233
Author(s):  
Cari Malcolm ◽  
Katherine Knighting
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Life Care ◽  
Care Providers ◽  
Specialist Care ◽  
Bereaved Parents ◽  
Home Based ◽  
Qualitative Interview Study ◽  
At Home

Background: End-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home. Aim: To explore the value and assess the effectiveness of an innovative model of care providing home-based, end-of-life care as perceived by families who accessed the service. Design: A qualitative descriptive study design was employed with in-depth semi-structured interviews conducted with bereaved parents. Setting/participants: Thirteen bereaved parents of 10 children supported by the home-based end-of-life care service. Results: Parents reported effective aspects of end-of-life care provided at home to include: (1) ability to facilitate changes in preferred place of death; (2) trusted relationships with care providers who really know the child and family; (3) provision of child and family-centred care; (4) specialist care and support provided by the service as and when needed; and (5) quality and compassionate death and bereavement care. Parents proposed recommendations for future home-based end-of-life care including shared learning, improving access to home-based care for other families and dispelling hospice myths. Conclusion: Parents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.

scholarly journals Acceptability, Feasibility and Preliminary Evaluation of a Novel, Personalised, Home-Based Physical Activity Intervention for Chronic Heart Failure (Active-at-Home-HF): a Pilot Study

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Nduka C. Okwose ◽  
Leah Avery ◽  
Nicola O’Brien ◽  
Sophie Cassidy ◽  
Sarah J. Charman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Heart Failure ◽  
Pilot Study ◽  
Chronic Heart Failure ◽  
Physical Activity Intervention ◽  
Step Count ◽  
Home Based ◽  
At Home

Abstract Purpose Less than 10% of heart failure patients in the UK participate in cardiac rehabilitation programmes. The present pilot study evaluated feasibility, acceptability and physiological effects of a novel, personalised, home-based physical activity intervention in chronic heart failure. Methods Twenty patients (68 ± 7 years old, 20% females) with stable chronic heart failure due to reduced left ventricular ejection fraction (31 ± 8 %) participated in a single-group, pilot study assessing the feasibility and acceptability of a 12-week personalised home-based physical activity intervention aiming to increase daily number of steps by 2000 from baseline (Active-at-Home-HF). Patients completed cardiopulmonary exercise testing with non-invasive gas exchange and haemodynamic measurements and quality of life questionnaire pre- and post-intervention. Patients were supported weekly via telephone and average weekly step count data collected using pedometers. Results Forty-three patients were screened and 20 recruited into the study. Seventeen patients (85%) completed the intervention, and 15 (75%) achieved the target step count. Average step count per day increased significantly from baseline to 3 weeks by 2546 (5108 ± 3064 to 7654 ± 3849, P = 0.03, n = 17) and was maintained until week 12 (9022 ± 3942). Following completion of the intervention, no adverse events were recorded and quality of life improved by 4 points (26 ± 18 vs. 22 ± 19). Peak exercise stroke volume increased by 19% (127 ± 34 vs. 151 ± 34 m/beat, P = 0.05), while cardiac index increased by 12% (6.8 ± 1.5 vs. 7.6 ± 2.0 L/min/m2, P = 0.19). Workload and oxygen consumption at anaerobic threshold also increased by 16% (49 ± 16 vs. 59 ± 14 watts, P = 0.01) and 10% (11.5 ± 2.9 vs. 12.8 ± 2.2 ml/kg/min, P = 0.39). Conclusion The Active-at-Home-HF intervention is feasible, acceptable and effective for increasing physical activity in CHF. It may lead to improvements in quality of life, exercise tolerance and haemodynamic function. Trial Registration www.clinicaltrials.gov NCT0367727. Retrospectively registered on 17 September 2018.

scholarly journals Meta-Analysis—Correlation between Spiral Ganglion Cell Counts and Speech Perception with a Cochlear Implant

2021 ◽  
Vol 11 (2) ◽  
pp. 220-226
Author(s):  
Yew-Song Cheng ◽  
Mario A. Svirsky
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Ganglion Cells ◽  
Meta Analysis ◽  
Spiral Ganglion ◽  
Spiral Ganglion Cell ◽  
Cell Counts ◽  
Temporal Bones ◽  
The Relationship ◽  
Existing Data

The presence of spiral ganglion cells (SGCs) is widely accepted to be a prerequisite for successful speech perception with a cochlear implant (CI), because SGCs provide the only known conduit between the implant electrode and the central auditory system. By extension, it has been hypothesized that the number of SGCs might be an important factor in CI outcomes. An impressive body of work has been published on findings from the laborious process of collecting temporal bones from CI users and counting the number of SGCs to correlate those numbers with speech perception scores, but the findings thus far have been conflicting. We performed a meta-analysis of all published studies with the hope that combining existing data may help us reach a more definitive conclusion about the relationship between SGC count and speech perception scores in adults.

Sign in / Sign up

Export Citation Format

Share Document