Validation of a Screening Test of Auditory Function Using the Telephone

2014 ◽  
Vol 25 (10) ◽  
pp. 937-951 ◽  
Author(s):  
Victoria Williams-Sanchez ◽  
Rachel A. McArdle ◽  
Richard H. Wilson ◽  
Gary R. Kidd ◽  
Charles S. Watson ◽  
...  
Keyword(s):  
United States ◽  
Speech Recognition ◽  
Screening Test ◽  
Pure Tone ◽  
The United States ◽  
Screening Tests ◽  
Auditory Function ◽  
Telephone Screening ◽  
Pure Tone Threshold ◽  
At Home

Background: Several European countries have demonstrated successful use of telephone screening tests for auditory function. The screening test consists of spoken three-digit sequences presented in a noise background. The speech-to-noise ratios of the stimuli are determined by an adaptive tracking method that converges on the level required to achieve 50% correct recognition. Purpose: A version of the three-digit telephone screening protocol for the United States was developed: the US National Hearing Test (NHT). The objective of the current study was to determine the sensitivity and specificity as well as the feasibility of the NHT for use within the Department of Veterans Affairs (VA). Research Design and Study Sample: Using a multisite study design with convenience sampling, we used the NHT to collect data from 693 participants (1379 ears) from three geographical areas of the United States (Florida, Tennessee, and California). Data Collection and Analysis: The NHT procedures were as follows: the participants (1) called a toll-free telephone number, (2) entered their assigned ear-specific identification code, (3) listened to 40-sets of digit triplets presented in speech-spectrum background noise, and (4) entered in the numbers that they heard on the telephone key pad. The NHT was performed on each ear, either at home or in a VA clinic. In addition to collecting data from the experimental task, we gathered demographic data and the data from other standard-of-care tests (i.e., audiometric thresholds and speech recognition tests in quiet and in noise). Results: A total of 505 participants completed the NHT at a VA clinic, whereas 188 completed the test at home. Although the ear-specific NHT and mean pure-tone threshold all correlated significantly (p < 0.001), there were more modest correlations in the low- and high-frequency ranges with the highest correlation seen with the 2000 Hz mean pure-tone threshold. When the NHT 50% point or threshold was compared with the three-frequency PTA at 500, 1000, and 2000 Hz, the sensitivity was 0.87 and specificity was 0.54. When comparing the NHT with the four-frequency PTA at 500, 1000, 2000, and 4000 Hz, the sensitivity was 0.81 and specificity increased to 0.65. The NHT also correlated strongly with other speech-in-noise measures. Conclusions: The NHT was found to correlate with other audiometric measures, including pure-tone thresholds and speech recognition tests in noise, at sufficiently high correlation values to support its use as a screening test of auditory function.

Telephone Screening Tests for Functionally Impaired Hearing: Current Use in Seven Countries and Development of a US Version

2012 ◽  
Vol 23 (10) ◽  
pp. 757-767 ◽  
Author(s):  
Charles S. Watson ◽  
Gary R. Kidd ◽  
James D. Miller ◽  
Cas Smits ◽  
Larry E. Humes
Keyword(s):  
Hearing Impairment ◽  
Pure Tone ◽  
Communication Disorders ◽  
The United States ◽  
Screening Tests ◽  
Correct Identification ◽  
Impaired Hearing ◽  
Indiana University ◽  
Hearing Test ◽  
Telephone Screening

Background: An estimated 36 million US citizens have impaired hearing, but nearly half of them have never had a hearing test. As noted by a recent National Institutes of Health/National Institute on Deafness and Other Communication Disorders (NIH/NIDCD) Working Group, “In the United States (in contrast to many other nations) there are no readily accessible low cost hearing screening programs…” (Donahue et al, 2010, p. 2). Since 2004, telephone administered screening tests utilizing three-digit sequences presented in noise have been developed, validated, and implemented in seven countries. Each of these tests has been based on a test protocol conceived by Smits and colleagues in The Netherlands. Purpose: Investigators from Communication Disorders Technology, Inc., Indiana University, and VU University Medical Center of Amsterdam agreed to collaborate in the development and validation of a screening test for hearing impairment suitable for delivery over the telephone, for use in the United States. This test, utilizing spoken three-digit sequences (triplets), was to be based on the design of Smits and his colleagues. Research Design: A version of the digits-in-noise test was developed utilizing digit triplets spoken in Middle American dialect. The stimuli were individually adjusted to speech-to-noise ratio (SNR) values yielding 50% correct identification, on the basis of data collected from a group of 10 young adult listeners with normal hearing. A final set of 64 homogeneous stimuli were selected from an original 160 recorded triplets. Each test consisted of a series of 40 triplets drawn at random, presented in a noise background. The SNR threshold for 50% correct identification of the triplets was determined by a one-down, one-up adaptive procedure. The test was implemented by telephone, and administered to listeners with varying levels of hearing impairment. The listeners were then evaluated with pure-tone tests and other audiometric measures as clinically appropriate. Study Sample: Ninety participants included 72 who were volunteers from the regular client population at the Indiana University Hearing Clinic, and 18 who were recruited with a newspaper ad offering a free hearing test. Of the 90 participants, 49 were later determined to have mean pure-tone thresholds greater than 20 dB hearing level (HL). Data Collection and Analysis: The primary data analyses were correlations between telephone test thresholds and other measures, including pure-tone thresholds and speech recognition tests, collected for the same participants. Results: The correlation between the telephone test and pure-tone thresholds (r = 0.74) was within the range of correlations observed with successful telephone screening tests in use in other countries. Thresholds based on the average of only 21 trials (trials five through 25 of the 40-trial tracking history) yielded sensitivity and specificity values of 0.80 and 0.83, respectively, using pure-tone average(0.5, 1.0, 2.0 kHz) >20 dB HL as the criterion measure. Conclusions: This US version of the digits-in-noise telephone screening test is sufficiently valid to be implemented for use by the general public. Its properties are quite similar to those telephone screening tests currently in use in most European countries. Telephone tests provide efficient, easy to use, and valid screening for functional hearing impairment. The results of this test are a reasonable basis for advising those who fail to seek a comprehensive hearing evaluation by an audiologist.

Armed Violence in the Ideology of Contemporary Islamic Fundamentalism - Study models

2019 ◽  
Vol 2 (4) ◽  
pp. 237
Author(s):  
Laith Mzahim Khudair Kazem
Keyword(s):  
United States ◽  
United States Of America ◽  
The United States ◽  
The Other ◽  
Islamic Fundamentalism ◽  
Islamic Movements ◽  
Important Means ◽  
Armed Violence ◽  
Goals And Objectives ◽  
At Home

The armed violence of many radical Islamic movements is one of the most important means to achieve the goals and objectives of these movements. These movements have legitimized and legitimized these violent practices and constructed justification ideologies in order to justify their use for them both at home against governments or against the other Religiously, intellectually and even culturally, or abroad against countries that call them the term "unbelievers", especially the United States of America.

REVISITING CONTEMPORARY HOMESCHOOLING: THE CASE OF THE UNITED STATES

2020 ◽  
Author(s):  
Sara Zamir
Keyword(s):  
United States ◽  
The United States ◽  
American States ◽  
At Home

The term “homeschooling” denotes the process of educating, instructing, and tutoring children by parents at home instead of having this done by professional teachers in formal settings. Although regulation and court rulings vary from one state to another, homeschooling is legal in all fifty American states. Contrary to the growing tendency of parents in the United States to move toward homeschooling in 1999-2012, the rate of homeschooling and the population of those educated in this manner appear to have leveled off in 2012–2016. This paper aims to explain both phenomena and asks whether a trend is at hand.

scholarly journals Impact of the COVID-19 Vaccine on Asymptomatic Infection Among Patients Undergoing Pre-Procedural COVID-19 Molecular Screening

2021 ◽  
Author(s):  
Aaron J Tande ◽  
Benjamin D Pollock ◽  
Nilay D Shah ◽  
Gianrico Farrugia ◽  
Abinash Virk ◽  
...  
Keyword(s):  
United States ◽  
Relative Risk ◽  
Healthcare System ◽  
The United States ◽  
Asymptomatic Infection ◽  
Screening Tests ◽  
Molecular Screening ◽  
Molecular Tests ◽  
Asymptomatic Individuals ◽  
The Impact

Abstract Background Several vaccines are now clinically available under emergency use authorization in the United States and have demonstrated efficacy against symptomatic COVID-19. The impact of vaccines on asymptomatic SARS-CoV-2 infection is largely unknown. Methods We conducted a retrospective cohort study of consecutive, asymptomatic adult patients (n = 39,156) within a large United States healthcare system who underwent 48,333 pre-procedural SARS-CoV-2 molecular screening tests between December 17, 2020 and February 8, 2021. The primary exposure of interest was vaccination with at least one dose of an mRNA COVID-19 vaccine. The primary outcome was relative risk of a positive SARS-CoV-2 molecular test among those asymptomatic persons who had received at least one dose of vaccine, as compared to persons who had not received vaccine during the same time period. Relative risk was adjusted for age, sex, race/ethnicity, patient residence relative to the hospital (local vs. non-local), healthcare system regions, and repeated screenings among patients using mixed effects log-binomial regression. Results Positive molecular tests in asymptomatic individuals were reported in 42 (1.4%) of 3,006 tests performed on vaccinated patients and 1,436 (3.2%) of 45,327 tests performed on unvaccinated patients (RR=0.44 95% CI: 0.33-0.60; p&lt;.0001). Compared to unvaccinated patients, the risk of asymptomatic SARS-CoV-2 infection was lower among those &gt;10 days after 1 st dose (RR=0.21; 95% CI: 0.12-0.37; p&lt;.0001) and &gt;0 days after 2 nd dose (RR=0.20; 95% CI: 0.09-0.44; p&lt;.0001) in the adjusted analysis. Conclusions COVID-19 vaccination with an mRNA-based vaccine showed a significant association with a reduced risk of asymptomatic SARS-CoV-2 infection as measured during pre-procedural molecular screening. The results of this study demonstrate the impact of the vaccines on reduction in asymptomatic infections supplementing the randomized trial results on symptomatic patients.

scholarly journals Family caregiving and place of death: Insights from cross-national analysis of the Harmonized End of Life Data

2020 ◽  
Author(s):  
Jennifer Ailshire ◽  
Margarita Osuna ◽  
Jenny Wilkens ◽  
Jinkook Lee
Keyword(s):  
United States ◽  
Older Adults ◽  
Nursing Home ◽  
End Of Life ◽  
Family Caregiving ◽  
The United States ◽  
Place Of Death ◽  
Life Data ◽  
Cross National ◽  
At Home

Abstract Objectives Family is largely overlooked in research on factors associated with place of death among older adults. We determine if family caregiving at the end of life is associated with place of death in the United States and Europe. Methods We use the Harmonized End of Life data sets developed by the Gateway to Global Aging Data for the Survey of Health, Ageing and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). We conducted multinomial logistic regression on 7,113 decedents from 18 European countries and 3,031 decedents from the United States to determine if family caregiving, defined based on assistance with activities of daily living, was associated with death at home versus at a hospital or nursing home. Results Family caregiving was associated with reduced odds of dying in a hospital and nursing home, relative to dying at home in both the United States and Europe. Care from a spouse/partner or child/grandchild was both more common and more strongly associated with place of death than care from other relatives. Associations between family caregiving and place of death were generally consistent across European welfare regimes. Discussion This cross-national examination of family caregiving indicates that family-based support is universally important in determining where older adults die. In both the United States and in Europe, most care provided during a long-term illness or disability is provided by family caregivers, and it is clear families exert tremendous influence on place of death.

PREVALENCE OF HOMOCYSTINURIA AMONG THE MENTALLY RETARDED: EVALUATION OF A SPECIFIC SCREENING TEST

PEDIATRICS ◽  
1967 ◽  
Vol 40 (4) ◽  
pp. 586-589
Author(s):  
George Link Spaeth ◽  
G. Winston Barber
Keyword(s):  
United States ◽  
Mental Retardation ◽  
Northern Ireland ◽  
Screening Test ◽  
Mentally Retarded ◽  
The United States ◽  
The Other ◽  
Other Hand

The prevalence of homocystinuria in patients with mental retardation institutionalized in the United States is about 0.02%; this is lower than a previous estimation from Northern Ireland (0.3%). On the other hand, about 5% of patients with dislocated lenses may be expected to have the disease. A silver-nitroprusside test which is almost completely specific for homocystine has been evaluated. It should be useful for screening.

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