Effects of Age on Speech-in-Noise Identification: Subjective Ratings of Hearing Difficulties and Encoding of Fundamental Frequency in Older Adults

BACKGROUND AND OBJECTIVES: Numerous studies have indicated deterioration of speech perception in noisy conditions among the elderly even those with normal hearing capabilities. The aim of this study was to investigate the effects of age on the speech-in-noise identification by speech-in-noise (SIN) test, subjective ratings of hearing difficulties by speech, spatial, and qualities of hearing scale (SSQ) questionnaire and encoding of fundamental frequency (F0) by Speech auditory brainstem response (ABR) in the elderly and comparing the results with young people. SUBJECTS AND METHODS: The present study was conducted on 32 elderly people aged over 60 years old (17 male and 15 female) with the mean age of 68.9 (standard deviation=6.33) possessing normal peripheral hearing and 32 young subjects (16 male and 16 female) aged 18-25 years old. RESULTS: Findings showed that the score of SIN test is lower among the elderly people as compared with young people in signal-to-noise ratios of 0 and -10 based on Iranian version of SSQ questionnaire (p < 0.001). The range of F0 amplitude in the elderly people is also lower than young people (p < 0.001) in Speech ABR. CONCLUSIONS: It seems that speech processing in older people is deteriorated comparing with young people regardless of their normal peripheral auditory thresholds. This decrease will result in weaker perception and improper segregation of speech from other competing sources.

Evaluation of effects of gradual increase length and complexity of utterance [GILCU] treatment method on the reduction of dysfluency in school-aged children with stuttering

Objectives: The Gradual Increase Length and Complexity of Utterance [GILCU] therapy method is a form of operant conditioning. This is a precise and controlled treatment that is done in 54 steps in 3 speech situations consisting of monologue, reading, and conversation

This study aimed at examining the effects of GILCU treatment method on the reduction of speech dysfluency of school-aged children with stuttering

Methods: In this quasi-experimental study, 32 children with stuttering [6-11 years old] who were referred to speech therapy clinics were selected using convenience sampling. Then, they were assigned into two groups. The first group was treated by GILCU therapy method by the researcher, and the second group was treated by traditional methods by another speech therapist. Both groups had fourteen 45-minute sessions that were conducted one to two times per week. Pre-test and post-test of both groups were assessed using the SSI-3 scores. The obtained data were analyzed using the Kolmogorov-Smirnov, t-test, and covariance test

Results: Both groups had Satirically significant difference [P<0.005] in the buttered syllables frequency

The average of moments of stuttering from the maximum moments of stuttering and the physical activity were examined according to the speech situations such as reading and conversation

The first group [GILCU therapy method] did not show any Satirically significant improvement [P>0.005] with respect to parameters of SSI-3 scores

Discussion: These results suggest that a non-programming treatment for stuttering may be effective with school-aged children who stutter

[Validity and reliability of WHOQOL-DIS questionnaire in Iranian older people with disability]

Objective: The main purpose of the present study was to evaluate psychometric properties of Persian version of WHOQOL-DIS questionnaire in elderly people with disability

Materials and Methods: A classical psychometric method was used to evaluate validity and reliability of WHOQOL-DIS questionnaire in elderly people with disability. Lawshe, and Waltz and Bausell methods were used for assessing content validity. During convenient sampling, 205 elderly, whose score in WHOQOL-DIS questionnaire was more than 4, completed the SF-12 questionnaire in order to assess convergent validity and criterion validity [using known group's comparison]. Reliability was estimated using internal consistency and test-retest reliability was determined by means of Intraclass Correlation Coefficients [ICC]

Results: According to Lawshe, and Waltz and Bausell methods of content validity, acceptable scores were obtained for all items. Correlation between the WHOQOL-DIS questionnaire and the SF-12 scales was satisfactory except for social domain [P=0.13]. The Intraclass Correlation Coefficients for score of questionnaire dimensions and total score was higher than 0.70. Cronbach's alpha for investigating Intraclass Correlation was higher than 0.70 except for social domain. Comparing known groups revealed distinctions in sex and health and disability status between elderly people [P<0.001]

Conclusion: In general, the findings suggested that the WHOQOL-DIS questionnaire is a reliable and valid measure of health related quality of life among elderly people with disabilities. Therefore, the questionnaire can be used in the investigation on the quality of life of elderly people

Effects of an Auditory Lateralization Training in Children Suspected to Central Auditory Processing Disorder

BACKGROUND AND OBJECTIVES: Central auditory processing disorder [(C)APD] refers to a deficit in auditory stimuli processing in nervous system that is not due to higher-order language or cognitive factors. One of the problems in children with (C)APD is spatial difficulties which have been overlooked despite their significance. Localization is an auditory ability to detect sound sources in space and can help to differentiate between the desired speech from other simultaneous sound sources. Aim of this research was investigating effects of an auditory lateralization training on speech perception in presence of noise/competing signals in children suspected to (C)APD. SUBJECTS AND METHODS: In this analytical interventional study, 60 children suspected to (C)APD were selected based on multiple auditory processing assessment subtests. They were randomly divided into two groups: control (mean age 9.07) and training groups (mean age 9.00). Training program consisted of detection and pointing to sound sources delivered with interaural time differences under headphones for 12 formal sessions (6 weeks). Spatial word recognition score (WRS) and monaural selective auditory attention test (mSAAT) were used to follow the auditory lateralization training effects. RESULTS: This study showed that in the training group, mSAAT score and spatial WRS in noise (p value≤0.001) improved significantly after the auditory lateralization training. CONCLUSIONS: We used auditory lateralization training for 6 weeks and showed that auditory lateralization can improve speech understanding in noise significantly. The generalization of this results needs further researches.

effects of whole word reading program on expressive vocabulary of Persian - speaking children with down syndrome

Reading is a language skill based on visual modality which recently is addressed as a facilitator of expressive language in children with Down syndrome. The aim was designing a whole word reading protocol and examining its effects on the language skills of Persian - Speaking children with Down syndrome. A whole word reading protocol was developed and was examined through a single- subject study with time-series design. The protocol was made up of 50 pictures of nouns which were used through assessment and treatment. The vocabulary stimuli were selected from the receptive lexicon of each child. Three children with Down syndrome [trisomy 21] participated in the study [3 Females, mean age=6.1 years, mean IQ=44], and each participant received an individualized treatment up to 20 sessions. Visual graphs and C-statistic test were used for data analysis. As a result of the treatment, naming ability of treated words was increased statistically in all children [Z= 2.46>1.64; Z=1.75>1.6; and Z=2.37>1.64]. Whole word reading protocol seems to be effective in improving expressive vocabulary in children with Down syndrome

level of awareness of rehabilitation professionals employed in rehabilitation academic centers regarding Tele-rehabilitation technology

Objective: The aim of this research was to assess the level of awareness of rehabilitation professionals employed in academic rehabilitation centers in Tehran with reference to Tele-rehabilitation technology

Methods: In this study, a descriptive cross-sectional research method was used. The research was implemented by using a researcher-designed questionnaire which was developed by the integration and cultural adaptation of different tools collected in the field of tele-health implementation feasibility. The content and face validity of the questionnaire was determined and approved by Lawsche's method. The reliability of the questionnaire was assessed by test-retest correlation coefficient determinations. After considering the inclusion and exclusion criteria, informed consent was obtained, and the questionnaires were distributed among the study sample, which comprised of 141 rehabilitation professionals

Results: The findings show that a desirable level of awareness does not exist among rehabilitation professionals with regards to this technology. Based upon the results, only 8% of the participants had basic knowledge of this technology required in case of implementation

Discussion: Since rehabilitation professionals' awareness and knowledge can be a major key to a better implementation and application of this technology, it seems that there is a need for some developmental and training programs, such as informative educational workshops and seminars, to help them improve their level of knowledge and awareness

[ effect of muscle fatigue on normal biomechanics of shoulder girdle: a systematic review of the literature]

Objective: Dynamic stability in shoulder is an important element in life and any disorder in muscular function which helps maintain this stability leads to shoulder pathology. One of these disturbing factors is fatigue. According to the research team information until now there has not been a study investigated systematically the effect of fatigue on shoulder girdle biomechanics. So the purpose of this systematic review is to determine the effect of muscle fatigue on normal shoulder girdle biomechanics

Materials and Methods: This study is a systematic review based on search in PubMed, Scopus, Elsevier, Ovid, CINAHL, Science Direct, ProQuest, Thompson, EMBASE and Medline databases for the period of 1995- 2012. The keywords used were Shoulder, Muscle Fatigue, Proprioception and Kinematics. Two levels of reevaluation were used on 350 citations

Results: The search strategy resulted in 350 results out of which 22 papers met the criteria for this study. Variation among studies in terms of sample size, fatigue protocol and method of measurement were investigated

Conclusion: Evidences demonstrated muscle fatigue leads to change in activation pattern of muscles shoulder girdle and consequently kinematics as well as reduction in proprioception during different positions and movements in both scapulothoracic and glenohumeral joints. Generally the results indicated that there are sufficient evidences based on the effect of fatigue on the muscular fatigue has disturbance effects on shoulder girdle kinematics and could alter the normal biomechanics

Word Definitional Skills in School age Persian Speaking Children: a Developmental Study on Form

Objectives: Word definitional skills [WDSs] were classified according to the quality of both semantic content and syntactic form. The aim of the present study was to investigate the syntactic development in WDSs in typically developing school- age children.

Methods: In this cross-sectional and descriptive- analytical study, 150 of typically developing schoolage children participated by the multistage sampling method in the second to sixth grade from primary schools in 1, 7 and 17 municipal districts of Tehran. The definition skill was assessed with word definition task. The reliability was assessed by two independent values and the validity was determined by the content. The results were analyzed by the SPSS [22th version] statistical software and with the method of independent- samples T test, univariate analysis of variance and Tukey test.

Results: The form analysis revealed that all children use phrase/clause or simple sentence, transitional form and Aristotelian form frequently, but by increasing the age, definitions were developed from simple syntactic structure into Aristotelian form, in fact mean score of the form in word definition was significantly increased by age [p< 0.001].

Discussion: Owing to the findings of this study, the development of word definitional skills in terms of form was developed from phrase/clause or simple sentence and transitional form responses into Aristotelian form. Also WDSs are closely related to academic success and the development of literacy.

Evaluation of Saccular Function Pre-Post Cochlear Implant Surgery Using VEMPs

Objectives: The aim of present study was evaluation of saccular function in cochlear implant candidates with severe to profound sensory neural hearing loss. Before and after cochlear implantation

Methods: In this study 35 Cochlear Implant [CI] candidates with bilateral severe to profound sensory neural hearing loss before and about 30 days after cochlear implantation and 20 normal-hearing cases as a control group underwent VEMP test. Both groups were matched based on gender and age.

Results: VEMP responses were absent bilaterally in 10 out of 35 patients. 4 patients were excluded from the study because they did not receive CI during present study. From 21 remaining patients, 5 cases lost VEMP response in their implanted ear after surgery. In control group, VEMP responses were present bilaterally.

Discussion: The results of present study show that saccular dysfunction in CI candidates is extremely probable and this is possible that saccule get impaired after CI.

[Angiotensin II of paraventricular nucleus exaggerates the renal ischemia-reperfusion injury]

Background: The renal sympathetic nerve activity [RSNA] is enhanced in renal failure. Paraventricular nucleus in hypothalamus is an important central site to regulate sympathetic activity. There are angiotensin II [Ang] II receptors in this nucleus

The aim of this study was to evaluate the effects of angiotensin II in hypothalamic paraventricular nucleus [PVN] on renal ischemia-reperfusion injury and RSNA

Methods: This study was done at 2013 in Physiology department of Tehran University of Medical Sciences. One week before the induction of renal Ischemia-Reperfusion [IR] in Sprague-Dawley rats, a cannula was inserted into the right PVN for microinjection of different doses of Ang II [3, 30, and 300 ng]

Then right nephrectomy was done. After one week recovery, renal IR injury was induced by clamping the left renal artery for 45 minute and then reperfusion for 3 or 24 hour. Ten minutes before the induction of renal ischemia-reperfusion, administration of different doses of angiotensin II were done in different groups. In all animals, left renal sympathetic activity was recorded before and during renal ischemia. After 3 or 24 hours reperfusion the blood, kidney and brain were collected to assay renal function and histology and oxidative stress indices Superoxide Dismutase, SOD and Malondialdehyde, MDA] in PVN

Results: Administration of different pharmacological doses of angiotensin II into PVN exaggerated the renal IR injury. Angiotensin II in different doses increased the plasma creatinine and BUN levels and renal histological markers in comparison to renal IR injury [P<0.05]

Angiotensin II had detrimental effects on RSNA and oxidative stress indices Super Oxide Dismutase [SOD] and Malondialdehyde [MDA] in PVN as the dose was increased [P<0.05]

Conclusion: These data showed that the PVN is a responsive site for central Ang II-induced damage in renal IR injury

We suggested the central effects of Ang II in the PVN on renal IR injury are mediated by oxidative stress in the PVN, and the peripheral effects by a sympathetic pathway

Semantic feature analysis treatment for anomia of two nonfluent Persian-speaking aphasic patients

Semantic Feature Analysis was designed to improve lexical retrieval of aphasic patients via activation of semantic networks of the words. In this approach, the anomic patients are cured with semantic information to assist oral naming. The purpose of this study was to examine the effects of Semantic Feature Analysis treatment on anomia of two nonfluent aphasic patients. A single-subject study with ABA design was applied to two Persian-speaking patients with chronic nonfluent aphasia. Assessment, baseline, intervention and maintenance phases were carried out respectively during 6 weeks. A picture naming task which was made up of pictures with high nameagreement comprising 12 target, 18 non-treated control and 5 easy words was used for probes and intervention. Intervention was performed in 5 successive days, 60 minutes per session. Descriptive statistics, level, trend and slope analyses, C and d statistics were used for data analysis. Both participants revealed statistically significant improvements in naming target words. Some generalizations to control words was also occured. A minimal decrease in naming of target words was observed in maintenance phase but the naming ability was still above the baseline. The therapy maintenance effect size for both patients were obtained as medium. The findings of the current study seems to confirm Semantic Feature Analysis as an effective intervention for improving naming ability of Persian- speaking aphasic patients

Auditory lateralization ability in children with [central] auditory processing disorder

The aim of the present study was to assess the auditory lateralization ability in children with [central] auditory processing disorder. Participants were divided in two groups: 15 children with Central Auditory Processing Disorder [8-10 years] and 80 normal children [8-11 years] from both genders with pure-tone air-conduction thresholds better than 20 dB HL bilaterally and interaural pure tone threshold difference better than 5 dB . All subjects had normal IQ and normal otoscopy: In the present study 9 imaginary positions were simulated in horizontal plane by Interaural Time Difference [ITD] and Interaural Intensity Difference [IID] to evaluate the auditory lateralization performance in normal and children with [central] Auditory Processing Disorder [C] APD. Lateralization performance were determined by ITD ranging from -880 to +880 microsecond and IID ranging from -10 to +10 dB for high pass and low pass noise[2 kHz cut off point]. Boltzmann function was used to describe the auditory lateralization performance and Independent Samples T-test was used to compare the two groups. According to Boltzmann function two major types of abnormalities were revealed in the lateralization performances: 1- completely disoriented, 2- side-oriented. 86.6% of [C] APD children showed significant increase in mean of test errors compared with normal ones [p<0.001]. The study supports the hypothesis that most children with [C] APD have poor auditory lateralization and abnormal processing of binaural cues

[Application of recurrent events model in determining the risk factors of recurrence of Schizophrenia]

Identifying the risk factors of recurrence of a disease is important both for physicians and patients. Analyzing the first recurrence may lead to an inaccurate evaluation of risk factors as it may not reflect the history of disease completely and may result in the loss of some valuable information. This study was aimed to analyze the time up to the recurrent relapses of schizophrenia as well as determining the risk factors that lead to the recurrence of the disease. In this study 159 registered schizophrenia patients at Razi hospital were selected from a longitudinal study. The effect of age, sex, marriage, start of disease, and history of head trauma variables on recurrence of disease was assessed by a frailty model. Data analysis was made on by R 2.14.1. Mean of patients' age was 21.5 +/- 6.6 year. Based on the Gamma frailty model, sex of patients [p=0.045] and history of head trauma [p=0.028] had significant effect on the hazard of recurrent relapses of Schizophrenia. In addition, the correlation of first, second and third times of recurrence was significant [p<0.001]. Based on the dependency between relapses, treatment and follow-up actions are suggested within the first recurrence time