Training Programs for Improving Speech Perception in Noise: A Review

Understanding speech in the presence of noise is difficult and challenging, even for people with normal hearing. Accurate pitch perception, coding and decoding of temporal and intensity cues, and cognitive factors are involved in speech perception in noise (SPIN); disruption in any of these can be a barrier to SPIN. Because the physiological representations of sounds can be corrected by exercises, training methods for any impairment can be used to improve speech perception. This study describes the various types of bottom-up training methods: pitch training based on fundamental frequency (F0) and harmonics; spatial, temporal, and phoneme training; and top-down training methods, such as cognitive training of functional memory. This study also discusses music training that affects both bottom-up and top-down components and speech training in noise. Given the effectiveness of all these training methods, we recommend identifying the defects underlying SPIN disorders and selecting the best training approach.

Knowledge, attitude and practice of community health workers regarding child abuse in Tabriz health centers in 2015-2016

Background: Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz

Methods: This is a descriptive [cross-sectional] study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive [mean and standard deviation] and analytical [Two Independent Samples T-test and analysis of variance] statistics

Results: Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complications of child abuse. Their total knowledge was good [57%]. The mean score of awareness [knowledge] was significant according to the variable of training participation [P=0.04]. The participants had a favorable attitude toward dealing with child abuse [91.3 %]; the mean score of attitude was significant according to the educational field [P<0.001] and their performance in dealing with child abuse was moderate and lower [94.3 %]

Conclusion: Community Health Workers had good knowledge regarding child abuse, favorable attitude toward dealing with child abuse, and poor performance in dealing with child abuse. This may be due to fear of side issues to deal with child abuse, or lack of clear legal guidelines regarding this

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

Prevalence of EPIYA motifs in Helicobacter pylori strains isolated from patients with dyspeptic disorders in northern Iran

Cytotoxin-associated gene A [CagA]-positive strains of Helicobacter pylori are associated with gastroduodenal diseases. Evidences have suggested that the type of H. pylori CagA EPIYA motifs may be associated with recurrent dyspepsia [i.e. gastritis, peptic ulcer, or gastric cancer]. We investigated the prevalence of different EPIYA motifs [A, B, C, or D] in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal [GI] endoscopy. We investigated the prevalence of different EPIYA motifs [A, B, C, or D] in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal [GI] endoscopy. H. pylori strains were isolated from biopsy specimens of 220 patients with recurrent dyspepsia. The presence of glmM gene, as a housekeeping gene, CagA gene, and pattern of CagA EPIYA motifs were determined using polymerase chain reaction [PCR] method. The association between the type of motifs and disease state was determined by the Chi-square test, Fisher's exact test, and logistic regression. CagA-positive H. pylori strains were identified in 125 [57%] of patients, including 36 [28.6%] gastritis, 31 [24.6%] duodenal ulcer, and 58 [46.4%] gastric cancer. The frequency of pattern of CagA EPIYA motifs were detected as 39 [31.2%] AB motifs, 54 [43.2%] ABC motifs, 32 [25.6%] ABCC motifs,and no D motifs. The risk of gastric cancer occurrence was estimated to be 2.57 times higher in patients infected by strains with ABCC motif when compared with gastritis and duodenal ulcer patients [p=0.03]. Moreover, patients with C-containing motifs were 2.27 times more likely to be afflicted with gastric cancer than with duodenal ulcer. AB motif was more associated with gastritis and duodenal ulcer than ABC and ABCC motifs. The results suggested that CagA-EPIYA ABCC might be associated with gastric cancer, while EPIYA-AB might be associated with duodenal ulcer

Toll like receptor-4 896a/g gene variation, a risk factor for migraine headaches

The pathogenesis of migraine involves immune-mediated mechanisms in the vascular endothelium. Toll like receptor 4 [TLR-4] is a signaling receptor of innate immunity which plays a role in various neuropathologies related to neuron inflammation. This case/control study is aimed to investigate whether TLR- 4 896A/G variation is related to migraine headaches in an Iranian population. A total of 170 migraine patients [130 females, mean age 33.24 +/- 11 years] and 170 age, sex, and ethnicity matched healthy controls [118 females, mean age of 31 +/- 10 years] were recruited. Genotyping was carried out using the tetra primer amplification refractory mutation system [ARMS]-PCR. The frequency of G allele was higher in migraine patients than the controls [15% vs. 4.7%; p<0.0001]. Interestingly, the distribution of heterozygous 896A/G genotype statistically differed between migraineurs and controls [25.3% vs. 8.2%, p=0.00002, OR 3.87, 95% CI; 2.02-7.4]. Multivariate logistic regression analysis indicated that G allele in affected female migraineurs is an independent factor associated with increased risk of migraine [OR 3.2, 95% CI 1.23-8.24, p=0.01]. Our results showed TLR-4 polymorphism as a genetic risk factor for migraine. However, further studies in different populations are required to elucidate the precise role of TLR-4 896A/G mutation in susceptibility to migraine.

impact of cognitive-behavioral stress management training program on job stress in hospital nurses: applying PRECEDE model

Nursing is one of the most stressful jobs. The present study aimed to determine the effect of a cognitive-behavioral stress management training program based on PRECEDE model on stress reduction among nurses. In this quasi-experimental study, which was conducted in 2010, 58 female nurses in Hamadan, northwest Iran were enrolled in the study and were divided into two equal groups included 29 nurses from one Hospital and 29 nurses from the other as intervention and control groups respectively. The data collection tool was a self-administered questionnaire including demographic characteristics and nursing stress scale [NSS]. In addition, a questionnaire based on PRECEDE model was used in order to assess predisposing, reinforcing and enabling factors. The intervention was a training program including five sessions during three weeks in which relaxation and problem-solving training was thought. A pre-test and a post-test were performed 1.5 months apart. The t-test, Mann Whitney and Willxocon statistical tests were used for data analysis at 95% significant level using SPSS 13. The baseline score average of job stress was 113.0 and 109.8 for intervention and control groups respectively [P=0.250]. After intervention, score average of job stress decreased to 94.0 in experimental group while that of control group remained relatively unchanged [109.2], [P<0.001]. A significant difference was found in PRECEDE model constructs and stress management behaviors in intervention group compared to control group after training interventions [P<0.001]. Training programs based on PRECEDE model might be effective on decreasing job stress in nurses