What are VBAC Women Seeking and Sharing? A Content Analysis of Online Discussion Boards.

BACKGROUND: In the United States, one-third of pregnancies result in a cesarean delivery. In subsequent pregnancies, mothers must decide whether to pursue a vaginal birth after a cesarean (VBAC) or a repeat cesarean delivery. Pregnant women frequently turn to the Internet for support and information. METHODS: We analyzed 300 posts from a popular online discussion board created for pregnant women who are in the process of deciding to have a VBAC and compared them to 300 posts from a discussion board for pregnant women in general. RESULTS: Women contemplating a VBAC sought more information on health care providers, more information about labor and delivery, and actively sought birth narratives from other women. Over one-third of VBAC posters shared a birth story, whereas this activity was rare on the general discussion board. Activity on the VBAC board suggested more involvement in the online community (longer entries and more feedback). CONCLUSIONS: Many women considering VBAC seek a substantial amount of information and emotional support from online discussion boards. Knowledge of information sought can assist health care providers in more fully meeting the needs of VBAC candidates.

Discrimination of frequency variance for tonal sequences.

Real-world auditory stimuli are highly variable across occurrences and sources. The present study examined the sensitivity of human listeners to differences in global stimulus variability. In a two-interval, forced-choice task, variance discrimination was measured using sequences of five 100-ms tone pulses. The frequency of each pulse was sampled randomly from a distribution that was Gaussian in logarithmic frequency. In the non-signal interval, the sampled distribution had a variance of σSTAN (2), while in the signal interval, the variance of the sequence was σSIG (2) (with σSIG (2) > σSTAN (2)). The listener's task was to choose the interval with the larger variance. To constrain possible decision strategies, the mean frequency of the sampling distribution of each interval was randomly chosen for each presentation. Psychometric functions were measured for various values of σSTAN (2). Although the performance was remarkably similar across listeners, overall performance was poorer than that of an ideal observer (IO) which perfectly compares interval variances. However, like the IO, Weber's Law behavior was observed, with a constant ratio of ( σSIG (2)- σSTAN (2)) to σSTAN (2) yielding similar performance. A model which degraded the IO with a frequency-resolution noise and a computational noise provided a reasonable fit to the real data.

The salience of enhanced components within inharmonic complexes.

A subjective listening task was used to measure the salience of enhanced components using typical intensity-enhancement stimuli, time-reversed versions of those stimuli, and stimuli which contained a frequency shift of the target component. Twenty-five listeners judged whether or not a pitch "stood out" within an inharmonic complex. For comparison, judgments also were made for stimuli with a single segment that consisted of a simultaneously masked target. The results indicate that the perceived salience of enhanced components is greater than might be predicted by the effective magnitude of those components, and that informational masking is likely involved.

Spectral and level effects in auditory signal enhancement.

Auditory enhancement refers generally to the increased perceptual salience of a spectral region when that region is preceded by its spectral complement, e.g., reinserting a missing component in a harmonic complex makes that component "pop out." One manifestation of enhancement is the increased detectability of a signal in certain spectro-temporal configurations. In the present experiments, detection thresholds were measured for a 2-kHz signal that was masked by an inharmonic complex with a spectral notch centered at 2-kHz. When the masker was preceded by a precursor/adaptor with a spectral gap identical to that of the masker, detection thresholds were lowest when the gap width was 0.6 octave. The amount of signal enhancement, the difference in thresholds between the no-precursor and precursor -conditions, decreased for smaller and larger gap widths. In addition, this general result was robust for precursors such as band-reject noise and harmonic complexes that were different in perceptual quality from the masker. This suggests that grouping/segregation processes do not mediate enhancement as assessed here. Similarly, significant enhancement was observed with precursor-masker level differences over a 40-dB range. Overall, these results further indicate that frequency resolution is a dynamic process that depends on spectro-temporal context. They also are consistent with a mechanism involving adaptation of inhibition that likely occurs at low levels in the auditory system.

The effects of unmodulated carrier fringes on the detection of frequency modulation.

Detection thresholds for 100 ms of either 5- or 20-Hz frequency modulation (FM) were measured at various temporal positions within a 600-ms, 4-kHz pure-tone carrier. The results indicated that the temporal position of the signal relative to the fringe influences detection thresholds, including an effect that is reminiscent of auditory backward recognition masking. A task involving frequency increments, rather than sinusoidal FM, yielded similar results. Additional manipulation of total carrier duration indicated that FM detection thresholds improve as the duration of the forward fringe increases, while a backward fringe only degrades performance in the absence of any forward fringe. The results suggest that listeners are insensitive to subtle frequency changes that occur at the onset of a longer stimulus and that the interaction between the opposing effects of the forward and backward fringes is not additive.

The effects of marker-related temporal cues on auditory gap-duration discrimination.

In three experiments, we examined the ability of listeners to discriminate the duration of temporal gaps (silent intervals) and the influence of other temporal stimulus properties on their performance. In the first experiment, gap-duration discrimination thresholds were measured either in continuous noise or with noise markers with durations of 3 and 300 ms. Thresholds measured with 300-ms markers differed from those measured in continuous noise or with 3-ms markers. In the second experiment, stimuli consisting of a gap between two discrete markers were generated such that the gap duration, the onset-to-onset duration between markers, and the duration of the first marker were pseudorandomized across trials. Listeners' responses generally were consistent with the cue that was identified as the target cue from among the three cues in each block of trials, but the data suggested that the onset-to-onset cue was particularly salient in all conditions. Using a modified method-of-adjustment procedure in the third experiment, subjects were instructed to discriminate between the durations of gaps in discrete markers of different durations in two intervals, where the gap duration in one interval was adapted to measure the point of subjective equality. Without feedback, listeners tended to equate the onset-to-onset times of the markers rather than the gap durations. Overall, the results indicated that listeners' judgments of silent gaps between two discrete markers are strongly influenced by the onset-to-onset time, or rhythm, of the markers.

The enhancement effect: evidence for adaptation of inhibition using a binaural centering task.

The enhancement effect is consistently shown when simultaneously masked stimuli are preceded by the masker alone, with a reduction in the amount of masking relative to when that precursor is absent. One explanation for this effect proposed by Viemeister and Bacon [(1982). J. Acoust. Soc. Am. 71, 1502-1507] is the adaptation of inhibition, which predicts that an enhanced component (the "target") will be effectively more intense within the auditory system than one that has not been enhanced. Forward masking studies have indicated this effect of increased gain; however, other explanations of the enhancement effect have also been suggested. In order to provide an alternative measure of the amount of effective gain for an enhanced target, a subjective binaural centering task was used in which listeners matched the intensities of enhanced and unenhanced 2-kHz tones presented to opposite ears to produce a centered stimulus. The results showed that the enhancement effect produces an effective 4-5 dB increase in the level of the enhanced target. The enhancement effect was also measured using other enhancement paradigms which yielded similar results over a range of levels for the target, supporting an account based on adaptation of inhibition.

Discrimination of temporally asymmetric modulation with triangular envelopes on a broadband-noise carrier (L).

Highly detectable, time-reversed triangular amplitude modulation, with linear increases and decreases in amplitude, was used in an adaptive task to measure just-noticeable differences for changes in the direction of envelope temporal asymmetry for different modulation depths (m = 1.0 and 0.5) and rates (8, 16, and 32 Hz). Thresholds were analyzed using three different measures of the modulator's shape based on (1) the change in the position of the peak within a cycle, (2) the change in the slope of the modulator's increasing amplitude portion, and (3) the change in slope measured in units of amplitude per unit cycle rather than amplitude per unit time. The amplitude per unit cycle measure resulted in the best fit to all the data, and predicted additional data that were gathered with roved modulation frequency. The results suggest that a time normalization process may be involved in the perception and discrimination of envelope shape.

Detection of modulation of a 4-kHz carrier.

To better understand the processing of complex high-frequency sounds, modulation-detection thresholds were measured for sinusoidal frequency modulation (SFM), quasi-frequency modulation (QFM), sinusoidal amplitude modulation (SAM), and random-phase FM (RPFM). At the lowest modulation frequency (5 Hz) modulation thresholds expressed as AM depth were similar for RPFM, SAM and QFM suggesting the predominance of envelope cues. At the higher modulation frequencies (20 and 40 Hz) thresholds expressed as total frequency excursions were similar for SFM and QFM suggesting a common mechanism, one perhaps based on single-channel FM-to-AM conversion or on a multi-channel place mechanism. The fact that the nominal envelopes of SFM and QFM are different (SFM has a flat envelope), seems to preclude processing based on the envelope of the external stimulus. Also, given the 4-kHz carrier and the similarity to previously published results obtained with a 1-kHz carrier, processing based on temporally-coded fine structure for all four types of modulation appears unlikely.

Extracting binaural information from simultaneous targets and distractors: effects of amplitude modulation and asynchronous envelopes.

When different components of a stimulus carry different binaural information, processing of binaural information in a target component is often affected. The present experiments examine whether such interference is affected by amplitude modulation and the relative phase of modulation of the target and distractors. In all experiments, listeners attempted to discriminate interaural time differences of a target stimulus in the presence of distractor stimuli with ITD=0. In Experiment 1, modulation of the distractors but not the target reduced interference between components. In Experiment 2, synthesized musical notes exhibited little binaural interference when there were slight asynchronies between different streams of notes (31 or 62 ms). The remaining experiments suggested that the reduction in binaural interference in the previous experiments was due neither to the complex spectra of the synthesized notes nor to greater detectability of the target in the presence of modulated distractors. These data suggest that this interference is reduced when components are modulated in ways that result in the target appearing briefly in isolation, not because of segregation cues. These data also suggest that modulation and asynchronies between modulators that might be encountered in real-world listening situations are adequate to reduce binaural interference to inconsequential levels.

Forward-masked monaural and interaural intensity discrimination.

Intensity-discrimination thresholds were measured for a 25-ms, 6-kHz pure tone for pedestal levels from 40 to 90 dB sound pressure level (SPL) with and without a forward masker (100-ms narrowband Gaussian noise, N(0)=70 dB). When the masker was present, the masker and probe were separated by 100 ms of silence. Unmasked and masked thresholds were measured in a two-interval monaural procedure and, separately, in a single-interval interaural procedure in which the pedestal and incremented pedestals were presented simultaneously to opposite ears. While the monaural thresholds were elevated markedly by the forward masker for mid-level pedestals, interaural thresholds were nearly unaffected by the masker across pedestal levels. The results argue against the notion that the monaural elevation in forward-masked thresholds is due to degraded encoding of intensity information at early stages of auditory processing.

Discrimination of depth of sinusoidal amplitude modulation with and without roved carrier levels.

Thresholds for the discrimination of the depth of sinusoidal amplitude modulation with a broadband noise carrier were measured for three listeners in a two-alternative, forced-choice task for modulation frequencies of 8, 32, and 128 Hz. Thresholds were measured with the spectrum level of the carrier fixed at 20 dB across all trials and, separately, with the carrier spectrum level roved randomly over a 20-dB range (10-30 dB) in each interval. Mean thresholds were equal or slightly lower (but not significantly so) for the fixed conditions relative to the roved conditions, and the differences between thresholds were too small to be explained by assuming that listeners compared instantaneous intensity at corresponding phases of the modulation cycle (for example, in the troughs). Rather, it appears that listeners discriminated modulation depth by extracting an estimate of the modulation depth within each interval that was independent of the overall level. Consequently, models of envelope extraction must include normalization of the envelope fluctuations to the envelope dc.

The influence of later-arriving sounds on the ability of listeners to judge the lateral position of a source.

This study examined the deleterious effects of a later-arriving sound on the processing of interaural differences of time (IDTs) from a preceding sound. A correlational analysis assessed the relative weight given to IDTs of source and echo clicks for echo delays of 1-64 ms when the echo click was attenuated relative to the source click (0-36 dB). Also measured were proportion correct and the proportion of responses predicted from the weights. The IDTs of source and echo clicks were selected independently from Gaussian distributions (mu=0 s, sigma = 100/s). Listeners were instructed to indicate the laterality of the source click. Equal weight was given to the source and echo clicks for echo delays of 64 ms with no echo attenuation. For echo delays of 16-64 ms, attenuating the echo had no substantial effect on source weight or proportion correct until the echo was attenuated by 18-30 dB. At echo delays < or =4 ms, source weights and proportions correct remained high regardless of echo attenuation. The proportions of responses predicted from the weights were lower at echo delays > or =16 ms. Results were discussed in terms of backward recognition masking and binaural sluggishness and compared to measurements of echo disturbance.

Comparing monaural and interaural temporal windows: effects of a temporal fringe on sensitivity to intensity differences.

In an effort to provide a unifying framework for understanding monaural and binaural processing of intensity differences, an experiment was performed to assess whether temporal weighting functions estimated in two-interval monaural intensity-discrimination tasks could account for data in single-interval interaural intensity-discrimination tasks. In both tasks, stimuli consisted of a 50-ms burst of noise with a 5-ms probe segment at temporal positions ranging between the onset and offset of the overall stimulus. During the probe segment, one monaural interval or binaural channel of each trial contained an intensity increment and the other contained a decrement. Listeners were instructed to choose the interval/channel containing the increment. The pattern of monaural thresholds was roughly symmetrical (an inverted U) across temporal position of the probe but interaural thresholds were substantially higher for a brief time interval following stimulus onset. A two-sided exponential temporal window fit to the monaural data accounted for the interaural data well when combined with a post-onset-weighting function that described greatest weighting of binaural information at stimulus onset. A second experiment showed that the specific procedure used in measuring fringed interaural-intensity-difference-discrimination thresholds affects thresholds as a function of fringe duration and influences the form of the best-fitting post-onset-weighting function.

Monaural and interaural temporal modulation transfer functions measured with 5-kHz carriers.

Temporal modulation transfer functions (TMTFs) were measured for detection of monaural sinusoidal amplitude modulation and dynamically varying interaural level differences for a single set of listeners. For the interaural TMTFs, thresholds are the modulation depths at which listeners can just discriminate interaural envelope-phase differences of 0 and 180 degrees. A 5-kHz pure tone and narrowband noises, 30- and 300-Hz wide centered at 5 kHz, were used as carriers. In the interaural conditions, the noise carriers were either diotic or interaurally uncorrelated. The interaural TMTFs with tonal and diotic noise carriers exhibited a low-pass characteristic but the cutoff frequencies changed nonmonotonically with increasing bandwidth. The interaural TMTFs for the tonal carrier began rolling off approximately a half-octave lower than the tonal monaural TMTF (approximately 80 Hz vs approximately 120 Hz). Monaural TMTFs obtained with noise carriers showed effects attributable to masking of the signal modulation by intrinsic fluctuations of the carrier. In the interaural task with dichotic noise carriers, similar masking due to the interaural carrier fluctuations was observed. Although the mechanisms responsible for differences between the monaural and interaural TMTFs are unknown, the lower binaural TMTF cutoff frequency suggests that binaural processing exhibits greater temporal limitation than monaural processing.

Discrimination of interaural phase differences in the envelopes of sinusoidally amplitude-modulated 4-kHz tones as a function of modulation depth.

Psychometric functions were measured for the discrimination of the interaural phase difference (IPD) of the envelope of a sinusoidally amplitude-modulated (SAM) 4-kHz pure tone for modulation frequencies of 128 and 300 Hz and modulation depths (m) of 0.2, 0.6, 0.9, and 1.0. Contrary to recent modeling assumptions, it was found that a constant change in normalized interaural envelope correlation, with or without additional model stages to simulate peripheral auditory processing, did not produce a constant level of performance. Rather, in some cases, performance could range from chance to near perfect across modulation depths for a given change in normalized interaural envelope correlation. This was also true for the maximum change in normalized interaural envelope correlation computed across the cross-correlation functions for the stimuli to be discriminated. The change in the interaural time difference (ITD) computed from the IPD accounted for discriminability across modulation depths better than the change in normalized interaural envelope correlation, although ITD could not account for all the data, particularly those for lower values of m.

Observer weighting strategies in interaural time-difference discrimination and monaural level discrimination for a multi-tone complex.

Two experiments measured listeners' abilities to weight information from different components in a complex of 553, 753, and 953 Hz. The goal was to determine whether or not the ability to adjust perceptual weights generalized across tasks. Weights were measured by binary logistic regression between stimulus values that were sampled from Gaussian distributions and listeners' responses. The first task was interaural time discrimination in which listeners judged the laterality of the target component. The second task was monaural level discrimination in which listeners indicated whether the level of the target component decreased or increased across two intervals. For both experiments, each of the three components served as the target. Ten listeners participated in both experiments. The results showed that those individuals who adjusted perceptual weights in the interaural time experiment could also do so in the monaural level discrimination task. The fact that the same individuals appeared to be analytic in both tasks is an indication that the weights measure the ability to attend to a particular region of the spectrum while ignoring other spectral regions.

Monaural and interaural intensity discrimination: level effects and the "binaural advantage".

This study examined whether the level effects seen in monaural intensity discrimination (Weber's law and the "near miss") in a two-interval task are also observed in discrimination of interaural intensity differences (IIDs) in a single-interval task. Both tasks were performed for various standard levels of 4-kHz pure tones and broadband noise. The Weber functions (10 log deltaI/I versus I in dB) in the monaural and binaural conditions were parallel. For noise, the Weber functions had slopes close to zero (Weber's law) while the Weber functions for the tones had a mean slope of -0.089 (near miss). The near miss for the monaural and binaural tasks with tones was eliminated when a high-pass masker was gated with the listening intervals. The near-miss was also observed for 250- and 1000-Hz tones in the binaural task despite overall decreased sensitivity to changes in IID at 1000 Hz. The binaural thresholds showed a small (about 2-dB) advantage over monaural thresholds only in the broadband noise conditions. More important, however, is the fact that the level effects seen monaurally are also seen binaurally. This suggests that the basic mechanisms responsible for Weber's law and the near miss are common to monaural and binaural processing.