Comparing Spatial Release From Masking Using Traditional Methods and Portable Automated Rapid Testing iPad App.

Purpose The purpose of this study was to compare speech identification abilities of individuals of various ages and hearing abilities using traditional methods and Portable Automated Rapid Testing (PART) iPad app. Method Speech identification data were collected using three techniques: over headphones using a virtual speaker array, using PART iPad app (UCR Brain Game Center, 2018), and using loudspeaker presentation in a sound-attenuated room. For all three techniques, Coordinate Response Measure sentences were used as the stimuli and "Charlie" was used as the call sign. A progressive tracking procedure was used to estimate the speech identification thresholds for listeners with varying hearing thresholds. The target sentence was always presented at 0° azimuth angle, whereas the maskers were colocated (0°) with the target or symmetrically spatially separated by ±15°, ±30°, or ±45°. Results Data analysis revealed similar speech identification thresholds for the iPad and headphone conditions and slightly poorer thresholds for the loudspeaker array condition across participant groups. This was true for all spatial separations between the target and the maskers. Conclusion Strong correlation between the headphone and iPad data presented in this study indicated that the spatial release from masking module in the PART iPad app can be used as a clinical tool to assess spatial processing ability prior to audiologic evaluation in the clinic and can also be used to make recommendations for and to track progress with aural rehabilitation programs over time.

Spine concerns in the Special Olympian with Down syndrome.

As with any child participating in sports, the safety of The Special Olympian participating in athletics is paramount. The preparticipation medical clearance is necessary to ensure these athletes' safety. In response to evidence that 15% of all individuals with Down syndrome have atlanto-occipital and/or atlanto-axial instability or subluxation, the Special Olympics Inc have additionally mandated preparticipation spine clearance for all individuals with Down syndrome. Spine clearance for the Special Olympian is challenging for the healthcare provider. In addition, controversy has arisen surrounding The Special Olympics Inc policy statement. The purposes of this article are to provide healthcare providers with a review of atlanto-occipital and atlanto-axial instability and subluxation, review spine clearance guidelines, discuss the details and controversy surrounding The Special Olympics Inc mandate, and provide recommendations on how to improve screening and ensure safety of the participants based on the current medical literature.

Postoperative analgesia following surgical correction for adolescent idiopathic scoliosis: a comparison of continuous epidural analgesia and patient-controlled analgesia.

STUDY DESIGN: A retrospective comparison of postoperative continuous epidural analgesia and patient-controlled analgesia following surgical treatment for adolescent idiopathic scoliosis. OBJECTIVES: To compare the safety and efficacy of continuous epidural analgesia and patient-controlled analgesia following adolescent idiopathic scoliosis surgery. SUMMARY OF BACKGROUND DATA: The most commonly used pain management techniques are continuous epidural analgesia and patient-controlled analgesia. However, no large published reports compare them following adolescent idiopathic scoliosis surgery. METHODS: A review was performed from 1990 to 2001 of patients undergoing primary surgery for adolescent idiopathic scoliosis. Visual analog scale scores were recorded postoperatively at multiple time periods. Adverse effects related to each pain management technique were noted. RESULTS: The average of all pain scores (1.3 vs. 1.9) (P < 0.0001) and scores at 2, 4, 6, 8, 12, 24, 36, and 48 hours (p < 0.001) was significantly better in the continuous epidural analgesia group when compared to the patient-controlled analgesia group. The range of pain scores (2.3 vs. 2.7) (P < 0.05) and the average maximum score was less in the continuous epidural analgesia group (2.6 vs. 3.2) (P < 0.05). The need to temporarily stop and then restart the pain management (12.3% vs. 7.0%) (P = 0.04) and premature permanent discontinuation (13.1% vs. 0.0%) (P < 0.001) was greater in the continuous epidural analgesia group than the patient-controlled analgesia group. No neurologic injuries occurred. CONCLUSIONS: Although both continuous epidural analgesia and patient-controlled analgesia provide effective pain control following surgery for adolescent idiopathic scoliosis, patients with continuous epidural analgesia had significantly better pain scores for all time periods, less fluctuations in pain, and lower maximum pain levels during the postoperative period.