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1.
J Am Acad Audiol ; 30(1): 54-65, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30461388

RESUMO

BACKGROUND: Speech recognition in noise (SRN) evaluations reveal information about listening ability that is unavailable from pure-tone thresholds. Unfortunately, SRN evaluations are not commonly used in the clinic. A lack of standardization may be an explanation for the lack of widespread acceptance of SRN testing. Arguments have been made for the utilization of steady-state speech-shaped noise vs. multi-talker babble. Previous investigations into the effect of masker type have used a monaural presentation of the stimuli. However, results of monaural SRN tests cannot be generalized to binaural listening conditions. PURPOSE: The purpose of this study was to investigate the effect of masker type on SRN thresholds under binaural listening conditions. RESEARCH DESIGN: The Hearing in Noise Test (HINT) protocol was selected in order to measure SRN thresholds in steady-state speech-shaped noise (HINT noise) and four-talker babble with and without the spatial separation of the target speech and masker stimuli. STUDY SAMPLE: Fifty native speakers of English with normal pure-tone thresholds (≤ 25 dB HL, 250-4000 Hz) participated in the study. The mean age was 20.5 years (SD 1.01). DATA COLLECTION AND ANALYSIS: All participants were tested using the standard protocol for the HINT in a simulated soundfield environment under TDH-50P headphones. Thresholds were measured for the Noise Front, Noise Left, and Noise Right listening conditions with HINT noise and four-talker babble. The HINT composite score was determined for each noise condition. The spatial advantage was calculated from the HINT thresholds. Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Statistical analyses include descriptive statistics, effect size, correlations, and repeated measures ANOVA followed by matched-pairs t-tests. RESULTS: Repeated measures ANOVA was conducted to investigate the effects of masker type and noise location on HINT thresholds. Both main effects and their interaction were statistically significant (p < 0.01). No significant differences were found between masker conditions for the Noise Front thresholds. However, for the Noise Side conditions the four-talker babble thresholds were significantly better than the HINT noise thresholds. Overall, greater spatial advantage was found for the four-talker babble as opposed to the HINT noise conditions (p < 0.01). Pearson correlation analysis revealed no significant relationships between four-talker babble and HINT noise speech recognition performances for the Noise Front, Noise Right conditions, and the spatial advantage measures. Significant relationships (p < 0.05) were found between masking noise performances for the Noise Left condition and the Noise Composite scores. CONCLUSIONS: One cannot assume that a patient who performs within normal limits on a speech in four-talker babble test will also perform within normal limits on a speech in steady-state speech-shaped noise test, and vice-versa. Additionally, performances for the Noise Front condition cannot be used to predict performances for the Noise Side conditions. The utilization of both HINT noise and four-talker babble maskers, with and without the spatial separation of the stimuli, may be useful when determining the range of speech recognition in noise abilities found in everyday listening conditions.


Assuntos
Ruído , Mascaramento Perceptivo , Teste do Limiar de Recepção da Fala/métodos , Limiar Auditivo , Feminino , Humanos , Masculino , Valores de Referência , Adulto Jovem
2.
J Am Acad Audiol ; 29(7): 634-647, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29988011

RESUMO

BACKGROUND: According to the World Health Organization (WHO), a pure-tone threshold average (PTA) ≤25 dB HL for the better ear represents "no impairment." This implies that patients with single-sided deafness (SSD) would have "no or very slight hearing problems." According to the American Medical Association (AMA), a patient with SSD would receive a binaural hearing impairment rating of 16.7%. The premise of the WHO and AMA methods is that PTA is related to the ability to perceive speech in everyday environments. PURPOSE: The overall goal of the study was to evaluate the WHO and AMA criteria for the rating of hearing impairment. The purpose of this study was to quantify the impact of simulated SSD on the ability to recognize speech in the presence of background noise in terms of binaural and spatial advantage measures. RESEARCH DESIGN: Study participants were tested using the standard protocol for the Hearing in Noise Test (HINT) in both binaural and monaural conditions using a simulated soundfield environment under headphones. The target sentences were presented at 0°. Binaural thresholds were obtained for the Noise Front (0°), Noise Left (270°), and Noise Right (90°) listening conditions. Monaural thresholds were collected for each ear for the Noise Front condition and for the unshadowed ear for the Noise Left and Noise Right conditions. Binaural advantage was determined by subtracting the binaural from the monaural thresholds. Spatial advantage was determined by subtracting the Noise Side from the Noise Front thresholds. STUDY SAMPLE: Twenty-five young native speakers of English with normal pure-tone thresholds (≤25 dB HL, 250-8000 Hz) participated in the study. DATA COLLECTION AND ANALYSIS: Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Speech recognition in noise data were collected using a Windows-based HINT software system. The binaural and spatial advantage measures were calculated from the HINT thresholds. Statistical analyses included descriptive statistics, correlation coefficients, and matched-pairs t-tests. RESULTS: The average binaural advantage for the Noise Front conditions was 1.21 dB (p < 0.01) or a maximum estimated intelligibility improvement of 12.01% when the speech and noise were presented at 0°. The average binaural advantage across the Noise Side conditions was 11.25 dB (p < 0.01) or a maximum estimated intelligibility improvement of 84.09% when the noise was spatially separated from the speech. The average spatial advantage for the binaural conditions was 6.72 dB (p < 0.01) or a maximum estimated intelligibility improvement of 60.03%. The average spatial advantage for the monaural conditions was -3.32 dB or a maximum estimated decrease in intelligibility of 32.27%. CONCLUSIONS: The results do not support the WHO or AMA hearing impairment ratings for SSD. The WHO and AMA criteria for the determination of hearing impairment should be updated to include speech recognition in noise testing with and without the spatial separation of the speech and noise stimuli. In this way actual, as opposed to inferred perceptions of speech in noisy environments, may be determined. This will provide a much-needed improvement in the ratings of hearing impairment.


Assuntos
American Medical Association , Avaliação da Deficiência , Perda Auditiva/diagnóstico , Organização Mundial da Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Testes Auditivos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Ruído , Estados Unidos , Adulto Jovem
3.
Int J Environ Res Public Health ; 11(10): 10226-68, 2014 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-25275889

RESUMO

Within the United States, close to 45 million youths between the ages of 6 and 18 participate in some form of organized sports. While recent reviews have shown the positive effects of youth sport participation on youth health, there are also several negative factors surrounding the youth sport environment. To date, a comprehensive review of the negative physical and psychological effects of organized sport on youth has not been done and little to date has documented the effect organized sport has on other players within a family, particularly on parents and siblings. Therefore the purpose of this paper is to conduct a review of papers on the negative effects of organized sport on the youth athlete and their parents and siblings. Articles were found by searching multiple databases (Physical Education Index and Sociology, Psychology databases (Proquest), SPORTDiscus and Health, History, Management databases (EBSCOhost), Science, Social Science, Arts and Humanities on Web of Science (ISI), SCOPUS and Scirus (Elsevier). Results show the darker side of organized sport for actors within the family unit. Ideas for future research are drawn and recommendations are made to optimize the youth sport experience and family health.


Assuntos
Esportes/psicologia , Traumatismos em Atletas , Canadá , Dieta , Humanos , Relações Pais-Filho , Pais/psicologia , Irmãos/psicologia , Esportes/economia , Estresse Psicológico , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos
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