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(Anesth Analg. 2023;136:728–737)It has been shown that cardiovascular disease is related to preeclampsia. It has also been found that preeclampsia can increase the risk of heart failure, maternal mortality, and other cardiovascular conditions. This study aimed to show the relationship between cardiovascular diseases and preeclampsia in patients.

Remember those graduate school lessons about the speech chain--in which a message travels between sender and receiver in stages, from one person's intention to another person's understanding? For decades, we [...]

There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans—in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.

AbstractBackground:The opioid epidemic continues to erode communities across Pennsylvania (PA). Federal and PA state programs developed grants to establish Hub and Spoke programs for the expansion of medications for opioid use disorders (MOUD). Employing the telementoring platform Project ECHO (Extension for Community Health Outcomes), Penn State Health engaged the other seven grant awardees in a Collaborative Health Systems (CHS) ECHO. We conducted key informant interviews to better understand impact of the CHS ECHO on health systems collaboration and opioid crisis efforts. Methods:For eight one-hour sessions, each awardee presented their unique strategies, challenges, and opportunities. Using REDCap, program characteristics, such as number of waivered prescribers and number of patients served were collected at baseline. After completion of the sessions, key informant interviews were conducted to assess the impact of CHS ECHO on awardee’s programs. Results:Analysis of key informant interviews revealed important themes to address opioid crisis efforts, including the need for strategic and proactive program reevaluation and the convenience of collaborative peer learning networks. Participants expressed benefits of the CHS ECHO including allowing space for discussion of challenges and best practices and facilitating conversation on collaborative targeted advocacy and systems-level improvements. Participants further reported bolstered motivation and confidence. Conclusions:Utilizing Project ECHO provided a bidirectional platform of learning and support that created important connections between institutions working to combat the opioid epidemic. CHS ECHO was a unique opportunity for productive and convenient peer learning across external partners. Open dialogue developed during CHS ECHO can continue to direct systems-levels improvements that benefit individual and population outcomes.

Background: Hearing loss and mild behavioral impairment (MBI), both non-cognitive markers of dementia, can be early warning signs of incident cognitive decline.Objective: We investigated the relationship between these markers and reported the influence of sex, using non-dementia participants (n?=?219; 107 females) from the Canadian Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND).Methods: Hearing was assessed with the 10-item Hearing Handicap for the Elderly–Screening (HHIE-S) questionnaire, a speech-in-noise test, screening audiometry, and hearing aid use. MBI symptoms were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Multivariable linear regressions examined the association between hearing and MBI symptom severity and multiple logistic regressions examined the association between hearing and MBI domains.Results: HHIE-S score was significantly associated with greater global MBI symptom burden, and symptoms in the apathy and affective dysregulation domains. Objective measures of audiometric hearing loss and speech-in-noise testing as well as hearing aid use were not associated with global MBI symptom severity or the presence of MBI domain-specific symptoms. Males were older, had more audiometric and speech-in-noise hearing loss, higher rates of hearing-aid use, and showed more MBI symptoms than females, especially apathy.Conclusion: The HHIE-S, a subjective self-report measure that captures emotional and social aspects of hearing disability, was associated with informant-reported global MBI symptom burden, and more specifically the domains of affective dysregulation and apathy. These domains can be potential drivers of depression and social isolation. Hearing and behavior change can be assessed with non-invasive measures, adding value to a comprehensive dementia risk assessment.

AbstractVision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.

What is the link between audition and cognition? The relationship has been recognized as important for decades, but advances in neuroscience and in digital signal processing now compel audiologists to [...]

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ABSTRACTThe purpose of this study was to describe the prevalence of hearing loss (HL), vision loss (VL), and dual sensory loss (DSL) in Canadians 45–85 years of age. Audiometry and visual acuity were measured. Various levels of impairment severity were described. Results were extrapolated to the 2016 Canadian population. In 2016, 1,500,000 Canadian males 45–85 years of age had at least mild HL, 1,800,000 had at least mild VL, and 570,000 had DSL. Among females, 1,200,000 had at least mild HL, 2,200,000 had at least mild VL, and 450,000 had DSL. Among Canadians 45–85 years of age, mild, moderate, and severe HL was prevalent among 13.4 per cent, 3.7 per cent, and 0.4 per cent of males, and among 11.3 per cent, 2.3 per cent, and 0.2 per cent of females, respectively. Mild and moderate, or severe VL was prevalent among 19.8 per cent and 2.4 per cent of males, and among 23.9 per cent and 2.6 per cent of females, respectively. At least mild DSL was prevalent among 6.4 per cent of males and 6.1 per cent of females.

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IntroductionChanges of environment brought about by deployments are often attributed to an increase in smoking of service personnel. Electronic cigarettes are recognised as being a viable aid to quitting smoking but are currently banned from sale in Oman and were therefore banned during exercise SAIF SAREEA 3 (SS3). This paper sought to establish whether smoking increased on this exercise and for what reasons. Also, if deployed smoking cessation services are likely to be used, if available.MethodsQuestionnaires were distributed to deployed troops at various locations in theatre for data collection.ResultsSmoking prevalence increased by 5.2% (29) in the deployed population by the end of the exercise. The largest increase was seen in those smoking 20 cigarettes a day or more, rising by 269.8% (73) with a mean increase of 9 cigarettes per day. During the exercise the number of personnel using electronic cigarettes decreased and individuals’ rate of electronic cigarette use also decreased. Those who smoked less during the exercise did mainly through choice (56.8%). 50% (280) of all individuals who increased smoking habits during the exercise did so out of boredom.ConclusionsDuring exercise SS3 the number of individuals who smoked and the quantity they smoked increased. The ban on electronic cigarettes in Oman and while on exercise potentially had an effect on the increased smoking habits. There is an argument to include smoking cessation material in medical modules to prevent ex-smokers from restarting, continue to aid those quitting and potentially lessen severity of increasing smoking habits while deployed.

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RÉSUMÉL’objectif était d’investiguer l’impact de la présence d’un bruit de fond sur la performance au Montreal Cognitive Assessment (MoCA). Deux versions du MoCA ont été administrées, utilisant écouteurs, avec des niveaux bas et élevés de bruit de fond à deux groupes de personnes âgées (un groupe présentant une audition cliniquement normale, le second présentant une perte d’audition) ainsi qu’à un groupe de jeunes adultes. Les niveaux d’intensité utilisés pour présenter la parole et le bruit étaient personnalisés en fonction des habiletés des participants présentant une perte de l’ouïe, et ce en vue de créer un niveau de difficulté uniforme à travers les participants dans la condition de bruit plus élevé. Les deux groupes de personnes âgées ont obtenu des scores plus faibles au MoCA en comparaison aux jeunes adultes. Il est également important de souligner que tous les participants ont obtenu des scores plus faibles au MoCA lorsque le test était administré dans un contexte de bruit élevé (M = 22,7/30), en comparaison à un contexte de bruit faible (M = 25,7/30, p < .001). Ces résultats suggèrent que le bruit de fond présent dans un contexte d’évaluation devrait être pris en considération au moment de l’administration de tests cognitifs ainsi que dans l’interprétation des résultats, en particulier lors de l’essai des adultes plus âgés.

The study investigated cross-sectional associations between hearing loss and poor health outcomes among older American adults with unaddressed hearing loss or unacknowledged hearing loss, people who might benefit from population-based hearing screening programs. Data was obtained from the U.S. National Health and Nutrition Examination Survey. Cross-sectional associations were analyzed between the pure-tone average in the better hearing ear and cognition, depression, social isolation, hospitalizations, and burden of physical and mental health. Significant associations existed between hearing loss and social isolation and lower cognition, suggesting that future studies examining the benefit of adult screening programs should analyze effects on these measures.Supplemental Digital Content is available in the text.

(Int J Obstet Anesth. 2020;44:116–121)Ketorolac is commonly used to manage postcesarean delivery pain. While the manufacturer recommends an intravenous (IV) dose of 30 mg for adults under age 65, a dose of 15 mg is sometimes used. There is a lack of data on the efficacy, outcomes, or side effects associated with a higher or lower dose. This study was conducted in a center that uses both doses for postcesarean analgesia and aimed to compare analgesic efficacy for each dose. The hypothesis was that the 30 mg dose would be associated with lower opioid use.

The goal of the research was to better understand the relationship between perceived social support and hearing aid satisfaction. In Study 1, 173 adult (age = 68.9; SD = 13.4) and in Study 2, 161 adult (age = 32.8; SD= 13.3) hearing aid wearers completed surveys assessing attitudes toward health, hearing, and hearing aids, as well as other psycho-social factors. In both studies, hearing aid satisfaction was best predicted by perceived social support. Furthermore, there is minimal support for the claim that participant response style accounts for the relationship between hearing aid satisfaction and perceived social support.

Abstract.The excavation of snow layers was used to compare observed and modeled plot-scale brightness temperature (TB) values for 19 and 37 GHz, with regard to snow water equivalent (SWE), snow type, grain size, and layered structure, for 3 land cover types acquired near Churchill, Manitoba, Canada in March of 2010. In situ snow geophysical measurements were input to the Helsinki University of Technology (HUT) multi-layer snow emission model, and performance was characterized by RMSE and MBE. Emission scattering from depth hoar was disproportionate to its SWE contribution when compared to other snow types, and it also masked observed scattering contributions from upper snow layers. The simulated and observed TB diverged above 130 mm SWE, as the model did not capture scattering extinction or snowpack emission. These may impact the initial effective grain size optimization process if applied to the GlobSnow SWE assimilation technique. Grain size is optimized to fit emission simulations to TB from satellite observations; the model's continued sensitivity to SWE above observed signal saturation may be attributed to the existing snowpack. These inaccuracies may then be carried forward in the assimilation process, through variance calculations used to weight the contributions of assimilation modules, leading to less accurate SWE retrievals.Résumé. L’excavation des couches de neige a été utilisée pour comparer les valeurs observées et modélisées de la température de brillance (TB) à 19 et 37 GHz à l’échelle de la parcelle, en lien avec l’équivalent en eau de la neige (SWE), le type de neige, la taille des grains, et la structure en couches, pour trois types de couverture terrestre acquises près de Churchill au Manitoba (Canada) en mars 2010. Les mesures géophysiques in situ de neige ont été utilisées en entrées du modèle HUT (Helsinki University of Technology), un modèle multicouche d’émission de la neige, et la performance a été caractérisée par l’écart moyen quadratique (RMSE) et l’erreur de justesse moyenne (MBE). La diffusion de l’émission du givre de profondeur était disproportionnée par rapport à sa contribution au SWE en comparaison avec d’autres types de neige et a aussi masqué les contributions observées de la diffusion des couches de neige supérieures. Les valeurs de TB simulées et observées ont divergé au-dessus de 130 mm de SWE, parce que le modèle n’a pas représenté l’extinction de la diffusion ou l’émission du manteau neigeux. Cela peut affecter le processus d’optimisation initiale de la taille effective des grains, s’il est appliqué à la technique d’assimilation GlobSnow SWE. La taille des grains est optimisée pour ajuster les simulations d’émission aux TB provenant des observations par satellite; la sensibilité du modèle au SWE au-dessus de la saturation du signal observé peut être attribuée au manteau neigeux existant. Ces inexactitudes peuvent ensuite être reportées dans le processus d’assimilation, par des calculs de la variance utilisés pour pondérer les contributions des modules d’assimilation ce qui conduit à des résultats moins précis d’estimation du SWE.

The main objective was to investigate age-related differences on the listening in spatialized noise-sentences (LiSN-S) test in adults with normal audiometric thresholds in most of the speech range. A second objective was to examine the contributions of auditory, cognitive, and linguistic abilities to LiSN-S outcomes.

Little is known about the influence of vocal emotions on speech understanding. Word recognition accuracy for stimuli spoken to portray seven emotions (anger, disgust, fear, sadness, neutral, happiness, and pleasant surprise) was tested in younger and older listeners. Emotions were presented in either mixed (heterogeneous emotions mixed in a list) or blocked (homogeneous emotion blocked in a list) conditions. Three main hypotheses were tested. First, vocal emotion affects word recognition accuracy; specifically, portrayals of fear enhance word recognition accuracy because listeners orient to threatening information andor distinctive acoustical cues such as high pitch mean and variation. Second, older listeners recognize words less accurately than younger listeners, but the effects of different emotions on intelligibility are similar across age groups. Third, blocking emotions in list results in better word recognition accuracy, especially for older listeners, and reduces the effect of emotion on intelligibility because as listeners develop expectations about vocal emotion, the allocation of processing resources can shift from emotional to lexical processing.

The effects of directing, switching, and misdirecting auditory spatial attention in a complex listening situation were investigated in 8 younger and 8 older listeners with normal-hearing sensitivity below 4 kHz.

The authors investigated the effects of hand function and aging on the ability to manipulate different hearing instrument controls. Over the past quarter century, hearing aids and hearing aid controls have become increasingly miniaturized. It is important to investigate the aging hand and hearing aid ergonomics because most hearing aid wearers are adults aged 65 years and above, who may have difficulty handling these devices.