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Introduction: Cochlear implant (CI) recipients vary in their speech understanding abilities. While some understand speech in the absence of visual cues, others struggle with basic speech comprehension. At present, there is no way to predict how an individual will perform with a CI. Cognitive skills play an essential role in complex auditory processing yet there are no guidelines for assessing cognitive skills in CI users. There is growing evidence, however, that modifying the modality of test material may improve the accuracy for quantifying cognitive skills in a hearingimpaired population. This study investigated the impact of visual versus auditory-visual presentation for assessing working memory skills in CI recipients; standard measures of nonverbal IQ, cognitive efficiency and processing speed as well as speech perception testing, and subjective report of CI benefit were also completed. Methods: 21 adult CI users (3 unilateral, 13 bimodal and 5 bilateral; all post-lingual hearing loss) with clinical speech understanding scores in quiet of ≥ 60% on AzBio sentences (in first ear if implanted bilaterally) were recruited. All participants demonstrated normal nonverbal IQ (mean=107, SD=7.86). Auditory-visual and visual working memory, processing speed and cognitive efficiency were assessed in addition to clinical measures of speech understanding (i.e., AzBio) and subjective rating of CI performance (i.e., Glasgow Benefit Inventory (GBI)). Results: Participants had greater recall for visual rather than auditory-visual working memory items. Visual working memory related with speech perception, unlike auditory- visual working memory. No correlations between speech perception and processing speed, cognitive efficiency, or IQ were seen. Speech perception, however, was positively associated with subjective CI GBI benefit. Conclusions: In high-performing CI users, visual working memory correlates with speech understanding unlike auditory-visual working memory, cognitive efficiency, processing speed and IQ. Higher subjective ratings of CI benefit, as measured by the GBI, translate into greater speech perception. [ABSTRACT FROM AUTHOR]

The five-year rule must die. Despite an extensive literature search, the origins of the five-year rule remain unknown. In an era when the nursing profession is so focused on evidence-based practice, any approach that arbitrarily limits literature searches to articles published in the previous five years lacks scientific basis. We explore some reasons for the pervasiveness of the practice and suggest that librarians need to engage with nursing faculty, who are well-positioned to be change agents in this practice., (Copyright © 2024 Eleanor Shanklin Truex, Jean Hillyer, Emily N. Spinner.)

Background: Health sciences librarians and nursing journal contributors have expressed concern about the impact of using strict parameters when searching the literature., Purpose: The purpose of this study was to explore the use of strict search criteria (eg, 5-year rule, "nurse as author") by direct care nurses and nursing students., Methods: Fourteen online focus groups were conducted with 54 participants: direct care nurses, health sciences librarians, nursing faculty, and nursing students. Nursing faculty and health sciences librarians were included as participants to add perspective to the origins and effects of the use of stringent search criteria., Results: The majority of the nurses viewed the 5-year rule and nurse as author search limits favorably, while noting that a strict date range may hamper successful searching. Librarians viewed these search criteria more unfavorably but recognized the value of topic-appropriate search limits., Conclusion: Reliance on strict limits can be detrimental to pertinent results; however, appropriate use is essential for relevant results. Pedagogy focused on searching the nursing literature needs to emphasize that limits are tools to be used judiciously., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: Previous studies examining the relationship between health-related quality of life (HRQoL) and speech perception ability in cochlear implant (CI) users have yielded variable results, due to a range of factors, such as a variety of different HRQoL questionnaires and CI speech testing materials in addition to CI configuration. In order to decrease inherent variability and better understand the relationship between these measures in CI users, we administered a commonly used clinical CI speech testing battery as well as two popular HRQoL questionnaires in bimodal and bilateral CI users., Methods: The Glasgow Benefit Inventory (GBI), a modified five-factor version of the GBI (GBI-5F), and the Nijmegen Cochlear Implant Questionnaire (NCIQ) were administered to 25 CI users (17 bimodal and 8 bilateral). Speech perception abilities were measured with the AzBio sentence test in several conditions (e.g., quiet and noise, binaural, and first-ear CI only)., Results: Higher performance scores on the GBI general subscore were related to greater binaural speech perception ability in noise. There were no other relationships between the GBI or NCIQ and speech perception ability under any condition. Scores on many of the GBI-5F factors were substantially skewed and asymmetrical; therefore, correlational analyses could not be applied. Across all participants, binaural speech perception scores were greater than first-ear CI only scores., Conclusion: The GBI general subscore was related to binaural speech perception, which is considered the everyday listening condition of bimodal and bilateral CI users, in noise; while the more CI-specific NCIQ did not relate to speech perception ability in any listening condition. Future research exploring the relationships between the GBI, GBI-5F, and NCIQ considering bimodal and bilateral CI configurations separately is warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Brumer, Elkins, Hillyer, Hazlewood and Parbery-Clark.)

Background: Epidemiological research of events related to labor and delivery frequently uses maternal interview or birth certificates as a primary method of data collection; however, the validity of these data are rarely confirmed. This study aimed to examine the validity of birth certificate data and maternal interview of maternal demographics and events related to labor and delivery with data abstracted from medical records in a US setting., Methods: Birth certificate and maternal recall data from the Iowa Health in Pregnancy Study (IHIPS), a population-based case-control study of risk factors for preterm and small-for-gestational age births, were linked to medical record data to assess the validity of events that occurred during labor and delivery along with reported maternal demographics. Sensitivity, specificity, positive and negative predictive values, and kappa scores were calculated., Results: Postpartum maternal recall and birth certificate data were excellent for infant characteristics (birth weight, gestational age, infant sex) and variables related to labor and delivery (mode of delivery) when compared with medical records. Birth certificate data for labor induction had low sensitivity (46.3%) and positive predictive value (18.3%) compared to medical records. Compared to maternal interview, birth certificate data also had poor agreement for smoking and alcohol use during pregnancy. Agreement between all three methods of data collection was very low for pregnancy weight gain (kappa = 0.07-0.08)., Conclusions: Maternal interview and birth certificate data can be a valid source for collecting data on infant characteristics and events that occurred during labor and delivery. However, caution should be used if solely using birth certificate data to gather data on maternal demographic and/or lifestyle factors., (© 2022. The Author(s).)

Purpose: Recent studies using the Montreal Cognitive Assessment (MoCA) suggest delayed recall is challenging for cochlear implant (CI) users. To better understand the underlying processes associated with delayed recall in CI users, we administered the MoCA and the California Verbal Learning Test, Third Edition (CVLT-3), which provides a more comprehensive assessment of delayed recall ability. Methods: The MoCA and CVLT-3 were administered to 18 high-performing CI users. For the CVLT-3, both the traditional scoring and a newer scoring method, the Item-Specific Deficit Approach (ISDA), were employed. Results: The original MoCA score and MoCA delayed recall subtest score did not relate to performance on any CVLT-3 measures regardless of scoring metric applied (i.e., traditional or ISDA). Encoding performance for both the CVLT-3 and ISDA were related. Consolidation, which is only distinctly defined by the ISDA, related to CVLT-3 cued delay recall performance but not free delay recall performance. Lastly, ISDA retrieval only related to CVLT-3 measures when modified. Conclusion: Performance on the MoCA and CVLT-3 in a high performing CI patient population were not related. We demonstrate that the ISDA can be successfully applied to CI users for the quantification and characterization of delayed recall ability; however, future work addressing lower performing CI users, and comparing to normal hearing controls is needed to determine the extent of potential translational applications. Our work also indicates that a modified ISDA retrieval score may be beneficial for evaluating CI users although additional work addressing the clinical relevance of this is still needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Brumer, Elkins, Parada, Hillyer and Parbery-Clark.)

Objectives: To ascertain parental perceptions of the impact of restricted visiting policies to neonatal intensive care units during the current COVID-19 pandemic., Design: Cross-sectional survey of parents impacted by visitation policies., Setting: Six tertiary level neonatal units, four from the UK and two from the USA, participated in the study., Participants: Parents and families of infants hospitalised in the participating centres between 1 May 2020 and 21 August 2020., Methods: Online-based and/or paper-based survey, querying the visitation policies and their impact on parents' ability to visit, care for and bond with their infants., Results: A total of 231 responses were received. Visitation limited to a single visitor with no restrictions on duration was the most frequently reported policy; 140/217 (63%). Visitation policies were perceived as being restrictive by 62% (138/219) of the respondents with 37% (80/216) reporting being able to visit less often than desired, 41% (78/191) reporting being unable to bond enough and 27% (51/191) reporting not being able to participate in their baby's daily care. Mild to severe impact on breast feeding was reported by 36% (75/209) of respondents. Stricter policies had a higher impact on families and were significantly associated with a lack of bonding time, inability to participate in care and an adverse impact on breast feeding., Conclusions: Visitation policies during the COVID-19 pandemic varied between centres and over time with stricter restrictions implemented earlier on in the pandemic. Parents reported significant impacts on their ability to visit, care for and bond with their infants with perceived severity of impact worse with stricter restrictions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose The bone-conduction device attached to a percutaneous screw (BCD) is an important treatment option for individuals with severe-to-profound unilateral hearing loss (UHL). Clinicians may use subjective questionnaires and speech-in-noise measures to evaluate BCD use in this patient population; however, the translation of these metrics to real-world aided performance is unclear. The purpose of this study was twofold: first, to measure speech-in-noise performance in BCD users with severe-to-profound UHL in a simulated real-world environment, relative to individuals with normal hearing bilaterally; second, to determine if BCD users' subjective reports of aided performance relate to simulated real-world performance. Method A between-subjects design with two groups was conducted with 14 adults with severe-to-profound UHL (BCD group) and 10 age-matched participants with normal hearing bilaterally (control group). Speech-in-noise tests were administered in an eight-speaker R-Space simulating a real-world environment. To further explore speech-in-noise evaluation methods for this population, testing was also completed in a clinically common two-speaker array. The effects of various microphone settings on performance were explored for BCD users. Subjective performance was measured with the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox & Alexander, 1995) and the Speech, Spatial and Qualities of Hearing Scale (Gatehouse & Noble, 2004). Statistical analyses to explore relationships between variables included repeated-measures analysis of variance, regression analyses, independent-samples t tests, nonparametric Mann-Whitney tests, and correlations. Results In the simulated real-world environment, BCD group participants struggled with speech-in-noise understanding compared to control group participants. BCD benefit was observed for all microphone settings when speech stimuli were presented to the side with the BCD. When adaptive directional or fixed directional microphone settings were used, a relationship was noted between simulated real-world speech-in-noise performance for speech stimuli presented to the side with the BCD and subjective reports on the Background Noise subscale of the APHAB. Conclusions The Background Noise subscale of the APHAB may help estimate real-world speech-in-noise performance for BCD users with severe-to-profound UHL for signals of interest presented to the implanted side, specifically when adaptive or fixed directional microphone settings are used. This subscale may provide an efficient and accessible alternative to assessing real-world speech-in-noise performance in lieu of less clinically available measurement tools, such as an R-Space.

Although research suggests a relationship between hearing impairment and cognitive decline in older adults, nuances of this relationship remain unclear. This uncertainty could be attributed to verbal administration of standardized cognitive measures to hearing-impaired (HI) individuals. Various strategies for testing HI populations have been suggested. We tested the efficacy of applying alternative scoring methods that systematically removed auditory-based items on the Montreal Cognitive Assessment (MoCA) in 27 cochlear implant patients. We calculated the original MoCA score and three alternative scores. The first alternative removed items from the Attention and Language sections; the second alternative removed the Delayed Recall task, and the third alternative removed the Attention, Language, and Delayed Recall items. QoL was assessed using the Glasgow Benefit Inventory and Nijmegen Cochlear Implant Questionnaire. Results indicate a significant difference in MoCA scores with two alternative scoring methods. The second alternative MoCA score related to self-reported performance on the GBI.

Objectives: Commonly used cognitive screening tools were not originally developed for patients with hearing loss (HL) and rely heavily on the ability to hear the instructions and test stimuli. Recently, the Montreal Cognitive Assessment (MoCA) was modified for use with hearing-impaired populations (ie, HI-MoCA). In order to investigate the clinical utility of the HI-MoCA, we assessed performance between the standard MoCA and HI-MoCA among postlingually deafened cochlear implant (CI) users., Methods: We administered the standard MoCA and HI-MoCA to 21 CI users and compared their performance. We assessed differences in pass/fail status when items from the attention and language sections and the delayed recall task were removed., Results: There was no significant difference in performance between the standard MoCA and HI-MoCA. Participants scored higher on both test versions when the delayed recall task was removed. Participants also performed better on the delayed recall task on the HI-MoCA than on the standard MoCA., Conclusions: While our findings suggest that the modality of presentation for the MoCA does not influence overall performance for postlingually deafened CI users, visual presentation of stimuli impacted performance on delayed recall. Furthermore, irrespective of presentation modality, our participants scored higher on both MoCA versions when the delayed recall task was removed. Clinically, modifications to the presentation of the MoCA might not be necessary for CI users; however, clinicians should be aware that the delayed recall task is inherently harder for these patients., (© 2020 John Wiley & Sons, Ltd.)

Despite being considered one of the most successful neural prostheses, cochlear implants (CIs) provide recipients with a wide range of speech perception performance. While some CI users can understand speech in the absence of visual cues, other recipients exhibit more limited speech perception. Cognitive skills have been documented as a contributor to complex auditory processing, such as language understanding; however, there are no normative data for existing standardized clinical tests assessing cognitive abilities in CI users. Here, we assess the impact of modality of presentation (i.e., auditory-visual versus visual) for the administration of working memory tests in high-performing CI users in addition to measuring processing speed, cognitive efficiency and intelligence quotient (IQ). Second, we relate performance on these cognitive measures to clinical CI speech perception outcomes. Methods: Twenty one post-lingually deafened, high-performing, adult CI users [age range: 52-88 years; 3 unilateral CI, 13 bimodal (i.e., CI with contralateral hearing aid), 5 bilateral CI] with clinical speech perception scores (i.e., AzBio sentences in quiet for the first-ear CI) of ≥60% were recruited. A cognitive test battery assessing auditory-visual working memory (AVWM), visual working memory (VWM), processing speed, cognitive efficiency and IQ was administered, in addition to clinical measures of speech perception in quiet (i.e., AzBio sentences in quiet). AzBio sentences were assessed in two conditions: first-ear CI only, and best-aided everyday wearing condition. Subjects also provided self-reported measures of performance and benefit from their CI using standardized materials, including the Glasgow Benefit Inventory (GBI) and the Nijmegen Cochlear Implant questionnaire (NCIQ). Results: High-performing CI users demonstrated greater VWM than AVWM recall. VWM was positively related to AzBio scores when measured in the first-ear CI only. AVWM, processing speed, cognitive efficiency, and IQ did not relate to either measure of speech perception (i.e., first-ear CI or best-aided conditions). Subjects' self-reported benefit as measured by the GBI predicted best-aided CI speech perception performance. Conclusion: In high-performing CI recipients, visual presentation of working memory tests may improve our assessment of cognitive function.

Objective: To determine how best to modify osseointegrated (OI) devices or environmental settings to maximize hearing performance., Study Design: Prospective cohort study., Setting: Tertiary referral center., Patients: Fourteen adults with single-sided deafness (SSD) with a minimum of 6 months OI usage and nine bilaterally normal hearing controls, Interventions: : Speech in noise (SIN) and localization ability were assessed in a multi-speaker array (R-Space) with patients repeating sentences embedded in competing noise and verbally indicating the source speaker, respectively., Main Outcome Measures: SIN and localization were assessed with multiple OI microphone settings-fixed-directional, omnidirectional, and adaptive-as well as an unaided (OI off) condition. Participants completed the Abbreviated Profile of Hearing Aid Benefit questionnaire., Results: Localization performance remains compromised for OI users with a high number of front-back confusions, but rapid learning using the fixed-directional microphone setting improved localization of sounds on the device side despite poorer localization of sounds on the normal-hearing side. SIN performance is greatly enhanced with speech presented to the contra hearing ear rather than the OI device side. Subjective report of hearing ability is highly predictive of objective SIN measures., Conclusions: Clinicians should consider implementing a fixed-directional microphone setting for improved localization for sounds behind the OI device, but inform patients of the trade-off in performance on the normal-hearing side. For better hearing in noise, clinicians should counsel OI recipients to orient the speech signal to their normal hearing ear rather than their OI device. The background noise subscale of the abbreviated profile of hearing aid benefit (APHAB) provides a meaningful metric by which to assess SIN performance of OI device users.

Scientists, clinicians, administrators, individuals with spinal cord injury (SCI), and caregivers seek a common goal: to improve the outlook and general expectations of the adults and children living with neurologic injury. Important strides have already been accomplished; in fact, some have labeled the changes in neurologic rehabilitation a "paradigm shift." Not only do we recognize the potential of the damaged nervous system, but we also see that "recovery" can and should be valued and defined broadly. Quality-of-life measures and the individual's sense of accomplishment and well-being are now considered important factors. The ongoing challenge from research to clinical translation is the fine line between scientific uncertainty (ie, the tenet that nothing is ever proven) and the necessary burden of proof required by the clinical community. We review the current state of a specific SCI rehabilitation intervention (locomotor training), which has been shown to be efficacious although thoroughly debated, and summarize the findings from a multicenter collaboration, the Christopher and Dana Reeve Foundation's NeuroRecovery Network., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically review the available pre-clinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we review treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications, or are available in a form that could be administered to humans. These include: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in-vivo animal model was utilized to assess the efficacy of the therapy in a traumatic SCI paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the pre-clinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation.

An increasing number of therapies for spinal cord injury (SCI) are emerging from the laboratory and seeking translation into human clinical trials. Many of these are administered as soon as possible after injury with the hope of attenuating secondary damage and maximizing the extent of spared neurologic tissue. In this article, we systematically reviewed the available preclinical research on such neuroprotective therapies that are administered in a non-invasive manner for acute SCI. Specifically, we reviewed treatments that have a relatively high potential for translation due to the fact that they are already used in human clinical applications or are available in a form that could be administered to humans. These included: erythropoietin, NSAIDs, anti-CD11d antibodies, minocycline, progesterone, estrogen, magnesium, riluzole, polyethylene glycol, atorvastatin, inosine, and pioglitazone. The literature was systematically reviewed to examine studies in which an in vivo animal model was utilized to assess the efficacy of the therapy in a traumatic spinal cord injury paradigm. Using these criteria, 122 studies were identified and reviewed in detail. Wide variations exist in the animal species, injury models, and experimental designs reported in the preclinical literature on the therapies reviewed. The review highlights the extent of investigation that has occurred in these specific therapies, and points out gaps in our knowledge that would be potentially valuable prior to human translation.