/ Matching biological and chemical data were COmpiled from numerous modeling, laboratory, and field ....._.,. studies performed in marine and estuarine sediments. Using these data, two guideline values (an effects range-low and an effects range-median) were determined for nine trace metals, total PCBs, two pesticides, 13 polynuclear aromatic hydrocarbons (PAHs), and three classes of PAHs. The two values defined concentration ranges that were: (1) rarely, (2) occasionally, or (3) frequently associated with adverse effects. The values generally agreed within a factor of 3 or less with those developed with the same methods applied to other data and to those developed with other effects-based methods. The incidence of adverse effects was quantified within each of the three concentration ranges as the number of cases in which effects were observed divided by the total number of observations. The incidence of effects increased markedly with increasing concentrations of all of the individual PAHs, the three classes of PAHs, and most of the trace metals. Relatively poor relationships were observed between the incidence of effects and the concentrations of mercury, nickel, total PCB, total DDT and p,p'-DDE. Based upon this evaluation, the approach provided reliable guidelines for use in sediment quality assessments. This method is being used as a basis for developing National sediment quality guidelines for Canada and informal, sediment quality guidelines for Florida.
Many standardized measures of cognition include items that must be seen or heard. Nevertheless, it is not uncommon to overlook the possible effects of sensory impairment(s) on test scores. In the current study, we investigated whether sensory impairments could affect performance on a widely used screening tool, the Montreal Cognitive Assessment (MoCA). Three hundred and one older adults (mean age = 71 years) completed the MoCA and also hearing and vision tests. Half of the participants had normal hearing and vision, 38% impaired hearing, 5% impaired vision, and 7% had dual-sensory impairment. More participants with normal sensory acuity passed the MoCA compared to those with sensory loss, even after modifying scores to adjust for sensory factors. The results suggest that cognitive abilities may be underestimated if sensory problems are not considered and that people with sensory loss are at greater risk of cognitive decline.
Abstract-With the increasing aging population, the number of veterans presenting with dual sensory impairment (DSI) (vision and hearing impairments) will increase. This study determined the prevalence and clinical characteristics of DSI in a veteran population receiving healthcare from the Department of Veterans Affairs (VA). A retrospective review was conducted on 400 charts randomly selected from a database of 1,472 unique veterans enrolled in the audiology and optometry outpatient clinics during a 1-year period. Depending on definition criteria, hearing impairment prevalence was 41.6% to 74.6%, vision impairment/blindness prevalence was 7.4%, and DSI prevalence was 5.0% to 7.4%. The vision impairment/ blindness prevalence governed the DSI prevalence. By age, DSI prevalence ranged from 0% (among veterans <65 years) to >20% (among veterans 85+ years). The complexities encountered in defining DSI are discussed and suggestions are made for determining standardized definitions. More research is needed to determine the unique characteristics of individuals with DSI and their impact on VA resources.
Discontinued hearing-aid use is caused by a number of factors, most of which may lead to low hearing-aid self-efficacy (i.e. low confidence in one's ability to B a successful hearing-aid user). This paper describes the development of the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA), which was constructed in accordance with published recommendations for self-efficacy questionnaire development. The psychometric properties of the MARS-HA were evaluated with new and experienced hearing-aid users. The results revealed strong internal consistency and good test-retest reliability in both groups, with the following subscales identified both for the new users and the experienced users: (1) basic handling, (2) advanced handling, (3) adjustment to hearing aids, and (4) aided listening skills. Validity was established through the examination of expected differences based on group comparisons, training effects, and the impact of particular hearing aid features. The MARS-HA is a reliable and valid measure of hearing-aid self-efficacy and can be used to assist clinicians in identifying areas of low confidence that require additional audiologic training.
Findings from this randomized controlled trial show that LACE training does not result in improved outcomes over standard-of-care hearing aid intervention alone. Potential benefits of AT may be different than those assessed by the performance and self-report measures utilized here. Individual differences not assessed in this study should be examined to evaluate whether AT with LACE has any benefits for particular individuals. Clinically, these findings suggest that audiologists may want to temper the expectations of their patients who embark on LACE training.
As is the case in other health domains, clinical intervention by audiologists will be more effective when incorporating a self-efficacy framework in the audiologic rehabilitation process.
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