Publications by authors named "Jillian Roberts"

9 Publications

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Combined Electric and Acoustic Stimulation (EAS) in Children: Investigating Benefit Afforded by Bilateral Versus Unilateral Acoustic Hearing.

Otol Neurotol 2021 Apr 14. Epub 2021 Apr 14.

Hearts for Hearing, Tulsa, Oklahoma Boys Town National Research Hospital, Omaha, Nebraska Vanderbilt University Medical Center, Nashville, Tennessee.

Purpose: Electric and acoustic stimulation (EAS) with preserved hearing in the implanted ear provides benefit for speech understanding, spatial hearing, and quality of life in adults. However, there is limited research on EAS outcomes in children. The aims of this study were to estimate the magnitude of EAS-related benefit on speech understanding in children with preserved acoustic hearing and to determine what role acoustic interaural time difference (ITD) sensitivity may have on said EAS benefit.

Methods: Six children with acoustic hearing preservation and 20 children with normal hearing (NH) were recruited to participate. Speech recognition was assessed via an eight-loudspeaker array with speech presented from one loudspeaker at 0 degree and restaurant noise from all other loudspeakers (45-315 degrees). ITD thresholds were measured for a 250-Hz signal presented acoustically via insert earphones.

Results: Only one EAS listener demonstrated significant benefit from bilateral acoustic hearing as compared with acoustic hearing from a single ear. ITD thresholds were poor in the range of 302 to 1000+ ms and were considerably poorer than ITD thresholds for the NH group.

Conclusion: These data suggest that children with acoustic hearing preservation may not exhibit initial EAS benefit for speech recognition in semi-diffuse noise; however, because none exhibited a decrement in performance with bilateral acoustic stimulation, EAS fittings are recommended to provide binaural acoustic access allowing for EAS adaptation to binaural cues over time. Future research should address the emergence of EAS benefit, binaural cue sensitivity, and the role of EAS experience in children and adults.
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April 2021

Rapid upscale of depot buprenorphine (CAM2038) in custodial settings during the early COVID-19 pandemic in New South Wales, Australia.

Addiction 2021 02 21;116(2):426-427. Epub 2020 Sep 21.

Hunter New England Local Health District, Newcastle, NSW, Australia.

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February 2021

Feasibility and acceptability of take-home naloxone for people released from prison in New South Wales, Australia.

Drug Alcohol Rev 2021 Jan 17;40(1):98-108. Epub 2020 Aug 17.

National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.

Introduction And Aims: To assess the feasibility and acceptability of a take-home naloxone program for people with a history of opioid use released from prison in New South Wales, Australia.

Design And Methods: Cross-sectional interviews with people with a history of opioid use who were recently released from prison (n = 105), and semi-structured interviews with key clinical and operational staff of Justice Health and Forensic Mental Health Network and Corrective Services NSW (n = 9).

Results: Among people with a history of opioid use who had recently left prison, there was very high awareness of the elevated risk of overdose following release from prison (95%) and the potential for naloxone to reverse an opioid overdose (97%). Participants considered that their personal risk of overdose was low, despite ongoing opioid use being common. Participants were largely supportive of take-home naloxone, but the majority (83%) stated that proactively obtaining naloxone would be a low priority for them following release. Key informants were supportive of introducing naloxone training and supply and identified barriers to implementation, including adequate resourcing, identifying the population for training, and developing an appropriate model of training and implementation.

Discussion And Conclusion: There was widespread support for naloxone training in custody and distribution at release among people recently released from prison and key stakeholders in health-care provision and prisons administration. As proactively accessing naloxone is a low priority for patients, naloxone supply at release may be more effective than programs that refer releasees to local pharmacies, but developing a sustainable supply model requires consideration of several barriers.
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January 2021

Effect of Microphone Configuration and Sound Source Location on Speech Recognition for Adult Cochlear Implant Users with Current-Generation Sound Processors.

J Am Acad Audiol 2020 09 27;31(8):578-589. Epub 2020 Apr 27.

Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.

Background: Microphone location has been shown to influence speech recognition with a microphone placed at the entrance to the ear canal yielding higher levels of speech recognition than top-of-the-pinna placement. Although this work is currently influencing cochlear implant programming practices, prior studies were completed with previous-generation microphone and sound processor technology. Consequently, the applicability of prior studies to current clinical practice is unclear.

Purpose: To investigate how microphone location (e.g., at the entrance to the ear canal, at the top of the pinna), speech-source location, and configuration (e.g., omnidirectional, directional) influence speech recognition for adult CI recipients with the latest in sound processor technology.

Research Design: Single-center prospective study using a within-subjects, repeated-measures design.

Study Sample: Eleven experienced adult Advanced Bionics cochlear implant recipients (five bilateral, six bimodal) using a Naída CI Q90 sound processor were recruited for this study.

Data Collection And Analysis: Sentences were presented from a single loudspeaker at 65 dBA for source azimuths of 0°, 90°, or 270° with semidiffuse noise originating from the remaining loudspeakers in the R-SPACE array. Individualized signal-to-noise ratios were determined to obtain 50% correct in the unilateral cochlear implant condition with the signal at 0°. Performance was compared across the following microphone sources: T-Mic 2, integrated processor microphone (formerly behind-the-ear mic), processor microphone + T-Mic 2, and two types of beamforming: monaural, adaptive beamforming (UltraZoom) and binaural beamforming (StereoZoom). Repeated-measures analyses were completed for both speech recognition and microphone output for each microphone location and configuration as well as sound source location. A two-way analysis of variance using mic and azimuth as the independent variables and output for pink noise as the dependent variable was used to characterize the acoustic output characteristics of each microphone source.

Results: No significant differences in speech recognition across omnidirectional mic location at any source azimuth or listening condition were observed. Secondary findings were (1) omnidirectional microphone configurations afforded significantly higher speech recognition for conditions in which speech was directed to ± 90° (when compared with directional microphone configurations), (2) omnidirectional microphone output was significantly greater when the signal was presented off-axis, and (3) processor microphone output was significantly greater than T-Mic 2 when the sound originated from 0°, which contributed to better aided detection at 2 and 6 kHz with the processor microphone in this group.

Conclusions: Unlike previous-generation microphones, we found no statistically significant effect of microphone location on speech recognition in noise from any source azimuth. Directional microphones significantly improved speech recognition in the most difficult listening environments.
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September 2020

Intraoperative Electrically Evoked Compound Action Potential (ECAP) Measurements in Traditional and Hearing Preservation Cochlear Implantation.

J Am Acad Audiol 2019 Nov/Dec;30(10):918-926. Epub 2019 Jul 2.

Vanderbilt University Medical Center, Nashville, TN.

Background: In current practice, the status of residual low-frequency acoustic hearing in hearing preservation cochlear implantation (CI) is unknown until activation two to three weeks postoperatively. The intraoperatively measured electrically evoked compound action potential (ECAP), a synchronous response from electrically stimulated auditory nerve fibers, is one of the first markers of auditory nerve function after cochlear implant surgery and such may provide information regarding the status of residual low-frequency acoustic hearing.

Purpose: This study aimed to evaluate the relationship between intraoperative ECAP at the time of CI and presence of preoperative and postoperative low-frequency acoustic hearing.

Research Design: A retrospective case review.

Study Sample: Two hundred seventeen adult ears receiving CI (42 Advanced Bionics, 82 Cochlear, and 93 MED-EL implants).

Interventions: Intraoperative ECAP and CI.

Data Collection And Analysis: ECAP measurements were obtained intraoperatively, whereas residual hearing data were obtained from postoperative CI activation audiogram. A linear mixed model test revealed no interaction effects for the following variables: manufacturer, electrode location (basal, middle, and apical), preoperative low-frequency pure-tone average (LFPTA), and postoperative LFPTA. The postoperative residual low-frequency hearing status was defined as preservation of unaided air conduction thresholds ≤90 dB at 250 Hz. Electrode location and hearing preservation data were analyzed individually for both the ECAP threshold and ECAP maximum amplitude using multiple t-tests, without assuming a consistent standard deviation between the groups, and with alpha correction.

Results: The maximum amplitude, in microvolts, was significantly higher throughout apical and middle regions of the cochlea in patients who had preserved low-frequency acoustic hearing as compared with those who did not have preserved hearing (p = 0.0001 and p = 0.0088, respectively). ECAP threshold, in microamperes, was significantly lower throughout the apical region of the cochlea in patients with preserved low-frequency acoustic hearing as compared with those without preserved hearing (p = 0.0099). Basal electrode maximum amplitudes and middle and basal electrode thresholds were not significantly correlated with postoperative low-frequency hearing.

Conclusions: Apical and middle electrode maximum amplitudes and apical electrode thresholds detected through intraoperative ECAP measurements are significantly correlated with preservation of low-frequency acoustic hearing. This association may represent a potential immediate feedback mechanism for postoperative outcomes that can be applied to all CIs.
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October 2020

Determination of ochratoxin A in cocoa beans using immunoaffinity column cleanup with high-performance liquid chromatography.

J AOAC Int 2014 May-Jun;97(3):884-8

A method was developed and validated for the determination of ochratoxin A (OTA), a fungal metabolite, in cocoa beans of high fat content. The sample was extracted by blending with a 1% sodium bicarbonate solution (pH 10) followed by ultrasonication, and the sample was defatted by treatment with a flocculant. The defatted sample was purified using immunoaffinity column chromatography, and OTA was detected using HPLC with fluorescence detection. The method was fully optimized, validated, and quality controlled using spike recovery analyses, with recoveries of 89-105% over spiking ranges of 320-2.5 ng/g with CV of analyses generally <10% over 4 consecutive years and an LOQ of 0.66 ng/g in cocoa bean samples. This method overcomes the problems posed by the high fat contents of cocoa and chocolate samples with a high degree of reliability.
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August 2014

Icteric skin, sclera and mucous membranes.

Adv Nurse Pract 2007 Sep;15(9):21-2

Shands Jacksonville Hospital, USA.

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September 2007

The quality of life of elderly women who underwent radiofrequency ablation to treat breast cancer.

Qual Health Res 2006 Jul;16(6):762-72

University of Victoria, British Columbia, Canada.

The purpose of this article is to explore the effects of radiofrequency ablation (RFA), an investigational treatment for breast cancer, on the quality of life of elderly women. For this descriptive phenomenological study, the authors interviewed 12 White women (aged 60-81 years) 4 months to 1 year after treatment and analyzed these interviews for common themes. They asked questions regarding the lived experience of RFA treatment and its effects on quality of life. Analyses focused on the effects of deciding to have the RFA treatment and the treatment itself. They found quality of life improved because the women felt empowered by (a) their decision to have the procedure, (b) knowing that the procedure might kill the tumor, (c) and feeling that they were contributing to cancer research. The level of support received from the medical team, family and friends, and other cancer survivors also improved participant quality of life.
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July 2006

Quality of life of patients who have undergone the Nuss procedure for pectus excavatum: Preliminary findings.

J Pediatr Surg 2003 May;38(5):779-83

University of Victoria, Victoria, British Columbia, Canada.

Background/purpose: The current project is a preliminary qualitative exploration of changes in quality of life of patients who have undergone the Nuss Procedure. The current study explores quality of life after surgical repair from the perspectives of both the patients and the parent(s) of the younger participants.

Methods: This research constitutes the first segment in a mixed-method longitudinal design. The author conducted semistructured interviews based on the Keith and Schalock's quality of life model. Five youth who have undergone the Nuss Procedure and the parent(s) of the 4 younger participants were included in the study for a total of 10 participants. Textual analysis has been carried out using Atlas.ti, a qualitative data analysis program that facilitates such activities as selecting, coding, and comparing textual segments.

Results: Results based on these preliminary data indicate that the patients interviewed had significant improvement in overall quality of life, which they attributed to the surgery. Specific examples of patients' expressions of improved self-confidence and renewed interest in physical activity are given.

Conclusions: The Nuss Procedure is a minimally invasive surgical option for correcting pectus excavatum deformities that may make important contributions to patients' self-perceptions and quality of life. The participants in the current study expressed satisfaction with both the physical results of the surgery and with how it improved their overall quality of life. The authors recommend further prospective longitudinal research that assesses pre- and postsurgery psychosocial status and the maintenance of perceived quality of life changes.
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May 2003