Publications by authors named "Julia Campbell"

35 Publications

An Evaluation of Post-Concussion Return to School Guidelines: A Survey of Massachusetts School Nurses.

J Sch Nurs 2021 Jul 21:10598405211032210. Epub 2021 Jul 21.

Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA.

Although all states have legislation pertaining to youth sports concussion, most of these laws focus on return-to-play procedures; only a few address return-to-learn (RTL) accommodations for students who have experienced a concussion. To address this gap in the legislation, some states and nongovernmental organizations have developed RTL guidelines to advise school personnel, parents, and health care providers on best practices for accommodating students' postconcussion reintegration into academic activity. In 2018, the Massachusetts Department of Public Health (MDPH) developed RTL guidelines which were disseminated to school nurses (SNs) at all public and nonpublic middle and high schools in the state. In 2020, the MDPH engaged the Injury Prevention Center at Boston Medical Center to survey Massachusetts SNs to assess the usefulness of the guidelines. The response rate was 63%; 92% found the booklet extremely useful or moderately useful; and 70% endorsed that the booklet fostered collaboration among stakeholders.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/10598405211032210DOI Listing
July 2021

All-Cause Mortality and Incidence of Major Adverse Cardiac Events in Sickle Cell Nephropathy: A Comparative Study.

Cureus 2021 May 16;13(5):e15059. Epub 2021 May 16.

Internal Medicine, Grand Strand Medical Center, Myrtle Beach, USA.

Background Sickle cell disease (SCD) is an autosomal recessive disease resulting in hemolytic anemia and recurrent vaso-occlusive events. Consequently, it can result in a broad range of functional and structural renal and cardiac alterations. Chronic kidney disease (CKD), in SCD, is associated with proteinuria, microalbuminuria, and hemoglobinuria. Cardiac complications in SCD include pulmonary hypertension, left ventricular diastolic heart disease, dysrhythmia, and sudden death. In patients with advancing age, cardio-renal dysfunction can have substantial effects on morbidity and mortality. Our primary aim was to compare the incidence of major adverse cardiac events (MACE) and all-cause mortality in sickle cell nephropathy (SCN). Methods In this retrospective study, we used International Classification of Diseases (ICD)-10 codes to identify admissions in 2019 with a diagnosis of MACE with a prior diagnosis of SCD and/or SCN. Our search of the HCA Healthcare Enterprise Data Warehouse for adult patients >18 years yielded 6,693 patients with SCD, of which 658 patients (9.8%) had SCN. Primary endpoints were incidence of MACE and all-cause mortality. Patients with MACE encompassed those with nonfatal stroke, nonfatal myocardial infarction, and congestive heart failure (CHF) exacerbations. A secondary endpoint was length of stay (LOS). Logistic regression analysis was used for MACE and all-cause mortality. LOS was analyzed using multiple linear regression analysis. Results were considered statistically significant for analyses showing p <0.05. All outcomes were adjusted for demographic variables and comorbidities. Results Logistic regression, after adjustment for comorbidities, demonstrated that SCN patients had significantly higher odds of all-cause mortality (odds ratio [OR] 2.343, p = 0.035, 95% confidence interval [CI] 1.063-5.166) compared to patients without SCN. Compared to those without SCN, those with SCN did not have a higher odds of MACE (OR 1.281, p = 0.265, 95% CI 0.828-1.982). Linear regression for LOS did not reveal a significant association with SCN (p = 0.169, 95% CI 0.157-0.899). Conclusion Based on the analysis of 6,693 patients with SCD, SCN was associated with significantly higher odds of all-cause mortality. SCN was not associated with significantly higher odds of MACE or prolonged LOS.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.15059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205106PMC
May 2021

Evaluation of the One Love Escalation Workshop for Dating Abuse Prevention: a Randomized Controlled Trial Pilot Study with a Sample of US Navy Sailors.

Prev Sci 2021 11 14;22(8):1060-1070. Epub 2021 Apr 14.

School of Public Health, Boston University, 801 Massachusetts Ave, Boston, MA, 02118, USA.

The purpose of this study was to evaluate the efficacy of the Escalation Workshop with a sample of US Navy sailors. Escalation is a one-session workshop designed to promote bystander behavior related to dating abuse. We conducted a two-arm RCT with follow-up at 4 and 8 months. Participants were 335 Navy sailors, recruited from two comparable ships based in the USA. The unit of randomization was the ship. The primary outcomes were as follows: (a) attitudes related to intervening as a bystander in dating abuse situations, (b) injunctive norms about dating abuse, (c) dating abuse-related prevention-oriented behaviors (e.g., such as posting dating violence prevention messages online), and (d) bystander behaviors including acting as a bystander to prevent peer self-harm, peer bullying, peer intoxication, or peer dating abuse, or being a proactive bystander and initiating conversations about dating abuse prevention with friends and others. Hierarchal linear models (HLMs) indicated that, compared to participants in the control group, participants in the intervention group demonstrated improvement in attitudes [β = .09, p < .001] and had more engagement than controls in prevention-oriented behavior at 8-month follow-up [β = 0.11, p < .01]. Those in the intervention group also reported larger increases than controls in bystander behavior related to peer self-harm, peer bullying, peer intoxication, and starting conversations about dating abuse. Results for dating abuse bystander behavior were mixed. At 4 months, workshop participation was marginally associated with increased bystander behavior with peers who had perpetrated dating abuse (β = 0.89, p = 0.06) and with peers experiencing physical or sexual dating abuse, or stalking or threats (β = 1.11, p = .07). However, workshop participation was not associated with increased bystander behavior with peers experiencing only physical abuse. The Escalation Workshop may be a promising strategy to promote change in dating abuse-related attitudinal change and prevention-oriented behavior, and bystander behavior with peers related to self-harm, bullying, intoxication, and some aspects of dating abuse prevention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11121-021-01240-9DOI Listing
November 2021

Approaches for Monitoring Warfighter Blast-related Exposures in Training to Develop Effective Safety Standards.

Mil Med 2021 01;186(Suppl 1):515-522

Department of Neurology, The University of Texas Dell Medical School, Austin, TX, 78712, USA.

Introduction: Traumatic brain injuries are of concern to the sports and military communities because of the age of the participants and costly burden to society. To markedly reduce the impact of traumatic brain injury and its sequela (TBI-S), it is necessary to determine the initial vulnerability of individuals as well as identify new technologies that indicate early signs of TBI-S.

Materials And Methods: Currently, diverse methods have been used by the authors and others in laboratory settings to reveal early signs of persistent TBI-S including simulation modeling of the effect of rapid deceleration on the deviatoric strain (shear force) imposed on specific brain regions, auditory evoked potential (AEP) measurements to determine injury to the auditory cortex optokinetic nystagmus (OKN) measures sensitive to vestibular trauma, and optical coherence tomography (OCT) measures that reveal changes in central visual function obtained noninvasively by examination of the retina.

Results: Simulation studies provided technical information on maximal deviatoric strain at the base of the sulci and interface of gray and white matter consistent with results from neuropathology and from magnetic resonance imaging. The AEP and OKN reveal measurable injury to similar regions below the Sylvian fissure including auditory cortex and midbrain, and the OCT reveals changes to the retina consistent with forceful deceleration effects.

Conclusions: The studies and results are consistent with prior work demonstrating that noninvasive tests may be sensitive to the presence of TBI-S, potentially in the training field as advances in the portability of test instruments are underway. When combined with baseline data gathered from individuals in quantitative form, key variances can emerge. Therefore, it is hypothesized that AEP, OKN, and OCT, taken together, may yield faster objective and quantitative neurophysiological measures serving as a "signature" of neural injury and more indicative of potentially persistent TBI-S-recommending larger scale longitudinal studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/milmed/usaa426DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7980484PMC
January 2021

It is time to rewrite state youth sports concussion laws.

BMJ Open Sport Exerc Med 2021 6;7(1):e000959. Epub 2021 Jan 6.

Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.

Between 2009 and 2014, all 50 states and the District of Columbia passed legislation to improve the recognition and management of youth concussed in sports. These laws can include requirements for concussion training for school athletic personnel, concussion education for children and their parents, return-to-play (RTP) procedures, and medical clearance to for RTP. Concussion can impact academic learning and performance in children and adolescents. Postconcussion academic accommodations during recovery can be an important component of secondary prevention for mitigating the sequalae of head injury. Few state youth concussion laws, however, include provision of postconcussion return-to-learn (RTL) accommodations and most of those that do address RTL apply to student athletes only. Concussions may occur in youth who are not participating in organised sports (eg, falls, traffic crashes) and thus may not be subjected to RTL accommodations, even if the state mandates such procedures for athletes. Low income and students of colour may be more likely to have non-sports concussions than their more affluent and white peers, thus potentially creating demographic disparities in the benefits of RTL procedures. State youth sports concussion laws should be revised so that they include RTL provisions that apply to all students, athletes and non-athletes alike.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjsem-2020-000959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789433PMC
January 2021

Social Anxiety as a Consequence of Non-consensually Disseminated Sexually Explicit Media Victimization.

J Interpers Violence 2020 Oct 27:886260520967150. Epub 2020 Oct 27.

Boston University School of Public Health, Boston, MA, USA.

The purpose of this qualitative study was to explore consequences of the non-consensual dissemination of sexually explicit media (NCDSEM) for survivors, with an emphasis on how NCDSEM may impact social relationships and social anxiety. One-on-one telephone interviews with ( = 17) self-identified survivors of NCDSEM were conducted between May and December 2019. Interviews were analyzed using a flexible coding methodology. There were five main ways in which participants described consequences of NCDSEM: (a) fear of going out in public, (b) fear of engaging in relationships, (c) fear of applying to jobs, (d) fear of seeking help, and (e) influencing depression and feelings of anxiety. These findings suggest that, for some people, NCDSEM victimization may influence whether and how they subsequently socialize with other people.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0886260520967150DOI Listing
October 2020

"He Would Take My Shoes and All the Baby's Warm Winter Gear so We Couldn't Leave": Barriers to Safety and Recovery Experienced by a Sample of Vermont Women With Partner Violence and Opioid Use Disorder Experiences.

J Rural Health 2021 01 14;37(1):35-44. Epub 2020 Sep 14.

Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.

Purpose: This qualitative study explored themes about barriers to substance use treatment for women who experience intimate partner violence (IPV) and opioid use in rural Vermont. The goal was to collect descriptive information to aid in the development of intervention ideas to facilitate better treatment access for women in this situation.

Methods: One-on-one telephone interviews with 33 rural Vermont women who experienced both IPV and opioid use took place between February and August 2019.

Findings: There were 5 main themes that emerged as barriers to accessing needed services: (1) geographic isolation and transportation difficulties, (2) inaccessibility of existing services, (3) lack of integrated substance use treatment and domestic violence services, (4) social isolation, and (5) amplification of stigma in small rural communities.

Conclusions: Improved access to care and increased collaboration between IPV and substance use service providers are required to better serve rural communities in which IPV and opioid use disorder are concurrent problems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jrh.12518DOI Listing
January 2021

Frontal Cortical Modulation of Temporal Visual Cross-Modal Re-organization in Adults with Hearing Loss.

Brain Sci 2020 Jul 30;10(8). Epub 2020 Jul 30.

Anu Sharma, Brain and Behavior Laboratory, Institute of Cognitive Science, Department of Speech, Language and Hearing Science, University of Colorado at Boulder, 409 UCB, 2501 Kittredge Loop Drive, Boulder, CO 80309, USA.

Recent research has demonstrated frontal cortical involvement to co-occur with visual re-organization, suggestive of top-down modulation of cross-modal mechanisms. However, it is unclear whether top-down modulation of visual re-organization takes place in mild hearing loss, or is dependent upon greater degrees of hearing loss severity. Thus, the purpose of this study was to determine if frontal top-down modulation of visual cross-modal re-organization increased across hearing loss severity. We recorded visual evoked potentials (VEPs) in response to apparent motion stimuli in 17 adults with mild-moderate hearing loss using 128-channel high-density electroencephalography (EEG). Current density reconstructions (CDRs) were generated using sLORETA to visualize VEP generators in both groups. VEP latency and amplitude in frontal regions of interest (ROIs) were compared between groups and correlated with auditory behavioral measures. Activation of frontal networks in response to visual stimulation increased across mild to moderate hearing loss, with simultaneous activation of the temporal cortex. In addition, group differences in VEP latency and amplitude correlated with auditory behavioral measures. Overall, these findings support the hypothesis that frontal top-down modulation of visual cross-modal re-organization is dependent upon hearing loss severity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/brainsci10080498DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465622PMC
July 2020

Disparities in baseline neurocognitive testing for student concussion management in Massachusetts high schools.

BMJ Open Sport Exerc Med 2020 28;6(1):e000752. Epub 2020 May 28.

Department of Emergency Medicine, Boston University Medical Center, Boston, Massachusetts, USA.

Purpose: There is evidence of socioeconomic disparities with respect to the implementation of student-sports concussion laws nationally. The purpose of this study was to examine school sociodemographic characteristics associated with the provision of computerised baseline neurocognitive testing (BNT) in Massachusetts (MA) high schools, and to assess whether the scope of testing is associated with the economic status of student populations in MA.

Methods: A cross-sectional secondary analysis of surveys conducted with MA athletic directors (n=270) was employed to investigate school characteristics associated with the provision of BNT. Correlation and regression analyses were used to assess whether the scope of testing is associated with the economic status of student populations in MA.

Results: The scope of BNT was independently associated with the economic disadvantage rate (EDR) of the student population (β=-0.02, p=0.01); whether or not the school employs an athletic trainer (AT) (β=0.43, p=0.03); and school size (β=-0.54, p=0.03). In a multivariable regression model, EDR was significantly associated with the scope of baseline testing, while controlling for AT and size (β=-0.01, p=0.03, adj-R=0.1135).

Conclusion: Among public high schools in MA, disparities in the provision of BNT for students are associated with the economic characteristics of the student body. Schools that have a greater proportion of low-income students are less likely to provide comprehensive BNT. The clinical implications of not receiving BNT prior to concussion may include diminished quality of postconcussive care, which can have short-term and long-term social, health-related and educational impacts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjsem-2020-000752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264696PMC
May 2020

Evaluation of Implementation of Massachusetts Sports Concussion Regulations: Results of Focus Groups with Athletic Directors.

Cureus 2020 Apr 16;12(4):e7691. Epub 2020 Apr 16.

Emergency Medicine, Boston Medical Center, Boston, USA.

In 2018, the Massachusetts Department of Public Health (MDPH) conducted focus groups with athletic directors (ADs) from Massachusetts middle and high schools to assess the implementation of legislated regulations relative to the management of concussion (mild traumatic brain injuries; mTBI) among students engaged in extracurricular sports. Two tape-recorded focus groups were conducted with a facilitator. Lists of themes were synthesized by investigators. Overall, participating ADs expressed that the law and accompanying regulations were necessary and important for protecting student athletes, despite some burdensome aspects of implementation. Emerging themes included support for the law, some implementation problems, impact on workload, and recommendations for improving mandated procedures. ADs assume an important role in the management of middle and high school students' mTBI when given the authority to do so through legislation and regulation. Nonetheless, challenges to the daily application of legislated protocols exist and should continue to be evaluated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.7691DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233511PMC
April 2020

Sensory Inhibition Is Related to Variable Speech Perception in Noise in Adults With Normal Hearing.

J Speech Lang Hear Res 2020 05 13;63(5):1595-1607. Epub 2020 May 13.

Department of Communication Sciences and Disorders, Central Sensory Processes Laboratory, The University of Texas at Austin.

Purpose Speech perception in noise (SPiN) varies widely in individuals with normal hearing, which may be attributed to factors that are not reflected in the audiogram, such as inhibition. However, inhibition is involved at both sensory and cognitive stages of auditory perception, and while inhibition at the cognitive level has been shown to be a significant factor in SPiN processes, it is unknown whether sensory inhibition may also contribute to SPiN variability. Therefore, the goal of this study was to evaluate sensory inhibition in adults with normal hearing and mild SPiN impairment. Method Cortical auditory evoked potentials (CAEPs) were recorded in 49 adults via high-density electroencephalography using an auditory gating paradigm. Participants were categorized according to a median signal-to-noise ratio (SNR) loss of 1.5 dB: typical SNR loss ≤ 1.5 dB ( = 32), mild SNR loss > 1.5 dB ( = 17). CAEP gating responses were compared and correlated with SNR loss and extended high-frequency thresholds. Current density reconstructions were performed to qualitatively observe underlying cortical inhibitory networks in each group. Results In comparison to adults with typical SPiN ability, adults with mild SPiN impairment showed an absence of the gating response. A CAEP gating component (P2) reflected decreased sensory inhibition and correlated with increased SNR loss. Extended high-frequency thresholds were also found to correlate with SNR loss, but not gating function. An atypical cortical inhibitory network was observed in the mild SNR loss group, with reduced frontal and absent prefrontal activation. Conclusion Sensory inhibition appears to be atypical and related to SPiN deficits in adults with mild impairment. In addition, cortical inhibitory networks appear to be incomplete, with a possible compensatory parietal network. Further research is needed to delineate between types or levels of central inhibitory mechanisms and their contribution to SPiN processes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1044/2020_JSLHR-19-00261DOI Listing
May 2020

Auditory Gating in Hearing Loss.

J Am Acad Audiol 2020 09 27;31(8):559-565. Epub 2020 Apr 27.

Department of Communication Sciences and Disorders, University of Texas at Austin, Austin, Texas.

Background: Sensory gating is a measure used to evaluate inhibitory deficits underlying neurological disorders. However, the effects of hearing loss (HL), thought to decrease inhibition, remain unknown on gating function.

Purpose: The goal of this study was to investigate gating performance in HL.

Research Design: This was a prospective, cross-sectional study with independent group comparison and correlational design.

Study Sample: Eleven adults (mean age/standard deviation = 47.546 ± 7.967 years) with normal hearing (NH) and 11 adults (mean age/standard deviation = 56.273 ± 13.871 years) with mild-moderate high-frequency HL.

Data Collection And Analysis: Cortical auditory evoked potentials (CAEPs) were recorded in response to tonal pairs via high-density electroencephalography. The CAEP response to the second tone in the pair (S2) was compared with the response to the first tone in the pair (S1) within groups. Amplitude gating indices were compared between groups and correlated with auditory behavioral measures. Current density reconstructions were performed to estimate cortical gating generators.

Results: Amplitude gating indices were decreased and correlated with elevated auditory thresholds. Gating generators in temporal, frontal, and prefrontal regions were localized in the NH group, while HL gating was localized in mainly temporal and parietal areas.

Conclusions: Reduced inhibition may be associated with compensatory cortical gating networks in HL and should be considered when utilizing gating in clinical populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1055/s-0040-1709517DOI Listing
September 2020

Perceptions of implementation of Massachusetts sports concussion regulations: results of a survey of athletic directors.

Inj Epidemiol 2020 Apr 20;7(1):13. Epub 2020 Apr 20.

Department of Counseling & School Psychology, University of Massachusetts Boston, Boston, MA, USA.

Background: In 2011 the Massachusetts Department of Public Health issued regulations pursuant to 2010 Massachusetts youth sports concussion legislation that provided policies and procedures for persons engaged in the prevention, training, management, and return-to-activity for students who sustain head injury during interscholastic athletics, including Athletic Directors (ADs).

Methods: A survey instrument was developed with participation from injury prevention experts at the Boston University School of Medicine, the Massachusetts Department of Public Health, and ADs. An electronic survey was sent to all AD members of the Massachusetts Interscholastic Athletic Association to assess their perceptions of implementation of the sports concussion law.

Results: Response rate was 75% (260/346). The mean rating on a 0-10 scale (10 being "very important") on importance of the law for student safety was 9.24, and the mean rating of the law's impact on workload was 5.54. Perceived impact on workload varied as a function of whether or not the school also employed an athletic trainer (t = 2.24, p = 0.03). Most respondents (88%) reported that their school had a concussion management team, and 74% reported that they were informed "always" (31%) or "often" (43%) when a student-athlete experienced a head injury in a venue other than extracurricular sports. Most respondents (95%) endorsed that "all" or "most" school nurses were "very knowledgeable" about the law and regulations. Approximately half of all respondents endorsed that "all" or "most" teachers and guidance counselors were "very knowledgeable" about the law and regulations; 76% endorsed that "all" or "most" of students' physicians were "very knowledgeable" about the law and regulations; 59% endorsed that "all" or "most" parents were "very knowledgeable" about the law and regulations. Sixty-six percent endorsed that student-athletes with concussion "often" (10%) or "sometimes" (56%) misrepresent their symptoms to accelerate return-to-play; and, 70% perceived that student-athletes with concussion "often" (15%) or "sometimes" (55%) misrepresent their symptoms to avoid academics.

Conclusions: ADs perceive the sports concussion legislation as very important to student safety and positively assess implementation of the law and associated regulations. More effort is needed to increase understanding of the law among stakeholders including teachers, parents, and physicians.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40621-020-00240-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168948PMC
April 2020

Stimulus-specific Cortical Visual Evoked Potential Morphological Patterns.

J Vis Exp 2019 05 12(147). Epub 2019 May 12.

Department of Communication Sciences and Disorders, The University of Texas at Austin; Central Sensory Processes Laboratory, The University of Texas at Austin.

This paper presents a methodology for the recording and analysis of cortical visual evoked potentials (CVEPs) in response to various visual stimuli using 128-channel high-density electroencephalography (EEG). The specific aim of the described stimuli and analyses is to examine whether it is feasible to replicate previously reported CVEP morphological patterns elicited by an apparent motion stimulus, designed to simultaneously stimulate both ventral and dorsal central visual networks, using object and motion stimuli designed to separately stimulate ventral and dorsal visual cortical networks.  Four visual paradigms are presented: 1. Randomized visual objects with consistent temporal presentation. 2. Randomized visual objects with inconsistent temporal presentation (or jitter).  3. Visual motion via a radial field of coherent central dot motion without jitter.  4. Visual motion via a radial field of coherent central dot motion with jitter.  These four paradigms are presented in a pseudo-randomized order for each participant.  Jitter is introduced in order to view how possible anticipatory-related effects may affect the morphology of the object-onset and motion-onset CVEP response.  EEG data analyses are described in detail, including steps of data exportation from and importation to signal processing platforms, bad channel identification and removal, artifact rejection, averaging, and categorization of average CVEP morphological pattern type based upon latency ranges of component peaks. Representative data show that the methodological approach is indeed sensitive in eliciting differential object-onset and motion-onset CVEP morphological patterns and may, therefore, be useful in addressing the larger research aim. Given the high temporal resolution of EEG and the possible application of high-density EEG in source localization analyses, this protocol is ideal for the investigation of distinct CVEP morphological patterns and the underlying neural mechanisms which generate these differential responses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3791/59146DOI Listing
May 2019

Auditory Gating and Extended High-Frequency Thresholds in Normal-Hearing Adults With Minimal Tinnitus.

Am J Audiol 2019 Apr;28(1S):209-224

Department of Communication Sciences and Disorders, The University of Texas at Austin.

Purpose The goal of this study was to assess whether peripheral auditory sensitivity in frequency regions above 8 kHz is related to central inhibitory function, as measured through a sensory gating paradigm, in normal-hearing adults with tinnitus (TINN) and without tinnitus (NTINN). The contribution of gating processes and peripheral sensitivity in extended high frequencies to tinnitus severity was evaluated via a hierarchical multiple regression method. Method Cortical auditory evoked potentials (CAEPs) were recorded in response to pairs of tones in normal-hearing adults without tinnitus, NTINN ( n = 45), and adults with tinnitus, TINN ( n = 21). CAEP peak component amplitude, latency, and gating indices were compared and correlated with extended high-frequency (EHF) pure-tone averages (PTAs) across groups and with tinnitus severity. An exploratory analysis was performed to investigate gating variability within the TINN group. Based on Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996) median scores, the TINN group was categorized into low- and high-median subgroups, and gating indices were compared between these subgroups. A hierarchical multiple regression analysis was performed to determine the amount of variance accounted for in the TINN group. Results Decreased gating via the CAEP Pa component and increased gating via the N1 component correlated with increased tinnitus severity, even in individuals who would traditionally be classified as having no tinnitus handicap. In the TINN group, lower EHF PTA thresholds correlated with tinnitus severity and decreased Pa gating. Individuals with a greater severity of tinnitus demonstrated atypical gating function reflected in both Pa and N1 components. Gating function and EHF PTA accounted for significant variance regarding tinnitus severity. Conclusions A trade-off between lower and higher level gating function was observed in adults with normal hearing and tinnitus, indicative of higher order compensatory mechanisms. Better cochlear sensitivity in extended high frequencies was related to decreased lower level gating processes and increased tinnitus THI scores, suggestive of an interaction between decreased gating and heightened auditory awareness. We are currently exploring whether gating processes in this population are compensatory, and the role of gating in auditory awareness.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1044/2019_AJA-TTR17-18-0036DOI Listing
April 2019

Normal hearing young adults with mild tinnitus: Reduced inhibition as measured through sensory gating.

Audiol Res 2018 Oct 2;8(2):214. Epub 2018 Oct 2.

Department of Communication Sciences and Disorders; Central Sensory Processes Laboratory, University of Texas at Austin, Austin, Texas, USA.

Decreased central inhibition, possibly related to hearing loss, may contribute to chronic tinnitus. However, many individuals with normal hearing thresholds report tinnitus, suggesting that the percept in this population may arise from sources other than peripheral deafferentation. One measure of inhibition is sensory gating. Sensory gating involves the suppression of non-novel input, and is measured through cortical auditory evoked potential (CAEP) responses to paired stimuli. In typical gating function, amplitude suppression is observed in the second CAEP response when compared to the first CAEP response, illustrating inhibitory activity. Using this measure, we investigated central inhibitory processes in normal hearing young adults with and without mild tinnitus to determine whether inhibition may be a contributing factor to the tinnitus percept. Results showed that gating function was impaired in the tinnitus group, with the CAEP Pa component significantly correlated with tinnitus severity. Further exploratory analyses were conducted to evaluate variability in gating function within the tinnitus group, and findings showed that high CAEP amplitude suppressors demonstrated gating performance comparable to adults without tinnitus, while low amplitude suppressors exhibited atypical gating function.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4081/audiores.2018.214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199556PMC
October 2018

Naproxen Is Transformed Via Acetogenesis and Syntrophic Acetate Oxidation by a Methanogenic Wastewater Consortium.

Microb Ecol 2018 Aug 11;76(2):362-371. Epub 2018 Jan 11.

Department of Environmental Sciences, Rutgers University, New Brunswick, NJ, USA.

Over-the-counter pharmaceutical compounds can serve as microbial substrates in wastewater treatment processes as well as in the environment. The metabolic pathways and intermediates produced during their degradation, however, are poorly understood. In this study, we investigate an anaerobic wastewater community that metabolizes naproxen via demethylation. Enriched cultures, established from anaerobic digester inocula receiving naproxen as the sole carbon source, transformed naproxen to 6-O-desmethylnaproxen (DMN) within 22 days. Continual enrichment and culture transfer resulted in consistent demethylation of naproxen with no loss of DMN observed. Methane was generated at 0.83 mmol per 1 mmol transformed naproxen. In addition to naproxen, the consortium readily demethylated syringic acid and vanillic acid. DNA analysis revealed a community of acetogenic bacteria and syntrophic acetate oxidizing archaea. Combined with the biotransformation data, this suggests the enriched consortium performs aromatic O-demethylation through a syntrophic relationship between specific acetogens, acetate oxidizers, and methanogens. The proposed model of carbon transfer through the anaerobic food web highlights the significance of linked community interactions in the anaerobic transformation of aromatic O-methyl compounds such as naproxen.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00248-017-1136-2DOI Listing
August 2018

The Case for an Epilepsy and Clinical Neurophysiology Match.

Pediatr Neurol 2017 07 19;72:5-6. Epub 2017 Apr 19.

Pediatric Neurology Division, Nationwide Children's Hospital, Columbus, Ohio.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pediatrneurol.2017.04.017DOI Listing
July 2017

Challenges in Implementation of the New Accreditation System.

J Child Neurol 2017 03 27;32(4):397-402. Epub 2016 Dec 27.

1 Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Despite major changes in US Graduate Medical Education, from Core Competencies (2002) to the Next Accreditation System (2012), few studies have evaluated the role of the Residency Coordinator in program accreditation. This role may be especially challenging in child neurology, which involves separate, accredited child and adult neurology residencies. The present study of Child Neurology Program Coordinators evaluated workforce factors and first-year implementation of new training requirements. The response rate was 65% (48/74). Concerning workforce features included high turnover, unpaid overtime, inconsistent job titles, limited career paths, inadequate training, and nonacademic supervision. Programs' average implementation of 14 new accreditation items averaged 7.5 (standard deviation 2.5). This survey demonstrated that greater Next Accreditation System implementation is linked to increased coordinator experience, supervision within Graduate Medical Education, and greater administrative support for the coordinator role. Changes in these areas could improve future compliance of US child neurology programs with Graduate Medical Education accreditation requirements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0883073816685241DOI Listing
March 2017

Intervention Mapping to Develop a Print Resource for Dog-Walking Promotion in Canada.

J Vet Med Educ Summer 2017;44(2):234-246. Epub 2016 Oct 25.

Promoting dog walking among dog owners is consistent with One Health, which focuses on the mutual health benefits of the human-animal relationship for people and animals. In this study, we used intervention mapping (a framework to develop programs and resources for health promotion) to develop a clearer understanding of the determinants of dog walking to develop curricular and educational resources for promoting regular dog walking among dog owners. Twenty-six adult dog owners in Ontario participated in a semi-structured interview about dog walking in 2014. Thematic analysis entailing open, axial, and selective coding was conducted. Among the reasons why the participating dog owners walk their dog were the obligation to the dog, the motivation from the dog, self-efficacy, the dog's health, the owner's health, socialization, a well-behaved dog, and having a routine. The main barriers to dog walking were weather, lack of time, the dog's behavior while walking, and feeling unsafe. We compared interview results to findings in previous studies of dog walking to create a list of determinants of dog walking that we used to create a matrix of change objectives. Based on these results, we developed a print resource to promote regular dog walking among dog owners. The findings can be used by veterinary educators to inform course content that specifically educates veterinary students on the promotion of dog walking among dog owners and the benefits to both humans and animals. The study also offers veterinarians a further understanding upon which to initiate a conversation and develop educational resources for promoting regular dog walking among dog-owning clients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3138/jvme.1115-189RDOI Listing
August 2017

Distinct Visual Evoked Potential Morphological Patterns for Apparent Motion Processing in School-Aged Children.

Front Hum Neurosci 2016 28;10:277. Epub 2016 Jun 28.

Brain and Behavior Laboratory, Department of Speech, Language and Hearing Science, Institute of Cognitive Science, University of Colorado Boulder, Boulder, CO USA.

Measures of visual cortical development in children demonstrate high variability and inconsistency throughout the literature. This is partly due to the specificity of the visual system in processing certain features. It may then be advantageous to activate multiple cortical pathways in order to observe maturation of coinciding networks. Visual stimuli eliciting the percept of apparent motion and shape change is designed to simultaneously activate both dorsal and ventral visual streams. However, research has shown that such stimuli also elicit variable visual evoked potential (VEP) morphology in children. The aim of this study was to describe developmental changes in VEPs, including morphological patterns, and underlying visual cortical generators, elicited by apparent motion and shape change in school-aged children. Forty-one typically developing children underwent high-density EEG recordings in response to a continuously morphing, radially modulated, circle-star grating. VEPs were then compared across the age groups of 5-7, 8-10, and 11-15 years according to latency and amplitude. Current density reconstructions (CDR) were performed on VEP data in order to observe activated cortical regions. It was found that two distinct VEP morphological patterns occurred in each age group. However, there were no major developmental differences between the age groups according to each pattern. CDR further demonstrated consistent visual generators across age and pattern. These results describe two novel VEP morphological patterns in typically developing children, but with similar underlying cortical sources. The importance of these morphological patterns is discussed in terms of future studies and the investigation of a relationship to visual cognitive performance.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnhum.2016.00277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923113PMC
July 2016

Visual Cross-Modal Re-Organization in Children with Cochlear Implants.

PLoS One 2016 25;11(1):e0147793. Epub 2016 Jan 25.

Brain and Behavior Laboratory, University of Colorado at Boulder, 409 UCB, 2501 Kittredge Loop Road, Boulder, Colorado, 80309, United States of America.

Background: Visual cross-modal re-organization is a neurophysiological process that occurs in deafness. The intact sensory modality of vision recruits cortical areas from the deprived sensory modality of audition. Such compensatory plasticity is documented in deaf adults and animals, and is related to deficits in speech perception performance in cochlear-implanted adults. However, it is unclear whether visual cross-modal re-organization takes place in cochlear-implanted children and whether it may be a source of variability contributing to speech and language outcomes. Thus, the aim of this study was to determine if visual cross-modal re-organization occurs in cochlear-implanted children, and whether it is related to deficits in speech perception performance.

Methods: Visual evoked potentials (VEPs) were recorded via high-density EEG in 41 normal hearing children and 14 cochlear-implanted children, aged 5-15 years, in response to apparent motion and form change. Comparisons of VEP amplitude and latency, as well as source localization results, were conducted between the groups in order to view evidence of visual cross-modal re-organization. Finally, speech perception in background noise performance was correlated to the visual response in the implanted children.

Results: Distinct VEP morphological patterns were observed in both the normal hearing and cochlear-implanted children. However, the cochlear-implanted children demonstrated larger VEP amplitudes and earlier latency, concurrent with activation of right temporal cortex including auditory regions, suggestive of visual cross-modal re-organization. The VEP N1 latency was negatively related to speech perception in background noise for children with cochlear implants.

Conclusion: Our results are among the first to describe cross modal re-organization of auditory cortex by the visual modality in deaf children fitted with cochlear implants. Our findings suggest that, as a group, children with cochlear implants show evidence of visual cross-modal recruitment, which may be a contributing source of variability in speech perception outcomes with their implant.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0147793PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4726603PMC
July 2016

Cortical Plasticity and Reorganization in Pediatric Single-sided Deafness Pre- and Postcochlear Implantation: A Case Study.

Otol Neurotol 2016 Feb;37(2):e26-34

*Department of Speech, Language, and Hearing Science and Institute of Cognitive Science, University of Colorado, Boulder †Denver Ear Associates, Englewood, Colorado ‡Department of Speech and Hearing Science, Arizona State University, Tempe, Arizona §Virginia Mason Medical Center, Seattle, Washington, U.S.A.

Hypothesis: The purpose of this study was to examine changes in cortical development and neuroplasticity in a child with single-sided deafness (SSD) before and after cochlear implantation (CI).

Background: The extent to which sensory pathways reorganize in childhood SSD is not well understood and there is currently little evidence demonstrating the efficacy of CI in children with SSD.

Methods: High-density 128-channel electroencephalography (EEG) was used to collect cortical auditory evoked potentials (CAEP), cortical visual evoked potentials (CVEP), and cortical somatosensory evoked potentials (CSSEP) in a child with SSD, pre-CI and at subsequent sessions until approximately 3 years post-CI in her right ear which occurred at age 9.86 years. Behavioral correlates of speech perception and sound localization were also measured.

Results: Pre-CI, high-density EEG showed evidence of delayed auditory cortical response morphology, auditory cortical development strongly contralateral (to the normal hearing ear), evidence of increased cognitive load, and cross-modal reorganization by the visual and somatosensory modalities. The post-CI developmental trajectory provided clear evidence of age-appropriate development of auditory cortical responses, and decreased cross-modal reorganization, consistent with improved speech perception and sound localization.

Conclusion: Post-CI, the child demonstrated age-appropriate auditory cortical development and improved speech perception and sound localization suggestive of significant benefits from cochlear implantation. Reversal of somatosensory recruitment was clearly apparent, and only a residual amount of visual cross-modal plasticity remained postimplantation. Overall, our results suggest that CI in pediatric SSD patients may benefit from a highly plastic cortex in childhood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MAO.0000000000000904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530986PMC
February 2016

Survey of the Child Neurology Program Coordinator Association: Workforce Issues and Readiness for the Next Accreditation System.

J Child Neurol 2016 Mar 26;31(3):333-7. Epub 2015 Jun 26.

Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

In preparation for the implementation of the Next Accreditation System in Child Neurology, the authors organized the first meeting of child neurology program coordinators in October 2014. A workforce and program-readiness survey was conducted initially. Coordinator job titles varied widely. Most respondents (65%) managed 1 or more fellowships plus child neurology residency. Most had worked in graduate medical education less than 5 years (53%), with no career path (88%), supervised by someone without graduate medical education experience (85%), in divisions where faculty knowledge was judged inadequate (72%). A small proportion of programs had established clinical competency committee policies (28%) and was ready to implement milestone-based evaluations (56%). A post-conference survey demonstrated substantial improvements in relevant skills. The complexity of residency program management in the Next Accreditation System era supports substantive modifications to the program coordinator role. Such changes should include defined career pathway, managerial classification, administrative support, and continuing education.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0883073815592226DOI Listing
March 2016

Developmental and cross-modal plasticity in deafness: evidence from the P1 and N1 event related potentials in cochlear implanted children.

Int J Psychophysiol 2015 Feb 26;95(2):135-44. Epub 2014 Apr 26.

Brain and Behavior Laboratory, Speech Language and Hearing Sciences, University of Colorado at Boulder, United States.

Cortical development is dependent on extrinsic stimulation. As such, sensory deprivation, as in congenital deafness, can dramatically alter functional connectivity and growth in the auditory system. Cochlear implants ameliorate deprivation-induced delays in maturation by directly stimulating the central nervous system, and thereby restoring auditory input. The scenario in which hearing is lost due to deafness and then reestablished via a cochlear implant provides a window into the development of the central auditory system. Converging evidence from electrophysiologic and brain imaging studies of deaf animals and children fitted with cochlear implants has allowed us to elucidate the details of the time course for auditory cortical maturation under conditions of deprivation. Here, we review how the P1 cortical auditory evoked potential (CAEP) provides useful insight into sensitive period cut-offs for development of the primary auditory cortex in deaf children fitted with cochlear implants. Additionally, we present new data on similar sensitive period dynamics in higher-order auditory cortices, as measured by the N1 CAEP in cochlear implant recipients. Furthermore, cortical re-organization, secondary to sensory deprivation, may take the form of compensatory cross-modal plasticity. We provide new case-study evidence that cross-modal re-organization, in which intact sensory modalities (i.e., vision and somatosensation) recruit cortical regions associated with deficient sensory modalities (i.e., auditory) in cochlear implanted children may influence their behavioral outcomes with the implant. Improvements in our understanding of developmental neuroplasticity in the auditory system should lead to harnessing central auditory plasticity for superior clinical technique.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijpsycho.2014.04.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209331PMC
February 2015

Cross-modal re-organization in adults with early stage hearing loss.

PLoS One 2014 28;9(2):e90594. Epub 2014 Feb 28.

University of Colorado at Boulder, Department of Speech, Language and Hearing Sciences, Boulder, Colorado, United States of America ; University of Colorado at Boulder, Institute of Cognitive Science, Boulder, Colorado, United States of America.

Cortical cross-modal re-organization, or recruitment of auditory cortical areas for visual processing, has been well-documented in deafness. However, the degree of sensory deprivation necessary to induce such cortical plasticity remains unclear. We recorded visual evoked potentials (VEP) using high-density electroencephalography in nine persons with adult-onset mild-moderate hearing loss and eight normal hearing control subjects. Behavioral auditory performance was quantified using a clinical measure of speech perception-in-noise. Relative to normal hearing controls, adults with hearing loss showed significantly larger P1, N1, and P2 VEP amplitudes, decreased N1 latency, and a novel positive component (P2') following the P2 VEP. Current source density reconstruction of VEPs revealed a shift toward ventral stream processing including activation of auditory temporal cortex in hearing-impaired adults. The hearing loss group showed worse than normal speech perception performance in noise, which was strongly correlated with a decrease in the N1 VEP latency. Overall, our findings provide the first evidence that visual cross-modal re-organization not only begins in the early stages of hearing impairment, but may also be an important factor in determining behavioral outcomes for listeners with hearing loss, a finding which demands further investigation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0090594PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3938766PMC
June 2015

Compensatory changes in cortical resource allocation in adults with hearing loss.

Front Syst Neurosci 2013 25;7:71. Epub 2013 Oct 25.

Department of Speech, Language and Hearing Sciences, University of Colorado at Boulder Boulder, CO, USA ; Institute of Cognitive Science, University of Colorado at Boulder Boulder, CO, USA.

Hearing loss has been linked to many types of cognitive decline in adults, including an association between hearing loss severity and dementia. However, it remains unclear whether cortical re-organization associated with hearing loss occurs in early stages of hearing decline and in early stages of auditory processing. In this study, we examined compensatory plasticity in adults with mild-moderate hearing loss using obligatory, passively-elicited, cortical auditory evoked potentials (CAEP). High-density EEG elicited by speech stimuli was recorded in adults with hearing loss and age-matched normal hearing controls. Latency, amplitude and source localization of the P1, N1, P2 components of the CAEP were analyzed. Adults with mild-moderate hearing loss showed increases in latency and amplitude of the P2 CAEP relative to control subjects. Current density reconstructions revealed decreased activation in temporal cortex and increased activation in frontal cortical areas for hearing-impaired listeners relative to normal hearing listeners. Participants' behavioral performance on a clinical test of speech perception in noise was significantly correlated with the increases in P2 latency. Our results indicate that changes in cortical resource allocation are apparent in early stages of adult hearing loss, and that these passively-elicited cortical changes are related to behavioral speech perception outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fnsys.2013.00071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905471PMC
January 2014

CENTRAL AUDTIORY DEVELOPMENT IN CHILDREN WITH HEARING LOSS: CLINICAL RELEVANCE OF THE P1 CAEP BIOMARKER IN HEARING-IMPAIRED CHILDREN WITH MULTIPLE DISABILITIES.

Hearing Balance Commun 2013 Sep;11(3)

Dept. of Speech, Language and Hearing Sciences, University of Colorado at Boulder, 2501 Kittredge Loop Road 409 UCB Boulder, CO 80309.

Objective: First, we review the development and plasticity of the central auditory pathways in infants and children with hearing loss who are fitted with cochlear implants (CIs). Second, we describe case studies demonstrating the clinical utility of the P1 central auditory evoked potential (CAEP) for evaluating cortical auditory maturation in the rapidly increasing number of cochlear-implanted children who have multiple disabilities.

Study Design: Children who receive CIs provide a platform to examine the trajectories of deprivation-induced and experience-dependent plasticity in the central auditory system. We review the evidence for, and time limits of sensitive periods for cortical auditory maturation framing an optimal period for cochlear implantation. Finally, we evaluate the use of the P1 biomarker as an objective assessment tool in the special case of children with multiple disabilities.

Results: The P1 response was useful in assessing central auditory maturation in patients with CHARGE association, ANSD, and Pallister-Killian Syndrome concomitant with hearing loss.

Conclusion: The presence of co-existing disabilities in addition to hearing loss poses unique challenges regarding both pre-intervention evaluation and post-intervention rehabilitation for children with multiple disabilities. When combined with a standard audiological test battery, the P1 CAEP biomarker has a useful role in objectively evaluating the maturation of central auditory pathways to determine the effectiveness of various intervention strategies in hearing-impaired children with multiple disabilities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3109/21695717.2013.812378DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833866PMC
September 2013

2011 NEHA sabbatical report: from then to now, and here to there: a glimpse at contaminated lands and environmental health issues in the UK.

Authors:
Julia Campbell

J Environ Health 2013 Apr;75(8):40-1

Environmental Health Section, Georgia Department of Public Health, Atlanta, GA 30303-3142, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
April 2013

Plasticity in the developing auditory cortex: evidence from children with sensorineural hearing loss and auditory neuropathy spectrum disorder.

J Am Acad Audiol 2012 Jun;23(6):396-411; quiz 495

Speech, Language and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA.

The developing auditory cortex is highly plastic. As such, the cortex is both primed to mature normally and at risk for reorganizing abnormally, depending upon numerous factors that determine central maturation. From a clinical perspective, at least two major components of development can be manipulated: (1) input to the cortex and (2) the timing of cortical input. Children with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) have provided a model of early deprivation of sensory input to the cortex and demonstrated the resulting plasticity and development that can occur upon introduction of stimulation. In this article, we review several fundamental principles of cortical development and plasticity and discuss the clinical applications in children with SNHL and ANSD who receive intervention with hearing aids and/or cochlear implants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3766/jaaa.23.6.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733172PMC
June 2012
-->