Biomedical subjects

S D Stephens

Publications and source records attributed to S D Stephens.

At least 19 recordsLinked to original sources

PubMed1999

Computed tomography evaluation of the inner ear as a diagnostic, counselling and management strategy in patients with congenital sensorineural hearing impairment.

The value of computed tomography (CT) of the petrous bone in the investigation of congenital sensorineural hearing impairment has been questioned. We have conducted a study to establish the usefulness of CT of the temporal bone in the evaluation and management of a consecutive series of unselected adolescent patients with congenital sensorineural hearing impairment of greater than 50 dB HL. Seventy-one patients (142 ears) were identified and images reviewed to establish the incidence of inner ear malformations. Fifteen ears were found to be abnormal in eight patients (seven bilateral and one unilateral abnormality). Three patients had Mondini abnormalities and one of these also had dilatation of the lateral semicircular canals. There were five patients with dilatation of the vestibular aqueduct. One patient had a unilateral dysplasia of the middle and external ear. A variety of incidental intracranial abnormalities were also discovered. We conclude that CT does have a valuable role in the management of SNHI.

Adolescent↗

PubMed1999

An analysis of the communication tactics used by hearing-impaired adults.

The aim of this study was to establish whether and to what degree certain types of communication strategies (hearing tactics) used by hearing-impaired adults could be shown to co-occur, and to find out which strategies were more likely to be used in which type of communicative situations. A consecutive series of 100 patients attending an audiological rehabilitation clinic was given a questionnaire asking how often they used each of five different hearing tactics in 11 different situations. 'Avoidance' and 'request for repetition' were the tactics used most commonly. 'Pretending to hear/understand' and 'positioning self to improve hearing' were used less frequently, with 'interruption' the least commonly used. There was some association between tactics and situations but no clear picture emerged. In a reassessment of our methodology and results, we suggest that the future research of communication strategies would benefit from a sociolinguistic approach based on the qualitative analysis of naturally occurring discourse (conversation) of hard-of-hearing people, focusing on the use of different strategies in relation to communicators' goals in interaction.

Adolescent↗

PubMed1999

TEOAE-based estimation of the auditory threshold in the mid-octave frequencies.

The purpose of this study was to estimate the hearing levels, at the mid-frequencies, of 233 ears with sensorineural hearing loss by classifying the corresponding transiently evoked otoacoustic emissions (TEOAE) recordings into three threshold groups. A classification algorithm was based upon a discriminant analysis of fast Fourier transform (FFT) data, evoked by non-linear click stimuli of 80 (+/-2) dB SPL per ear. To validate the efficiency of the proposed methodology TEOAE recordings were initially grouped by mean hearing level values of the 1 kHz and 2 kHz octaves into three threshold ranges according to two strategy schemes: in the first, TEOAE data were assigned into 10-19 dB HL, 20-39 dB HL or > or = 40 dB HL groups. In the second, TEOAE data were assigned into 10-29 > dB H >, 30-39 dB HL or > or = 40 dB HL groups. The most accurate prediction estimates were obtained from the second strategy scheme with a 90.9% accuracy in the 10-29 dB HL group, 82% in the 30-39 dB HL group and 71.4% in the > or = 40 dB HL group.

Adult↗

PubMed1997

Storage stability of screwpress-extracted oils and residual meals from CELSS candidate oilseed crops.

The efficacy of using screwpress extraction for oil was studied with three Controlled Ecological Life-Support System (CELSS) candidate oilseed crops (soybean, peanut, and canola), since use of volatile organic solvents for oil extraction likely would be impractical in a closed system. Low oil yields from initial work indicated that a modification of the process is necessary to increase extraction efficiency. The extracted oil from each crop was tested for stability and sensory characteristics. When stored at 23 degrees C, canola oil and meal were least stable to oxidative rancidity, whereas peanut oil and meal were least stable to hydrolytic rancidity. When stored at 65 degrees C, soybean oil and canola meal were least stable to oxidative rancidity, whereas peanut oil and meal were least stable to hydrolytic rancidity. Sensory evaluation of the extracted oils used in bread and salad dressing indicated that flavor, odor intensity, acceptability, and overall preference may be of concern for screwpress-extracted canola oil when it is used in an unrefined form. Overall results with screwpress-extracted crude oils indicated that soybean oil may be more stable and acceptable than canola or peanut under typical storage conditions.

Arachis↗

PubMed1997

The use of qualitative questionnaires in patients having and being considered for cochlear implants.

Within this study we have examined the particular hearing complaints of patients being considered for a cochlear implant and the specific benefits/shortcomings experienced by implanted patients using open-ended questionnaires. As we expected, the difficulty of hearing general conversation was the most common individual hearing complaint. However, 45% of complaints were concentrated in the 'psychosocial' category, which was significantly higher than that found among general audiological rehabilitation patients. The average number of benefits listed by patients having implants was significantly higher than that of the shortcomings. Moreover, the main benefits listed were focused on the acoustical and psychological factors, e.g. 'environmental sound awareness', 'general conversation easier' and 'feeling of self-confidence'. The main shortcomings were related to the acoustical and practical areas, e.g. hearing difficulty in noisy background, processor being cumbersome.

Cochlear Implants↗

PubMed1996

Who prompts patients to consult about hearing loss?

Amongst the patients who are seen in audiology clinics about their hearing loss, many factors must exist which determine the outcome of subsequent rehabilitation. In this pilot study, 95 patients were seen in two audiology centres (London and Cardiff), and were questioned as to who primarily motivated them to first seek help for their hearing loss. It was found that only a minority of patients reported that they were self-motivated and that in the majority, especially with the older patients and those not working outside the home, it was a family member who persuaded the patient to consult his doctor. Possible implications of these findings with regard to the design and outcome of subsequent rehabilitation are discussed. The extension of this work, in order to compare the outcome of rehabilitation in self-motivated patients with that in non-self-motivated patients, is outlined.

Aged↗

PubMed1995

Compositional and toxicological evaluation of the diazotrophic cyanobacterium, Cyanothece sp. strain ATCC 51142.

Compositional analyses of Cyanothece sp. strain ATCC 51142 showed high protein (50-60%) and low fat (0.4-1%) content, and the ability to synthesize vitamin B12. The amino acid profile indicated that Cyanothece sp. was a balanced protein source. Fatty acids of the 18:3n-3 type were also present. Mineral analyses indicated that the cellular biomass may be a good source of Fe, Zn and Na. Caloric content was 4.5 to 5.1 kcal g dry weight-1 and the carbon content was approximately 40% on a dry weight basis. Nitrogen content was 8 to 9% on a dry weight basis and total nucleic acids were 1.3% on a dry weight basis. Short-term feeding studies in rats followed by histopathology found no toxicity or dietary incompatibility problems. The level of uric acid and allantoin in urine and tissues was low, suggesting no excess of nucleic acids, as sometimes reported in the past for a cyanobacteria-containing diet. The current work discusses the potential implications of these results for human nutrition applications.

Amino Acids↗

PubMed1995

An approach to the audit of tinnitus management.

This study examines the advantages and internal consistency of an open-ended questionnaire (Benefit-problem questionnaire), over the Tinnitus questionnaire used by Jakes et al. (1985) in the auditing of a stress management programme. The Tinnitus questionnaire showed very little difference pre- and post-treatment, while the Benefit/problem questionnaire showed good improvement over a number of variables. This included some of the more traditional orthogonal values of tinnitus complaint. The clinical assessment made blindly and over a different time scale to the Benefit/problem questionnaire matched these positive results quite closely.

Female↗

PubMed1995

Alport's syndrome: can carriers be identified by audiometry?

Alport's syndrome is characterized by familial nephropathy with haematuria, sensorineural hearing loss and ocular abnormalities. It is transmitted as an X-linked dominant condition. In the affected males the symptoms are severe compared with females who show a more variable clinical picture due to the effect of lyonization of the X-chromosome. The diagnosis of carriers of genetic disease is extremely valuable for the purpose of counselling the patients as well as their relatives. A number of attempts have been made in the past to diagnose these carriers. Some studies have shown that it is possible to diagnose carriers of conditions where hearing loss is a symptom, by sensitive audiometric techniques. In this study we examined obligate and possible carriers of Alport's syndrome with pure-tone audiometry (PTA) and the audioscan method. We found that all obligate carriers and a predictable proportion of possible carriers had either a hearing loss on PTA or a mid frequency notch in the audioscan.

Adult↗

PubMed1995

Patients' reports of the effect of alcohol on tinnitus.

One hundred chronic sufferers attending a tinnitus outpatient clinic completed self-report questionnaires assessing the quantity of alcohol they consumed weekly and its effect on tinnitus. The results showed a mixed effect of alcohol on tinnitus with 22% of the sample reporting that drinking worsened tinnitus, 62% reporting no effect of alcohol on tinnitus and 16% reporting that alcohol improved tinnitus. The reported effect of alcohol on tinnitus significantly influenced the reported change in the level of alcohol intake since tinnitus onset, with significantly more units of alcohol being consumed by those sufferers who reported that alcohol improved their tinnitus. However, for the sample as a whole, drinking behaviour was not significantly different to that of the general population.

Adult↗

PubMed1994

Tinnitus and suicide.

A retrospective study of tinnitus sufferers who had committed suicide was undertaken. A questionnaire was compiled, and circulated world-wide. Adequate information was obtained on 28 suicides. An association between suicide and left-sided tinnitus reported previously, was not conclusively replicated. In fact, no particular tinnitus parameter, or associated audiological symptom was over-represented in the suicide series. Demographically, tinnitus suicide victims were characterized by being male, elderly, and socially isolated. There was a high prevalence of psychiatric morbidity, in particular depression (70%). A suicide attempt within the year preceding suicide occurred in five individuals.

Adolescent↗

PubMed1994

Use of the open-ended questionnaire with patients and their significant others.

One hundred and twenty-one hearing impaired people and their accompanying adult significant other answered an open-ended questionnaire. It asked them to list the difficulties they had as a result of hearing loss. As expected, the most common difficulties which patients report are those dealing with understanding speech, yet these complaints comprise only 58.5% of all the specific responses made by patients. These speech-related difficulties fell into only two of the eight categories of complaints. This would clearly indicate that there are more subtle difficulties occurring that need to be addressed and which would be missed by more standard disability/handicap questionnaires largely based on speech disability. The number of specific difficulties related to loudness of TV and radio and to the psychosocial aspects of hearing loss (such as withdrawal and unsociable behaviours) was reported by greater numbers of significant others than patients. The patient, however, was significantly more apt to list a non-specific problem related to the radio and TV. Specific medical problems were reported by a greater number of patients than significant others.

Adaptation, Psychological↗

PubMed1992

Prescription of hearing aids for the elderly: the views of general practitioners.

A questionnaire survey was carried out to examine the views of general practitioners in one Northern city regarding whether or not they thought that hearing aids should be prescribed from general practice, who they thought should prescribe them and whether or not additional resources and training would be needed if the responsibility for hearing aid prescription for the elderly was placed upon general practitioners. The survey indicated that whereas many general practitioners would be in favour of prescribing hearing aids from Health Centres, many would need extra training and resources to enable them to do so.

Aged↗

PubMed1992

An investigation of normally hearing subjects with tinnitus.

The hearing sensitivity and psychological profile of 18 young subjects with tinnitus and normal hearing were investigated by pure-tone and high-frequency audiometry, notched-noise tests, auditory-brainstem responses, evoked otoacoustic emissions and Crown-Crisp experiential index. Psychoacoustical and brainstem tests were comparable to those of 19 normally hearing subjects without tinnitus. Otoacoustic emissions were worse in ears of tinnitus subjects. Neurotic personality traits were stronger in the tinnitus subjects. These traits may be secondary to otological dysfunction, or may contribute to complaint behaviour.

Adult↗

PubMed1991

Clinical investigation of hearing loss in the elderly.

The prevalence of hearing loss increases with age. Epidemiological and histopathological studies relating hearing loss to age are reviewed and clinical evidence presented suggesting that hearing loss is due not only to age but also to disease processes known to be associated with hearing threshold deterioration. 80 elderly patients presenting with a hearing problem at hospital have been studied and compared with 287 'non-complainers'. 83% of the study group were found to have factors, additional to age, contributing to their hearing loss; 50% had a medical condition previously unrecognized; 30% were taking potentially ototoxic drugs. Audiometric measurements indicate that hearing thresholds of the elderly are influenced by numerous disease processes. Patients attending hospital with hearing impairment are at greater risk of having a vascular or biochemical abnormality than a group of elderly 'non-complainers'. Elderly patients presenting with hearing loss should therefore be adequately investigated before being labelled as having presbyacusis.

Aged↗

PubMed1991

Intermediate hearing tests as predictors of hearing aid acceptance.

This prospective study analyses the ability of several different intermediate hearing screening techniques to predict hearing aid acceptance in a pre-retirement population. In addition to the traditional methods of using sensitivity and specificity to analyse test performance, signal detection theory has been used to obtain a single detectability rate for each test. Questionnaires were able to identify individuals with hearing difficulties but included a significant group of people who ultimately would not accept a hearing aid. This group could be eliminated either clinically using free field speech testing, or audiometrically using warble tone thresholds, without the need for formal pure tone audiometry.

Aged↗

PubMed1991

Acceptability of binaural hearing aids: a cross-over study.

Using screening questionnaires we were able to detect individuals aged 50-65 years with hearing disability in a general practice population. Those who had better ear hearing levels of 30 dB or worse were invited to take place in a cross-over study comparing the acceptability of a monaural or binaural hearing-aid fitting. Fifty-five per cent ultimately opted for a binaural fitting and had greater hearing disability and worse mean hearing levels than those who opted for a monaural fitting. They made their choice for acoustical reasons, particularly on the basis of improved localization ability.

Audiometry↗

PubMed1991

The desynchrony between complaints and signs of vestibular disorders.

As part of an early intervention study on the acceptability of auditory rehabilitative intervention, we examined patient complaints and clinical findings of balance disorders. Hallam et al. have discussed desynchrony between such findings in hospital patient populations, and the aim of the present study was to investigate these relationships in a general population. The study was conducted in two industrial villages in Wales in which questionnaires were circulated to all individuals in the 50-65 age group. A marked desynchrony between semeions and clinical findings was found. This has been related to the desynchrony between auditory impairment, disability and handicap in this population. Subjects reporting giddiness or vertigo were more disabled but not more impaired in respect of auditory measures than those not reporting such balance problems. Those with abnormal balance test results showed no auditory differences from those with normal results.

Aged↗