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Biomedical subjects

William Noble

Publications and source records attributed to William Noble.

15 recordsLinked to original sources
PubMed2006

Benefits of sign language interpreting and text alternatives for deaf students' classroom learning.

Four experiments examined the utility of real-time text in supporting deaf students' learning from lectures in postsecondary (Experiments 1 and 2) and secondary classrooms (Experiments 3 and 4). Experiment 1 compared the effects on learning of sign language interpreting, real-time text (C-Print), and both. Real-time text alone led to significantly higher performance by deaf students than the other two conditions, but performance by deaf students in all conditions was significantly below that of hearing peers who saw lectures without any support services. Experiment 2 compared interpreting and two forms of real-time text, C-Print and Communication Access Real-Time Translation, at immediate testing and after a 1-week delay (with study notes). No significant differences among support services were obtained at either testing. Experiment 3 also failed to reveal significant effects at immediate or delayed testing in a comparison of real-time text, direct (signed) instruction, and both. Experiment 4 found no significant differences between interpreting and interpreting plus real-time text on the learning of either new words or the content of television programs. Alternative accounts of the observed pattern of results are considered, but it is concluded that neither sign language interpreting nor real-time text have any inherent, generalized advantage over the other in supporting deaf students in secondary or postsecondary settings. Providing deaf students with both services simultaneously does not appear to provide any generalized benefit, at least for the kinds of materials utilized here.

Adolescent↗
PubMed2006

Tinnitus: standard of care, personality differences, genetic factors.

We comment on three areas related to tinnitus. The standard of care should include counseling that is collaborative and that addresses the overall emotional well-being of the patient. Utilizing management and coping strategies is desirable. Our new tinnitus activities treatment is an example of such a protocol. We believe that the notions of fearfulness and acceptance have the potential to be integrated into tinnitus treatment. Some patients reject, control or accept their tinnitus. We believe in some instances there may be a common genetic cause of tinnitus and depression. A potential candidate is the serotonin transporter gene SLC6A4.

Adaptation, Psychological↗
PubMed2006

Considerations for the design of clinical trials for tinnitus.

CONCLUSION: There are many possible control conditions to consider in designing research on tinnitus treatments. Some of the counseling procedures involve more than simply 'talking' or providing information, and it is important to make this distinction. Several good handicap scales are available, but we believe that 100-point interval scales have some superior attributes. Both primary and secondary measures of benefit should be used. Open trials have some merit, but should only be used cautiously. Several recent guidelines have been suggested for improving the design and reporting of clinical trials. OBJECTIVES: This paper reviews some basic considerations in the design of research to evaluate tinnitus treatments, particularly counseling and sound therapies. METHODS: We have reviewed some of the basic issues, referenced some relevant work, and provided some data supporting some of our assertions. RESULTS: We provide some recommendations for consideration for the design of clinical trials.

Clinical Trials as Topic↗
PubMed2006

Effects of bilateral versus unilateral hearing aid fitting on abilities measured by the Speech, Spatial, and Qualities of Hearing Scale (SSQ).

The Speech, Spatial and Qualities of Hearing Scale (Gatehouse & Noble, 2004) was applied to three independent clinical groups: 144 people prior to being fitted with amplification; 118 people with six months experience with unilateral amplification; and 42 people with six months experience with bilateral amplification. For traditional speech hearing contexts (one-on-one, in groups, in quiet, in noise) there was benefit with one aid, and no further benefit with two. By contrast, hearing speech in demanding contexts (divided or rapidly switching attention) showed benefit with one aid and further benefit with two. In the spatial domain, directional hearing showed some benefit with one hearing aid, and particular further benefit in distance and movement discrimination from fitting with two. There was some benefit from unilateral fitting for elements of the qualities domains (clarity, naturalness, recognisability, segregation of sounds), with no consistent sign of further benefit from two. Bilateral fitting added benefit with respect to listening effort. Two hearing aids offer advantage in demanding and dynamic contexts; these contexts are argued as significant in the maintenance of social competence and emotional wellbeing. The present results go toward establishing the real-world advantages of bilateral hearing aid fitting and suggest that previous, inconclusive clinical findings reflect inquiry limited to more traditional areas of hearing function.

Aged↗
PubMed2006

Bilateral hearing aids: a review of self-reports of benefit in comparison with unilateral fitting.

The literature on self-assessed outcomes from bilateral and unilateral hearing aid fitting is reviewed. The nature, aims, and design of different studies are quite varied, and limitations attend many of them. Nonetheless, certain indications can be extracted from the pattern of reported results. Thus, greater measured impairment, greater self-rated disability, and/or more critical contexts of listening emerge as candidate predictors of preference for, or persistence with, a bilateral fitting profile. Two matters are briefly critiqued regarding one vs two hearing aids: 1) the analogue with binocular optical correction; 2) the unaided ear ("deprivation") effect. Questions are raised about the adequacy of the range of hearing functions addressed by previous investigations of bilateral vs. unilateral fitting-and a broadened range of functions is outlined. A recent self-report-based comparison of one versus two hearing aids (Noble & Gatehouse, International Journal of Audiology, 2006) reveals that the benefit of two lies in contexts of more demanding and dynamic listening and in reduced listening effort.

Audiology↗
PubMed2006

Some benefits and limitations of binaural cochlear implants and our ability to measure them.

We review new recognition and localization skills in patients using one or two cochlear implant(s). We observed one unilateral patient who showed localization performance above chance. We also provide evidence for binaural processing in bilateral cochlear implant patients, even when tested with speech from the front without noise. We unsuccessfully attempted to find correlations between localization and squelch, between these variables and pre-implant threshold differences, or these variables and post-implant recognition differences. We strongly believe that new tests are needed to examine the potential benefit of two implants. We describe three tests that we use to show a binaural advantage: cued recognition, movement direction, and recognition with multiple jammers.

Auditory Threshold↗
PubMed2005

Couples' attributions about behaviours modulated by hearing impairment: links with relationship satisfaction.

The aim of the study was to examine the link between the nature of attributions made by partners about behaviours modulated by hearing loss, and overall relationship satisfaction. Forty-three hearing-impaired males and 23 hearing-impaired females together with their partners, each rated the hearing-impaired person's hearing ability, their own relationship satisfaction, and their attributions for hypothetical behaviours typically associated with impaired hearing. Attributions covered perceived causes of behaviour and perceived responsibility. The extent to which the behaviours typically associated with impaired hearing, were attributed to personal causes and responsibilities was inversely correlated with relationship satisfaction. Female partners (more than male partners, or females with impaired hearing) made attributions that accentuated the unpleasant implications of behaviour. Where attributions and ratings of degree of hearing loss were greater in partners than in the person with the loss, relationship satisfaction was lower. Implications for rehabilitation counselling are discussed.

Adaptation, Psychological↗
PubMed2004

The Speech, Spatial and Qualities of Hearing Scale (SSQ).

The Speech, Spatial and Qualities of Hearing Scale (SSQ) is designed to measure a range of hearing disabilities across several domains. Particular attention is given to hearing speech in a variety of competing contexts, and to the directional, distance and movement components of spatial hearing. In addition, the abilities both to segregate sounds and to attend to simultaneous speech streams are assessed, reflecting the reality of hearing in the everyday world. Qualities of hearing experience include ease of listening, and the naturalness, clarity and identifiability of different speakers, different musical pieces and instruments, and different everyday sounds. Application of the SSQ to 153 new clinic clients prior to hearing aid fitting showed that the greatest difficulty was experienced with simultaneous speech streams, ease of listening, listening in groups and in noise, and judging distance and movement. SSQ ratings were compared with an independent measure of handicap. After differences in hearing level were controlled for, it was found that identification, attention and effort problems, as well as spatial hearing problems, feature prominently in the disability handicap relationship,. along with certain features of speech hearing. The results implicate aspects of temporal and spatial dynamics of hearing disability in the experience of handicap. The SSQ shows promise as an instrument for evaluating interventions of various kinds, particularly (but not exclusively) those that implicate binaural function.

Aged↗
PubMed2004

Interaural asymmetry of hearing loss, Speech, Spatial and Qualities of Hearing Scale (SSQ) disabilities, and handicap.

A series of comparative analyses is presented between a group with relatively similar degrees of hearing loss in each ear (n = 103: symmetry group) and one with dissimilar losses (n = 50: asymmetry group). Asymmetry was defined as an interaural difference of more than 10dB in hearing levels averaged over 0.5. 1, 2 and 4kHz. Comparison was focused on self-rated disabilities as reflected in responses on the Speech, Spatial and Qualities of Hearing Scale (SSQ). The connections between SSQ ratings and a global self-rating of handicap were also observed. The interrelationships among SSQ items for the two groups were analysed to determine how the SSQ behaves when applied to groups in whom binaural hearing is more (asymmetry) versus less compromised. As expected, spatial hearing is severely disabled in the group with asymmetry; this group is generally more disabled than the symmetry group across all SSQ domains. In the linkages with handicap, spatial hearing, especially in dynamic settings, was strongly represented in the asymmetry group, while all aspects of hearing were moderately to strongly represented in the symmetry group. Item intercorrelations showed that speech hearing is a relatively autonomous function for the symmetry group, whereas it is enmeshed with segregation, clarity and naturalness factors for the asymmetry group. Spatial functions were more independent of others in the asymmetry group. The SSQ shows promise in the assessment of outcomes in the case of bilateral versus unilateral amplification and/or implantation.

Aged↗
PubMed2003

Safety and immunogenicity of a recombinant parvovirus B19 vaccine formulated with MF59C.1.

A recombinant human parvovirus B19 vaccine (MEDI-491; MedImmune) composed of the VP1 and VP2 capsid proteins and formulated with MF59C.1 adjuvant was evaluated in a randomized, double-blind, phase 1 trial. Parvovirus B19-seronegative adults (n=24) received either 2.5 or 25 microg MEDI-491 at 0, 1, and 6 months. MEDI-491 was safe and immunogenic. All volunteers developed neutralizing antibody titers that peaked after the third immunization and were sustained through study day 364.

Adjuvants, Immunologic↗
PubMed2002

Patients utilizing a hearing aid and a cochlear implant: speech perception and localization.

OBJECTIVE: The purpose of this pilot study was to document speech perception and localization abilities in patients who use a cochlear implant in one ear and a hearing aid in the other ear. DESIGN: We surveyed a group of 111 cochlear implant patients and asked them whether they used a hearing aid on their unimplanted ear. The first three patients who were available were tested on word and sentence recognition and localization tasks. Speech stimuli were presented from the front in quiet and in noise. In the latter conditions, noise was either from the front, the right, or the left. Localization was tested with noise bursts presented at 45 degrees from the right or left. In addition we asked the patients about their abilities to integrate the information from both devices. RESULTS: Speech perception tests in quiet showed a binaural advantage for only one of the three patients for words and none for sentences. With speech and noise both in front of the patient, two patients performed better with both devices than with either device alone. With speech in front and noise on the hearing aid side, no binaural advantage was seen, but with noise on the cochlear implant side, one patient showed a binaural advantage. Localization ability improved with both devices for two patients. The third patient had above-chance localization ability with his implant alone. CONCLUSIONS: A cochlear implant in one ear and a hearing aid in the other ear can provide binaural advantages. The patient who did not show a clear binaural advantage had the poorest hearing aid alone performance. The absolute and relative levels of performance at each ear are likely to influence the potential for binaural integration.

Cochlear Implants↗
PubMed2002

Extending the IOI to significant others and to non-hearing-aid-based interventions.

Two extensions of the International Outcome Inventory for Hearing Aids are described: the first is designed for the significant other (SO) (IOI-HA-SO), and the second for alternative interventions for hearing difficulties (IOI-AI). A feature of the IOI-HA-SO is that several items are modified to inquire about effects of the partner's hearing loss on the SO. The IOI-AI is designed to cover effects of use of listening aids other than personally worn hearing aids, use of hearing tactics, and aural surgery.

Communication↗
PubMed2002

Hearing speech against spatially separate competing speech versus competing noise.

Listeners had the task of following a target speech signal heard against two competitors either located at the same spatial position as the target or displaced symmetrically to locations flanking it. When speech was the competitor, there was a significantly higher separation effect (maintained intelligibility with reduced target sound level), as compared with either steady-state or fluctuating noises. Increasing the extent of spatial separation slightly increased the effect, and a substantial contribution of interaural time differences was observed. When same- and opposite-sex voices were used, a hypothesis that the similarity between target and competing speech would explain the role for spatial separation was partly supported. High- and low-pass filtering showed that both parts of an acoustically similar competing signal contribute to the phenomenon. We conclude that, in parsing the auditory array, attention to spatial cues is heightened when the components of the array are confusable on other acoustic grounds.

Adult↗
PubMedDate not supplied

U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

Attitude↗