Prevention of cisplatin-induced hearing loss in children: Informing the design of future clinical trials.

Cisplatin is an essential chemotherapeutic agent in the treatment of many pediatric cancers. Unfortunately, cisplatin-induced hearing loss (CIHL) is a common, clinically significant side effect with life-long ramifications, particularly for young children. ACCL05C1 and ACCL0431 are two recently completed Childrens Oncology Group studies focused on the measurement and prevention of CIHL. The purpose of this paper was to gain insights from ACCL05C1 and ACCL0431, the first published cooperative group studies dedicated solely to CIHL, to inform the design of future pediatric otoprotection trials. Use of otoprotective agents is an attractive strategy for preventing CIHL, but their successful development must overcome a unique constellation of methodological challenges related to translating preclinical research into clinical trials that are feasible, evaluate practical interventions, and limit risk. Issues particularly important for children include use of appropriate methods for hearing assessment and CIHL severity grading, and use of trial designs that are well-informed by preclinical models and suitable for relatively small sample sizes. Increasing interest has made available new funding opportunities for expanding this urgently needed research

A Survey on Application Specific Processor Architectures for Digital Hearing Aids

On the one hand, processors for hearing aids are highly specialized for audio processing, on the other hand they have to meet challenging hardware restrictions. This paper aims to provide an overview of the requirements, architectures, and implementations of these processors. Special attention is given to the increasingly common application-specific instruction-set processors (ASIPs). The main focus of this paper lies on hardware-related aspects such as the processor architecture, the interfaces, the application specific integrated circuit (ASIC) technology, and the operating conditions. The different hearing aid implementations are compared in terms of power consumption, silicon area, and computing performance for the algorithms used. Challenges for the design of future hearing aid processors are discussed based on current trends and developments

Medicare Advantage: Options for Standardizing Benefits and Information to Improve Consumer Choice

Describes the complex choices Medicare Advantage enrollees face. Discusses whether providing better information and decision-support tools, limiting out-of-pocket expenses, or standardizing benefits and cost-sharing would lead to better-informed choices

FISA Reform

Congress and the Executive Branch are poised to take up the issue of FISA reform in 2014. What has been missing from the discussion is a comprehensive view of ways in which reform could be given effect—i.e., a taxonomy of potential options. This article seeks to fill the gap. The aim is to deepen the conversation about abeyant approaches to foreign intelligence gathering, to allow fuller discussion of what a comprehensive package could contain, and to place initiatives that are currently under consideration within a broader, over-arching framework. The article begins by considering the legal underpinnings and challenges to the President\u27s Surveillance Program. It then examines how technology has altered the types of information available, as well as methods of transmission and storage. The article builds on this to develop a taxonomy for how a statutory approach to foreign intelligence gathering could be given force. It divides foreign intelligence gathering into two categories: front-end collection and back-end analysis and use. Each category contains a counterpoise structured to ensure the appropriate exercise of Congressionally-mandated authorities. For the front-end, this means balancing the manner of collection with requirements for approval. For the back-end, this means offsetting implementation with transparency and oversight. The article then considers the constituent parts of each category

Situation analysis of programs to meet the HIV prevention, care, and treatment needs of persons with disabilities in Ghana, Uganda, and Zambia

National HIV strategic plans, HIV-related services, and HIV outreach efforts have tended to overlook persons with disabilities, and persons with disabilities are not reached by general HIV prevention, care, support, and treatment campaigns and services. To increase our understanding of how to make HIV programming more inclusive for persons with disabilities, HIVCore and partners conducted a three-country situation analysis (Uganda, Zambia, and Ghana). The study explored existing HIV services for persons with disabilities and determined the factors affecting their access to and use of HIV/sexual and reproductive health (SRH) services. Key findings: Persons with disabilities experience greater sexual vulnerability to HIV and are eager for HIV prevention support; the environments in these countries do not facilitate access for persons with disabilities to HIV prevention, treatment, care, and support services; when accessed, HIV and sexual health services are not disability-friendly; a major barrier to utilizing services is stigma; the environments for facilitating HIV programming for persons with disabilities in the three countries varied, yet similar challenges exist. This study identified significant gaps in HIV and SRH programs to meet the needs of persons with disabilities

Impact of an Activity Mini-Schedule on the Inattention of Preschoolers With Cochlear Implants During a Group Activity

This pilot study evaluated the effectiveness of using an activity mini-schedule which divided a circle time activity into four sub-activities with four preschoolers who were deaf and had received cochlear implants. Often preschoolers with cochlear implants display difficulty directing attention to appropriate stimuli during large group activities (Chute & Nevins, 2003). It was hypothesized that the use of an activity mini-schedule would decrease inattention. Using a multiple baseline design across participants, an activity mini-schedule was introduced to each participant sequentially by a paraeducator who sat behind the children during circle time. Participants\u27 behaviors were videotaped and coded. The introduction of an activity mini-schedule decreased inattention in all participants, yet individual outcomes varied. Although this study offers some evidence that activity mini-schedules may positively impact attention in young children, more research is needed

Simulating naturalistic instruction: the case for a voice mediated interface for assistive technology for cognition

A variety of brain pathologies can result in difficulties performing complex behavioural sequences. Assistive technology for cognition (ATC) attempts support of complex sequences with the aim of reducing disability. Traditional ATCs are cognitively demanding to use and thus have had poor uptake. A more intuitive interface may allow ATCs to reach their potential. Insights from psychological science may be useful to technologists in this area. We propose that an auditory-verbal interface is more intuitive than a visual interface and reduces cognitive demands on users. Two experiments demonstrate a novel ATC, the General User Interface for Disorders of Execution (GUIDE). GUIDE is novel because it simulates normal conversational prompting to support task performance. GUIDE provides verbal prompts and questions and voice recognition allows the user to interact with the GUIDE. Research with non-cognitively impaired participants and a single participant experiment involving a person with vascular dementia provide support for using interactive auditory-verbal interfaces. Suggestions for the future development of auditory-verbal interfaces are discussed