Perceived disability from hearing and voice changes in the elderly

Aim: Dysphonia and hearing loss are underestimated conditions in the elderly, despite their significant prevalence (18% and 50%, respectively) and their sociopsychological implications. Previous studies have shown that the reason for this lack of consideration is related to the general misconception of a simple age-related issue, as well as to the reduced communication requirements of this population, which can result in infrequent requests/supply of care. The purpose of the present study was to evaluate, within an elderly population, the subjective perception of hearing and voice dysfunctions, the resulting changes in communication skills, and the perception of handicap and disability. Methods: Four anonymous questionnaires were administered to 400 participants (218 men, 182 women) aged older than 65 years, some of whom (276) were hospitalized and some of whom (124) were outpatients. The questionnaires consisted of questions regarding age-related changes in voice, multiple-choice questions on the qualitative characteristics of the voice, questions regarding verbo-acoustic communication (hearing), the Voice Handicap Index, and the Self Assessment of Communication regarding the perception of hearing loss-related handicap and disability. Statistical correlations were calculated for voice dysfunction between the perception of disability and the clinical assessment of voice quality obtained by the Grade, Roughness, Breathiness, Asthenia, Strain scale, and between the perception of disability and the demand for care. Results: More than half of the elderly patients reported not perceiving voice changes throughout their lives. Most of the participants were satisfied with their own voices, although 65% of them judged them to be qualitatively altered, and in 31.5% of the participants, pathology was found on phoniatric evaluation. Low scores for vocal handicap (Voice Handicap Index) were found, and the type of perceived disability was mainly physical, although the association between Voice Handicap Index scores and Grade, Roughness, Breathiness, Asthenia, Strain was statistically significant. A total of 62% of the patients perceived hearing changes over their lifetimes not related to previous ear infections, but significantly correlated with a family history of hearing problems and with the need for specialist consultations. However, the perception of hearing loss handicaps and disability showed lower mean values, showing that older patients recognized dysfunction, but did not consider it to be a disability. Conclusions: The present study showed that, despite the relevant incidence of hearing and voice disorders among the elderly population, the implications for communication abilities seems to be underestimated. Hence, it appears to be extremely important to undergo specialist screening consultations to detect eventual voice and hearing alterations, and to correct them with appropriate therapeutic strategies

Distance, speed and high intensity characteristics of 0 to 24-goal, mixed and women’s polo

This dataset presents information pertaining to the spatiotemporal characteristics of Polo play from a 0 to 24-goal level. Data were collected by player worn GPS units, across a New Zealand Polo season. The dataset comprises observations from 466 chukkas of Polo, across mixed and women’s only Polo and is curated by cumulative player handicap. Data are presented for distance, speed and high intensity metrics, which have further categorised into five equine-based speed zones. The purpose of this dataset is to provide a detailed quantification of a range of Polo performance levels, advancing the scope and size of previous Polo literature that has employed GPS technology. This dataset may be of value to equine scientists and trainers, veterinary practitioners and sports scientists

A transcriptomic investigation of handicap models in sexual selection

We are grateful to D. Calder and T. Helps for access to study sites, and G. Murray-Dickson and M. Oliver for help with fieldwork and comments on manuscript drafts. This work was funded by NERC grant NE/D000602/1 (SBP), a NERC advanced fellowship (FM) and a BBSRC studentship (MAW)Peer reviewedPostprin

All things being equal: Spatiotemporal differences between open and women’s 16-goal polo

Polo is an equestrian team sport, consisting of Open and Women’s only handicapping systems. As cumulative player handicap increases in Open Polo, distance covered, average speeds and high intensity work performed per chukka also increase. These activities may differ in terms of distribution of, and their affect upon, match outcome in Women’s Polo, and thus have implications for equine preparation and management. This study aimed to quantify spatiotemporal differences between Open and Women’s Polo when matched for handicap and assess their affect upon chukka and match outcome using a prospective cohort design. Distance, speed and high intensity activity data were collected via player worn global positioning system (GPS) units during 16-goal Open and Women’s Polo tournaments. Notational analysis quantified chukka duration and chukka and game outcomes. Between group differences were assessed by independent samples t-tests, and two factor mixed effects ANOVA for within group analyses. Between group differences were analysed using an independent samples t-test with alpha defined a priori as p<0.05. Open and Women’s Polo differed by a small to large extent (ES: 0.54 – 1.81) for all spatiotemporal metrics. In Open Polo, players covered moderately more distance (429.0m; 238.9m to 619.0m), with small to large increases in high intensity activities performed in games won. Whereas in Women’s Polo, moderately higher maximum speeds were attained in games won (17.13 km/h; 11.86 km/h to 22.40 km/h) and a small increase in accelerations performed (5.1; 0.2 to 10.0). Open and Women’s Polo, when matched for handicap, present with small to large spatiotemporal differences that are likely of practical significance, and influence game outcome differently between codes. These differences do not necessarily mean that Polo ponies need to be trained differently for each code

The spatiotemporal characteristics of 0–24-Goal Polo

Global positioning systems (GPS) have recently been shown to reliably quantify the spatiotemporal characteristics of Polo, with the physiological demands of Polo play at low- and high-goal levels also investigated. This study aims to describe the spatiotemporal demands of Polo across 0–24 goal levels. A player-worn GPS unit was used to quantify distance, speed and high-intensity activities performed. Data were divided into chukkas and five equine-based speed zones, grouped per cumulative player handicap and assessed using standardized mean differences. Average distance and speed per chukka increased in accordance with cumulative player handicap, with the magnitude of differences being trivial–large and trivial–very large, respectively. Differences between time spent in high-intensity speed zones (zones 4 and 5) show a linear increase in magnitude, when comparing 0 goal Polo to all other levels of play (Small–Very Large; 6–24 goals, respectively). High-intensity activities predominantly shared this trend, displaying trivial–large differences between levels. These findings highlight increased cardiovascular, anaerobic and speed based physiological demands on Polo ponies as playing level increases. Strategies such as high-intensity interval training, maximal speed work and aerobic conditioning may be warranted to facilitate this development and improve pony welfare and performance

An evolutionary advantage for extravagant honesty

A game-theoretic model of handicap signalling over a pair of signalling channels is introduced in order to determine when one channel has an evolutionary advantage over the other. The stability conditions for honest handicap signalling are presented for a single channel and are shown to conform with the results of prior handicap signalling models. Evolutionary simulations are then used to show that, for a two-channel system in which honest signalling is possible on both channels, the channel featuring larger advertisements at equilibrium is favoured by evolution. This result helps to address a significant tension in the handicap principle literature. While the original theory was motivated by the prevalence of extravagant natural signalling, contemporary models have demonstrated that it is the cost associated with deception that stabilises honesty, and that the honest signals exhibited at equilibrium need not be extravagant at all. The current model suggests that while extravagant and wasteful signals are not required to ensure a signalling system's evolutionary stability, extravagant signalling systems may enjoy an advantage in terms of evolutionary attainability

Evidence for the stress-linked immunocompetence handicap hypothesis in humans

Secondary sexual traits that develop under the action of testosterone, such as masculine human male facial characteristics, have been proposed to signal the strength of the immune system due to the sex hormone's immunosuppressive action. Recent work has suggested that glucocorticoid stress hormones may also influence expression of such sexual signals due to their effects on immune function. Precise roles, however, remain unclear. Here we show positive relationships between testosterone, facial attractiveness and immune function (antibody response to a hepatitis B vaccine) in human males, and present some preliminary evidence that these relationships are moderated by naturally co-occurring cortisol (a glucocorticoid stress hormone involved in the fight-or-flight response). We conclude that our results provide support for a role of glucocorticoids in hormonally mediated sexual selection

Recruitment to Sheltered Employment: Evidence from Samhall, a Swedish State-Owned Company

This paper analyses recruitment practices to Samhall, a state-owned company that provides sheltered employment for individuals with severe work disabilities. Besides providing employment for disabled workers and rehabilitating them to employment outside Samhall, the company is expected to decrease its dependence on Government subsidies. This profitability goal may come into conflict with the recruitment goals, resulting in cream skimming effects. The job security offered at the company may also provide incentives at the individual level for using Samhall as a means of escaping unemployment rather than as an employer of last resort for the most disabled. The evidence regarding cream skimming is mixed; the recruitment-to-Samhall hazards of the prioritised groups, i.e., individuals with intellectual or psychic disabilities, are significantly higher than the hazards for some, but not all, disability groups. Individuals without disabilities tend to be hired by the company, which suggests creaming and is contrary to the guidelines. Finally, the Samhall hazard increases slightly with time in unemployment. This is consistent both with Samhall acting as an employer of last resort and the existence of incentives among individuals to use Samhall in order to escape unemployment.Policy Programmes; Disability; Performance Standards

The MS Symptom and Impact Diary (MSSID): psychometric evaluation of a new instrument to measure the day to day impact of multiple sclerosis

OBJECTIVES: This study aimed to develop further a diary originally devised to measure the impact of multiple sclerosis (MS) as part of a cost utility study of beta interferon, and to evaluate its reliability, validity, and responsiveness in an outpatient sample of people with MS. METHODS: The original diary was further developed using qualitative and quantitative methods to ensure that it addressed the views of people with MS. The psychometric properties of the MS Symptom and Impact Diary (MSSID) were evaluated in a sample of 77 people who completed the MSSID daily for 12 weeks. Internal and test–retest reliability, discriminant and convergent validity, and responsiveness were assessed using traditional psychometric methods. RESULTS: The MSSID formed three, internally consistent scales that measured mobility, fatigue, and the overall impact of MS. The test–retest reliability of the mobility scale was adequate for individual comparisons (ICC.0.90) and the fatigue and overall impact scales were adequate for group comparisons (ICC.0.70). The MSSID was able to distinguish between clinical groups depending on clinical course, indoor ambulation status, and relapse status. It demonstrated associations with other single point instruments in the expected direction. Compared with single point instruments, its responsiveness was similar or better, especially in detecting short term improvements in functioning. CONCLUSIONS: The MSSID may provide a useful complement to currently available instruments to measure the outcomes of MS within clinical trials. Further research is needed to explore its feasibility in the context of a randomised controlled trial and its utility for clinicians