Effects of virtual acoustics on dynamic auditory distance perception

Sound propagation encompasses various acoustic phenomena including reverberation. Current virtual acoustic methods, ranging from parametric filters to physically-accurate solvers, can simulate reverberation with varying degrees of fidelity. We investigate the effects of reverberant sounds generated using different propagation algorithms on acoustic distance perception, i.e., how faraway humans perceive a sound source. In particular, we evaluate two classes of methods for real-time sound propagation in dynamic scenes based on parametric filters and ray tracing. Our study shows that the more accurate method shows less distance compression as compared to the approximate, filter-based method. This suggests that accurate reverberation in VR results in a better reproduction of acoustic distances. We also quantify the levels of distance compression introduced by different propagation methods in a virtual environment.Comment: 8 Pages, 7 figure

Sleeping behaviors of adolescents with depressive disorders: adolescent self-description of sleeping reported through a web-based support system

Background: Depression is the leading health disorder in adolescence and often manifests itself as sleeping problems. A number of quantitative analyses have assessed the quality of adolescents' sleeping, but there is still a lack of information on how adolescents themselves perceive their sleeping behavior. Method: Using a mixed-methods approach, we describe sleeping behaviors and sleeping habits among adolescents with depressive disorders, who have been referred to psychiatric outpatient services. Results: Adolescents monitored their own sleeping patterns (n = 13) and reported on them through self-reflecting writings (n = 16) on a web-based support system for one week. They went to bed to about 23:00, remained awake for around 40 minutes, slept eight and a half hours, woke up at 9:00, and described themselves as being tired after the night. Adolescents were able to self-reflect on their sleeping in various ways and find meanings and interpretations of it. Conclusion: The results contribute valuable information to health care personnel who work with adolescents, for example school nurses and mental health professionals. More emphasis should be put on adolescents' perceptions of their sleeping behavior and how to increase their insight into their own wellbeing

Gender has to be taken into account in diagnosing adult growth hormone deficiency by the GHRH plus arginine test

Objective: Data on the effect of gender on the interpretation of the GHRH plus arginine stimulation test (GHRH + ARG test) is controversial. We validated the GHRH + ARG stimulation test in control subjects and patients with organic or idiopathic pituitary disease and a suspicion of adult growth hormone deficiency (AGHD) using the Immulite 2000 XPi GH assay. Design: We studied 126 apparently healthy adults (median age 38.8 years) and 34 patients with a suspicion of AGHD (median age 42.2 years). Identification of AGHD with the GHRH + ARG test was investigated with commonly accepted BMI-related consensus cut-off limits for peak GH concentrations. Serum samples collected during the GHRH + ARG test were analysed for GH in 2014-2015. Serum IGF-1 concentrations were studied as a reference. Results: In 14 of 65 (22%) control males the GH peak value was below the BMI-related cut-off limits for GH sufficiency indicating a false diagnosis of AGHD. All control females had a normal GHRH + ARG response. Median peak GH response was significantly (p <0.001) higher in female (39.3 mu g/L) than in male controls (21 mu g/L). According to consensus cut-offs all but one young female patient had a deficient response compatible with a diagnosis of AGHD. Conclusions: The GH response to stimulation by GHRH + ARG is gender-dependent, being lower in healthy males than in females. Gender should be considered when defining cut-off limits for peak GH concentrations in the GHRH + ARG test. The presently used BMI-related cut-off levels will lead to a significant misclassification of males as GH deficient.Peer reviewe

Childhood growth predicts higher bone mass and greater bone area in early old age : findings among a subgroup of women from the Helsinki Birth Cohort Study

We examined the associations between childhood growth and bone properties among women at early old age. Early growth in height predicted greater bone area and higher bone mineral mass. However, information on growth did not improve prediction of bone properties beyond that predicted by body size at early old age. We examined the associations between body size at birth and childhood growth with bone area, bone mineral content (BMC), and areal bone mineral density (aBMD) in early old age. A subgroup of women (n = 178, mean 60.4 years) from the Helsinki Birth Cohort Study, born 1934-1944, participated in dual-energy X-ray absorptiometry (DXA) measurements of the lumbar spine and hip. Height and weight at 0, 2, 7, and 11 years, obtained from health care records, were reconstructed into conditional variables representing growth velocity independent of earlier growth. Weight was adjusted for corresponding height. Linear regression models were adjusted for multiple confounders. Birth length and growth in height before 7 years of age were positively associated with femoral neck area (p <0.05) and growth in height at all age periods studied with spine bone area (p <0.01). Growth in height before the age of 7 years was associated with BMC in the femoral neck (p <0.01) and birth length and growth in height before the age of 7 years were associated with BMC in the spine (p <0.05). After entering adult height into the models, nearly all associations disappeared. Weight gain during childhood was not associated with bone area or BMC, and aBMD was not associated with early growth. Optimal growth in height in girls is important for obtaining larger skeleton and consequently higher bone mass. However, when predicting bone mineral mass among elderly women, information on early growth does not improve prediction beyond that predicted by current height and weight.Peer reviewe

Patient Aggression and the Wellbeing of Nurses: A Cross-Sectional Survey Study in Psychiatric and Non-Psychiatric Settings

Wellbeing of nurses is associated with patient aggression. Little is known about the differences in these associations between nurses working in different specialties. We aimed to estimate and compare the prevalence of patient aggression and the associations between patient aggression and the wellbeing of nurses in psychiatric and non-psychiatric specialties (medical and surgical, and emergency medicine). A sample of 5288 nurses (923 psychiatric nurses, 4070 medical and surgical nurses, 295 emergency nurses) participated in the study. Subjective measures were used to assess both the occurrence of patient aggression and the wellbeing of nurses (self-rated health, sleep disturbances, psychological distress and perceived work ability). Binary logistic regression with interaction terms was used to compare the associations between patient aggression and the wellbeing of nurses. Psychiatric nurses reported all types of patient aggression more frequently than medical and surgical nurses, whereas nurses working in emergency settings reported physical violence and verbal aggression more frequently than psychiatric nurses. Psychiatric nurses reported poor self-rated health and reduced work ability more frequently than both of the non-psychiatric nursing groups, whereas medical and surgical nurses reported psychological distress and sleep disturbances more often. Psychiatric nurses who had experienced at least one type of patient aggression or mental abuse in the previous year, were less likely to suffer from psychological distress and sleep disturbances compared to medical and surgical nurses. Psychiatric nurses who had experienced physical assaults and armed threats were less likely to suffer from sleep disturbances compared to nurses working in emergency settings. Compared to medical and surgical nurses, psychiatric nurses face patient aggression more often, but certain types of aggression are more common in emergency settings. Psychiatric nurses have worse subjective health and work ability than both of the non-psychiatric nursing groups, while their psychiatric wellbeing is better and they have less sleep problems compared to medical and surgical nurses. Psychiatric nurses maintain better psychiatric wellbeing and experience fewer sleep problems than non-psychiatric nurses after events of exposure to patient aggression. This suggest that more attention should be given to non-psychiatric settings for maintaining the wellbeing of nurses after exposure to patient aggression

Feasibility, Acceptability, and Preliminary Impacts of Web-Based Patient Education on Patients With Schizophrenia Spectrum Disorder: Quasi-Experimental Cluster Study

Background: Web-based interventions are promising tools for increasing the understanding of illness and treatment among patients with serious mental disorders.Objective: This study aimed to test the feasibility and acceptability of a Web-based patient education intervention using a quasi-experimental cluster design to report feedback on patient education sessions and the website used and to report preliminary evidence of the intervention's impact on patients with schizophrenia spectrum disorder.Methods: A single-blind, parallel, quasi-experimental cluster study over a 6-month period comparing Web-based education (n=33) with a nonequivalent control group (treatment as usual, n=24) for people with schizophrenia spectrum disorder was conducted. Participants (N=57) were recruited from one psychiatric hospital (6 wards). Feasibility was assessed by participants' commitment (refusal rate, dropout rate) to the study. Acceptability was assessed as participants' commitment to the intervention. Patient education sessions and website feedback were assessed by the patients and health care professionals. The preliminary impact of the sessions on patients' self-efficacy, self-esteem, illness cognition, and knowledge level was measured at baseline and follow-ups (8 weeks, 6 months) with self-rated questionnaires.Results: The refusal rate among patients was high with no statistically significant difference (69% [74/107] in the intervention group, 76% [76/100] in the control group; P =.21). The same result was found for the dropout rates (48% [16/33] vs 58% [14/24]; P=. 46). The acceptability of the intervention was good; 31 participants out of 33 (94%) completed all five sessions. Feedback on the intervention was mainly positive; three out of four subscales of session were rated above the midpoint of 4.0. Feedback on the website was also positive, with a grade of good for content (69%, 20/29 patients; 75%, 21/28 professionals), layout (62%, 18/29 patients; 61%, 17/28 professionals), and usability (62%, 18/29 patients; and 68%, 19/28 professionals). The patients using the intervention had significantly higher scores 6 months after the sessions in self-efficacy (baseline mean 26.12, SD 5.64 vs 6-month mean 29.24, SD 6.05; P=.003) and regarding knowledge level about schizophrenia (mean 11.39, SD 4.65 vs 6-month mean 15.06, SD 5.26; P=. 002), and lower scores in the subscale of helplessness in illness cognition (mean 2.26, SD 0.96 vs 6-month mean 1.85, SD 0.59; P=.03). Differences from the control group were not significant. No differences were found in patients' self-esteem or other subscales in illness cognition.Conclusions: The patients were reluctant to participate in the study and tended to drop out before the follow-ups. Once they had participated, their acceptance of the intervention was high. A more effective recruitment strategy and monitoring method will be needed in future studies. To assess the impact of the intervention, a more rigorous study design with an adequately powered sample size will be used in cooperation with outpatient mental health services

The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09–0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05–2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42–4.95; p &lt; 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13–0.56; p = 0.001; I2 = 54.1%) (p &lt; 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers’ psychological well-being is assessed and supported, to benefit both themselves and those for whom they care

Waveguide model of the hearing aid earmold system

BACKGROUND: The earmold system of the Behind-The-Ear hearing aid is an acoustic system that modifies the spectrum of the propagated sound waves. Improper selection of the earmold system may result in deterioration of sound quality and speech intelligibility. Computer modeling methods may be useful in the process of hearing aid fitting, allowing physician to examine various earmold system configurations and choose the optimum one for the hearing aid user. METHODS: In this paper, a computer model adequate for this task is proposed. This model is based on the waveguide modeling method. The waveguide model simulates the propagation of sound waves in the system of cylindrical tubes. Frequency response of the hearing aid receiver is simulated in the model and the influence of the ear canal and the eardrum on the earmold system is taken into account. The model parameters are easily calculated from parameters of a physical hearing aid system. Transfer function of the model is calculated and frequency response plots are obtained using the Matlab system. RESULTS: The frequency response plots of the earmold model were compared to the measurement plots of the corresponding physical earmold systems. The same changes in frequency responses caused by modification of length or diameter of a selected waveguide section, are observed in both measurement data of a real earmold system and in computed model responses. CONCLUSION: Comparison of model responses obtained for various sets of parameters with measurement data proved that the proposed model accurately simulates the real earmold system and the developed model may be used to construct a computer system assisting the physician who performs earmold system fitting