Public Health Perspectives on Hearing Loss and Aging Outcomes: Preventive Care Utilization among Adults with Hearing Loss in the United States

Hearing loss (HL) can negatively impact patient–provider communication and limit access to health promotion information, which may lead to decreased preventive care utilization. Using data from the 2015 and 2018 National Health Interview Survey, we examined the association between perceived HL with and without hearing aid use with self-reported age-appropriate uptake of breast and colon cancer screening, and influenza and pneumococcal vaccination. In models adjusted for sociodemographic characteristics, access to care, and health status, people with HL had lower odds of receiving breast cancer screening (odds ratio [OR] = 0.83, 95% confidence interval [CI] = 0.72–0.96) and higher odds of receiving pneumococcal vaccination (OR = 1.11, 95% CI = 1.00–1.24) relative to those without HL. There were no differences in their colon cancer or influenza vaccination uptake. Compared with those without HL, people with HL who used hearing aids had increased odds of colon cancer screening and influenza and pneumococcal vaccination, while people with HL who did not use hearing aids were less likely to report cancer screening. Overall, Americans with untreated HL were less likely to report completing cancer screening. Hearing aid use may modify the association between HL and preventive care uptake. Screening for HL in primary care settings and communication trainings for providers may help reduce cancer screening disparities.     

Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

Objective

To investigate the use of time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems.

Methods

Time intervals from injury to admission, admission to surgery and surgery to discharge for patients with isolated femur fractures in four low- and middle-income countries were compared with the corresponding values from one German hospital, an Israeli hospital and the National Trauma Data Bank of the United States of America by means of Student’s t-tests. The correlations between the time intervals recorded in a country and that country’s expenditure on health and gross domestic product (GDP) were also evaluated using Pearson’s product moment correlation coefficient.

Findings

Relative to patients from high-income countries, those from low- and middle-income countries were significantly more likely to be male and to have been treated by open femoral nailing, and their intervals from injury to admission, admission to surgery and surgery to discharge were significantly longer. Strong negative correlations were detected between the interval from injury to admission and government expenditure on health, and between the interval from admission to surgery and the per capita values for total expenditure on health, government expenditure on health and GDP. Strong positive correlations were detected between the interval from surgery to discharge and general government expenditure on health.

Conclusion

The time intervals for the treatment of femur fractures are relatively long in low- and middle-income countries, can easily be measured, and are highly correlated with accessible and quantifiable country data on health and economics.     

1 year test–retest reliability of ImPACT in professional ice hockey players

The Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery is widely used to assess neurocognitive outcomes following sports-related concussion. The purpose of this study was to examine the 1 year test–retest reliability of ImPACT in a multilingual sample of professional hockey players. A total of 305 professional hockey players were tested 1 year apart using ImPACT. Reliable change confidence intervals were calculated and test–retest reliability was measured using Pearson and Intraclass correlation coefficients. Results indicated that the 1-year test–retest reliabilities for the Visual Motor and Reaction Time Composites ranged from low to high (.52 to .81). In contrast, 1-year test–retest reliabilities for the Verbal and Visual Memory Composites were low (.22 to .58). The 1-year test–retest results provided mixed support for the use of Visual Motor and Reaction Time Composites in select samples; in contrast, the Verbal and Visual Memory Composites may not be sensitive to clinical change.     

Development and preliminary validation of the First Episode Social Functioning Scale for early psychosis

The current study aimed at developing and conducting a preliminary validation a novel social functioning measure for people with early psychosis. The First Episode Social Functioning Scale (FESFS) was developed to cover many domains specific to this population in their contemporary reality. The self-report version of the FESFS was administered to 203 individuals receiving services in first episode clinics. Scores of the GAF, SOFAS, Social Functioning Scale and BPRS were also obtained for parts of the sample to calculate convergent and discriminant validity. A subgroup also answered the FESFS at several time points during treatment in order to determine sensibility to change. Principal component factor analyses and internal consistency analyses revealed the following nine factors with alphas ranging from 0.63 to 0.80: Friendships and social activities, Independent living skills, Interacting with people, Family, Intimacy, Relationships and social activities at work, Work abilities, Relationships and social activities at school, Educational abilities. Convergent and discriminant validity were demonstrated, as well as sensitivity to change. Clinical and research utility of the FESFS are discussed.