Cognitive processing and body balance in elderly subjects with vestibular dysfunction

Abnormal body balance and cognitive dysfunction may develop in elderly patients with chronic vestibular dysfunction.AimTo evaluate the relationship between cognitive processing and body balance in elderly patients with chronic peripheral vestibular disease. Type of Study: Cross-sectional.MethodsSeventy-six patients (≥ 60 years) with chronic peripheral vestibular dysfunction and dizziness for more than three months were enrolled. The tests for investigating body balance were: the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) Timed Up and Go Test modified (TUGTm); the Mini Mental State Examination (MMSE), Test Clock (RT,) and Verbal Fluency Test (VF) were applied for assessing cognition.ResultsThe mean age was 69.03 years (SD=6.21 years); most were female (82.9%). There was a significant negative correlation between the MMSE and the TUGT (ρ=-0.312; p=0.01), MMSE and TUGTm (ρ=-0.306; p=0.01), FV and TUGT (ρ=-0.346; p=0.01), and FV and TUGTm (ρ=-0.536; p=0.01); there was a significant positive correlation between the TR and BBS (ρ=0.343; p=0.01), TR and DGI (ρ=0.298; p=0.01), FV and BBS (ρ=0.299; p=0.01), and FV and DGI (ρ=0.306; p=0.01).ConclusionElderly patients with chronic peripheral vestibular disease and worse performance in body balance tests have functional impairment in cognitive skills.     

Uncomfortable loudness levels among children and adolescents seeking help for tinnitus and/or hyperacusis

Objective: To assess the prevalence of hyperacusis and severe hyperacusis among children and adolescents seen at an audiology outpatient tinnitus and hyperacusis service.

Design: This was a retrospective study. Hyperacusis was considered as present if the average uncomfortable loudness level (ULL) at 0.25, 0.5, 1, 2, 4 and 8?kHz for the ear with the lower average ULL, which is denoted as ULLmin, was ≤77?dB HL. Severe hyperacusis was considered as present if the ULL was 30?dB HL or less for at least one of the measured frequencies for at least one ear.

Study sample: There were 62 young patients with an average age of 12?years (SD?=?4.1?years, range 4–18?years).

Results: Eighty-five percent of patients had hyperacusis and 17% had severe hyperacusis. On average, ULLs at 8?kHz were 9.3?dB lower than ULLs at 0.25?kHz. For 33% of patients, ULLs were at least 20?dB lower at 8 than at 0.25?kHz.

Conclusions: Among children and adolescents seen at an audiology outpatient clinic for tinnitus and hyperacusis, hyperacusis diagnosed on the basis of ULLs is very prevalent and it is often characterised by lower ULLs at 8 than at 0.25?kHz.     

Early Experiences of Threat,but Not Deprivation,Are Associated With Accelerated Biological Aging in Children and Adolescents

Background

Recent conceptual models argue that early life adversity (ELA) accelerates development, which may contribute to poor mental and physical health outcomes. Evidence for accelerated development in youths comes from studies of telomere shortening or advanced pubertal development following circumscribed ELA experiences and neuroimaging studies of circuits involved in emotional processing. It is unclear whether all ELA is associated with accelerated development across global metrics of biological aging or whether this pattern emerges following specific adversity types.

The assessment of fitness to stand trial for defendants with an intellectual disability: A proposed assessment procedure involving mental health professionals and lawyers

Guidelines for mental health professionals regarding an assessment of fitness to stand trial procedure that is functional, context‐dependent and pragmatic (Grisso, 1988) are clearly required; no published tool exists in Australia. This article addresses Victorian legal criteria as outlined by the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 based upon the Presser criteria. It is argued that the procedure should include the lawyer's predictions regarding the complexity of the forthcoming trial and the ability of the defendant to communicate, together with the mental health professional's assessment of the capacity of the defendant to make decisions. Current difficulties in assessing fitness to stand trial will be presented and an assessment procedure to overcome them is proposed.     

Outdoor fungi and child asthma health service attendances

Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer‐reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged <18 yr, diagnosis of asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta‐analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross‐sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses.