The experiments described in this thesis investigate the temporal relationship between frequency bands in a cochlear implant sound processor. Initial studies were of cochlea-based traveling wave delays for cochlear implant sound processing strategies. These were later broadened into studies of an ensemble of across-frequency delays. / Before incorporating cochlear delays into a cochlear implant processor, a set of suitable delays was determined with a psychoacoustic calibration to pitch perception, since normal cochlear delays are a function of frequency. The first experiment assessed the perception of pitch evoked by electrical stimuli from cochlear implant electrodes. Six cochlear implant users with acoustic hearing in their non-implanted ears were recruited for this, since they were able to compare electric stimuli to acoustic tones. Traveling wave delays were then computed for each subject using the frequencies matched to their electrodes. These were similar across subjects, ranging over 0-6 milliseconds along the electrode array. / The next experiment applied the calibrated delays to the ACE strategy filter outputs before maxima selection. The effects upon speech perception in noise were assessed with cochlear implant users, and a small but significant improvement was observed. A subsequent sensitivity analysis indicated that accurate calibration of the delays might not be necessary after all; instead, a range of across-frequency delays might be similarly beneficial. / A computational investigation was performed next, where a corpus of recorded speech was passed through the ACE cochlear implant sound processing strategy in order to determine how across-frequency delays altered the patterns of stimulation. A range of delay vectors were used in combination with a number of processing parameter sets and noise levels. The results showed that additional stimuli from broadband sounds (such as the glottal pulses of vowels) are selected when frequency bands are desynchronized with across-frequency delays. Background noise contains fewer dominant impulses than a single talker and so is not enhanced in this way. / In the following experiment, speech perception with an ensemble of across-frequency delays was assessed with eight cochlear implant users. Reverse cochlear delays (high frequency delays) were equivalent to conventional cochlear delays. Benefit was diminished for larger delays. Speech recognition scores were at baseline with random delay assignments. An information transmission analysis of speech in quiet indicated that the discrimination of voiced cues was most improved with across-frequency delays. For some subjects, this was seen as improved vowel discrimination based on formant locations and improved transmission of the place of articulation of consonants. / A final study indicated that benefits to speech perception with across-frequency delays are diminished when the number of maxima selected per frame is increased above 8-out-of-22 frequency bands.

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The employment of audiology assistants to relieve masters and doctoral level audiologists of routine tasks is a timely and controversial topic in our field. Berardino (2000) examined the roles of audiology assistants within Veteran’s Administration (VA) Hospitals using an e-mail survey that was sent out to VA audiologists. The results of that survey suggested that the majority of VA audiologists were in favor of the participation of audiology assistants in the clinic to varying degrees. The purpose of this survey was to determine the current attitudes of audiologists and otolaryngologists toward the role of audiology assistants in the hearing health care profession. The attitudes and opinions of otolaryngologists were of particular interest because this population had not been included in earlier surveys despite the fact that they often employ both audiologists and audiology assistants. The survey was e-mailed to a randomly selected group of audiologists and otolaryngologists. In addition to general opinion and demographic questions, participants were asked to rate specific audiology tasks on a six-point scale ranging from very appropriate to very inappropriate. Results indicate that audiologists and otolaryngologists generally agree on which tasks are appropriate for audiology assistants; however, audiologists feel audiology assistants may be a threat to the profession of audiology whereas otolaryngologists do not.

Global surgery describes the systematic way to reduce health disparities and realize accessibility and sustainability in surgical care. Nearly five billion individuals lack access to adequate and necessary surgical and peri-surgical care. The contemporary model of global surgery is that of short-term surgical trips, which have origins in European and North American colonialism. The current state of global surgery in the surgical subspecialty of otolaryngology and head & neck surgery (OHNS) care fails to meet an adequate ethical threshold based on traditional bioethical principles. In order to improve the system of global OHNS care to promote sustainability and long-term impact, global OHNS care needs to shift away from providing direct clinical care. This work presents an ethical framework composed of four primary domains—(1) preparation and understanding the local context, (2) education, (3) partnership and exchange, (4) research and evaluation. This model can be used to shephard a future with stronger ethical global OHNS care. / Urban Bioethics

Deterioration in voice quality following radiation therapy for the treatment of laryngeal cancers (LC) is well documented in literature. The majority of studies show that these voice problems are long term and in some cases permanent. Deterioration in voice quality, especially over a period of time could lead to significant communication difficulties in daily life or in some cases could even result in loss of profession. Despite the negative effects of radiation therapy on voice quality being well documented, few studies have focused on the efficacy of voice therapy in the irradiated LC population. The purpose of this study was to investigate the efficacy of a well researched, evidence based voice therapy approach, known as Vocal Function Exercises (VFEs) in improving vocal function in patients who have been irradiated for LCs. The present study conducted in three systematic stages with distinct and related study aims. The first involved characterizing the head and neck cancer treatment seeking population at the University of Kentucky (UK). Stage 2 involved characterizing vocal function following irradiation for LC using a multidimensional assessment approach. Stage 3 was a phase 2 clinical trial aimed at treating these deficits in vocal function identified through stage 2 using a systematic evidence based voice therapy approach, Vocal Function Exercises. For the phase 2 clinical trial, the comparison group received vocal hygiene (VH) counseling. Observations from stage 1 showed that majority of patients from the treatment seeking population at UK between a 3 year time period from 2008 to 2010 were diagnosed with laryngeal cancers and were treated with chemoradiation therapy. Stage 2 demonstrated a multidimensional deterioration in vocal function following radiation therapy for laryngeal cancers. Stage 3 demonstrated a significant improvement in vocal function across the primary outcome measure (Voice Handicap Index) as a result of VFE+VH. Improvements were also seen in select parameters across the five domains of voice assessment in the VFE group. No significant improvements were observed in the vocal hygiene group in any parameters in each domain of voice assessment. Our study demonstrated adults irradiated for laryngeal cancers demonstrated a multi-dimensional deterioration of vocal function. These changes were long term since study participants were 2- 7 years post radiation therapy. Implementation of VFE+VH demonstrated a significant improvement in voice related quality of life and select parameters across the five domains of voice assessment. The present study demonstrated promising preliminary evidence for the use of VFE+VH to improve vocal function in patients irradiated for laryngeal cancers.

Chronic otitis media (OM) is an archetypal complex disease, which is particularly prevalent in childhood. Epidemiological data suggest high heritability for disease susceptibility, but previous genetic association studies have had methodological flaws, and none have specifically focused on chronic OM phenotypes. Mouse models represent one way to ascertain candidate loci for human association testing. A number of mouse models of middle ear inflammation have been reported, but many susceptibility loci remain undiscovered. I demonstrate that oto-endoscopy is a robust and scalable phenotyping platform for OM in the mouse, and discuss its value in new model discovery. Chronic OM is also a feature of trisomy HSA21 (Down Syndrome). Through an interrogation of the mouse library of segmental trisomy models of Down Syndrome, I identify a critical trisomic region for chronic otitis media. This region may underlie OM susceptibility in Down Syndrome, but could also contribute to disease susceptibility in non-syndromic disease. Mouse models can also be used to interrogate disease mechanisms. Our previous work has shown that the chronically inflamed middle ear is hypoxic, and that hypoxia signalling is a potential therapeutic target. Exploiting the Junbo mouse model, I demonstrate that surgical ventilation of the Junbo ear improves inflammation, and that this is associated with loss of hypoxia signalling. I present preliminary results from transcript analyses of human middle ear effusions showing marked upregulation of hypoxia signalling. A systematic review of existing mouse models suggests that the loci FBXO11, EVI1, SMAD2, and TGIF1 are good candidates genes for human association testing. I detail recruitment and collection of DNA from families in the UK where a child is undergoing grommet insertion. Association testing using a variant of the transmission disequilibrium test shows susceptibility associated with polymorphisms at FBXO11, and possibly also SMAD2 and TGIF1.

Professional research project (Au.D.)--University of South Florida, 2002. / Title from PDF of title page. / Document formatted into pages; contains 35 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The employment of audiology assistants to relieve masters and doctoral level audiologists of routine tasks is a timely and controversial topic in our field. Berardino (2000) examined the roles of audiology assistants within Veteran's Administration (VA) Hospitals using an e-mail survey that was sent out to VA audiologists. The results of that survey suggested that the majority of VA audiologists were in favor of the participation of audiology assistants in the clinic to varying degrees. / The purpose of this survey was to determine the current attitudes of audiologists and otolaryngologists toward the role of audiology assistants in the hearing health care profession. The attitudes and opinions of otolaryngologists were of particular interest because this population had not been included in earlier surveys despite the fact that they often employ both audiologists and audiology assistants. The survey was e-mailed to a randomly selected group of audiologists and otolaryngologists. In addition to general opinion and demographic questions, participants were asked to rate specific audiology tasks on a six-point scale ranging from very appropriate to very inappropriate. / Results indicate that audiologists and otolaryngologists generally agree on which tasks are appropriate for audiology assistants; however, audiologists feel audiology assistants may be a threat to the profession of audiology whereas otolaryngologists do not. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

This item contains the agenda, minutes, and attachments for the Faculty Senate meeting on this date. There may be additional materials from the meeting available at the Faculty Center.

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Purpose The purpose of this study was to quantify the number of surgical programs currently training osteopathic residents and to solicit advice for current osteopathic medical students who are interested in pursuing a surgical residency. Methods A questionnaire was sent to all listed Electronic Residency Application Service® (ERAS®) email contacts for the following specialties: General Surgery, Neurological Surgery, Orthopedic Surgery, Otolaryngology, Urology, Integrated Vascular Surgery, Integrated Plastic Surgery, and Integrated Thoracic Surgery. The questionnaire was sent a total of three times. Results Two hundred sixty-four of the 1,040 surgical residency programs responded to the questionnaire. Of these responses, 19% were formerly American Osteopathic Association (AOA) accredited programs. About 47.3% of responding programs indicated they are not currently training an osteopathic physician. One hundred thirteen programs provided additional comments on how osteopathic medical students may improve the competitiveness of their residency applications. These comments included increasing volumes of research activities, performing well on the United States Medical Licensing Exam (USMLE), and completing a sub-internship in the desired field or at a specific institution. Conclusion Osteopathic students still face many barriers to matching into surgical residencies. This study provides concrete steps students may take to increase the competitiveness of their application.