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PubMed1995

Altered rectal perception is a biological marker of patients with irritable bowel syndrome.

BACKGROUND & AIMS: Lowered visceral perception thresholds have been suggested as a biological marker of irritable bowel syndrome (IBS). The current study sought to determine the prevalence of altered rectal visceral perception in patients with IBS and the correlation of altered perception thresholds with subjective symptoms. METHODS: Anorectal manometry and rectal perception thresholds to balloon distention were determined in 100 patients with IBS and 15 control subjects. Gastrointestinal and psychological symptoms were assessed by questionnaire. Perception thresholds and symptoms were reassessed after 3 months in 15 patients with IBS. RESULTS: Ninety-four percent of patients showed altered rectal perception in the form of lowered thresholds for aversive sensations (discomfort), increased intensity of sensations, or altered viscerosomatic referral. Hypersensitivity was found only for aversive sensations in response to rapid phasic distention; stool thresholds and thresholds in response to slow ramp distention were normal. Cluster analysis by physiological parameters identified three IBS subgroups with predominant patterns of symptoms. Longitudinal evaluation indicated a correlation between changes in perception thresholds and symptom severity. CONCLUSIONS: Because altered rectal perception is present in almost all patients with IBS and perception thresholds correlate with temporal changes in retrospective symptom severity, altered rectal perception represents a reliable biological marker of IBS.

Adult↗

PubMed2004

Speech perception and speech intelligibility in children after cochlear implantation.

OBJECTIVE: This study aimed to evaluate the long-term speech perception and speech intelligibility of congenitally and prelingually deaf children after cochlear implantation. It was a longitudinal study following 63 congenitally or prelingually deaf children up to 5 years after implantation. They each received a nucleus multichannel cochlear implant before they were 10 years old. METHODS: Perception is evaluated using the Test for the Evaluation of Voice Perception and Production (TEPP) and concerns closed- and open-set word and sentence perception without lip-reading. The intelligibility is classified according to the Speech Intelligibility Rating (SIR). The evaluations have been made every 3 months for 1 year, then at 18 months, 2 years, 3 years and 5 years after the cochlear implantation. RESULTS: After 5 years of implantation, the median percentage of closed-words speech perception (CSW) is 95.5%-93.67% for closed-sentence speech perception (CSS) and 76.3% for open-sentence speech perception (OSS); the median Speech Intelligibility Rating is 3.83. CONCLUSIONS: Congenitally and prelingually deaf children who receive cochlear implant before the age of 10 years develop speech perception and speech intelligibility abilities. The closed-set perception progresses quickly and seems to reaching a plateau at 5 years post implantation. The improvement of open-sentence perception is not significant until the first year post implantation. The speech intelligibility improves regularly the five first year post implantation.

Audiometry, Speech↗

PubMed2004

Deficits in facial emotion perception in adults with recent traumatic brain injury.

UNLABELLED: We examined whether facial emotion perception was compromised in adults with recent traumatic brain injury (TBI). Few studies have examined emotion perception in TBI; those that have, examined chronic patients only. Recent and chronic TBI populations differ according to degree of functional reorganization of the brain, use of compensatory strategies, and severity of cognitive impairments--any of which might differentially affect presentation of emotion perception deficits. A secondary aim of the study was to utilize the TBI population--in whom diffuse axonal injury (DAI) is a cardinal neurological feature--to examine the suggestion of Adolphs et al. [Journal of Neuroscience 20(7) (2000) 2683] that damage to white matter tracts should give rise to emotion perception deficits. METHODS: Thirty TBI participants and 30 age-matched controls were tested. A 2 x 3 mixed design was employed. The dependent variable was accuracy on neutral and emotional face perception tests. RESULTS: (1) The TBI group performed significantly less accurately than the matched controls on the facial emotion perception tasks, whereas the groups performed equivalently on a non-emotional face perception control task. (2) A sub-group of TBI participants without evidence of focal injury to areas of the brain most commonly implicated in facial emotion perception was as impaired on the emotion perception tasks as a second sub-group who had sustained focal lesions to these areas. This suggests an alternative neurological mechanism for deficits in the first sub-group, such as DAI. CONCLUSIONS: Patients with recently acquired TBI are impaired in their ability to perceive emotions in faces. DAI alone may cause facial emotion perception deficits.

Adult↗

PubMed2006

Perception of dyspnea during exacerbation and histamine-related bronchoconstriction in patients with asthma.

BACKGROUND: Numerous studies have been performed concerning the perception of dyspnea during changes in airway caliber provoked in the laboratory setting, but studies of asthma exacerbation are scarce. OBJECTIVE: To investigate whether the perception of dyspnea during histamine-induced bronchoconstriction might be used to identify patients with asthma who sense dyspnea poorly during exacerbation. METHODS: The perception of dyspnea in 50 patients (45 female, 5 male) with asthma was evaluated at admission with exacerbation and during a stable period. Perceived intensity of dyspnea was estimated using a modified Borg scale. The perception of dyspnea in the stable period 4 to 6 weeks after exacerbation was measured with the histamine challenge test. Perception parameters were defined as the change in Borg score divided by the change in forced expiratory volume in 1 second (FEV1) as a percentage of the baseline FEV1 (deltaBorg/deltaFEV1) and as the Borg score at 20% decrease (PS20Histamine) or increase (PS20Exacerbation) in FEV1. RESULTS: The perception of dyspnea during asthma exacerbation was unrelated to the perception of dyspnea during histamine-induced bronchoconstriction (for deltaBorg/deltaFEV1, beta = .08, P = .50; for PS20, beta = -.11, P = .40). The kappa value for the agreement of poor perceivers at exacerbation and during the stable period was -0.21 (P = .10). However, the intensity of dyspnea caused by histamine-induced bronchoconstriction was lower than that caused by asthma exacerbation (PS20: 1.6 +/- 1.1 vs 2.8 +/- 2.5, respectively, P = .004; deltaBorg/deltaFEV1: 0.08 +/- 0.05 vs 0.21 +/- 0.28, respectively, P = .001). CONCLUSION: The perception of dyspnea during asthma exacerbation is not correlated with the perception of dyspnea during histamine-induced bronchoconstriction. Therefore, the perception of dyspnea during histamine-induced bronchoconstriction cannot be used to identify the asthmatic patients who perceive dyspnea poorly.

Adult↗

PubMed1997

Attention and distraction: effects on gut perception.

BACKGROUND & AIMS: Paying attention to the gut may magnify perception of abdominal symptoms, but the actual influence of attention by anticipatory knowledge and distraction on gut perception remains poorly defined. The aim of this study was to determine whether mental activity, attention vs. distraction, affects intestinal perception and whether mental effects are synergistic with other modulatory mechanisms. METHODS: Perception of 1-minute intestinal balloon distentions applied at 7-13-minute random intervals was measured in healthy subjects. First, distentions were tested during attention by anticipatory knowledge and during distraction (n = 8). Because somatic transcutaneous electrical nerve stimulation (TENS) reduces gut perception, distentions were then tested during attention alone, attention plus somatic TENS, and during distraction plus TENS (n = 8). RESULTS: Perception of intestinal distentions was higher during attention than during distraction (3.3 +/- 0.2 vs. 2.9 +/- 0.1 [mean +/- SEM]; P < 0.05). The area of somatic projection was greater during attention (P < 0.05). Intestinal compliance and oral reflex relaxation remained unchanged. During application of somatic TENS, perception of intestinal distention was higher during attention than distraction (2.4 +/- 0.3 vs. 1.7 +/- 0.2; P < 0.05). However, TENS did not alter the perception score during attention. CONCLUSIONS: Mental activity may modulate gut perception and overrides the effects of somatic TENS on gut perception.

Adult↗

PubMed2003

Factors associated with development of speech perception skills in children implanted by age five.

OBJECTIVE: This study investigated factors contributing to speech perception outcomes in children with prelingual deafness after 4 to 7 yr of multichannel cochlear implant use. The analysis controlled for the effects of child, family and implant characteristics so that educational factors most conducive to maximum implant benefit could be identified. DESIGN: One hundred eighty-one 8- and 9-yr-old children from across the US and Canada who received a cochlear implant by age 5 were administered a battery of speech perception tests. Type and amount of educational intervention since implantation constituted the independent variables. Characteristics of the child, the family, and the implant itself constituted intervening variables. A series of multiple regression analyses determined the amount of variance in speech perception ability accounted for by the intervening variables and the amount of additional variance attributable to independent variables. RESULTS: The children achieved an average level of about 50% open-set speech perception through listening alone and almost 80% through lipreading and listening together, but with scores for individual children ranging from 0 to 100% correct. Over half of the variance in speech perception scores was predicted by characteristics of the child, family, implant and educational program. Significant predictors of good speech perception included greater nonverbal intelligence, smaller family size, longer use of the updated SPEAK/CIS processing strategy, a fully active electrode array, greater electrical dynamic range between threshold and maximum comfort level, and greater growth of loudness with increasing stimulus intensity. After the variance due to these variables was controlled, the primary rehabilitative factor associated with good speech perception skill development was educational emphasis on oral-aural communication. CONCLUSIONS: Children with profound hearing loss achieved unprecedented levels of speech perception skill 4 to 7 yr after cochlear implantation. Use of an updated speech processor, such as SPEAK, contributed significantly to improved speech perception skills, even in children who were initially fitted with an earlier strategy, such as M-PEAK. In addition, the audiologist who programs the cochlear implant makes an important contribution to the child's successful outcome with the device. A well-fitted map, as evidenced by a wide dynamic range and optimal growth of loudness characteristics, contributed substantially to the child's ability to hear speech. Finally, the classroom communication mode used in the child's school affects speech perception outcome. Children whose educational program emphasized dependence on speech and audition for communication were better able to use the information provided by the implant to understand speech.

Canada↗

PubMed2006

Effects of language experience and stimulus complexity on the categorical perception of pitch direction.

Whether or not categorical perception results from the operation of a special, language-specific, speech mode remains controversial. In this cross-language (Mandarin Chinese, English) study of the categorical nature of tone perception, we compared native Mandarin and English speakers' perception of a physical continuum of fundamental frequency contours ranging from a level to rising tone in both Mandarin speech and a homologous (nonspeech) harmonic tone. This design permits us to evaluate the effect of language experience by comparing Chinese and English groups; to determine whether categorical perception is speech-specific or domain-general by comparing speech to nonspeech stimuli for both groups; and to examine whether categorical perception involves a separate categorical process, distinct from regions of sensory discontinuity, by comparing speech to nonspeech stimuli for English listeners. Results show evidence of strong categorical perception of speech stimuli for Chinese but not English listeners. Categorical perception of nonspeech stimuli was comparable to that for speech stimuli for Chinese but weaker for English listeners, and perception of nonspeech stimuli was more categorical for English listeners than was perception of speech stimuli. These findings lead us to adopt a memory-based, multistore model of perception in which categorization is domain-general but influenced by long-term categorical representations.

Acoustic Stimulation↗

PubMed1998

Parents' influence on children's achievement-related perceptions.

Two aspects of the relation between parents' perceptions of their children and children's self- and task perceptions in math and English were investigated: (a) the mediating role of parents' perceptions between grades and adolescents' self-perceptions and (b) the gendered nature of parents' perceptions. Data for this study are part of a longitudinal investigation (the Michigan Study of Adolescent Life Transitions). Data from 914 sixth-grade adolescents and their parents are used in this article. Results showed that parents' perceptions mediate the relation between children's grades and children's self- and task perceptions in both domains. Parents' perceptions had a stronger influence on children's perceptions than children's own grades. Significant but low correlations between gender and self- and task perceptions were found in both math and English.

Achievement↗

PubMedDate not supplied

Patient-practitioner perceptions: can chiropractors assume congruence?

BACKGROUND: Advances in mind-body medicine have resulted in the realization that beliefs can modulate pathophysiologic processes. Because symbolic interaction affects health status, perceptions and the congruence between the perceptions of chiropractors and their patients become a relevant clinical consideration. OBJECTIVE: A case study to explore the congruence of health-relevant perceptions of chiropractors and their patients was undertaken. METHOD: This Australian case study was undertaken to explore the concurrence of patient-practitioner perceptions with respect to the patient's stress levels, the importance of injury as a causative factor in the presenting symptom and the responsibility the patient should take "in getting themselves well." Purposive sampling of practitioners and convenience sampling of patients was undertaken. Data were collected by means of a patient questionnaire and a practitioner questionnaire and interview. Data were analyzed to determine the congruence of patient-practitioner perceptions within each of 173 consultations. RESULTS: A total of 9 practitioners and 173 patients participated. Within each patient-practitioner dyad, congruence of perceptions was <50% in each of 3 dimensions examined. Most patients believed they should take a high level of responsibility for "getting well." DISCUSSION: Although the results of a case study cannot be extrapolated to the chiropractic patient population, this study does suggest that it may be prudent for chiropractors to ascertain the extent to which their patients share their perceptions of the presenting clinical problem. "Thinking hats" are proposed as a helpful perception management tool. CONCLUSION: This exploratory study suggests that practitioners should not assume that their patients share their perceptions. Given that each patient-practitioner encounter is unique, it may be prudent for chiropractors to actively ascertain the patient's opinions. A patient's perception of his or her responsibility for "getting well" should be harnessed in developing management plans with high compliance.

Chiropractic↗

PubMed1996

Job satisfaction and perceptions of health.

Workers' perceptions of health have become one focus of research on the costs of health care, yet little is understood about the relationship between perceptions of health and perceptions of work. An exploratory cross-sectional study was conducted on a large southern university campus to determine if perceptions of select facets of work were related to perceptions of health. Results indicated that satisfactory perceptions of coworkers was the strongest predictor of current and future health perceptions, and the strongest predictor of perceptions of resistance to illness. Other significant job-facet predictors of health perceptions were autonomy, the work done on the present job, and pay. Satisfaction with supervision and opportunities for promotion were not predictive of health-perception measures. Implications for enhanced employee health include a greater emphasis on coworker relationships, especially in the current context of organizational change in business and industry.

Adult↗

PubMed1997

Changes over a workshift in aesthesiometric and vibrotactile perception thresholds of workers exposed to intermittent hand transmitted vibration from impact wrenches.

OBJECTIVES: To investigate the changes over a workshift in fingertip tactile perception thresholds in users of impact wrenches exposed to intermittent hand transmitted vibration. A further aim was to assess the relation between acute changes in tactile sensation, sensorineural disorders, and vibration dose. METHODS: The study populations consisted of 30 workers exposed to vibration (16 men and 14 women) and 25 control manual workers (10 men and 15 women). Sensorineural disorders in the fingers and hands were graded according to the staging system of the Stockholm workshop scale. Tactile function was tested by measuring aesthesiometric thresholds (two point discrimination and depth sense perception) and vibrotactile perception thresholds at 16, 31.5, and 125 Hz before and after a workshift. Temporary threshold shift was then calculated as the difference between threshold measures before and after the shift. The measurement and assessment of exposure to vibration were made according to the international standard ISO 5349. The vibration dose accumulated over a workshift (m2s-4h) was estimated for each user of impact wrenches. Daily exposure to vibration was also expressed in terms of eight hour energy equivalent frequency weighted acceleration ((ahw)eq(8) in ms-2 rms). RESULTS: After adjustment for age and alcohol consumption, vibrotactile perception thresholds before exposure were greater in the workers exposed to vibration than in the controls. No differences in aesthesiometric thresholds before the shift were found between the study groups. Sensorineural disorders were mild in the workers exposed to vibration and minor neurological abnormalities were detected at the physical examination. Owing to the intermittent use of impact wrenches, the estimated mean (ahw)eq(8) for the subjects exposed to vibration was low (1.3 ms-2 rms). A significant temporary threshold shift in vibration perception at all test frequencies was found in the workers exposed to vibration but not in the controls. A significant increase in depth sense perception thresholds was found in the men exposed to vibration. The temporary threshold shift in vibration perception at 125 Hz, and to a lesser extent at 16 and 31.5 Hz, was associated with the severity of sensorineural disorders. In the workers exposed to vibration the temporary threshold shift in vibration sense at all test frequencies was positively related to the estimated dose of vibration received over a workshift. No significant relation was found between aesthesiometric threshold changes and vibration dose. CONCLUSIONS: Intermittent exposure to hand transmitted vibration over a workshift can cause a deterioration of tactile perception in the fingers of users of impact wrenches. Acute tactile dysfunction was related to both the estimated dose of vibration and the severity of sensorineural symptoms. The temporary threshold shift in vibration perception suggested that fast adapting skin mechanoreceptors such as Pacinian and Meissner corpuscles were mainly involved in the acute sensory impairment to the fingertips of the workers exposed to vibration. Changes in tactile perception can occur in workers with daily exposure to vibration that is considered to be associated with a minimal risk of adverse health effects induced by vibration.

Adult↗

PubMedDate not supplied

Comparing the standard rating scale and the magnifier scale for assessing risk perceptions.

OBJECTIVE: A new risk perception rating scale ("magnifier scale") was recently developed to reduce elevated perceptions of low-probability health events, but little is known about its performance. The authors tested whether the magnifier scale lowers risk perceptions for low-probability (in 0%-1% magnifying glass section of scale) but not high-probability (>1%) events compared to a standard rating scale (SRS). METHOD: In studies 1 (n = 463) and 2 (n = 105), undergraduates completed a survey assessing risk perceptions of high- and low-probability events in a randomized 2 x 2 design: in study 1 using the magnifier scale or SRS, numeric risk information provided or not, and in study 2 using the magnifier scale or SRS, high- or low-probability event. In study 3, hypertension patients at the Philadelphia Veterans Affairs hospital completed a similar survey (n = 222) assessing risk perceptions of 2 self-relevant high-probability events-heart attack and stroke-with the magnifier scale or the SRS. RESULTS: In study 1, when no risk information was provided, risk perceptions for both high- and low-probability events were significantly lower (P < 0.0001) when using the magnifier scale compared to the SRS, but risk perceptions were no different by scale when risk information was provided (interaction term: P = 0.003). In studies 2 and 3, risk perceptions for the high-probability events were significantly lower using the magnifier scale than the SRS (P = 0.015 and P = 0.014, respectively). CONCLUSIONS: The magnifier scale lowered risk perceptions but did so for low- and high-probability events, suggesting that the magnifier scale should not be used for assessments of risk perceptions for high-probability events.

Female↗

PubMed2004

Risk perceptions and their relation to risk behavior.

BACKGROUND: Because risk perceptions can affect protective behavior and protective behavior can affect risk perceptions, the relations between these 2 constructs are complex and incorrect tests often lead to invalid conclusions. PURPOSE: To discuss and carry out appropriate tests of 3 easily confused hypotheses: (a). the behavior motivation hypothesis (perceptions of personal risk cause people to take protective action), (b). the risk reappraisal hypothesis (when people take actions thought to be effective, they lower their risk perceptions), and (c). the accuracy hypothesis (risk perceptions accurately reflect risk behavior). METHODS: Longitudinal study with an initial interview just after the Lyme disease vaccine was made publicly available and a follow-up interview 18 months later. Random sample of adult homeowners (N = 745) in 3 northeastern U.S. counties with high Lyme disease incidence. Lyme disease vaccination behavior and risk perception were assessed. RESULTS: All 3 hypotheses were supported. Participants with higher initial risk perceptions were much more likely than those with lower risk perceptions to get vaccinated against Lyme disease (OR = 5.81, 95% CI 2.63-12.82, p <.001). Being vaccinated led to a reduction in risk perceptions, chi2(1, N = 745) = 30.90, p <.001, and people vaccinated correctly believed that their risk of future infection was lower than that of people not vaccinated (OR =.44, 95% CI.21-.91, p <.05). CONCLUSIONS: The behavior motivation hypothesis was supported in this longitudinal study, but the opposite conclusion (i.e., that higher risk led to less protective behavior) would have been drawn from an incorrect test based only on cross-sectional data. Health researchers should take care in formulating and testing risk-perception-behavior hypotheses.

Adult↗

PubMed2006

Post-traumatic stress disorder and illness perceptions over time following myocardial infarction and subarachnoid haemorrhage.

OBJECTIVES: This study investigated post-traumatic stress disorder (PTSD) symptoms and illness perceptions in people who suffered the acute medical trauma of a myocardial infarction (MI) or a subarachnoid haemorrhage (SAH). The study tested hypotheses regarding changes in PTSD symptoms and illness perceptions over time, associations between PTSD and illness perceptions and cognitive predictors of PTSD. DESIGN AND METHOD: The study employed a longitudinal design and measured the illness perceptions and PTSD symptoms of an MI group (N=17) and a SAH group (N=27). Data were collected within 2 weeks of admission (T1), 6 weeks after admission (T2) and 3 months after admission (T3). Statistical analysis was undertaken to examine associations between illness perceptions and PTSD and to examine cognitive predictors of PTSD. RESULTS: The prevalence of PTSD within the total acute medical trauma sample was 16% at 2 weeks, 35% at 6 weeks and 16% at 3 months. Illness perception factors of identity, timeline (acute/chronic), consequences and emotional representation were strongly correlated with PTSD at all three time points. PTSD symptoms and illness perceptions were shown to have changed over time. The results also showed that several illness perception factors are significant predictors of PTSD. CONCLUSIONS: Both PTSD symptoms and illness perceptions changed significantly over time following an MI or SAH. Illness perception factors are significant predictors of PTSD.

Attitude to Health↗

PubMedDate not supplied

Perceptions of healthy eating: state of knowledge and research gaps.

To effectively promote and support healthy eating among Canadians, there needs to be a better understanding of the factors that influence eating behaviours. Perceptions of healthy eating can be considered as one of the many factors influencing people's eating habits. For this review, "perceptions of healthy eating" are defined as the public's and health professionals' meanings, understandings, views, attitudes and beliefs about healthy eating, eating for health, and healthy foods. This article's aim is to review and summarize the literature on the perceptions of healthy eating and to identify the current state of knowledge and key knowledge gaps. Databases, the worldwide web, selected journals and reference lists were searched for relevant papers from the last 20 years. Reviewed articles suggest relative homogeneity in the perceptions of healthy eating despite the studies being conducted in different countries and involving different age groups, sexes and socio-economic status. Perceptions of healthy eating were generally based on food choice. Fruits and vegetables were consistently recognized as part of healthy eating. Characteristics of food such as naturalness, and fat, sugar and salt contents were also important in people's perceptions of healthy eating. Concepts related to healthy eating, such as balance, variety and moderation, were often mentioned, but they were found to be polysemous, conveying multiple meanings. The main gap identified in this review concerns the lack of knowledge available on perceptions of healthy eating. More data are needed on the perceptions of healthy eating in general, on the influence on perceptions of messages from diverse sources such as food companies, and, most important, on the role of perceptions of healthy eating as a determinant of food choice.

Adolescent↗

PubMed1991

[A study on the perception level of nursing activities of nurses in general hospitals].

The Study was carried out for the purpose of investigating the degree of perception in nursing activities. This study reports perceptions of nurses on the choices they make among competing activities, contrasts this perception with their opinion of what tasks they would like to spend time on. A sample of 231 clinical nurses was selected to participate in this study at two general hospitals in Seoul. The data was collected from July 10th to 25th, 1990. Subjects were instructed to rate one of five points likert type scale on the 43 items of nursing activities. Analysis of data was done by means of the SPSS-X Program using frequency, t-test and ANOVA. The results of this study were as follows; 1. The characteristics of the subjects were as follows: The age group of 25-29 years was 45.9%. For religion, Christians had the highest score, 68.4% and singles in subjects were 81.4%. For academic background, 64.5% were graduated from nursing junior colleges. In the subjects, staff nurses were 86.6%. 22.5% of them had worked for less than 1 year and 20.8% had 37 months to 5 years experience at the time of the survey. 62.8% were satisfied with the job. 2. The perception level of nursing activities: 1) The mean score for perception of professional nursing functions was 4.157 point, with a maximum score set at 5 points. The mean score for perception of priorities was 3.781. Perception of spending time was 3.932. 2) In perception of professional nursing functions, more important items were Aseptic technique (4.866), Shift and exchange of information concerning patients(4.654), Observing patients (4.799). Less important items were Transporting patients(3.411), Changing linens(3.442), Giving a bed shampoo (3.506). In priorities, more important ones were Aseptic technique(4.706), Shift and exchange of information concerning patients(4.524), Observing patients(4.390), Taking vital signs(4.355). And less important ones were Changing linens (3.100), Giving bed baths(3.113), Giving back rubs(3.121). In spending time, more important ones were Aseptic technique(4.706), Observing patients (4.532), Shift and exchange of information concerning patients(4.532). And less important ones were Changing lines(3.368), Transporting patients(3.394), Giving bed baths(3.450). 3) In the role perception level, the mean distribution of perception was 3.511-4.335; the role was perceived to be in order of frequency as a facilitator, coordinator, change agent and advocator role. The most important scale of factors by nursing activities was indirect nursing activities.

Adult↗

PubMed2000

Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II.

Test weighing is the "gold standard" for documenting lactogenesis stage II. However, this method is impractical for use in population studies. Maternal perception of the timing of the onset of lactation may be a useful proxy for lactogenesis stage II. This study seeks to validate maternal perception of the onset of lactation as a marker of lactogenesis stage II. Women (n = 60) were recruited after cesarean delivery. Beginning at 24 h postpartum (pp), the onset of lactation was assessed 3 times daily by both test weighing and maternal perception. Delayed onset of lactation was defined as follows: 1) milk transfer < 9.2 g/feeding at 60 h pp and 2) maternal perception >/= 72 h pp. Misclassification analyses were conducted. Multivariate logistic regression, bivariate analyses and Cox survival analyses were used to evaluate the determinants and consequences of delayed onset of lactation, using both definitions. The sensitivity and specificity of delayed maternal perception as an indicator of delayed lactogenesis were 71.4 and 79.3%, respectively. Four risk factors for low milk transfer were significant (P: < 0.05) or nearly significant (P: </= 0.08) predictors of delayed perception of the onset of lactation. The effects of low milk transfer and delayed maternal perception on breast-feeding duration were similarly modified by intended breast-feeding duration. The magnitude and directionality of the ss coefficients for the milk transfer and perception variables were consistent. On the basis of these results, we conclude that maternal perception of the onset of lactation is a valid public health indicator of lactogenesis stage II.

Adult↗

PubMed1985

Relations between psychophysical data and speech perception for hearing-impaired subjects. II.

Twenty-one sensorineurally hearing-impaired adolescents were studied with an extensive battery of tone-perception, phoneme-perception, and speech-perception tests. Tests on loudness perception, frequency selectivity, and temporal resolution at the test frequencies of 500, 1000, and 2000 Hz were included. The mean values and the gradient across frequencies were used in further analysis. Phoneme-perception data were gathered by means of similarity judgments and phonemic confusions. Speech-reception thresholds were determined in quiet and in noise for unfiltered speech material, and with additional low-pass and high-pass filtering in noise. The results show that hearing loss for speech is related to both the frequency resolving power and temporal processing by the ear. Phoneme-perception parameters proved to be more related to the filtered-speech thresholds than to the thresholds for unfiltered speech. This finding may indicate that phoneme-perception parameters play only a secondary role, and for that reason their bridging function between tone perception and speech perception is only limited.

Acoustic Stimulation↗