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Purpose: The U.S. Food and Drug Administration finalized regulations for overthe- counter hearing aids (OTC-HAs) on August 17, 2022. Little is known about the comparative performance of OTC-HAs and prescription HAs. This study compared amplification accuracy of prescription HAs and direct-to-consumer devices (DTCDs, including personal sound amplification products [PSAPs] and OTC-HAs). Method: Eleven devices were programmed to meet prescriptive targets in an acoustic manikin for three degrees of hearing loss. Devices consisted of highand low-end HAs, PSAPS, and OTC-HAs. Each was tested, and deviations from target measured with an HA analyzer at every combination of 10 frequencies and low-, average-, and high-level inputs. Accuracy was compared using a multilevel Poisson model with device-specific intercepts controlling for input level, frequency, and device type. Results: For mild--moderate hearing loss, deviations from targets were not statistically different between high- and low-end HAs, but PSAPs (5.50 dB, SE = 0.92 dB) and OTC-HAs (8.83 dB, SE = 1.10 dB) had larger differentials. For flat moderate hearing loss, compared to high-end HAs, average differentials were larger for all device types at all input levels and frequencies (Low HA: 3.82 dB, SE = 1.10 dB; PSAP: 9.24 dB, SE = 1.22 dB; OTC-HA: 8.61 dB, SE = 1.19 dB). For mild sloping to severe hearing loss, compared to high-end HAs, OTC-HAs (9.72 dB, SE = 1.20 dB) and PSAPs (7.34 dB, SE = 1.07 dB) had larger differentials and significant variability at the highest and lowest frequencies. Half (three) of the PSAPs and OTC-HAs met most targets within ±5 dB. Conclusions: DTCDs were unable to meet prescriptive targets for severe types of hearing loss but could meet them for mild hearing loss. This study provides an examination of current hearing devices. More research is needed to determine whether meeting prescriptive targets provides any benefit in the outcomes and performance with DTCD devices. [ABSTRACT FROM AUTHOR]

Background: Black Americans have a higher prevalence of stroke and stroke-related deaths than any other racial group. Racial disparities in stroke outcomes are even wider among women than men. Conventional studies have cited differences in lifestyle (i.e. smoking, alcohol consumption, etc.) and vascular risk factors between races as the source of these disparities. However, these studies fail to account for the higher prevalence of minoritized populations at the lower end of the socioeconomic distribution. Objectives: This study explores differences in stroke risk factors across age and socioeconomic cohorts to determine whether comorbidities can sufficiently explain disparities at all ages and income levels. Design: Using the 2006–2018 National Health Interview Survey data, statistical analysis evaluated differences in risk factors among a full sample cohort (aged 18–85 years; n = 131,091) and a "young" subsample cohort (aged 18–59 years; n = 6183) of women. Methods: Logistics and unconditional quantile regression models assessed the relationship between stroke and comorbid, demographic, and behavioral characteristics across socioeconomic classes. Results: Results suggest that Black women had a 1.415-fold (confidence interval = 1.259, 1.591) higher likelihood of stroke compared with White women after controlling for age, behavior, and comorbidities. Racial disparities were not statistically significant at the higher income ranges for either the full (odds ratio = 1.404, p = 0.3114) or young samples (odds ratio = 1.576, p = 0.7718). However, Blacks had significantly higher odds of stroke in the lower quartiles (lower odds ratio: 1.329, p = 0.0242; lower middle odds ratio: 1.233, p = 0.0486; and upper middle odds ratio: 1.994, p = 0.0005). Disparities were larger among young women (odds ratio = 1.449, confidence interval = 1.211, 1.734). Conclusion: While comorbidities were highly associated with stroke prevalence in all socioeconomic cohorts, Blacks only had higher relative odds in the lower income classes. Lack of biological or behavioral explanations for these findings suggests that unobserved or uncontrolled factors such as systemic racism, prejudicial institutions, or differential treatment may contribute to this. [ABSTRACT FROM AUTHOR]

Background: Notable disparities exist in ischemic heart disease (IHD) and stroke outcomes. Studies have identified several causal factors that contribute to these disparities, but few have assessed the disparate quality of life (QOL) among individuals living with IHD, stroke, or both. This study evaluated the impact of IHD, stroke, and both conditions on health‑related QOL (HRQOL) and quantified existing disparities. Materials and Methods: Using the data from the 2021 National Health Interview Survey, we calculated the health and activities limitation index — a generic HRQOL measure comprising perceived health and activities limitations — for 29,482 adults. Adjusting for sex, age, income, education, urbanicity, marital status, household size, region of residence, and insurance status, the differences in HRQOL between racial and ethnic groups were estimated as well as racial/ethnic differences in the HRQOL of IHD, stroke, or both conditions. Results: Compared to those with neither condition, individuals with IHD (−0.214, Standard Error (SE)=0.015, stroke (−0.291, SE=0.028), and both (−0.438, SE=0.040) had 20% to 44% lower HRQOL. Blacks (−0.014, SE=0.004) and hispanics (−0.012, SE=0.003) had lower HRQOL compared to whites even after sample heterogeneity. Diagnosis with stroke (−0.182, SE=0.082), IHD (−0.137, SE=0.052), or both (−0.208, SE=0.126) lowered the HRQOL more for black individuals compared to white individuals, while other subgroups showed no statistically significant difference in HRQOL. In general, sex, age, and household composition showed little difference in adjusted HRQOL. Conclusion: While IHD and stroke are independently associated with significantly low HRQOL, their co‑occurrence has a substantially negative impact on HRQOL, particularly among minoritized racial groups. [ABSTRACT FROM AUTHOR]

Purpose: The U.S. Food and Drug Administration (FDA) introduced the Reauthorization Act that included provisions for self-fitting hearing aids to be sold over the counter in 2017, and in August 2022, the FDA published the final regulatory guidelines for the safety and efficacy of the devices. The American Speech- Language-Hearing Association and other professional organizations provided feedback to proposed regulations before they were finalized. This article updates hearing health care and related professionals on the history and state of hearing aid delivery models and addresses considerations for clinicians, physicians, and consumers. Conclusions: Direct-to-consumer (DTC) hearing devices can vary largely in quality and performance capability. Some might meet the finalized FDA safety and performance criteria for over-the-counter hearing aids and be able to provide accurate amplification for mild-to-moderate hearing loss but most likely cannot meet the needs of more severe hearing losses, for which they are not approved. Other DTC devices may not meet the FDA criteria and may not provide accurate amplification for many degrees of hearing loss. It is important that these devices are correctly advertised and marketed to those with hearing loss no worse than mild to moderate. Consumers and health care providers also need to know how to identify quality devices that can meet patients' hearing needs. The DTC hearing devices may be difficult to program; thus, manufacturers should provide support for consumers to properly fit these devices. Lastly, hearing health care professionals should take the time to verify that any current and soon-to-come DTC hearing devices can be useful for a given patient population. [ABSTRACT FROM AUTHOR]

Purpose: Stuttering is a disorder that has been associated with coexisting developmental disorders. To date, detailed descriptions of the coexistence of such conditions have not consistently emerged in the literature. Identifying and understanding these conditions can be important to the overall management of children who stutter (CWS). The objective of this study was to generate a profile of the existence of disabling developmental conditions among CWS using national data. Method: Six years of data from the National Health Interview Survey (2010--2015) were analyzed for this project. The sample consisted of children whose respondents clearly indicated the presence or absence of stuttering. Chi-square tests of independence were used for comparing categorical variables; and independent-samples t tests, for comparing continuous variables. Multiple logistic regression analyses were used for determining the odds of having a coexisting disabling developmental condition. Results: This study sample included 62,450 children, of which 1,231 were CWS. Overall, the presence of at least 1 disabling developmental condition was 5.5 times higher in CWS when compared with children who do not stutter. The presence of stuttering was also associated with higher odds of each of the following coexisting developmental conditions: intellectual disability (odds ratio [OR] = 6.67, p < .001), learning disability (OR = 5.45, p < .001), attentiondeficit hyperactivity disorder/attention-deficit disorder (OR = 3.09, p < .001), seizures (OR = 7.52, p < .001), autism/Asperger's/pervasive developmental disorder (OR = 5.48, p < .001), and any other developmental delay (OR = 7.10, p < .001). Conclusion: Evidence from the National Health Interview Survey suggests a higher prevalence of coexisting developmental disabilities in CWS. The existence of coexisting disabling developmental conditions should be considered as part of an overall management plan for CWS. [ABSTRACT FROM AUTHOR]

The article offers information on histological features of chronic periodontal disease in rats maintained on a soft diet. The following progression of events were witnessed which leads to the disease. Particles of appropriate size produce trauma to the gingival papillae to which the epithelium responds by migrating apically along the root surface. Further trauma causes the epithehum to recede, producing a gingival pocket which becomes a niche for the accumulation of pathogenic organisms. In response to the microorganisms, inflammatory cells accumulate in the subgingival tissues and as inflammation increases, collagenous tissues are degraded and functional bundles of collagen fibers are disrupted. These events results in bone loss and the condition of severe periodontal disease.

The article focuses on the vision that emerged for occupational therapy as the American Occupational Therapy Association (AOTA) reaches its centennial. AOTA's centennial vision of occupational therapy symbolizes science-driven, widely recognized and evidence-based profession with global and diverse workforce. It also notes that the limited emergence of occupational therapy probings of differences linked with race and ethnicity is among the massive opportunities and challenges of the profession.