A previous study demonstrated that consonant recognition improved significantly in normal hearing listeners when useful frequency and time ranges were intensified by 6 dB. The goal of this study was to determine whether bilateral cochlear implant and bilateral hearing aid users experienced similar enhancement on consonant recognition with these intensified spectral and temporal cues in noise. In total, 10 BCI and 10 BHA users participated in a recognition test using 14 consonants. For each consonant, we used the frequency (...) and time ranges that are critical for its recognition, identified from normal hearing listeners. Then, a signal processing tool called the articulation-index gram was utilized to add a 6 dB gain to target frequency and time ranges. Consonant recognition was monaurally and binaurally measured under two signal processing conditions, unprocessed and intensified target frequency and time ranges at +5 and +10 dB signal-to-noise ratio and in quiet conditions. We focused on three comparisons between the BCI and BHA groups: AI-Gram benefits, enhancement in binaural benefits via the AI-Gram processing, and reduction in binaural interferences via the AI-Gram processing. The results showed that the mean AI-Gram benefit was significantly improved for the BCI and BHA groups. However, the mean binaural benefit was not improved after AI-Gram processing. Individual data showed wide ranges of the AI-Gram benefit and binaural benefit for both groups. Individual data also showed a decrease in binaural interference in both groups after AI-Gram processing. These results suggest that the frequency and time ranges, intensified by the AI-Gram processing, contribute to consonant enhancement for monaural and binaural listening and both BCI and BHA technologies. The intensified frequency and time ranges helped to reduce binaural interference but contributed less to the synergistic binaural benefit in consonant recognition for both groups. (shrink)

This study investigated eye-movement patterns during emotion perception for children with hearing aids and hearing children. Seventy-eight participants aged from 3 to 7 were asked to watch videos with a facial expression followed by an oral statement, and these two cues were either consistent or inconsistent in emotional valence. Results showed that while normal-hearing children paid more attention to the upper part of the face, children with hearing aids paid more attention to the lower face after (...) the oral statement was presented. When there was an inconsistency between the visual and auditory cues, children with hearing aids were likely to increase attention to the upper face. The results revealed the underlying mechanism of deficits in emotion perception for hearing-impaired children. (shrink)

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions in older Chinese adults with HAs and with untreated hearing loss. Participants were 49 Chinese older adults who used HAs and had moderate to severe HL, and 46 older Chinese who (...) had mild to moderately severe HL but did not use HAs. Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group. Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL. (shrink)

Auditory scene analysis is an elementary aspect of music perception, yet only little research has scrutinized auditory scene analysis under realistic musical conditions with diverse samples of listeners. This study probed the ability of younger normal-hearing listeners and older hearing-aid users in tracking individual musical voices or lines in JS Bach's The Art of the Fugue. Five-second excerpts with homogeneous or heterogenous instrumentation of 2–4 musical voices were presented from spatially separated loudspeakers and preceded by a short cue (...) for signaling the target voice. Listeners tracked the cued voice and detected whether an amplitude modulation was imposed on the cued voice or a distractor voice. Results indicated superior performance of young normal-hearing listeners compared to older hearing-aid users. Performance was generally better in conditions with fewer voices. For young normal-hearing listeners, there was interaction between the number of voices and the instrumentation: performance degraded less drastically with an increase in the number of voices for timbrally heterogeneous mixtures compared to homogeneous mixtures. Older hearing-aid users generally showed smaller effects of the number of voices and instrumentation, but no interaction between the two factors. Moreover, tracking performance of older hearing aid users did not differ when these participants did or did not wear hearing aids. These results shed light on the role of timbral differentiation in musical scene analysis and suggest reduced musical scene analysis abilities of older hearing-impaired listeners in a realistic musical scenario. (shrink)

Older adults with age-related hearing loss often use hearing aids to compensate. However, certain challenges in speech perception, especially in noise still exist, despite today’s HA technology. The current study presents an evaluation of a home-based auditory exercises program that can be used during the adaptation process for HA use. The home-based program was developed at a time when telemedicine became prominent in part due to the COVID-19 pandemic. The study included 53 older adults with age-related symmetrical sensorineural (...) hearing loss. They were divided into three groups depending on their experience using HAs. Group 1: Experienced users. Group 2: New users. Group 3: Non-users. These three groups underwent auditory exercises for 3 weeks. The auditory tasks included auditory detection, auditory discrimination, and auditory identification, as well as comprehension with basic and more complex stimuli, presented in quiet and in noisy listening conditions. All participants completed self-assessment questionnaires before and after the auditory exercises program and underwent a cognitive test at the end. Self-assessed improvements in hearing ability were observed across the HA users groups, with significant changes described by new users. Overall, speech perception in noise was poorer than in quiet. Speech perception accuracy was poorer in the non-users group compared to the users in all tasks. In sessions where stimuli were presented in quiet, similar performance was observed among new and experienced uses. New users performed significantly better than non-users in all speech in noise tasks; however, compared to the experienced users, performance differences depended on task difficulty. The findings indicate that HA users, even new users, had better perceptual performance than their peers who did not receive hearing aids. (shrink)

The Pacific Islands are estimated to have among the highest global burdens of hearing loss, however, hearing health services are limited throughout this region. The provision of hearing aid is desirable, but should be delivered in accordance with WHO recommendations of appropriate and locally sustainable services. Large-scale hearing aid donation programmes to the Pacific Islands raise ethical questions that challenge these recommendations.The aim of this paper is to consider the ethical implications of large-scale hearing aid (...) donation programmes to Samoa, a nation of the Pacific Islands. Evaluation of both ‘Western’ and ‘Pacific Island’ perspectives reveals important cross-cultural differences regarding attitudes to donation programmes. We attempt to offer possible solutions that satisfy both ethical frameworks, and which should enable us to deliver an effective hearing health service for Samoa. These solutions may be translational and benefit other Pacific Island nations in a similar context. (shrink)

Deaf or hard-of-hearing children who use auditory-oral communication display considerable variability in spoken language and executive functioning outcomes. Furthermore, language and executive functioning skills are strongly associated with each other in DHH children, which may be relevant for explaining this variability in outcomes. However, longitudinal investigations of language and executive functioning during the important preschool period of development in DHH children are rare. This study examined the predictive, reciprocal associations between executive functioning and spoken language over a 1-year period (...) in samples of 53 DHH and 59 typically hearing children between ages 3–8 years at baseline. Participants were assessed on measures of receptive spoken language and caregiver-completed executive functioning child behavior checklists during two in-person home visits separated by 1 year. In the sample of DHH children, better executive functioning at baseline was associated with better performance on the higher-order language measures 1 year later. In contrast, none of the Time 1 language measures were associated with better executive functioning in Time 2 in the DHH sample. TH children showed no significant language-executive functioning correlations over the 1-year study period. In regression analyses controlling for Time 1 language scores, Time 1 executive functioning predicted Time 2 language outcomes in the combined DHH and TH samples, and for vocabulary, that association was stronger in the DHH than in the TH sample. In contrast, after controlling for Time 1 executive functioning, none of the regression analyses predicting Time 2 executive functioning from Time 1 language were statistically significant. These results are the first findings to demonstrate that everyday parent-rated executive functioning behaviors predict basic and higher-order spoken language development 1 year later in young DHH children, even after accounting for initial baseline language skills. (shrink)

We describe a patient LS, profoundly deaf in both ears from birth, with underdeveloped superior temporal gyri. Without hearing aids, LS displays no ability to detect sounds below a fixed threshold of 60 dBs, which classifies him as clinically deaf. Under these no-hearing-aid conditions, when presented with a forced-choice paradigm in which he is asked to consciously respond, he is unable to make above-chance judgments about the presence or location of sounds. However, he is able to make above-chance (...) judgments about the content of sounds presented to him under forced-choice conditions. We demonstrated that LS has faint sensations from auditory stimuli, but questionable awareness of auditory content. LS thus has a form of type-2 deaf hearing with respect to auditory content. As in the case of a subject with acquired deafness and deaf hearing reported on a previous occasion, LS’s condition of deaf hearing is akin in some respects to type-2 blindsight. As for the case of type 2 blindsight the case indicates that a form of conscious hearing can arise in the absence of a fully developed auditory cortex. (shrink)

Objective: Individually, vision and hearing impairments have been linked to higher levels of anxiety and depression. We investigated the effect of dual sensory impairment in a large representative sample of Spanish adults. Methods: Data from a total of 23,089 adults from the Spanish National Health Survey 2017 were analyzed. Self-reported difficulty of seeing and hearing, and depression and chronic anxiety were analyzed. Multivariable logistic regression was assessed for difficulty with vision alone, hearing alone and with difficulty with (...) both, adjusting for gender, age, marital status, living as a couple, education, smoking, alcohol consumption, BMI, physical activity, use of glasses/contact lenses, and hearing aid. Results: Visual difficulty, hearing difficulty, and dual difficulties were all associated with significantly higher odds for depression and for chronic anxiety. Dual sensory difficulty was associated with higher odds ratios for depression and anxiety when compared to either impairment alone. Conclusion: Dual sensory difficulty is associated with significantly higher odds of anxiety and depression when compared to either vision or hearing difficulty alone. Appropriate interventions are needed to address any reversible causes of vision and hearing as well as anxiety and depression in people in these specific groups. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How I Lost My HearingJanessa SalesI was born as a healthy and strong hearing person, but I became deaf through a result of painful and traumatic cancer treatments. I was diagnosed with a malignant brain tumor called Germinoma in 2003. I went through surgery, chemotherapy, and radiation. I was good for one and a half years. However, in 2005 when I turned 12 my cancer relapsed. My doctors (...) told me and my family that I had to undergo a much stronger treatment plan called a Bone Marrow Transplant (BMT). One of the possible side effects to this treatment was hearing loss. I unfortunately received this devastating side effect.I still remember the day that I lost my hearing. Before going to sleep that night, I received a dose of chemo. Waking up the next morning, something was terribly wrong. I couldn’t hear anything! I felt as if I were wearing earplugs. I called for my mother and I told her the alarming news, but as she was speaking back to me, I strained to hear her voice. All I saw were her lips moving. My doctors made arrangements for me to get my hearing tested with an audiologist.As the days that passed, I went through a deep depression. My doctors and my family tried different ways to communicate with me. They used note pads or white boards and wrote down what they wanted to say to me. As my hearing lessened, my other senses kicked in. I read body language and expressions. I learned to read lips. It was a little over a month before I got my hearing aids.Going back to school was very difficult, but my hearing loss, in itself, wasn’t as traumatic as the refusal to accept my new life. I spent the next four years trying to be hearing—trying to fix myself— trying to be what I once was. I always strained my ears trying to listen to my teachers. I tried fitting in with my friends, trying to keep up with their conversations, but it was no use. I couldn’t hear a thing; I was lost and confused.However, during my eighth grade year, I was given the choice to transfer to a different school. It was a mainstream school that had a DHH (Deaf and Hard of Hearing) program. It was a scary transition going to a new school, not knowing anybody. I hesitated and did not want to go at first, but eventually I got over my fears.When I transferred over to the other middle school, I still felt lost. I was still trying to be a hearing student. I only knew how to be auditory learner. I couldn’t focus because I wasn’t able to hear my teachers. I was new at sign language, so I couldn’t understand any of my interpreters. I had frequent meltdowns every week.I felt like I didn’t fit into the deaf world or the hearing world. I couldn’t understand either one. I was always misunderstanding my hearing friends, and I wasn’t able to understand my deaf peers because I didn’t fully know their language. I had low self–esteem and I felt like I didn’t belong anywhere.I had to learn to become a visual learner. I was given the use of a Frequency Modulated (FM) system. The FM system is an assistive listening device worn by the speaker to amplify his/her voice and transmit it directly to the listener’s ears via an electronic receiver and special earphones or the listener’s own hearing aids. I also had an interpreter and closed captions when needed.My DHH teacher Mr. H, who was my greatest mentor and role model, set me up with an Individualized Educational Program (IEP) that required that I had to have my homework written down instead being verbally told. I was allowed to have more time on tests when needed, and a note taker for lectures. All of these arrangements really helped me through my new “deaf world.”My mother and I took Sign Language classes at Sacramento State University where Mr. H also taught... (shrink)

Research into the potential associations between tinnitus and cognition has investigated specific cognitive domains in laboratory settings despite adults with tinnitus reporting broad cognitive difficulties in every-day life. To address this limitation, the present study compared performance and perceived exertion on a visual office-like task in 38 adults with tinnitus and 38 adults without tinnitus matched for age, sex and educational background. All participants were also assessed for hearing, anxiety and depression, and participants with tinnitus were also assessed for (...) tinnitus handicap. No associations were found between presence of tinnitus and cognitive performance and perceived exertion on the visual office-like task when corrected for standard and extended high frequency hearing thresholds, anxiety, and depression. The correction for extended high frequency average hearing threshold was significant for performance but not perceived exertion on the visual office-like task. Overall, the results showed extended high frequency hearing, but not tinnitus, was associated with every-day cognitive performance. This indicates clinical testing of hearing thresholds above 8 kHz could support clinicians’ identification and management of cognitive difficulties. One management method suggested by the current findings would include provision of auditory stimulation at frequencies exceeding the frequency response of many current hearing aids. (shrink)

This mixed method study (Explanatory Design - the Participant Selection Model) investigated the use of joint drawing (the Family Squiggle) as a family climate assessment tool for hearing families who have a deaf / hard of hearing (D/HH) child. The goal was to evaluate the possibilities of applying a quantitative approach to characterize the pictorial phenomena produced by hearing families who have a D/HH child, and then apply qualitative research approaches to better understand the meaning of these (...) phenomena. Twenty-eight hearing families (parents and child) whose child was diagnosed as D/HH and used hearing devices (hearing aids, implant) were recruited along with 16 families with a hearing child of a similar age enrolled in a mainstream school. The sessions involved a joint drawing followed by a family interview. In the quantitative stage, pictorial phenomena for which there was a significant association between the phenomena and the group of families were defined. These were: (1) The number of dominant images, (2) Images occupying less than a quarter of the page. (3) Images with accentuated outlines. (4) Moderate colorfulness with four to five colors in each drawing. (5) Minimal representation of the face. (6) Concrete rather than creative titles. (7) Muting of conflictual themes. (8) Images reminiscent of hearing devices (hearing aids, implant). In the qualitative phase, interviews were conducted with the hearing families with a D/HH child to better understand the meaning of these pictorial phenomena. The findings suggest that each of these phenomena represent the preoccupation of the family with deafness / being hard of hearing, capture a certain aspect of family dynamics, and together provide a broader and deeper picture of the family climate and the interactions between the child's family and hearing. This assessment tool may thus be utilized when verbal tools cannot be easily applied. (shrink)

During the early twentieth century, otologists began collaborating with organizers of the New York League for the Hard of Hearing to build a bridge to “adjust the economic ratio” of deafness and create new research avenues for alleviating or curing hearing loss. This collegiality not only defined the medical discourse surrounding hearing impairment, anchoring it in hearing tests and hearing aid prescription, but, in so doing, solidified the notion that deafness was a “problem” in dire (...) need of a “solution.” Public health campaigns thus became pivotal for spreading this message on local and national levels. This paper focuses on how, from the 1920s to 1950s, as otologists became more involved with social projects for the deaf and hard of hearing — advocating lip-reading, community work, and welfare programs — at the same time, they also mandated for greater therapeutic regulation, control of hearing aid distribution, and standardization of hearing tests. The seemingly paradoxical nature of their roles continued to reinforce the stigmatization of deafness: with widespread availability of effective help, the hearing impaired were expected to seek out therapeutic or technological measures rather than live with their affliction. (shrink)

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and (...) effective communication strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

Older adults with age-related hearing loss exhibit substantial individual differences in speech perception in adverse listening conditions. We propose that the ability to rapidly adapt to changes in the auditory environment is among the processes contributing to these individual differences, in addition to the cognitive and sensory processes that were explored in the past. Seventy older adults with age-related hearing loss participated in this study. We assessed the relative contribution of hearing acuity, cognitive factors, rapid perceptual learning (...) of time-compressed speech, and hearing aid use to the perception of speech presented at a natural fast rate, speech embedded in babble noise, and competing speech. Speech perception was modeled as a function of the other variables. For fast speech, age [odds ratio = 0.79], hearing acuity, pre-learning perception of time-compressed speech, and rapid perceptual learning were all significant predictors. For speech in noise, only hearing and pre-learning perception of time-compressed speech were significant predictors. Consistent with previous findings, the severity of hearing loss and auditory processing was strong contributors to individual differences in fast speech and speech in noise perception. Furthermore, older adults with good rapid perceptual learning can use this capacity to partially offset the effects of age and hearing loss on the perception of speech presented at fast conversational rates. Our results highlight the potential contribution of dynamic processes to speech perception. (shrink)

Hearing loss in old age, which often goes untreated, has far-reaching consequences. Furthermore, reduction of cognitive abilities and dementia can also occur, which also affects quality of life. The aim of this study was to investigate the hearing performance of seniors without hearing complaints with respect to speech perception in noise and the ability to localize sounds. Results were tested for correlations with age and cognitive performance. The study included 40 subjects aged between 60 and 90 years (...) with not self-reported hearing problems. The subjects were screened for dementia. Audiological tests included pure-tone audiometry and speech perception in two types of background noise which was either co-located or spatially separated from the target speech. Sound localization ability was assessed and hearing performance was self-evaluated by a questionnaire. Speech in noise and sound localization was compared with young normal hearing adults. Although considering themselves as hearing normal, 17 subjects had at least a mild hearing loss. There was a significant negative correlation between hearing loss and dementia screening score. Speech perception in noise decreased significantly with age. There were significant negative correlations between speech perception in noise and DemTect score for both spatial configurations. Mean SRTs obtained in the co-located noise condition with amplitude-modulated noise were on average 3.1 dB better than with continuous noise. This gap-listening effect was severely diminished compared to a younger normal hearing subject group. In continuous noise, spatial separation of speech and noise led to better SRTs compared to the co-located masker condition. SRTs in MSNF deteriorated in modulated noise compared to continuous noise by 2.6 dB. Highest impact of age was found for speech perception scores using noise stimuli with temporal modulation in binaural test conditions. Mean localization error was in the range of young adults. Mean amount of front/back confusions was 11.5% higher than for young adults. Speech perception tests in the presence of temporally modulated noise can serve as a screening method for early detection of hearing disorders in older adults. This allows for early prescription of hearing aids. (shrink)

In this essay, I utilize the concept of the echo, as formulated in the historical and methodological work of Michel Foucault and Joan W. Scott, to help theorize the historical relationship between health feminism and AIDS activism. I trace the echoes between health feminism and AIDS activism in order to present a more complex history of both movements, and to try to think through the ways that the coming together of these two struggles in a particular place and time—New York (...) City in the 1980s—created particular practices that might be effective in other times and places. The practice that I focus on here is one that I call 'doing queer love '. As I hope to show, 'doing queer love ' both describes a particular history of health activism and opens up the possibility of bringing into being a different future than the one a conventional history of AIDS seems to predict. It is an historical echo that I believe we must try to hear now, not just in order to challenge a particular history of AIDS activism in the United States, but also in order to provide a model that can be useful for addressing the continuing problem of AIDS across the globe. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The National Commission on AIDSDonald S. Goldman (bio) and Jeff Stryker (bio)A decade after the first cases were recognized in the United States, AIDS continues to vex policymakers and fascinate the public. It has been said that AIDS acts as a prism, refracting a spectrum of controversial topics. For bioethicists, these topics include: equity in the allocation of resources for treatment and research; forgoing life-sustaining care and proxy decision (...) making; informed consent in the context of HIV testing and screening; the ethical duties of health care workers to provide care for persons with HIV disease; and competing obligations of health care professionals to patients and to third parties who may be put at risk.The Role of CommissionsIf AIDS is the quintessential case study for bioethicists, it is a potential quagmire for politicians. The association of HIV disease with drug use and sexual behavior makes it a topic that all but the most courageous (or the most homophobic) politicians shy away from. A frequent political response is to form a commission.Alexander Capron, who was executive director of the President's Commission for the Study of Ethical Problems in Medicine, has described some roles commissions play: a watchdog, overseeing the work of particular government agencies; a crucible, providing a means for "publicly hammering out conclusions on controversial issues when consensus, both in the public and in the relevant disciplines, is not yet apparent"; and "a lightning rod for public concern—or viewed less charitably, dumping ground for an issue that is too difficult for the ordinary political process to handle" (Capron 1983, p. 9).Nearly every state has created a gubernatorial-level task force or commission on AIDS. The National Commission on AIDS was established under the Health Omnibus Program Extension (HOPE) Act of 1988, which was signed by President Reagan on November 4, 1988. The official charter of the commission was approved August 2, 1989 and its original two-year term was extended for a third year. The mission statement crafted by the commission to reflect its Congressional mandate reads: [End Page 339]The National Commission on Acquired Immune Deficiency Syndrome is an independent body of 15 members created to advise the President and Congress. The Commission seeks to build a broad public understanding on the magnitude, scope and urgency of the HIV/AIDS epidemic; provide and inspire leadership at all levels of both the public and private sectors; empower individuals and communities; and advocate for effective, cooperative and non-discriminatory resources required for prevention, comprehensive care, and the research necessary to halt the epidemic.As the mission statement implies, the National Commission on AIDS has viewed itself from the outset not only as a crucible for policy analysis, but also as a forum for those affected by HIV disease. In site visits and hearings the commissioners have met with hundreds of people living with HIV disease, and with caregivers on the front lines. This odyssey has taken the commission on visits to homeless shelters in New York City; to "shooting galleries" where intravenous drug users congregate in Seattle; to Native American communities in four states; to private homes in rural Georgia; and to hospitals, HIV antibody testing centers, drug treatment clinics, and hemophilia treatment centers throughout the nation. It quickly became clear during the commission's travels that HIV disease cannot be understood outside the context of the racism, homophobia, poverty and unemployment that provide the medium that fosters its spread. It also became apparent that issues of HIV prevention, care and treatment, and clinical research are inextricably intertwined and must be dealt with as such.Early InitiativesUnder the leadership of Chairperson June Osborn and Vice-chairperson David Rogers, the commission decided that the problems it saw in its first few meetings were too urgent to await a full-length annual report. Hence the commission entered the fray with a series of brief interim reports on particular aspects of AIDS. These reports enabled the commission to draw attention to urgent problems of limitations in access to health care and to underscore the plight of people with HIV disease who might otherwise garner little media attention, such as prisoners and drug users (National Commission... (shrink)

Nagel’s challenge is to devise an objective phenomenological vocabulary that can describe the objective structural similarities between aural and visual perception. My contention is that Charles Sanders Peirce’s little studied and less understood phenomenological vocabulary makes a significant contribution to meeting this challenge. I employ Peirce’s phenomenology to identify the structural isomorphism between seeing a scarlet red and hearing a trumpet’s blare. I begin by distinguishing between the vividness of an experience and the intensity of a quality. I proceed (...) to identify further points of structural isomorphism (a) between the experience of seeing a scarlet red and of hearing a trumpet blare and (b) between the qualities of those experiences. Lastly, I gesture towards how these distinctions can be an aid in describing what it is like to be a bat. (shrink)

Against the backdrop of an aging world population increasingly affected by a diverse range of abilities and disabilities as well as the rise of ubiquitous computing and digital app cultures, this paper questions how mobile technologies mediate between heterogeneous environments and sensing beings. To approach the current technological manufacturing of the senses, two lines of thought are of importance: First, there is a need to critically reflect upon the concept of assistive technologies as artifacts providing tangible solutions for a specific (...) disability. Second, the conventional distinction between user and environment requires a differentiated consideration. This contribution will first review James Gibson’s concept of “affordances” and modify this approach by introducing theories and methods of Science and Technology Studies and Actor-Network Theory. Then, we present two case studies where we explore the relations between recent “assistive” app technologies and human sensory perception. As hearing and seeing are key in this regard, we concentrate on two specific media technologies: ReSound LINX2, a hearing aid which allows for direct connect with iPhone, iPad, or iPod Touch, and Camassia, an IOS app for sonic wayfinding for blind people. We emphasize the significance of dis-/abling practices for manufacturing novel forms of hearing and seeing and drawing on sources like promotional materials by manufacturers, ads, or user testimonials and reviews. Our analysis is interested in the reciprocal relationships between users and their socio-technical and media environments. By and large, this contribution will provide crucial insights into the contemporary entanglement of algorithm-driven technologies, daily practices, and sensing subjects: the production of techno-sensory arrangements. (shrink)

Listening effort helps explain why people who are hard of hearing are prone to fatigue and social withdrawal. However, a one-factor model that cites only effort due to hardness of hearing is insufficient as there are many who lead happy lives despite their disability. This paper explores other contributory factors, in particular motivational arousal and pleasure. The theory of rational motivational arousal predicts that some people forego listening comprehension because they believe it to be impossible and hence worth (...) no effort at all. This is problematic. Why should the listening task be rated this way, given the availability of aids that reduce its difficulty? Two additional factors narrow the explanatory gap. First, we separate the listening task from the benefit derived as a consequence. The latter is temporally more distant, and is discounted as a result. The second factor is displeasure attributed to the listening task, which increases listening cost. Many who are hard of hearing enjoy social interaction. In such cases, the actual activity of listening is a benefit, not a cost. These people also reap the benefits of listening, but do not have to balance these against the displeasure of the task. It is suggested that if motivational harmony can be induced by training in somebody who is hard of hearing, then the obstacle to motivational arousal would be removed. This suggests a modified goal for health care professionals. Don’t just teach those who are hard of hearing how to use hearing assistance devices. Teach them how to do so with pleasure and enjoyment . (shrink)

In this article, we will consider how far we might be said to be active in forming our beliefs; in particular, we will ask to what extent we can be said to be free in believing what we want to believe. It is clear that we ought to believe only what is really so, at least in so far as it lies in our power to determine this, but reflection shows that, regrettably, we do not confine our beliefs to what (...) we have evidence for, nor do we always believe in accordance with the evidence we do have. So it is natural to conclude that non-intellectual factors may be at work here; such, at least, was the view of Descartes, who attributed error to the influence of our will in leading us to assent to judgments which go beyond the evidence presented by our infallible intellect. This view has some initial plausibility when we think of cases in which emotional considerations lead people to take up and genuinely believe things they have no evidence for, but it is not a view which has received much support from modern philosophers. So, in Part 1 we will look at criticisms levelled against Descartes' view by J. L. Evans, and in Part 2 we will see how far Descartes can be defended. Our conclusions here will lead us to give in Part 3 a general account of the influence of the will in beliefs. We will suggest that we are always responsible for our explicit beliefs, even though it is not true that we can simply believe what we like. Thus we will reject the idea that a man can consciously know something, and at the same time, by will power, believe the opposite. Belief is not then totally free, but we will argue that people do sometimes form beliefs which go against what they should and could believe, and that this can in a way be put down to the influence of the will. Finally we will consider some of the ways in which it is possible to influence our beliefs by willed acts over a long period of time, though this is not the way that we clami that the will might be said to play a part in every judgment that we make. (shrink)

This book is available either individually, or as part of the specially-priced Arguments of the Philosphers Collection.

ABSTRACT Popper's attitude to traditions is fundamentally rationalistic. He analyses traditions, along with other institutions and practices, in terms of their efficiency in promoting goals which can be specified independently of the traditions themselves. Hayek, by contrast, looks at traditions in terms of their contributions to the survival of the culture in which they are embedded, something whose evaluation may be opaque even to people within the culture. Both these approaches are flawed compared to Oakeshott's insistence that traditions are not (...) goal‐oriented, and that goals cannot be specified independently of agents’forms of life. Oakeshott's views constitute a via media between Popperian rationalism and Hayekian anti‐rationalism. (shrink)

We spent a wonderful morning in the van Gogh gallery in Amsterdam. Of course we knew all the paintings, we had seen them all in reproduction, and the building was more like a bank vault than a setting for art. But what art! At first sight how small and uniform the paintings were in reality: yet every blade of grass, every flower in a field, every olive tree, every vibration in the sky, every patch of colour, every brush stroke, testified (...) to life and to a life vibrating beneath the surface form. In a true sense, an artist inspired, an artist breaking convention, artistic and social, but nevertheless an artist transforming life with a vision of the enhancement of life, a vision inviting each one of us to look again at the natural forms around us, to feel the spirit or the gods dwelling in them, a vision of enchantment and of humanity in a disenchanted world. Art—painting—can, then, be a source of spiritual nourishment as Kant and Schiller and Ruskin in their different ways thought it should be. (shrink)

Even today, apologists for modernist and post-modernist architecture frequently appeal to what, following Sir Karl Popper, I will call historicist arguments. Such arguments have a particular poignancy when they are used to justify the replacement of some familiar part of an ancient city with some intentionally untraditional structure; as, for example, when a familiar nineteenth century block of offices in a prime city site is swept away to make room for something supposedly more fitting to the ‘new millennium’, a ‘twentieth (...) century contribution to monumental architecture’, a building ‘of substantial importance to the present age’. Similarly, those architects or consumers of architecture who fail to conform to whatever stylistic demands the age is held to demand are marginalized in many supposedly serious discussions of architecture, and made to feel out of place and out of time. (shrink)

ABSTRACT Popper's attitude to traditions is fundamentally rationalistic. He analyses traditions, along with other institutions and practices, in terms of their efficiency in promoting goals which can be specified independently of the traditions themselves. Hayek, by contrast, looks at traditions in terms of their contributions to the survival of the culture in which they are embedded, something whose evaluation may be opaque even to people within the culture. Both these approaches are flawed compared to Oakeshott's insistence that traditions are not (...) goal‐oriented, and that goals cannot be specified independently of agents’forms of life. Oakeshott's views constitute a via media between Popperian rationalism and Hayekian anti‐rationalism. (shrink)

In this controversial new book O'Hear takes a stand against the fashion for explaining human behavior in terms of evolution. He contends that while the theory of evolution is successful in explaining the development of the natural world in general, it is of limited value when applied to the human world. Because of our reflectiveness and our rationality we take on goals and ideals which cannot be justified in terms of survival-promotion or reproductive advantage. O'Hear examines the nature of human (...) self-consciousness, and argues that evolutionary theory cannot give a satisfactory account of such distinctive facets of human life as the quest for knowledge, moral sense, and the appreciation of beauty; in these we transcend our biological origins. It is our rationality that allows each of us to go beyond not only our biological but also our cultural inheritance: as the author says in the Preface, "we are prisoners neither of our genes nor of the ideas we encounter as we each make our personal and individual way through life.". (shrink)

Anthony O'Hear; Academic Freedom and the University, Journal of Philosophy of Education, Volume 22, Issue 1, 30 May 2006, Pages 13–21, https://doi.org/10.1111/j.

Anthony O'Hear; VI*—Guilt and Shame as Moral Concepts, Proceedings of the Aristotelian Society, Volume 77, Issue 1, 1 June 1977, Pages 73–86, https://doi.org/10.