2b.

Dysmenorrhea affects up to 80% of reproductive age women, in many cases causing sufficient pain to dramatically affect social and occupational roles. The prevalence varies across ethnic groups, which in part may reflect varying cultural attitudes toward women and menstruation. Key identified risk factors for dysmenorrhea include age of menarche, body mass, dietary habits, associated uterine bleeding disorders, comorbid pelvic pathology, and psychosocial problems. While much of the focus on the pathogenesis of dysmenorrhea has focused on aberrant inflammatory mediators in the uterine environment, recent studies using experimental quantitative sensory testing suggest central processing of pain is enhanced in many of these women as well, similar to both irritable bowel syndrome and painful bladder syndrome, which are closely related visceral pain disorders. The mainstays of treatment include nonsteroidal antiinflammatories and combined oral contraceptives; although only the former has extensive level I evidence to support its efficacy. Surgical treatments (presacral neurectomy or uterosacral nerve ablation) appear to be beneficial in a subset of women, but are associated with small, but serious, risks of visceral or vascular injury. Complementary and alternative treatments such as vitamin B1 and magnesium supplementation have not been studied as extensively but show some promise as well. In particular, treatments targeting central aberrations in pain processing, as used in chronic pain management, may prove beneficial as a more multidimensional approach to this common malady is accepted in our field.

2b Laryngoscope, 127:746-752, 2017.

This pilot study explored the potential for Project ASPIRE to effect behavior change in a sample of 11 parents of children with hearing loss who were from typically underserved populations, such as families from backgrounds of low socioeconomic status or families who speak English as a second language. The study consisted of one education session, five 16-hour home audio environment recordings, and four linguistic feedback reviews. The educational session focused on child language development and early language environment enrichment strategies. Parents received ‘quantitative linguistic feedback’ on the home audio recordings to further support behavior change through increased awareness of linguistic behaviors. The audio recordings were completed with the Language ENvironment Analysis system. This system measured parental linguistic behavior (adult word count or AWC), child linguistic behavior (child vocalization count or CVC), and child–parent interactive linguistic behavior (conversational turn count or CTC). Post-intervention both CTC and CVC had increased significantly compared to pre-intervention recording counts (p < 0.01; p < 0.05). Increase in AWC trended towards significance between pre- and post-intervention recordings (p < 0.1). These preliminary findings support ‘quantitative linguistic feedback’ as a viable behavior change strategy for enriching children’s early language environments through parental linguistic behaviors.

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