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Hearing
Kinds of Hearing Terms modified by Hearing Selected AbstractsAn Examination of Clothing Issues and Physical Limitations in the Product Development ProcessFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 1 2010Katherine Carroll The purpose of this study was to explore physical limitations and clothing problems among working women with physical disabilities to determine whether types of physical limitations are linked to specific clothing problems. The sample included 117 working women with a variety of disabilities. Principle Components Factor Analysis and Multiple Regression were used to analyze the data. Three distinct factors emerged to represent clothing problems (called Design, Materials Performance, and Dressing) and four distinct factors emerged to represent physical limitations (called Limbs/Outer Extremities, Central Core/Torso, Central Nervous System, and Intellect, Vision and Hearing). Regression analysis showed that the physical limitations impact each of the three clothing factors. The study extends research by focusing on an underserved market segment and providing the apparel industry with a potential method of addressing the needs of that market. The study also contributes to interdisciplinary research by further developing an Inclusive Design model for apparel product development. [source] Hearing Impairment Affects Older People's Ability to Drive in the Presence of DistractersJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 6 2010Louise Hickson PhD OBJECTIVES: To investigate the effects of hearing impairment and distractibility on older people's driving ability, assessed under real-world conditions. DESIGN: Experimental cross-sectional study. SETTING: University laboratory setting and an on-road driving test. PARTICIPANTS: One hundred seven community-living adults aged 62 to 88. Fifty-five percent had normal hearing, 26% had a mild hearing impairment, and 19% had a moderate or greater impairment. MEASUREMENTS: Hearing was assessed using objective impairment measures (pure-tone audiometry, speech perception testing) and a self-report measure (Hearing Handicap Inventory for the Elderly). Driving was assessed on a closed road circuit under three conditions: no distracters, auditory distracters, and visual distracters. RESULTS: There was a significant interaction between hearing impairment and distracters, such that people with moderate to severe hearing impairment had significantly poorer driving performance in the presence of distracters than those with normal or mild hearing impairment. CONCLUSION: Older adults with poor hearing have greater difficulty with driving in the presence of distracters than older adults with good hearing. [source] Understanding and Responding to Patients' Requests for Assistance in DyingJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2003Judith Kennedy Schwarz Purpose: To explore how nurses experience and respond to patients' requests for assistance in dying (AID). Design and Methods: A phenomenological study of 10 self-selected nurses. Findings: Four major themes: Being Open to Hear and Hearing; Interpreting and Responding to the Meaning; Responding to Persistent Requests for AID, and Reflections. When faced with persistent requests for AID, participants provided a continuum of interventions: refusal, providing palliative care that might secondarily hasten dying, respecting and not interfering with patients' or families' plans to hasten dying, and providing varying types and degrees of direct AID. Their responses were context-driven rather than rule-mandated, and they drew a distinction between secondarily hastening and directly causing death. Conclusions: Few nurses in this study unequivocally agreed or refused to directly help a patient die. Most struggled alone and in silence to find a morally and legally acceptable way to help patients who persisted in requesting AID. Regardless of how they responded, many described feelings of conflict, guilt, and moral distress. [source] Overheard in the Halls: What Adolescents Are Saying, and What Teachers Are Hearing, About Health IssuesJOURNAL OF SCHOOL HEALTH, Issue 7 2007Alwyn T. Cohall MD ABSTRACT Background:, Schools have long been recognized as an excellent place to offer health education and supportive services. Teachers are among the most important influences in the lives of school-aged children and can provide valuable insight into the health issues important to adolescents. The purpose of this study was to examine the potential role general academic teachers may play in facilitating adolescent health promotion efforts. Methods:, To determine what teachers think about the role of health promotion in schools and what tools and topics they would find most helpful as critical advisers to students, we administered a 28-question survey at staff development meetings in 4 New York City schools. Results:, Teachers agreed that schools were an important venue for discussing and providing health messages. More than half of those surveyed reported having overheard student discussions about health once a week or more, and 70% stated that they had been actively approached by students 1-3 or more times per semester with reports of personal problems or health issues. Teachers expressed concern about their ability to handle student mental, behavioral, and reproductive health problems and desired additional staff development workshops to address these needs. Conclusions:, Teachers felt that schools were important places to promote dialogue about health and accept the importance of playing a broader role in the lives of youth beyond education. To enhance the prospect of health-promoting interactions between teachers and students, attention must be paid to developing the overall skill and comfort level of teachers with respect to adolescent health concerns. [source] Efficacy of Cognitive Nursing Intervention for Voice HearingPERSPECTIVES IN PSYCHIATRIC CARE, Issue 2 2007Margaret England PhD PROBLEM.,Many individuals who hear negative voices are troubled by their voices even when they adhere to prescribed neuroleptic medication regimens. At the same time, recent clinical trials provide evidence that structured, cognitive intervention can reduce distress tied to refractory auditory hallucinations and other psychiatric symptoms. PURPOSE.,The purpose of this randomized controlled trial was to determine whether usual care (UC), or usual care plus 12, 90-min episodes of cognitive nursing intervention (UC + CNI) led to sustained improvement in the psychiatric symptoms and self-esteem of 65 voice hearers assigned a diagnosis of schizophrenia or schizoaffective disorder. ANALYSIS AND FINDINGS.,Analysis of covariance with repeated measures procedures indicate that the 44 participants exposed to UC + CNI, were significantly more likely than the 21 participants exposed to UC only, to sustain significant improvement in psychiatric symptoms and self-esteem 1 year following treatment. IMPLICATIONS.,These findings provide encouragement for nurses to further develop and investigate cognitive strategies to treat psychiatric symptoms of voice hearers. [source] Not Giving the Skeptic a Hearing: Pragmatism and Radical DoubtPHILOSOPHY AND PHENOMENOLOGICAL RESEARCH, Issue 1 2005ERIK J. OLSSON Pragmatist responses to radical skepticism do not receive much attention in contemporary analytic epistemology. This observation is my motivation for undertaking a search for a coherent pragmatist reply to radical doubt, one that can compete, in terms of clarity and sophistication, with the currently most popular approaches, such as contextualism and relevant alternatives theory. As my point of departure I take the texts of C. S. Peirce and William James. The Jamesian response is seen to consist in the application of a wager argument to the skeptical issue in analogy with Pascal's wager. The Peircean strategy, on the other hand, is to attempt a direct rejection of one of the skeptic's main premises: that we do not know we are not deceived. I argue that while the Jamesian attempt is ultimately incoherent, Peirce's argument contains the core of a detailed and characteristically "pragmatic" rebuttal of skepticism, one that deserves to be taken seriously in the contemporary debate. [source] Hearing of note: An electrophysiologic and psychoacoustic comparison of pitch discrimination between vocal and instrumental musiciansPSYCHOPHYSIOLOGY, Issue 6 2008Dee A. Nikjeh Abstract Cortical auditory evoked potentials of instrumental musicians suggest that music expertise modifies pitch processing, yet less is known about vocal musicians. Mismatch negativity (MMN) to pitch deviances and difference limen for frequency (DLF) were examined among 61 young adult women, including 20 vocalists, 21 instrumentalists, and 20 nonmusicians. Stimuli were harmonic tone complexes from the mid-female vocal range (C4,G4). MMN was elicited by multideviant paradigm. DLF was obtained by an adaptive psychophysical paradigm. Musicians detected pitch changes earlier and DLFs were 50% smaller than nonmusicians. Both vocal and instrumental musicians possess superior sensory-memory representations for acoustic parameters. Vocal musicians with instrumental training appear to have an auditory neural advantage over instrumental or vocal only musicians. An incidental finding reveals P3a as a sensitive index of music expertise. [source] AM-111 prevents hearing loss from semicircular canal injury in otitis media,THE LARYNGOSCOPE, Issue 1 2010Tyler C. Grindal MD Abstract Objectives/Hypothesis: Iatrogenic semicircular canal (SC) transection during mastoidectomy for chronic otitis media often leads to profound hearing loss. AM-111, an apoptosis inhibitor, has been shown to mitigate hearing loss resulting from a variety of inner ear injuries. The goal of this study was to determine if round window application of AM-111 following SC transection in the presence of Pseudomonas aeruginosa otitis media (PA-OM) may reduce the associated hearing loss. Study Design: Prospective, randomized, controlled study in an animal model. Methods: PA-OM was induced bilaterally in 34 guinea pigs. After 3 days, both bullae were opened and the lateral SC of one ear was transected. AM-111 or vehicle was applied topically to the round window of the ear that had undergone SC transection. Hearing was assessed with auditory brainstem responses. Results: The mean change in hearing thresholds was significantly less in transected ears treated with AM-111 than those receiving vehicle alone when testing with clicks (22.1 dB vs. 35.0 dB; P = .019) and at 4kHz (11.3 dB vs. 40.0 dB; P = .021). A similar trend was shown with 16 kHz tone pips (27.7 dB vs. 41.1 dB; P = .119). Conclusions: AM-111 prevents hearing loss from SC transection in the guinea pig model of PA-OM. Laryngoscope, 2010 [source] Small Vestibular Schwannomas With No Hearing: Comparison of Functional Outcomes in Stereotactic Radiosurgery and MicrosurgeryTHE LARYNGOSCOPE, Issue 11 2008Daniel H. Coelho MD Abstract Objectives: To date, numerous studies have compared functional outcomes between stereotactic radiosurgery (SRS) and microsurgery (MS) in the treatment of vestibular schwannomas (VS). However, most of them involve tumors of difference sizes, radiation dosages, and surgical approaches. Few have systematically compared issues of dysequilibrium. By studying only patients with small tumors and no hearing, we sought to minimize confounding variables. Study Design: A retrospective chart review and telephone questionnaire. Methods: From 1998,2006, 31 patients with small (<1.5 cm) VS and nonserviceable hearing (American Academy of Otolaryngology,Head and Neck Surgery [AAO-HNS] Class C or D) were treated at our institution. Twenty-two were available for follow-up and telephone questionnaire, including the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ). Twelve underwent SRS and 10 underwent MS. All MS patients underwent the translabyrinthine approach to their tumors. Outcomes measurements included tumor control, facial nerve function, tinnitus, trigeminal function, and imbalance. Results: Patients undergoing SRS had comparable rates of tumor control, facial nerve function, tinnitus, and trigeminal function to MS patients. However, SRS did result in statistically significantly worse long-term imbalance when compared with MS patients. Detailed comparisons of the two modalities are made. Conclusions: In our study population, patients with small tumors and no serviceable hearing, these data suggest that MS results in comparable minimal morbidity with SRS, though posttreatment dysequilibrium is significantly decreased. While the authors recommend translabyrinthine resection of small VS with no hearing in patients able to tolerate surgery, the need for further prospective investigation is clear. [source] Long-Term Hearing Results in Gamma Knife Radiosurgery for Acoustic Neuromas,THE LARYNGOSCOPE, Issue 6 2008Matthew L. Bush MD Abstract Objectives: There are many studies that have examined functional outcomes following Gamma Knife treatment; however, few have reported long-term audiometric data. This study analyzed the long-term hearing results of Gamma Knife radiosurgery in the treatment of acoustic neuromas. Study Design: Retrospective cohort study. Methods: Seventeen patients were selected from our acoustic neuroma Gamma Knife registry of 113 patients treated from 1991 to 2005. Pretreatment audiograms were analyzed for pure-tone average and word recognition scores and assigned a Gardner-Robertson classification score (GRC). Either a current audiogram was obtained or the most recent audiogram (if the patient was lost to follow-up) was reviewed from clinic charts and these were compared with the preoperative results. Audiometric data of the pre- and posttreatment normal ear were obtained and used as the patient's own control. Results: The tumor size ranged from 0.5 to 2.8 cm (mean, 1.33 cm) and patients received a range of 12.5,16 Gy (mean, 13.82 Gy) to 50% isodose line. Patient follow-up ranged from 3 to 82 months with a mean of 33.6 months. Pretreatment pure-tone average for the involved side group was 30.6 dB HL with a word recognition score of 74%. Pretreatment mean GRC was 1.76. posttreatment pure-tone average for the group was 59.7 dB HL with a word recognition score of 37%. posttreatment mean GRC was 3.29. Comparing pre- versus post-Gamma Knife radiosurgery results on the treatment ear, means were statistically significantly different for both pure-tone average and word recognition scores, based on a paired-samples t test (P < .001 for both). The group "normal" ear pure-tone average was 14 dB HL and 17.75 dB HL pre- and posttreat-ment, respectively. Normal ear pre- and posttreatment word recognition score and GRC were 93% and 98%, and 1.13 and 1.31, respectively. Conclusion: Gamma Knife radiosurgery remains a noninvasive treatment option for patients with acoustic neuromas; however, they may experience a delayed hearing loss. Of those patients with useful audition pretreatment, 42% maintained useful hearing posttreatment. [source] Surgical Management of Jugular Foramen Meningiomas: A Series of 13 Cases and Review of the Literature,THE LARYNGOSCOPE, Issue 10 2007Mario Sanna MD Abstract Objective: Primary meningiomas occurring within the jugular foramen are exceedingly rare lesions presumed to originate from arachnoid-lining cells situated within the jugular foramen. The objective of this study is to analyze the management and outcome in a series of 13 primary jugular foramen meningiomas collected at a single center. Study Design: Retrospective study. Setting: Quaternary referral otology and skull base private center. Methods: Charts belonging to 13 consecutive patients with pathologically confirmed jugular foramen meningioma surgically treated between September 1991 and May 2005 were examined retrospectively. The follow-up of the series ranged from 12 to 120 (mean, 42.8 ± 27.5) months. Results: Four (28.5%) patients underwent single-stage tumor removal through the petro-occipital transigmoid (POTS) approach. In two patients with preoperative unserviceable hearing, a combined POTS-translabyrinthine approach was adopted. Two patients underwent a combined POTS-transotic approach because of massive erosion of the carotid canal. A modified transcochlear approach type D with posterior rerouting of the facial nerve and transection of the sigmoid sinus and jugular bulb was performed in two patients with a huge cerebellopontine angle tumor component with extension to the prepontine cistern together with massive involvement of the petrous bone and middle ear and encasement of the vertical and horizontal segments of the intrapetrous carotid artery. In one patient with evidence of a dominant sinus on the site of the tumor, a subtotal tumor removal via an enlarged translabyrinthine approach (ETLA) was planned to resect the intradural component of the tumor. Two patients in our series underwent a planned staged procedure on account of a huge tumor component in the neck. One of these patients underwent a first-stage infratemporal fossa approach type A to remove the tumor component in the neck; the second-stage intradural removal of the tumor was accomplished via an ETLA. The last patient underwent a first-stage modified transcochlear type D approach to remove the intradural tumor component followed by a second-stage transcervical procedure for removal of the extracranial component. Gross total tumor removal (Simpson grade I,II) was achieved in 11 (84.6%) cases. Subtotal removal of the tumor was accomplished in two patients. Good facial nerve function (grades I and II) was achieved in 46.1% of cases, whereas acceptable function (grade III) was achieved in the remaining cases 1 year after tumor removal. Hearing was preserved at the preoperative level in all four patients who underwent surgery via the POTS approach. After surgery, no patient recovered function of the preoperatively paralyzed lower cranial nerves. A new deficit of one or more of the lower cranial nerves was recorded in 61.5% of cases. Conclusions: Surgical resection is the treatment of choice for jugular foramen meningiomas. Among the various surgical techniques proposed for dealing with these lesions, we prefer the POTS approach alone or combined with the translabyrinthine or transotic approaches. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge. [source] The Surgical Learning Curve in Aural Atresia SurgeryTHE LARYNGOSCOPE, Issue 1 2007FRACS, Nirmal Patel MBBS (Hons) Abstract Objective: The objective of this retrospective case review is to examine the effect of surgical learning on hearing outcomes and complications in congenital aural atresia surgery. Patients: Sixty-four consecutive ears (in 60 patients) operated on during the period of 1994 to 2004 at a tertiary referral center were studied. Intervention)s): Intervention consisted of aural atresiaplasty through an anterior approach by the same surgeon (C.S.). Main Outcome Measure)s): Hearing outcomes and complication rates were compared between four temporally sequential groups of 16 ears. Acceptable hearing and complication rate outcomes were defined as results comparable to larger series in the literature. Results: Hearing results, in the short term, comparable to larger series were achieved during the first group of ears (nos. 1,16). A plateau in the learning curve for short-term hearing outcomes was achieved after the first two groups, that is, after 32 ears. Hearing outcomes, in the long term (>1 year) comparable to larger series, were achieved in the second group of ears (nos. 16,32). The learning curve for long-term hearing demonstrated a significant improvement in outcomes in the final group of 16 ears compared with the first 48 ears. Long-term hearing results for the final group show closure of the postoperative air-bone gap to less than 30 dB in 94% of cases. Postoperative complication rates were equivalent to larger series in the first group of 16 ears and showed no statistically significant difference between the four groups. There was one patient with sensorineural hearing loss after surgery; there were no anacoustic ears and no facial palsies in the study group. Conclusions: A learning curve of at least 32 ears was required to achieve stable short-term hearing results. To achieve stable long-term hearing results required a learning curve of at least 48 patients in our series. Complication rates remained stable throughout the study period. [source] Analysis of the Long-Term Hearing Results after the Surgical Repair of Aural AtresiaTHE LARYNGOSCOPE, Issue 10 2006Sun O. Chang MD Abstract Objectives: Careful surgical candidate selection guarantees a high probability of serviceable hearing postoperatively in congenital aural atresia (CAA) patients. The authors analyzed hearing results after CAA surgery with long-term follow-up (F/U) with respect to several clinical factors. Study Design: This was a retrospective study. Methods: The medical records of 93 CAA patients (100 ears) who underwent operations from January 1987 through December 2002 at Seoul National University Hospital were reviewed. Mean duration was 56.9 months. The authors evaluated the results of hearing after surgery over 3 year F/U with a view to clarifying the factors accounting for unsuccessful results. Results: Approximately 64% of patients treated surgically achieved a considerable hearing gain over long-term F/U. Postoperative hearing remained relatively stable over the period from 6 months to 3 years postoperatively, yielding only 2.75 dB of aggravation. However, hearing results in revision cases deteriorated with time, which led to statistically higher air-conduction thresholds than those of primary cases at the 1 and 3 year F/Us. Resultantly, only 26.6% of patients having achieved a poor hearing gain post first surgery benefited from revision audiologically. The severity of microtia was found to help predict poor long-term hearing outcomes after CAA surgery. Conclusions: Nonrevision cases and cases with mild microtia appear to have acceptable and stable long-term hearing results. Disappointing long-term hearing results in revision, and severe microtia cases should lead to considerations of alternative options in these cases, such as bone-anchored hearing aids, which offer reliable and stable results. [source] Intratympanic Dexamethasone Injection for Refractory Sudden Sensorineural Hearing LossTHE LARYNGOSCOPE, Issue 5 2006Yun-Hoon Choung DDS Abstract Objective: This case-control study aimed to analyze the effect of intratympanic dexamethasone injection (ITDI) as a treatment option for patients with sudden sensorineural hearing loss (SSNHL) who were refractory to classic oral steroid treatment. Methods: Sixty-six patients with SSNHL, who were refractory to a course of oral steroid therapy, were included in this study. We prospectively treated consecutive 33 patients (34 ears) with ITDI from August 2002 to January 2004. We then retrospectively collected data from age- and sex-matched previous patients who did not take any more treatments after the initial regimen between March 2000 and July 2002. ITDI was performed in the supine position on four separate occasions over the course of 2 weeks. Hearing was assessed immediately before every injection and at 1 week after therapy. Hearing improvement was defined as more than 10 dB in pure-tone average (PTA). Results: Hearing improvement was observed in 13 (39.4%) of 33 patients who underwent ITDI and in two (6.1%) of 33 patients in the control group. Five of 13 represented hearing improvement over than 20 dB in PTA, and 11 of 20 patients, who showed no improvement in PTA by ITDI, showed improvement over 10 dB in some frequencies. There were no definite prognostic factors between the patients who responded to ITDI and those who did not. Conclusion: ITDI may be a simple and effective therapy for patients with refractory SSNHL. [source] Central Effects of Residual Hearing: Implications for Choice of Ear for Cochlear Implantation,THE LARYNGOSCOPE, Issue 10 2004Howard W. Francis MD Abstract Objectives/Hypothesis: The study tested the hypothesis that among patients with similar levels of residual hearing in the nonimplanted ear, speech perception outcome is the same whether or not the implanted ear has profound or severe levels of hearing loss. Study Design: Retrospective. Methods: Levels of hearing loss in postlingually deafened adults who had cochlear implantation at Johns Hopkins University (Baltimore, MD) between 1991 and 2002 were classified according to pure-tone averages as bilateral severe (n = 20), severe-profound (severe in one ear and profound in the other) (n = 23), and bilateral profound (n = 43). There was no significant difference in the age at onset and duration of deafness among the three patient groups. Individuals in the bilateral severe and severe-profound groups had comparable levels of severe hearing loss in their nonimplanted ears, whereas those in severe-profound and bilateral profound groups had comparable levels of profound hearing loss in their implanted ears. Speech perception performance was evaluated using words from the Consonant Nucleus Consonant word list, Hearing in Noise Test sentences in quiet, and Central Institute for the Deaf sentences through recorded presentation at 70 dB sound pressure level (SPL). Results: Despite the profound hearing loss of the implanted ear in the asymmetrical group, there was no significant difference in mean speech perception scores compared with the bilateral severe group within the first year after implant surgery. By comparison, the bilateral profound group had lower speech perception results compared with patients with residual hearing in one or both ears. Conclusion: The study results suggest that implantation of the profoundly deafened ear does not diminish the functional advantage conferred by residual hearing in a patient with asymmetrical hearing loss. Therefore, the central auditory pathway may be the site at which persistent auditory function has its most beneficial effects. [source] Optimum Tension for Partial Ossicular Replacement Prosthesis Reconstruction in the Human Middle Ear,THE LARYNGOSCOPE, Issue 2 2004David P. Morris BSc Abstract Objective: Hearing results from ossiculoplasty are unpredictable. There are many potentially modifiable parameters. One parameter that has not been adequately investigated in the past is the effect of tension on the mechanical functioning of the prosthesis. Our goal was to investigate this parameter further, with the hypothesis that the mechanical functioning of partial ossicular replacement prostheses (PORP) from the stapes head to the eardrum will be affected by the tension that they are placed under. Methods: Fresh temporal bones were used to reconstruct a missing incus defect with a PORP-type prosthesis. Three different lengths of PORP were used, and the stapes vibrations were measured with a laser Doppler vibrometer using a calibrated standard sound in the ear canal. Eight temporal bones were used. Results: Tension had a very significant effect on stapes vibration. In general, loose prostheses resulted in the best overall vibration transmission. The effects were most marked at the lower frequencies. There was a slight advantage to tight prostheses in the higher frequencies, but much less than the decrement in lower frequencies with tight prostheses. Conclusion: In ossicular reconstruction, best stapes vibration results in our model are achieved by shorter prostheses, which result in lower tension. [source] Candidate's Thesis: Platelet-Activating Factor,Induced Hearing Loss: Mediated by Nitric Oxide?,THE LARYNGOSCOPE, Issue 12 2003Chung-Ku Rhee MD Abstract Objectives/Hypothesis Platelet-activating factor (PAF)in middle ear effusion is thought to induce hearing loss. The purpose of this study is to investigate the role of nitric oxide (NO) in the mechanism of PAF-induced hearing loss by studying the effects of PAF application on the round window membrane (RWM) with and without PAF-antagonist NO-blocker. Study Design Longitudinal study on randomized guinea pigs using PAF to induce hearing loss. Methods Guinea pigs were divided into four groups: PBS, PAF, PAF-antagonist, and L-NAME. The PBS group received phosphate buffered saline (PBS) and the PAF groups received 10, 20, and 40 ,g of PAF soaked into gelfoam and placed on the RWM. PAF-antagonist (WEB 2170) and NOS inhibitor NG-nitro-l-arginine-methylester (L-NAME) were injected intraperitoneally prior to PAF 20 ,g application on the RWM. The following three tests were performed on each animal group: Hearing was tested with an auditory brainstem response (ABR) test over 24 hours. At the end of 24 hours, cochlear hair cells were examined by scanning electron microscopy (SEM) and immunohistochemistry was carried out on the cochlea to test the expression of inducible nitric oxide synthase (iNOS). Results The PAF group developed significant elevation of ABR threshold and cochlear hair cell damage in the SEM group as compared with the PBS control group. The PAF-antagonist (WEB 2170) and the L-NAME groups did not show significant elevation of ABR threshold and cochlear hair cell damage compared with the group administered PAF 20 ,g, but in the PAF-antagonist group, the elevation of ABR threshold was significant compared with that of the PBS control group, whereas it was not significant compared with the PBS group in the L-NAME group. Strong expression of iNOS on cochlea was observed in the PAF group and lighter expression was seen in PBS, WEB 2170, and L-NAME groups. Conclusions This study demonstrated that PAF placed on the RWM induced hearing loss and cochlear hair cell damage. The PAF-antagonists and L-NAME prevented the PAF-induced hearing loss and inhibited iNOS expression in the cochlea. These findings suggest that the PAF-induced hearing loss caused by cochlear hair cell damage may have been mediated by NO. PAF-antagonists and L-NAME may have future therapeutic implications in preventing sensorineural hearing loss associated with chronic otitis media. The results of this study have significant potential clinical application. [source] Hearing Results After Primary Cartilage Tympanoplasty,THE LARYNGOSCOPE, Issue 12 2000Matthew J. Gerber MD Abstract Objectives/Hypothesis Cartilage,perichondrium grafting of the tympanic membrane has been used in an effort to reduce recurrence or progression of middle ear disease. The rigidity of cartilage has obvious benefit in preventing tympanic membrane retraction, but concern has been raised regarding its sound conduction properties. Few studies in the literature address hearing results after cartilage tympanoplasty. The purpose of this study was to investigate the hearing results after primary cartilage tympanoplasty and compare them with results after primary tympanoplasty with temporalis fascia. Study Design A retrospective review of all ear surgeries using cartilage between 1994 and 1999 was performed. Methods Only primary cases in which the ossicular chain was intact and no mastoid surgery was performed were included. Indications for surgery included tympanic membrane perforation, retraction, and cholesteatoma. Pre- and postoperative speech reception thresholds and air,bone gaps at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz were compared. Results Eleven patients comprised the cartilage study group, and there were 11 age- and temporally matched control subjects. The mean improvement in speech reception threshold for both the study group and the control group was 10 dB. The majority of patients in both groups had ABG closure to within 10 dB at all frequencies examined. There were no statistically significant differences in speech reception threshold improvement or air,bone gap closures between the two groups. Conclusions These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after temporalis fascia tympanoplasty. Therefore, when indicated, a cartilage,perichondrium graft can be used for prevention of disease recurrence or progression without fear of impairing hearing. [source] Candidate's Thesis: Universal Newborn Hearing Screening in an Inner-City, Managed Care Environment ,THE LARYNGOSCOPE, Issue 6 2000Glenn Isaacson MD Abstract Objectives/Hypothesis Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations. As larger states attempt to implement such programs, important obstacles have arisen, particularly in sparsely populated rural environments and in the inner city, where poverty, unstable living situations, and inadequate access to health care make follow-up of infants failing initial testing difficult. Study Design We performed a prospective longitudinal study e-amining the effects of increasingly comple- and e-pensive interventions designed to ensure that children failing initial hearing screening returned for complete evaluation and habilitation. Methods A UNHS program based on transient evoked otoacoustic emissions testing was implemented at Temple University Hospital, with 2,000 births per year. At 6 months into the program, efficacy was assessed and modifications in follow-up methodology were made in an attempt to improved rate of return of infants failing newborn screening. The effect of these interventions was reassessed 6 months later. Results In its first 12 months, the Temple University Infant and Young Child Hearing Intervention Initiative successfully screened 95% (2,031) of all newborns using transient evoked otoacoustic emissions. Collecting a complete database profile for each newborn, establishing rapport with the family, and offering immediate follow-up appointments yielded a 61% return rate after discharge. The addition of a dedicated project secretary, free day-care for siblings, and cab vouchers for transportation and the elimination of a requirement for health maintenance organization referrals increased follow-up yield to 75%. Conclusion Given adequate resources and planning, UNHS can be successful, even in economically depressed environments. [source] An overview of the Scottish multidisciplinary child protection reviewCHILD & FAMILY SOCIAL WORK, Issue 3 2004Brigid Daniel ABSTRACT Following the murder of a young child by her stepfather a ministerial review of child protection across Scotland was established. It was carried out by a multidisciplinary team of representatives from education, health-nursing, health-medical, police, social work and the Reporter to the Children's Hearing. The review comprised a number of subprojects and included a direct audit of the practice of all the key agencies. The views of the general public, parents, children and professionals were obtained via a set of consultation subprojects. The audit of practice was built around a set of individual, in-depth case studies. The cases were drawn from the spectrum of child care and protection cases by sampling from cases known to health visitors, education departments, the police and social work departments. The audit considered compliance with guidance, but the key focus was on outcomes for children. The findings indicated that although there were many examples of good practice with children, a significant number of children were left unprotected or their needs were not met. The issues were not unique to Scotland and are discussed under four key areas. The paper sets out the extent of chronic need amongst the child population that the audit revealed, looks at the messages from consultation about issues of accessing help for children or by children directly, and describes some shortcomings of the current system. Finally the paper analyses the ways that the different agencies interact and sets out a model for how the system can provide a protective network for children who are in need of protection and support. [source] Out of Hearing: Representing Children in Care ProceedingsCHILD & FAMILY SOCIAL WORK, Issue 3 2001173 pp. £19.99., J. Masson, M. Winn Oakley John Wiley & Sons No abstract is available for this article. [source] Ascertaining the prevalence of childhood disabilityCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 1 2005T. Hutchison Abstract Objectives, To reapply 1985 Office of Population Census and Surveys (OPCS) disability survey methods, modified as necessary, to a sample of children to ascertain presence of disability. To compare OPCS-based prevalence with prevalence based on carer's views and medical records. Design, Analytical study. Setting, Community Child Health Department in UK. Participants, Principal carers of 100 children aged 5,15, selected from a district special needs register. Main outcome measures, Comparable information about disability from three sources and diagnosis from carers and medical records. Results, Medical records of 46% contained a diagnosis. Carers were always aware of this, although a single question did not always elicit their knowledge. OPCS-derived threshold disability criteria in categories of Hand function, Personal care, Consciousness and Continence gave prevalence results similar to medical records and carers. OPCS criteria yielded higher prevalence of disability in the areas of Locomotion (8%), Communication (14%) and Hearing (18%). Carers, OPCS and medical records disagreed markedly about prevalence of disabilities of Vision, probably because of the use of differing definitions. OPCS learning criteria were judged unsuitable and standard attainment targets (SATs) were substituted. These provided similar prevalence figures to carers and medical records. OPCS behaviour criteria were also unsuitable and were replaced by the General Health and Behaviour Questionnaire (GHBQ). This found an increased prevalence of problems compared with carers and doctors. Conclusions, Diagnostic labels have limited use when collecting data about disabled children. Doubt is cast on the validity of some of the 1985 OPCS threshold criteria, and reassessment is suggested before their future use. Further work is needed on the use of SATs and GHBQ in the benchmarking of disability. To collect population data it would be easier and at least equally effective (with caution in the case of Vision) to ask carers directly rather than applying descriptive thresholds and external judgements. Similar information could be obtained from medical records, however, they are likely to be out of date. [source] Health related quality of life in survivors of pneumococcal meningitisACTA PAEDIATRICA, Issue 3 2009Rosa Legood Abstract Aim: To estimate the overall long-term health related quality of life implications of an episode of pneumococcal meningitis in childhood. Method: Cases were identified through two regional UK surveillance studies and traced via their general practitioners (GPs) or local hospital paediatrician. Siblings were used as controls where available. Health related quality of life was assessed using the health utilities index (HUI). Mean utility scores were compared between cases and controls and univariate linear regression was used to identify factors that influenced the overall utility scores. Results: HUI data were available for 71 cases and 66 controls. The mean overall utility score for cases 0.774 (95% CI 0.711, 0.837) was significantly lower than for controls 0.866 (95% CI 0.824,0.907) (p-value = 0.0185). Hearing was the most significantly affected health attribute (p-value < 0.006). In cases, males had lower quality of life scores than females (p-value = 0.018), however this was not seen in controls. Conclusion: An episode of pneumococcal meningitis results in a long-term decrement in overall health related quality of life and is significantly related to hearing loss. [source] Implementation of a nation-wide automated auditory brainstem response hearing screening programme in neonatal intensive care unitsACTA PAEDIATRICA, Issue 3 2003HLM van Straaten Aim: As part of a future national neonatal hearing screening programme in the Netherlands, automated auditory brainstem response (AABR) hearing screening was implemented in seven neonatal intensive care units (NICUs). The objective was to evaluate key outcomes of this programme: participation rate, first stage success rate, pass/referral rates, rescreening compliance, diagnostic referral rates, age of first diagnostic evaluation and prevalence of congenital hearing loss (CHL). Methods: This prospective cohort study collected data on 2513 survivors. NICU graduates with one or more risk factors according to the Joint Committee on Infant Hearing were included in a two-stage AABR hearing screening programme. Conventional ABR was used to establish a diagnosis of CHL. Results: A total of 2513 newborns enrolled in the programme with a median gestational age of 31.6 (range 24,43) wk and a median birthweight of 1450 (range 510,4820) g. In 25 (1%) cases parents refused screening. Four out of 2513 newborns were initially lost; 2484 newborns have been tested initially. A final 98% participation rate (2465/2513) was obtained for the whole programme. After a median postmenstrual age at the first test of 33.7 (range 27,54) wk, a pass rate of 2284/2484 (92%) resulted at the first stage. The rescreening compliance after the first test was 92% (184/200). A referral rate for diagnostic ABR of 3.1% (77/2484) resulted. Of the 77 referrals 14 (18.2%) had normal screening thresholds, 15 (19.5%) had unilateral CHL and 48 (62.3%) had bilateral CHL. The prevalence of unilateral CHL was 0.6% (15/2484) and of bilateral CHL 1.9% (48/2484). Conclusion: A financially supported two-stage AABR hearing screening programme can be successfully incorporated in NICU centres and detects a high prevalence of CHL in NICU graduates. Neonatal hearing screening should be part of standard clinical practice in all NICU infants. [source] Suspension of Deportation Hearings and Measures of "Americanness"JOURNAL OF LATIN AMERICAN & CARIBBEAN ANTHROPOLOGY, Issue 2 2003Susan Bibler Coutin Una forma de identificar las características que, según las autoridades y la ley, el ciudadano ideal debe de tener es estudiar casos de inmigración en corte. Por medio de observar la preparatión de tales casos, entrevistar a abogados y solicitantes, y asistir a audiencias en la corte federal de inmigración en Los Angeles, se analiza estas características. La investigatión se enfoca en los casos conocidos como "suspensión de deportatión". Para ganar, el solicitante tiene que haber vivido en los Estados Unidos por siete años, mostrar buen caracter moral y probar que deportation causarfa un dafio extremo al aplicante o a un pariente del aplicante. El anãlisis indica que, aunque no se menciona la raza ni la etnicidad del solicitante, las características preferidas se basan en la cultura anglosajóna, lo cual promueve un modelo anglosajón del cuidadano ideal. Por eso, aún cuando se ganan los casos, la ley impone requisitos que perjudican a ciertos sectores de la población. [source] Parole Board Hearings: Law and Practice by H. Arnott and S. CreightonTHE HOWARD JOURNAL OF CRIMINAL JUSTICE, Issue 2 2008JOHN STAPLES No abstract is available for this article. [source] Traumatised permanent teeth in 11,16-year-old Saudi Arabian children with a sensory impairment attending special schoolsDENTAL TRAUMATOLOGY, Issue 3 2003M. AlSarheed Abstract ,,,The aim of this study was to determine the prevalence of traumatised permanent teeth among sensory (visual (VI) and hearing (HI)) impaired children attending special schools in Riyadh, Saudi Arabia. All the dental injuries involved incisor teeth, and trauma was noted in 33 (6.7%) children attending government schools (control group) compared to 7 (9%) VI children and 24 (11.4%) HI children. Differences in the dental trauma only reached statistical significance between the HI and control group (P < 0.05). Gender differences were only apparent in the HI group, with males having higher levels of traumatised teeth. In addition, HI children aged 11,12 years were more prone to trauma than children in the control group of the same age (P < 0.05). In conclusion, sensory impaired children do have a tendency for more dental trauma. However, this was only statistically significant for HI children. Whereas a gender difference was most noticeable for the HI group, with males having higher levels of trauma, this was noticeable by its absence among VI children. [source] Comparative analysis of Gata3 and Gata2 expression during chicken inner ear developmentDEVELOPMENTAL DYNAMICS, Issue 1 2007Kersti Lilleväli Abstract The inner ear is a complex sensory organ with hearing and balance functions. Gata3 and Gata2 are expressed in the inner ear, and to gain more insight into their roles in otic development, we made a detailed expression analysis in chicken embryos. At early stages, their expression was highly overlapping. At later stages, Gata2 expression became prominent in vestibular and cochlear nonsensory epithelia. In contrast to Gata2, Gata3 was mainly expressed in the developing sensory epithelia, reflecting the importance of this factor in the sensory,neural development of the inner ear. While the later expression patterns of both Gata3 and Gata2 were highly conserved between chicken and mouse, important differences were observed especially with Gata3 during early otic development, providing indications of divergent molecular control during placode invagination in mice and chickens. We also found indications that the regulatory hierarchy observed in mouse, where Gata3 is upstream of Gata2 and Fgf10, could be conserved in chicken. Developmental Dynamics 236:306,313, 2007. © 2006 Wiley-Liss, Inc. [source] Factors affecting vocabulary acquisition at age 2 in children born between 23 and 28 weeks' gestationDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2007Louise Marston MSc Language development is often slower in preterm children compared with their term peers. We investigated factors associated with vocabulary acquisition at 2 years in a cohort of children born at 28 weeks' gestation or less. For children entered into the United Kingdom Oscillation Study, language development was evaluated by using the MacArthur-Bates Communicative Development Inventories score, completed by parents as part of a developmental questionnaire. The effect of demographic, neonatal, socioeconomic factors, growth, and disability were investigated using multifactorial random effects modelling. Questionnaires were returned by 288 participants (148 males, 140 females). The mean number of words vocalized was 42 (SD 29). Multifactorial analysis showed only four factors were significantly associated with vocabulary acquisition. These were: (1) level of disability (mean words: no disability, 45; other disability, 38; severe disability, 30 [severe disability is defined as at least one extreme response in one of the following clinical domains: neuromotor, vision, hearing, communication, or other physical disabilities]; 95% confidence interval [CI] for the difference between no and severe disability 7- 23); (2) sex (39 males, 44 females; 95% CI 0.4-11); (3) length of hospital stay (lower quartile, 47; upper quartile, 38; 95% CI -12 to -4); and (4) weight SD score at 12 months (lower quartile, 39; upper quartile, 44; 95% CI 1,9). There was no significant association between gestational age and vocabulary after multifactorial analysis. There was no significant effect of any socioeconomic factor on vocabulary acquisition. We conclude that clinical factors, particularly indicators of severe morbidity, dominate the correlates of vocabulary acquisition at age 2 in children born very preterm. [source] Manometric study in Kearns,Sayre syndromeDISEASES OF THE ESOPHAGUS, Issue 1 2001K. H. Katsanos Although swallowing difficulties have been described in patients with Kearns,Sayre syndrome (KSS), the spectrum of manometric characteristics of dysphagia is not yet well known. Moreover, it is conceivable that a combination of various degrees of swallowing difficulties with different patterns in manometric studies exist, each playing a major role in the prognosis, natural history, and quality of life of KSS patients. An 18-year-old girl diagnosed at the age of 5 years with KSS (muscle biopsy) was admitted to our department with an upper respiratory tract infection and dysphagia. Clinical examination revealed growth retardation, external ophthalmoplegia, pigmentary retinopathy, impaired hearing, and ataxia. An electrocardiogram revealed cardiac conduction defects (long Q-T), and brain magnetic resonance imaging showed abnormalities in the cerebellar hemispheres. A manometric and motility study for dysphagia was conducted and the pharynx and upper esophageal sphincter (UES) resting pressures were similar to control group values, but the swallowing peak contraction pressure of the pharynx and the closing pressure of the UES were very low and could not promote effective peristaltic waves. Relaxation and coordination of the UES were not affected although pharyngeal and upper esophagus peristaltic waves proved to be very low and, consequently, were practically ineffective. The patient was started on treatment comprising a diet rich in potassium, magnesium, and calcium, and oral administration of vitamin D and co-enzyme Q10 100 mg daily; she was discharged 6 days later with apparent clinical improvement. [source] | ||||||||||||||||||||||||||||||||||||||||